Submitted by William Justo Figueiro (williamjf) on 2015-08-20T19:05:51Z No. of bitstreams: 1 25e.pdf: 4282986 bytes, checksum: e643d635b114364f6711e3a08dc4882e (MD5) / Made available in DSpace on 2015-08-20T19:05:51Z (GMT). No. of bitstreams: 1 25e.pdf: 4282986 bytes, checksum: e643d635b114364f6711e3a08dc4882e (MD5) Previous issue date: 2012-12-17 / Nenhuma / A obesidade vem atingindo prevalências alarmantes na população infantil, em todo mundo, e por esse motivo foi denominada, pela Organização Mundial da Saúde de epidemia do século XXI. Essa condição tem atingido, de forma mais incidente, segmentos populacionais com menor nível socioeconômico. Estudos têm identificado a insegurança alimentar, definida como o acesso limitado ou incerto a alimentos em quantidade e qualidade adequadas, como um potencial fator determinante de excesso de peso e obesidade em crianças. Essa associação coloca os pesquisadores diante de um grande paradoxo, já que historicamente, a insegurança alimentar sempre esteve associada ao processo de desnutrição. Assim, o objetivo deste estudo foi avaliar a associação entre insegurança alimentar e excesso de peso em escolares do 1º ano do ensino fundamental das escolas municipais de São Leopoldo, RS. A amostra incluiu 782 escolares do primeiro ano do ensino fundamental, de 35 escolas municipais. Para a coleta de dados, foi utilizado um questionário pré-codificado e pré- testado. O questionário incluiu questões elaboradas pelos pesquisadores e questões pertencentes a outros dois instrumentos: “Formulário de Marcadores de Consumo Alimentar”, constante no protocolo do Sistema de Vigilância Alimentar e Nutricional – SISVAN e Escala Brasileira de Insegurança Alimentar - EBIA. As informações foram obtidas com as mães/responsáveis pelos escolares. Os dados de peso e altura foram fornecidos pelo Serviço de Nutrição da Secretaria Municipal de Educação. As prevalências de EP e IA foram, respectivamente, 38,1% [Intervalo de Confiança de 95% (IC95%) 34,7-41,5] e 45,1% (IC95% 41,6-48,6). Após ajuste para fatores de confusão, escolares com IA apresentaram probabilidade 22% menor de ter EP quando comparadas aos escolares sem IA. Estes resultados mostram elevadas prevalências de IA e EP, com associação inversa entre estas variáveis, revelando a complexidade desta relação, o que demanda mais estudos para compreendê-la e políticas públicas robustas para enfrentar este paradoxo. / Obesity is reaching alarming prevalence in children worldwide, and for that reason has been called by the World Health Organization as “one of the most serious public health challenges of the 21st century”. This condition has been more common among those of lower socioeconomic status. Studies have identified food insecurity, defined as limited or uncertain access to food in adequate quantity and quality as a potential determinant of overweight and obesity in children. The researchers faced a great paradox, since historically food insecurity has always been associated with malnutrition. The objective of this study was to evaluate the association between food insecurity (FI) and overweight (OW) in children. This is a cross-sectional study, school-based, conducted in São Leopoldo, RS. The sample included 782 schoolchildren in first-year elementary school, of the 35 city public schools. Data were obtained with the mother/guardian. FI was measured by the Brazilian Food Insecurity Scale (EBIA). Weight and height were provided by the Nutrition Service of the City Department of Education. The prevalence of OW and FI were, respectively, 38.1% [95% Confidence Interval (95% CI) 34.7-41.5] e 45.1% (95% CI 41.6-48.6). After adjustment for confounders, children with FI had a 22% lower probability of having OW when compared to children without FI. Despite the inverse association between the exposition and the outcome, this sample showed high frequencies of AI and OW. These results reveal the complexity of this relationship, and demand for more studies and robust public policies to address this paradox.

Objetivo. Verificar a existência de associações entre a insegurança alimentar e nutricional e padrões alimentares, a participação em programas sociais, dentre outros fatores em adolescentes de escolas públicas de Piracicaba (SP). Métodos. Este estudo foi conduzido em amostra probabilística de 488 escolares da 5ª série do ensino fundamental da rede pública de Piracicaba. Foram coletadas informações demográficas, antropométricas, bioquímicas e de pressão arterial, sobre a adesão à alimentação escolar, e de consumo alimentar a partir de Questionário de Frequência Alimentar Simplificado para Adolescentes (QFASA). Também foram obtidas informações sobre situações de insegurança alimentar e nutricional (IAN), participação em programas de transferência de renda e informações socioeconômicas. Foram realizadas análises descritivas, testes de Qui-quadrado de Pearson, t de Student e U de Mann Whitney. Padrões alimentares foram definidos a partir de Análise de Componentes Principais. A análise de regressão logística avaliou a influência de múltiplas variáveis na presença de IAN (variável dependente dicotômica). O estudo foi aprovado pelo Comitê de Ética da Faculdade de Saúde Pública. Resultados. De 308 escolares da amostra final, 54,5 por cento eram meninas. Mais de 40 por cento dos lares de escolares entrevistados apresentaram algum nível de IAN. Observaram-se elevadas proporções de adesão à alimentação escolar (70 por cento ) e de excesso de peso (39 por cento ). O principal padrão alimentar observado contou com maior participação de doces, massas, carnes, salgados, pães, frutas e hortaliças. Conclusão. A insegurança alimentar e nutricional determinou a participação no Programa Nacional de Alimentação Escolar e em programas de transferência de renda. Quando se observa um adolescente que pratica o padrão alimentar descrito, que reconhece a importância da alimentação escolar para o desenvolvimento físico e que cujo domicílio tem mais pessoas ocupadas, a probabilidade de tratar-se de um indivíduo que está em situação de IAN é menor. / Objective . To verify possible associations between food insecurity and food patterns, participation in social programs and other factors among adolescents enrolled in public schools of Piracicaba (SP). Methods . This study was conducted in a representative sample of 488 students enrolled in the fifth grade of public schools of Piracicaba. Data about demographic, anthropometric, biochemical, blood pressure, school feeding and food intake information were collected using computerized questionnaires and a Food Frequency Questionnaire Simplified for Adolescents (QFASA). Information about food insecurity, socioeconomic characteristics, and participation in Conditional Cash Transfer Programs were also obtained. Descriptive analysis, Chi-squared test to categorical variables, and t-Student and Mann-Whitney U test in order to compare means between groups were performed. Food patterns were predicted from food intake data, using the Principal Component Analysis method. These food patterns were transformed in variables and were used in logistic regression analysis. Food insecurity was the dependent variable. The study was approved by the Ethical Committee of the School of Public Health. Results. Out of the total 308 scholars of the final sample, 55 per cent were girls. More than 40 per cent of adolescents households presented some level of food insecurity. High proportions of students who consumed the school feeding (70 per cent ) and that were overweight (39 per cent ) were observed. The main dietary pattern observed was composed of higher participation of sweets, pasta, meats, pastries breads, fruits and vegetables. Conclusion. Food and nutrition insecurity (FNI) in scholars enrolled in public schools of Piracicaba determined their participation in the National School Feeding Program and in the Conditional Cash Transfer Programs. A teenager who practices the described eating pattern, who recognizes the importance of the school feeding for the physical development and whose home has more people employed, is less likely to be in a FNI status.

Segurança Alimentar e Nutricional é a garantia, a todos, de condições de acesso a alimentos básicos de qualidade, em quantidade suficiente, de modo permanente e sem comprometer outras necessidades essenciais, e o desrespeito a este direito indica a insegurança alimentar. Para caracterizar a situação de segurança alimentar das famílias e o estado nutricional de crianças menores de 5 anos de idade de creches no município de Ribeirão Preto-SP desenvolveu-se um estudo transversal e descritivo, com 344 crianças e suas famílias. A segurança alimentar das famílias foi avaliada com a Escala Brasileira de Segurança Alimentar e Nutricional (EBIA) e as famílias classificadas em situação de Segurança Alimentar (SA) e Insegurança Alimentar Leve (IAL), Moderada (IAM) e Grave (IAG). Aplicou-se uma entrevista com os pais para coleta de variáveis sócio-econômicas e demográficas com um questionário estruturado. A antropometria foi realizada nas creches e os índices Peso/Idade (P/I), Peso/Estatura (P/E), Estatura/Idade (E/I) e IMC/Idade (IMC/I) calculados segundo padrão da Organização Mundial da Saúde (2006). Para a classificação do estado nutricional adotou-se os pontos de corte do SISVAN (Ministério da Saúde). Foram calculadas medidas de prevalências e verificou-se associação entre as variáveis do estudo pelo teste qui-quadrado. Identificou-se que a SA estava presente em 45,7% das famílias, enquanto que a IAL, IAM e IAG foram encontradas em 42,4%, 7,8% e 4,1% das famílias, respectivamente. A análise dos dados sócio-econômicos apontou maior proporção de mães com ensino fundamental e de pais que não moram com a família entre aquelas com IA. Verificou-se proporção maior de residência inacabada, menor número de cômodos, maior número de moradores no domicílio, vinculo com programas sociais e menor renda per capita entre as famílias em situação de IA (p<0,05). Não se observou diferenças entre as prevalências de desvios nutricionais e a condição de SA das famílias. Entretanto, observou-se prevalência de 9,3% de baixa estatura, 2,3% de baixo peso pelo índice P/I e 1,5% de magreza segundo P/E e IMC/I. O excesso de peso segundo P/I foi encontrado em 11,0% das crianças. Os índices IMC/I e P/E indicaram prevalências de 8,7% e 7,3% de crianças acima de +2 escoreZ, 2,9% e 2,3% acima de +3 escoreZ, respectivamente. A situação de insegurança alimentar é prevalente na população estudada, sobretudo entre as famílias com pior condição socioeconômica. Foi observado que o excesso de peso é o principal problema nutricional nesta população infantil. Novos estudos são necessários para o melhor conhecimento das características que condicionam a insegurança alimentar e o estado nutricional desta população visando a elaboração de estratégias de enfrentamento desta situação. / Food and Nutritional Security is the assurance of everyone´s right to regular and permanent acess to food in sufficient amounts, permanently and without endangering other essential needs. Disregard to such rights would indicate food security. In order to characterize a situation of food insecurity in families and the nutritional status of under 5-year-old 344 children enrolled in day care center in Ribeirão Preto city and their families was developed on descriptive and cross-section study. The food security of each family was assessed with the Brazilian Food Security Scale Escala Brasileira de Segurança Alimentar e Nutricional (EBIA) and the families were rated according to their situation: food security and mild, moderate and severe food insecurity. Interviews with the parents was performed to collect socioeconomic and demographic variables with a structured questionnaire. The childrens weight and heigth were taken and the indicators of weight-for-age (WAZ), weight-for-height (WHZ), height-for-age (HAZ) and body mass index-age (BMZ) was defined to the 2006 WHO child growth tandards, and the classification of the nutritional status were adopted the cut-off scores of SISVAN. The prevalence values were calculated and an association between the variables of the study was evaluated by according to the chi-quadrate test. Prevalence of food security was 45.7%, and mild, moderate and severe food insecurity were found in 42.4%, 7.8% and 4.1% households. Socioeconomic analysis showed a higher frequence of low maternal education and fathers who do not live with their families among household food insecurity. There was a higher proportion of unfinished residence, fewer rooms, a larger number of household members, social programs link and with lower per capita income among families in IA (p <0.05). However, the prevalence of 9.3% of stunting (HAZ), 2.3% of underweight (WAZ) and 1.5% of wasting to WHZ and BMZ was observed. Overweight according to WAZ was found in 11.0%. The BMZ and WHZ indicated the prevalence of 8.7% and 7.3% overweight and 2.9% and 2.3% children of obesity. The situation of food insecurity is prevalent in this population, especially among families with lower socioeconomic status. We found that excess weight is the main nutritional problem in this infant population. Further studies are necessary to improve knowledge of the characteristics that govern food insecurity and the nutritional status of this population, with the goal of elaborating coping strategies for such a situation.

Made available in DSpace on 2017-07-10T16:32:26Z (GMT). No. of bitstreams: 1 FLAVIA_BEDIN.pdf: 3008592 bytes, checksum: 68597b77415fb2664bd6fc3ce016051f (MD5) Previous issue date: 2015-03-12 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The food has been directly related to the quality of life of the population, so that the number of elderly people is ever increasing, it is necessary to know the food reality these individuals. Thus, this study aimed to analyze food security in participants of the groups of elderly in Francisco Beltrão - PR, to identify the incidence of elderly in a situation of food insecurity, relating socioeconomic conditions with the prevalence of food security and insecurity as well as identify and profile of the aged. Using a questionnaire with socioeconomic variables and also the Brazilian Food Insecurity Scale, were interviewed 497 elderly. The results showed that 50,9% of the elderly are food security situation, and 49.1% in food insecurity, the latter , subdividing them into mild, moderate and severe insecurity. The variables, income, gender and type of residence were observed with greatest influence on cases food insecurity. Considering that the highest rates of food insecurity are concentrated in light insecurity when there is concern about the lack of food and moderate insecurity is the lack of some types of food, you realize that some actions to financial education planning spending and familiar menu can contribute to the better use of available income. / A alimentação tem sido diretamente relacionada à qualidade de vida da população, portanto num momento em que o número de idosos é cada vez mais crescente, torna-se necessário conhecer a realidade alimentar destes indivíduos. Neste sentido, este estudo teve por objetivo analisar a segurança alimentar em participantes dos grupos de idosos do município de Francisco Beltrão PR, visando identificar a prevalência de idosos em situação de insegurança alimentar, relacionar as condições socioeconômicas com a prevalência de segurança e insegurança alimentar, assim como identificar o perfil dos idosos estudados. Utilizando-se de um questionário com variáveis socioeconômicas e também da Escala Brasileira de Insegurança Alimentar, foram entrevistados 497 idosos. Os resultados obtidos evidenciaram que 50,9% dos idosos estão em situação de segurança alimentar, e 49,1% em insegurança alimentar, estes últimos, subdividindo-os em insegurança leve, moderada e grave. As variáveis, renda, gênero e tipo de moradia foram as constatadas com maior influencia diante dos casos insegurança alimentar. Tendo em vista que os maiores índices de insegurança alimentar concentram-se em insegurança leve, quando há preocupação pela falta dos alimentos e insegurança moderada que é a falta de alguns tipos de alimentos, percebe-se que algumas ações voltadas à educação financeira, planejamento dos gastos e do cardápio familiar podem contribuir com o melhor uso da renda disponível.

abstract: Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal plan use, may help decrease nutrition-related issues. Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates. Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together. Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition. / Dissertation/Thesis / Doctoral Dissertation Exercise and Nutritional Sciences 2019

Background: College food insecurity (CFI) is a prevalent social justice and public health issue in the U.S. with the prevalence ranging between 15-59%. Though numerous quantitative studies were first conducted in the past decade, little qualitative research was conducted to assess CFI. Objective: To explore and deeply understand the contexts of CFI at a land-grant university in Kentucky. Methods: This qualitative study used a validated food insecurity survey tool and hour-long focus groups that were audio recorded and transcribed. Three theoretical models were combined into an adapted model and utilized for the thematic analysis. Results: Thirty-three students participated in one of eight different focus groups. Among participants, 72.7% were female, 81.9% were undergraduate students, and 63.6% were food insecure. Access-related themes included transportation, time-related issues, awareness of resources, coping strategies and suggestions for improvements; availability-related themes consisted of city- and campus-wide availability of food choices and coping strategies; utilization-related themes constituted dietary needs and coping strategies; and stability-related themes involved disrupted element(s) of food security and their effects on well-being and academics. Conclusion: All elements of food security need to be fulfilled to achieve a sustainable food security. For future CFI studies, the use of theoretical framework(s) is recommended.

Food insecurity (FI) is a significant risk factor in malnutrition which can lead to obesity and type 2 diabetes. The association of FI to undernutrition can additionally lead to impaired cognitive development in children. Nearly $100 billion is spent annually on federal nutrition programs yet FI still affects 1 in 8 American households pointing to the urgent need for the further refinement of our national/regional anti-hunger models. One notable and underutilized tool is the community food security assessment (CFA) which seeks to eliminate FI at the local level by improving food access throughout the community. A major limitation in knowledge about CFAs is the dearth of empirical studies of their effectiveness. The principal aim of this dissertation research was to statistically examine secondary data on U.S. counties where CFAs have been conducted and to determine whether they helped reduce individual FI over a two-year, post-test period. Repeated measures of ANOVA across the longitudinal time frame for n=66 counties revealed the main effect of FI was not statistically significant. A majority (56.9%) of 37 counties experienced a decrease in FI over the period. Linear regression found that unemployment was a significant influence in communities that experienced decreases in individual FI at the county level during the pre-test/post-test interval (β = .387 [.067], p<.01). This dissertation found that CFAs can be more effective in areas of higher unemployment as well as geographically where FI is initially higher, however further research is clearly needed in more communities over a longer time period. Also, the study suggests that proper development and structure of state and local-level food policy councils (FPCs) may lead CFAs to find better structure, funding and best practices to become more effective. Overlays prepared with ArcGIS mapping demonstrate that, in general, CFAs are not being performed in areas of highest FI when measured at the county level. The most important take-away from the visual mapping is the dearth of studies performed in the southeastern and southwestern regions of the country where county-level FI is higher, on average, than the rest of the country. These regions coincide with much of the Southern Black Belt and areas where Hispanic or Latino populations are most prevalent suggesting that communities in these regions may be able to benefit from the intervention.

Since 1999, there has been a significant increase in the number of food insecure individuals in the United States. The Great Recession (2007-2009) and slow economic recovery has led to additional increases in rates of food insecurity and the usage of emergency food assistance programs. Thirty qualitative interviews with individuals seeking emergency food assistance at a Tampa Bay food pantry were conducted. Interviews focused on collecting the life experiences of participants, the barriers they face in having food security, their strategies to cope with limited food budgets, and how food insecurity impacts their household's overall health and wellbeing. Recommendations for fulfilling the immediate need for food as well as addressing the larger issues that lead to and perpetuate food insecurity and hunger are presented in this paper. In collaboration with the food pantry, a booklet presenting personal experiences of hunger alongside broad institutional forces affecting food insecurity was disseminated in the community in hopes of increasing awareness of and support for combating this important social issue.

This study examines how people in dryland areas cope with food insecurity and adversities over time. It draws from the experience of the Gogo people living in Mvumi in the semiarid zone of central Tanzania, an area with a long history of food shortages. The study specifically examines the potential for dryland resources to sustain livelihoods. The study looks at the historical perspective of the problem in order to explore factors influencing the food situation in the area. It specifically investigates the role of local knowledge as a factor for adapting to dryland conditions by exploiting seasonality and local diversity. A detailed account is made of the coping strategies among three identified wealth groups in the area. Apart from their wealth levels, households in these wealth categories differ in how they mobilise and deal with labour in various seasons. Households in the well-off group have greater ability in mobilising and using external labour as well as accumulating and managing food surplus. The households in the intermediate group are flexible in utilising their own labour by performing various farm and non-farm activities according to their seasonalities. The households in the poor category sell their own labour and perform various farm and non-farm activities regardless of the season. It is clear from the study that different wealth groups differ in their ability to develop immediate coping into more pro-active livelihood strategies. The study winds up by assessing the potentials of the prominent land resource utilisation strategies in terms of economic, social and environmental perspectives.

Food insecurity is defined as “a household‐level economic and social condition of limited or uncertain access to adequate food” (USDA Economic Research Service 2009). Low‐income households tend to be food insecure for many reasons. The first and most obvious would be the access to monetary resources. If a household does not have a sufficient income, it is difficult to keep an adequate amount of food for all household members at all times. Another reason would be that many low‐income households cannot afford a car and/or do not have easy access to public transportation or reliable private transportation.