Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-27T13:21:42Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Nicolly Patrícia Gregório.pdf: 1566405 bytes, checksum: 77cabf76d8cbb32a6ed2bab269b9b347 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-28T10:59:46Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Nicolly Patrícia Gregório.pdf: 1566405 bytes, checksum: 77cabf76d8cbb32a6ed2bab269b9b347 (MD5) / Made available in DSpace on 2015-01-28T10:59:46Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Nicolly Patrícia Gregório.pdf: 1566405 bytes, checksum: 77cabf76d8cbb32a6ed2bab269b9b347 (MD5) Previous issue date: 2014-03-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study aimed to characterize the exercise of professional nutritionist in the National School Feeding Program and its association with food and nutrition education. Is an analytic cross-sectional descriptive study realized in 432 municipalities in the North, Northeast, Midwest, Southeast and South regions, by telephone interview, from April 2012 to November 2013. Interviews were conducted with the nutritionist responsible for school feeding in the municipalities, in the absence, was replaced by the coordinator of school feeding or municipal secretary of education. For writing this dissertation became a division of the study and considered only the interviews with the nutritionist. Descriptive analyzes were performed, to verify the association between the dependent variable and the explanatory variables the values of the correlation coefficient Cramer's V were estimated. To verify the hypothesis, the Pearson’s chi-square test or Fisher's Exact was conducted. We considered statistical significance level of 5%. Of the 384 study participants nutritionists, the principal information in relation to this observed in professional school feeding were: 84,9% had food and nutrition education, 50,2% had worked for more than two years, 56% were gazetted and 59,6 % worked with higher workload to 30 hours/week. The dedication in other sectors of the municipality besides school feeding was reported by 23,7% of interviewees being most prevalent (89%), the health sector. The presence of other nutritionists in school feeding, besides the technical manager, was found in only 20% of municipalities. These were found in 54% of the municipalities the presence of more than two professionals in the technical framework. Among them was founded the presence of more than two professionals in the technical framework in 54%. Analyses indicated relatively strong association, statistically significant, between the realization of food and nutrition education to employment in the North region (Cramér V = 0.42, p = 0.02). We conclude that most nutritionists school feeding worked for more than two years in school feeding with higher workload to 30 hour week and are public employees. These elements tend to contribute positively to the realization of food and nutrition education in school feeding. / Este estudo teve como objetivo caracterizar o exercício profissional do nutricionista no Programa Nacional de Alimentação Escolar e sua associação com a educação alimentar e nutricional. Trata-se de um estudo transversal, descritivo e analítico, realizado em 432 municípios das regiões Norte, Nordeste, Centro-Oeste, Sudeste e Sul, por meio de entrevista telefônica, no período abril de 2012 a novembro de 2013. As entrevistas foram realizadas com o nutricionista responsável pela alimentação escolar do município, na ausência, era substituído pelo coordenador da alimentação escolar ou secretário municipal de educação. Para a escrita desta dissertação fez-se um recorte do estudo e considerou somente as entrevistas realizadas com o nutricionista. Foram realizadas análises descritivas e para verificar a associação entre a variável dependente e as variáveis explicativas foram estimados os valores do coeficiente de correlação V de Cramér. Para verificar a hipótese foi realizado o teste de qui-quadrado de Pearson ou Exato de Fischer. Considerou-se o nível de significância estatística de 5%. Dos 384 nutricionistas participantes do estudo, as principais informações observadas em relação a estes profissionais que atuam na alimentação escolar foram: 84,9% realizavam educação alimentar e nutricional; 50,2% atuavam há mais de dois anos; 56% eram concursados e 59,6% trabalhavam com carga horária superior a 30 horas/semanais. A dedicação em outros setores da prefeitura, além da alimentação escolar foi relatada por 23,7% dos entrevistados, sendo, mais prevalente (89%), o setor da saúde. A presença de outros nutricionistas na alimentação escolar, além do responsável técnico, foi constatada em apenas 20% dos municípios. Destes foi verificada em 54% dos municípios a presença de mais de dois profissionais no quadro técnico. As análises indicaram associação relativamente forte, estatisticamente significativa, entre a realização de educação alimentar e nutricional e o vínculo empregatício na região Norte (V Cramér=0,42; p=0,02). Conclui-se que a maioria dos nutricionistas da alimentação escolar atuava há mais de dois anos na alimentação escolar com carga horária superior a 30 horas semanais e são servidores concursados. Estes elementos tendem a contribuir positivamente para a realização de educação alimentar e nutricional na alimentação escolar.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-03-06T18:52:52Z No. of bitstreams: 2 Dissertação - Géssica Mercia de Almeida - 2014.pdf: 2301540 bytes, checksum: 2d9e1272b61b9b77b357379d444ddf1f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-03-06T18:53:09Z (GMT) No. of bitstreams: 2 Dissertação - Géssica Mercia de Almeida - 2014.pdf: 2301540 bytes, checksum: 2d9e1272b61b9b77b357379d444ddf1f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-06T18:53:09Z (GMT). No. of bitstreams: 2 Dissertação - Géssica Mercia de Almeida - 2014.pdf: 2301540 bytes, checksum: 2d9e1272b61b9b77b357379d444ddf1f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-12-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study aimed to analyze the actions of food and nutrition education at the National School Feeding Programme in Brazilian towns. It is a cross-sectional descriptive and analytical study, conducted through telephone interviews during the period from April 2012 to November 2013. The survey was developed with school feeding’s nutritionists from 388 towns distributed proportionally between the North, Northeast, Southeast, South and Midwest regions. The studied variables included: actions of food and nutrition education and their frequency, social actors involved, form of guidance for achieving food and nutrition education, inclusion of food and nutrition theme in Political Pedagogical Project and the difficulties in achieving food and nutrition education. Statistical analyses were performed using the χ2 Fisher’s test or Pearson’s exact test, beyond the multivariate logistic regression, with a significance level of 5% model. Out of the 388 interviewed nutritionists, 85.1% perform actions of food and nutrition education in schools and day care centers, with the highest frequency in the South region (94.6%) and lowest in the Northeast (79.2%) (p = 0.04). The actions of food and nutrition education are predominantly developed through lectures, with biannual frequency, with the participation of the pedagogical coordinator and teacher in the planning and execution of these practical activities. In less than half of the towns, the food and nutrition issues are worked into the school curriculum, with emphasis on the discipline of Sciences. When nutritionists orient the social actors in schools and day care centers through training activities on healthy eating, reduce the chances by 61% of inclusion of food and nutrition education in the Pedagogical Political Project. It is possible to suggest that these formations present weaknesses and limitations and is not a satisfactory strategy for entering these educational practices at school. The actions of food and nutrition education are focused on a traditional model of education, punctually and with little articulation with the school curriculum. It is hoped that the information presented can support nutritionists, school community and trainers and regulatory agencies of the profession, in the search for new approaches in order to encourage and qualify the actions of food and nutrition education in schools. / Esse estudo objetivou analisar as ações de educação alimentar e nutricional do Programa Nacional de Alimentação Escolar de municípios brasileiros. Trata-se de um estudo transversal, descritivo e analítico, realizado por meio de entrevistas telefônicas, no período de abril de 2012 a novembro de 2013. A pesquisa foi desenvolvida com nutricionistas da alimentação escolar de 388 municípios brasileiros distribuídos proporcionalmente entre as regiões Norte, Nordeste, Sudeste, Sul e Centro-Oeste. As variáveis estudadas incluíram: ações de educação alimentar e nutricional e sua frequência, atores sociais envolvidos, forma de orientação para realização da educação alimentar e nutricional, inserção do tema alimentação e nutrição no Projeto Político Pedagógico e as dificuldades para a realização da educação alimentar e nutricional. As análises estatísticas foram realizadas utilizando o teste χ2 de Person ou Exato de Fisher, além do modelo de regressão logística multivariada, com um nível de significância de 5%. Dos 388 nutricionistas entrevistados, 85,1% realizam ações de educação alimentar e nutricional nas escolas e creches, sendo a frequência maior na região Sul (94,6%) e menor na Nordeste (79,2%) (p=0,04). As ações de educação alimentar e nutricional são desenvolvidas predominantemente por meio de palestras, com frequência semestral, contando com a participação do coordenador pedagógico e do professor nas atividades de planejamento e execução dessas práticas. Em menos da metade dos municípios, os temas alimentação e nutrição são trabalhados no currículo escolar, com destaque para a disciplina de Ciências. Quando os nutricionistas orientam os atores sociais nas escolas e creches por meio de atividades de formação sobre alimentação saudável, diminuem as chances em 61% de inserção da educação alimentar e nutricional no Projeto Político Pedagógico. É possível sugerir que essas formações apresentem fragilidades e limitações, não sendo uma estratégia satisfatória para a inserção dessas práticas educativas na escola. As ações de educação alimentar e nutricional estão voltadas para um modelo tradicional de educação, de modo pontual e com pouca articulação com o currículo escolar. Espera-se que as informações apresentadas possam subsidiar nutricionistas, comunidade escolar e órgãos formadores e fiscalizadores da profissão, na busca de novas abordagens com o intuito de fomentar e qualificar as ações de educação alimentar e nutricional na escola.

Introdução: Brasil e Colômbia têm investido na Atenção Primária à Saúde (APS) por meio do fortalecimento das ações educativas. Aponta-se a Educação Nutricional (EN) como uma estratégia de ação baseada em um processo de aprendizagem constante e dinâmico, que contribui para a formação de indivíduos autônomos, sendo os grupos uma ferramenta de trabalho. Entretanto, devido à falta de respaldo metodológico, verificou-se a importância de conhecer e analisar os grupos de EN, entre as duas maiores cidades destes países. Além disso, pretende-se explorar possíveis estratégias para a prática. Objetivo: Analisar as práticas e as teorias educativas utilizadas nos grupos de alimentação e nutrição, na Atenção Primária à Saúde, em São Paulo (Brasil) e Bogotá (Colômbia). Métodos: Estudo descritivo comparativo com abordagem qualitativa, realizado com nutricionistas da APS, constituído por cinco momentos: identificação dos nutricionistas, aplicação do questionário online, entrevista semiestruturada, elaboração da comparação e reflexão sobre possíveis estratégias. Aplicou-se a técnica do Discurso do Sujeito Coletivo para a análise das percepções sobre a EN. Para a comparação, segmentaram-se os dados por cidade e a contextualizou-se os achados na ótica da EN, grupo e APS. Resultados: Verificou-se semelhança no perfil dos entrevistados, entre São Paulo e Bogotá, porém com diferença na formação e na autonomia de trabalho. Obtiveram-se 17 Ideias Centrais da EN, classificadas em seis eixos temáticos. Observou-se que os eixos associam-se com as características grupais, que por sua vez, possuem diferenças relacionadas aos programas. Constatou-se que teoria e prática da EN estão em transição da abordagem tradicional para outra mais humanista. Entretanto, em uma velocidade lenta comparada às políticas e necessidades de saúde. Por meio da reflexão sobre estratégias para os grupos de EN, recomenda-se como metodologia de trabalho, especialmente para São Paulo, a articulação dos conceitos de Grupo Operativo, Problematização e Planejamento, dado que enfocam o aprendizado, a transformação e a autonomia. Considerações: Identificou-se que São Paulo e Bogotá, possuem uma herança conceitual das ações educativas, associada a sequelas políticas, como ausência de teoria e metodologias educacionais na construção da APS. Apresenta-se uma necessidade de investimento político e de gestão na formação dos profissionais de saúde que estão educando a população / Introduction: Brazil and Colombia have invested in the Primary Health Care (PHC) through the strengthening of educational activities. Points to Nutrition Education (NE) as an action strategy which based on a constant and dynamic learning process, which contributes to the formation of autonomous individuals, groups being a working tool. However, due to lack of methodological support, it is of importance to know and to analyze the groups of NE, between the two major cities of these countries. Furthermore, intend to explore possible strategies for practice. Objective: To analyze the practices and theories educational used in groups of food and nutrition, in Primary Health Care, in São Paulo (Brazil) and Bogota (Colombia). Methods: Descriptive and comparative study with qualitative approach performed with PHC nutritionists. Comprising five stages: identification of nutritionists, application of the online questionnaire, semi structured interview, development of the comparison and reflection about possible strategies. The technique applied was of the Discourse of the Collective Subjective, so to analyze the perceptions about NE. For comparison, the data was segmented by city and the findings contextualized in the optical of the NE, the group and PHC. Results: There was similarity in the profile of the respondents, between Sao Paulo and Bogotá, although with distinction in training and working autonomy. We obtained 17 Main Ideas of NE, classified into six themes. It was observed that the themes are associated with the group characteristics, which in turn, have differences related to the programs. It was found that the NE theory and practice are in transition from the traditional approach to a more humanistic. However, at a slow speed compared to policies and health needs. Through reflection about strategies for groups of NE, it is recommended as a work methodology, especially for São Paulo, the articulation of the concepts of Operative Group, Questioning and Planning, as focus on learning, the transformation and the autonomy. Considerations: We identified that Sao Paulo and Bogotá have a conceptual heritage of the educational activities, associated the policies fallout as the lack of educational theory and methodology in the construction of the PHC. Thus, presents a need for political investment and management in the training of health professionals who are \"educating\" the population

A educação alimentar é uma abordagem reconhecidamente eficaz para transformação, recuperação e promoção de hábitos saudáveis, sendo muito utilizada no manejo dietético do tratamento da obesidade. No entanto, a manutenção da perda de peso nem sempre é satisfatória, dada a dificuldade de incorporação de novos hábitos como rotina de vida. O objetivo deste estudo foi investigar mudanças comportamentais em adultos com excesso de peso após um programa educativo e os fatores associados à sua manutenção. Para tanto, dados sociodemográficos, antropométricos, de imagem corporal, fatores comportamentais e relativos à saúde foram coletados de 94 adultos com excesso de peso, de ambos os sexos, participantes do Programa de Educação Alimentar da Universidade de São Paulo - PRAUSP, no período de 2005 a 2009. Os indivíduos foram divididos nos grupos intervenção - GI (frequência mínima de 70%; n=64) e abandono - GA (frequência inferior a 30%; n=30) sendo que as informações foram obtidas no início (GI e GA) e final da intervenção (GI) por meio de um banco de dados, e no momento atual (GI e GA) por entrevista estruturada. Comparações intra-grupos foram realizadas para avaliar alterações ocorridas no decorrer do tempo e comparações entre-grupos para identificar as mudanças resultantes da intervenção e os fatores associados. Como resultados, houve predomínio de mulheres (71,8%), casadas (68,2%), com idade média de 43,5 anos e elevado nível de escolaridade (91,8% com nove anos ou mais de escolaridade), sem diferença entre os grupos. Os sujeitos do GI aumentaram o consumo de álcool, a mastigação e o fracionamento da alimentação, e reduziram a compulsão alimentar, as medidas antropométricas imediatamente após a intervenção (IMC = -1,4kg/m 2 ; circunferência da cintura = -5,5cm), e o risco de doenças cardiovasculares a longo prazo. Ambos os grupos apresentaram frequências elevadas de percepção corporal superestimada e insatisfação (GI=75% e 85,9%; GA= 81% e 95,2%, respectivamente). De modo geral, os participantes do GA apresentaram mudanças comportamentais pontuais, demonstrando grande heterogeneidade entre o grupo. Entre os fatores associados à manutenção das mudanças encontram-se a motivação para a perda de peso e melhora da imagem corporal, a presença de doenças associadas e do histórico familiar de obesidade, e a percepção distorcida e a insatisfação corporais. Como aspectos facilitadores foram apontados as melhoras obtidas e a força de vontade, e como dificultadores, os resultados lentos, a falta de tempo, a vida social muito ativa e o custo elevado dos alimentos. Conclui-se que indivíduos que finalizaram o protocolo (GI) realizaram mais mudanças comportamentais do que aqueles que abandonaram (GA), mas as alterações nem sempre foram mantidas no período posterior. O programa mostrou-se eficaz em promover modificações comportamentais, sendo recomendado considerar as características sociodemográficas e antropométricas dos participantes no planejamento das atividades a fim de subsidiar ações mais específicas e melhor prognóstico. A manutenção dos resultados constitui-se em um grande desafio aos profissionais de saúde devido à influência de fatores ambientais e culturais inerentes ao proceso de mudança. / Nutrition education is recognized as an effective approach for changing, recovering and promoting healthy habits, commonly used in nutritional management of obesity. However, the maintenance of weight loss is not always satisfactory, due to the difficulty in incorporating new habits as daily life routine. This study aimed to investigate behavioral changes in adults with excess weight after an educational program and the factors associated with its maintenance. Sociodemographic and anthropometric data, body image and behavioral factors and health-related data were collected from 94 adults with excess weight, of both sexes, participants in the University of Sao Paulo Nutrition Education Program - PRAUSP, between 2005 and 2009. Participants were divided into two groups: IG (intervention group) (minimum frequency of 70%, n = 64) and AG (abandonment group) (frequency less than 30%, n = 30), with information being obtained at baseline (IG and AG) and at the end of the intervention (IG) through a database, and at present (IG and AG) by structured interview. Intra-group comparisons were performed to assess changes occurred over time and comparisons between groups to identify changes resulting from the intervention and associated factors. As results, there was a predominance of women (71.8%), married (68.2%), with a mean age of 43.5 years and a high level of education (91.8% with nine or more years of school education), without difference between the groups. Participants of IG increased alcohol consumption, chewing and fractionating of food, and reduced binge eating, anthropometric measures immediately after intervention (BMI = -1.4 kg/m 2 , waist circumference = -5.5 cm), and the risk for cardiovascular disease in the long term. Both groups had high rates of overestimated body perception and dissatisfaction (IG = 75% and 85.9%, AG = 81% and 95.2%, respectively). In general, participants of AG showed specific behavioral changes, showing great heterogeneity among the group. Among the factors associated with maintenance of the changes, there are the motivation for weight loss and improved body image, the presence of associated diseases and family history of obesity, as well as distorted perception and body dissatisfaction. Facilitating factors were identified as the improvements obtained and willpower, and as difficulties were the slow results, lack of time, a very active social life and high cost of food. It is concluded that individuals who completed the protocol (IG) had more behavioral changes than those who dropped (AG), but the changes were not always maintained thereafter. The program was effective in promoting behavioral changes, being recommended to consider the socio-demographic and anthropometric characteristics of participants in planning activities, in order to support more specific actions and a better prognosis. The maintenance of the results is a great challenge to health professionals due to the influence of environmental and cultural factors inherent to the process of change.

A obesidade é problema de saúde que afeta diversas sociedades. Seu tratamento deve ter abordagem multiprofissional e interdisciplinar. No entanto, tratamentos crônicos têm, em geral, menor adesão, pelo fato de exigirem muito empenho do sujeito para modificar seus hábitos de vida e atingir as metas propostas. O objetivo deste estudo foi investigar a taxa de abandono do tratamento da obesidade e seus aspectos motivacionais, com vistas a contribuir para o planejamento de estratégias terapêuticas mais eficazes que diminuam o impacto das consequências dessa doença para a saúde pública. O estudo foi realizado a partir de informações contidas no banco de dados do Programa de Reeducação Alimentar (PRAUSP), com informações de 192 adultos com excesso de peso, de ambos os sexos, que participaram de 14 grupos formados no período de 2004 a 2009, concluindo ou não a estratégia. Foi considerado abandono quando o indivíduo apresentou 30% ou mais de faltas nos 10 encontros realizados e não participou da avaliação final do programa. Com esses sujeitos, foi realizada uma entrevista para coleta de dados sociodemográficos, realização de medidas de circunferência da cintura, além de peso e estatura para cálculo do índice de massa corporal (IMC). Nesse momento, foi investigado o motivo do abandono e aplicada a Escala de Silhuetas para avaliação da imagem corporal. Como resultados, 82 pessoas abandonaram o programa (43,8%) e 50 delas aceitaram participar do estudo. A maioria era do sexo feminino (n=35; 70%) com idade média de 46,8 anos, casada (n=30; 60%) e ensino médio completo (n=28; 56%). Quase metade deles (n=23; 46%) tinha renda familiar mensal de quatro salários-mínimos. O motivo mais frequente do abandono citado pelos sujeitos foi o horário inadequado (46%). Depois da participação no PRAUSP, 80% (n=40) relataram alguma tentativa de redução de peso; 64% (n=32) obtiveram sucesso, mas 88% (n=44) referem que ainda precisam emagrecer. Mais da metade deles (n=26; 52%) participaria novamente do programa. O IMC médio antes do PRAUSP e atualmente foi de 33,4kg/m2±5,9kg/m2 e 33,8kg/m2±6,8kg/m2, respectivamente. Oito por cento (n=4) estão eutróficos e a porcentagem de obesidade grave aumentou de 12 para 18%. A circunferência da cintura média antes do PRAUSP e atualmente foi de 112,5cm±15,1cm e 109,7cm±14,4 cm para os homens e 102,4cm±13,1cm e 96,3cm±14,7 cm para as mulheres, respectivamente. Houve superestimação do tamanho corporal nas mulheres (p=0,00), ao se comparar o IMC atual (33,1kg/m²) com aquele relativo à silhueta que elas achavam que possuíam (IMC real=37,4kg/m²). A insatisfação corporal foi encontrada em todos indivíduos (p=0,00), ao escolherem silhuetas mais magras (IMC desejado= 27,4kg/m² para mulheres e 24,5kg/m² para homens (amostra total: 26,5kg/m²). Conclui-se que a taxa de abandono é alta e o motivo citado (horário incompatível com o trabalho) merece reflexão cuidadosa, visto que os indivíduos já tinham essa informação ao decidirem participar do programa. Nesse sentido, outros estudos são necessários para melhor compreensão dos fatores que interferem na adesão a estratégias para perda de peso. / Obesity is a health problem which affects many societies; its treatment should have a multiprofessional and interdisciplinary approach. However, chronic treatments have, in general, lower adherence because they require much individuals\' effort to modify their lifestyle and achieve proposed goals. This study aimed to investigate the dropout rate in treatment of obesity and its motivational aspects in order to contribute to the planning of more effective therapeutic strategies that reduce the impact of consequences of this disease to public health. The study was conducted based on information contained in the Food Retraining Program (PRAUSP) database with information about 192 overweight adults, men and women who participated in 14 groups formed in the period from 2004 to 2009, concluding or not the strategy. It was considered dropout when the individual had 30% or more absences during the 10 meetings and did not attend the final evaluation of the program. With these subjects, an interview was conducted to collect demographic data; the measures of waist circumference, weight and height to calculate body mass index (BMI) were performed. At this point, the reason for dropout was investigated and the Silhouettes Scale for assessment of body image was applied. As a result, 82 people left the program (43.8%) and 50 of them agreed to participate in the study. Most were female (n=35; 70%) with mean age of 46.8 years old, married (n=30, 60%) and with completed high school (n=28; 56%). Almost half of them (n=23, 46%) had monthly family income of four Brazilian minimum wages. The most frequent reason for dropout reported by subjects was the inadequate time (46%). After participation in PRAUSP, 80% (n=40) reported some attempt at weight reduction; 64% (n=32) were successful but 88% (n=44) state that they still need to lose weight. More than half of them (n=26; 52%) would participate in the program again. The mean BMI before PRAUSP and currently was 33.4kg/m2±5.9kg/m2 and 33.8kg/m2±6.8kg/m2, respectively. Eight percent (n=4) were eutrophic and the percentage of severe obesity increased from 12 to 18%. The average waist circumference before PRAUSP and currently was 112.5cm±15.1cm and 109.7cm±14.4 cm for men and 102.4cm± 13.1cm and 96.3cm±14.7 cm for women, respectively. There was overestimation of body size in women (p=0.00) when comparing the current BMI (33.1kg/m²) with the silhouette that they thought they had (real BMI=37.4 kg/m²). The body dissatisfaction was found in all subjects (p=0.00) by choosing leaner silhouettes (desired BMI=27.4 kg/m² for women and 24.5kg/m² for men (total sample: 26.5kg/m²). It was concluded that the dropout rate is high and the reason reported (time incompatible with the work) deserves careful consideration, since the individuals had this information when they decide to participate in the program. Thus, further studies are needed to better understanding of the factors that influence adherence to strategies for weight loss.

Objetivo: avaliar uma intervenção nutricional educativa desenvolvida para alunos de Universidades Abertas à Terceira Idade. Metodologia: a população de estudo foi constituída por indivíduos com 45 anos de idade ou mais, freqüentadores de quatro instituições de ensino no Município de São Paulo. O delineamento consistiu em estudo quase experimental do tipo \"antes\" e \"depois\", sem grupo controle. A ação educativa (quatro aulas de três horas cada; distribuição de uma apostila com o conteúdo das aulas e de guia alimentar com orientações gerais) era parte das atividades oferecidas pelas instituições e foi desenvolvida por nutricionistas durante o segundo semestre de 1996. Os dados pessoais, morbidade referida e de conhecimentos sobre nutrição foram coletados por meio de questionário autoaplicado. O conhecimento foi identificado aplicando-se teste especialmente elaborado. As práticas alimentares, identificadas por meio de registro de alimentos de três dias, tiveram como variáveis analisadas: valor energético total, proporção de macro nutrientes. teor de colesterol, de vitamina A, de cálcio e de ferro. O estado nutricional foi diagnosticado pelo Índice de Massa Corpórea. Resultados: a população inicial era constituída de 121 indivíduos, a maioria do sexo feminino, com idade inferior a 60 anos e situação sócio-cultural privilegiada quando comparada com a média da população brasileira; perfil de morbidade identificando sobrepeso, problemas de coluna, hipertensão arterial e hipercolesterolemia. Os temas de nutrição com maior porcentagem de respostas adequadas relacionaram-se aos cuidados preventivos da osteoporose e do envelhecimento precoce, à substituição de alimentos reguladores, número de refeições da dieta e à fonte de nutrientes antioxidantes. O desconhecimento maior foi sobre a função das gorduras dietéticas, alimentos ricos em colesterol e alimentos que colaboram no controle da hipercolesterolemia. A maioria desses indivíduos apresentou dieta adequada em termos de vitamina A, ferro e colesterol; e inadequada em termos de energia e distribuição calórica dos macro nutrientes (proteínas, carboidratos e lipídios). O consumo adequado apresentou associação estatística significativa entre percentual de gorduras e presença de doença cardíaca; percentual de gorduras e conhecimento sobre função dos lipídios; consumo de colesterol e sexo; consumo de vitamina A e responsabilidade pelas despesas no domicílio. A população estudada após a intervenção educativa constituiu-se de 44 indivíduos. Para esse grupo de indivíduos, as modificações identificadas foram: aumento dos conhecimentos sobre nutrição, diminuição de consumo de lipídios, de proteínas e de colesterol. As modificações citadas referiram-se ao tipo de alimento consumido, ingestão de água e maneira de preparar os alimentos. Estas modificações ocorreram por motivos de saúde, sendo as fontes de informações sobre nutrição mais citadas, a Universidade Aberta e o médico pessoal. Conclusão: apesar das limitações do estudo, concluiu-se que a intervenção nutricional educativa foi uma atividade importante para a promoção da saúde do grupo populacional analisado e que foi uma fonte de informação para as modificações realizadas. / Objective: to evaluate an educational nutrition intervention developed for students of Open Universities to the Third Age. Methodology: the studied population was constituted by individuals with 45 years or older, who frequent four teaching institutions in São Paulo County. The general plan consisted of quasi experimental study of the kind pre/test and post/test, with no control group. The educational action (four classes of three hours each; distribution of a study outline with the classes contents and a food guide with general information) was part of the activities offered by the institutions and was developed by nutritionists during the second term of 1996. The personal data, referred morbidity and concerning knowledge about nutrition were gathered by a self-applied questionnaire. The knowledge was identified applying specially elaborated test. The alimentary practices, identified by three days\' food diary, had as analyzed variables: total energetic value. macronutrient proportion. cholesterol. vitamin A, calcium and iron content. The nutrition status was diagnosed by the Body Mass Index. Results: the initial population was constituted of 121 individuals, mostly female, with age under 60 years old and privileged socio-cultural situation when compared with the average of Brazilian population; morbidity profile indicating overweight, column problems, arterial hypertension and hypercholesterolemia. The nutrition subject with greater percentage of adequate answers related to the preventive care of the osteoporosis and early aging, to the replacement of regulators foods, number of the meals and the sources of antioxidant nutrients. The greater lack of knowledge was about the function of the dietary fats, foods riches in cholesterol and foods that contribute to hypercholesterolemia control. Most ofthese individuaIs presented an adequate diet in terms of vitamin A, iron, calcium and cholesterol; and inadequate in terms of energy and caloric distribution of the nutrients (proteins, carbohydrates and lipids). The appropriate intake presented a significant statistical association among percentage of fats and presence of heart disease; percentage of fats and knowledge about function of the lipids; intake of cholesterol and sex; intake of vitamin A and responsibility for domestic expenses. After the educational intervention the studied population consisted of 44 individuais. For this group of individuals, the identified modifications were: increase of the knowledge about nutrition, decrease of consumption of lipids, protein and cholesterol. The mentioned modifications referred to the kind of food consumed, ingestion of water and ways of preparing the foods. These alterations occurred for health reasons, with the most mentioned information sources being the Open University and the personal doctor. Conclusion: despite of the limitations of the study, it was concluded that the educational nutritional intervention was an important activity for the health promotion to the analyzed population group besides being an information source for accomplished alterations.

Introducción: El etiquetado nutricional ayuda a los consumidores a realizar elecciones más saludables, sin embargo, este es poco leído, mal interpretado o no usado. Objetivos: Evaluar la frecuencia y factores asociados a la lectura, uso e interpretación de etiquetas nutricionales en usuarios de gimnasios en la ciudad de Huancayo, Perú. Materiales y métodos: Estudio de corte transversal en 385 usuarios de una cadena de gimnasios. Se midió la interpretación con un test a partir de dos etiquetas, lectura reportada (frecuentemente o no) y el uso reportado para elegir un producto (frecuentemente o no), así como variables demográficas, dietéticas y relacionadas al gimnasio. Se evaluó la asociación calculando las razones de prevalencias ajustadas en base a las variables significativas del modelo bivariado. Resultados: Los participantes tuvieron una edad media de 27,8 + 9,3 años, 44,7% fueron varones, 49,4% contaron con educación universitaria. El 27,5% reporta leer frecuentemente y dentro de estos el 55,7% reporta usarlas frecuentemente, asimismo el 17,4% sabe interpretar. La lectura se asoció con factores dietéticos y de uso de gimnasio y la interpretación con capacitación previa de lectura de la etiqueta. El uso fue principalmente para seleccionar productos bajos en grasa total (65,1%), alto en proteínas (64,2%) y en menor proporción, productos bajo en sodio (47,2%). Conclusiones: La frecuencia de lectura, uso e interpretación de etiquetas nutricionales es baja. La capacitación previa de lectura es un factor necesario para una elección saludable. Es necesario establecer estrategias educativas para enseñar a interpretar en forma adecuada las etiquetas nutricionales. / Introduction: The nutritional labeling helps users to make healthier choices, nevertheless, this is overseen, misunderstood or not used at all. Objectives: To evaluate the frequency and the factors associated with the reading, interpretation and use of nutritional labels by fitness center users in the city of Huancayo, Peru. Materials and methods: A cross-sectional survey was conducted on 385 users of a fitness center chain. Interpretation was measured by using a test with 2 labels, reported reading (frequently or not) and the reported use to choose a product (frequently or not), as well as demographic, dietetic and fitness-center-related variables. The association was evaluated by calculating the prevalence ratios adjusted based on the significant variables from bivariate model. Results: The participants had an average age of 27,8± 9,3 years, 44,7% were men and 49,4% had college degree. 27,5% report reading frequently and 55,7% of them reports use frecuently, furthermore 17,4% know how to interpret. The reading was associated with dietetic factors and gym use, and interpretation with prior training of reading labeling. The use was mainly high to select low fat products (65,1%), high in protein (64,2%) and was mainly low in low sodium products (47,2%). Conclusions: The reading, use and interpretation frequency of nutritional labels is low. The prior training of reading labeling is a required factor to make healthier choices. It is necessary to establish educative strategies for teaching to interprete the nutrition labels in an adequate way.

Master of Science / Department of Human Nutrition / Valentina Remig / The use of computer-based and personal assistive technology is projected to increase as the boomer generation continues to age. Technology is infiltrating and improving the lives of older adults, including their education. This study determined older adults’ preferences toward the use of technology to learn about nutrition and health. The sample included 132 volunteer subjects, mostly female, white non-Hispanic, ranging in age from 65−92 years, recruited from local organizations, senior centers, churches, and senior apartments. All participants completed a newly developed, 32-item pilot tested questionnaire that included demographic and self-rated health characteristics, current use of technology, factors that motivate and/or influence attitudes and interest toward use of technology, and preferred formats and topics of interest for nutrition and health education information. The results indicated that, overall, these older adults self-rated their health as either excellent or good, and that those who were younger and among the higher income brackets and education levels were more likely to use computers than those who were older, with less income, and education levels. Findings also indicated that older adults were interested and willing to learn about technology, had positive attitudes toward it and showed a high demand for user-friendly programs and training. Finally, results show that although newsletters, magazines and television were mostly preferred by older adults, computers were also considered very helpful and were used to learn about nutrition and health information.

included 24-hour food recalls, infant feeding practices, women's food preferences and frequency of food intake. Anthropometry consisted of weight, height, mid-upper-arm circumference (MUAC), and triceps skinfold (TSF) thickness measurements in women and children, with additional head circumference measurements in children less than 3 years. Major findings from dietary assessment revealed that adult diets were simplistic, consisting primarily of rice, beans, and coffee (with sugar). Analysis of nutrient intake and comparison with international standards showed that women were probably at high risk for vitamin A, iron, calcium, ascorbic acid, and riboflavin deficiencies; children appeared at high risk for vitamin A, iron, and ascorbic acid deficiencies. Infant feeding practices indicated that all children (under 5 years) had been breast fed at birth, although many were weaned at an early age. Negative nutritional infant feeding practices were reported, especially for conditions such as fever and diarrhoea. Belief in the "hot/cold" food classification system was reported by women. Although food taboos were reported for menstruation, pregnancy, immediately post partum, and lactation, relatively few taboos had potentially negative nutritional consequences. Anthropometric assessment indicated that a significant number of women were probably undernourished; a small percentage of women, however, were overweight or obese. Children did not generally appear undernourished; many, however, were stunted in growth. Summative evaluation of the nutrition education program indicated that for women who participated in the program, nutrition knowledge scores showed improvement and were statistically significant at ∝ =.05, using Wilcoxon signed rank test. / Land and Food Systems, Faculty of / Graduate

Studies have shown that many low-income and disadvantaged Americans have a poor diet quality, which increases obesity and chronic disease risk. According to the Massachusetts Department of Public Health, education and income levels of Springfield residents are well below state averages, and racial diversity in Springfield has increased significantly over the past few decades. Springfield’s demographics increase the risk of health disparities in the community, and higher rates of diabetes, heart disease, and obesity are seen in Springfield. To promote healthy eating behaviors among Springfield residents, Mason Square Health Task Force (MSHTF), a Live Well Springfield (LWS) partner, created a 6-session nutrition curriculum, entitled The MENU Program. The goal was to increase overall health awareness and healthy eating behaviors among residents in communities that are being targeted by the LWS initiative. Topics of the The MENU Program included MyPlate guidelines and label reading, budget shopping and cooking, healthy restaurant choices, diet and chronic disease, and food justice. The objective of this study was to evaluate The MENU Program to assess its strengths, weaknesses, and effectiveness using both quantitative and qualitative data from surveys, process evaluation, and facilitator observations. There were two phases of this study: Phase 1 was the evaluation of the pilot program delivered to a group of senior women recruited through the Dunbar YMCA; Phase 2 evaluated the second offering of the curriculum to Mason Square residents enrolled in the Task Force Fit Challenge. All participants responded positively to The MENU Program sessions and positive changes were seen in knowledge, attitudes, and behaviors after both Phases. Participant-perceived useful material included handouts, group discussions, and hands-on activities. Observational data supports the usefulness of group discussion over lecture-based teaching methods. This study supports the use of The MENU Program as an effective community education program for Springfield, MA. It has the potential to positively influence residents’ diet quality and nutrition-related behaviors through improved nutrition knowledge and attitudes.