Introdução: a Educação Alimentar e Nutricional (EAN) é parte fundamental da promoção da alimentação saudável dentro do conceito de Atenção Primária à Saúde (APS). A priorização das temáticas abordadas nos grupos de EAN guarda correspondência com o modelo dos serviços de APS e as políticas públicas relacionadas. Objetivo: comparar as temáticas, processo de determinação e referencial técnico utilizado nos grupos de EAN do nível da Atenção Primária à Saúde das cidades de São Paulo e Bogotá, levando em consideração a configuração da EAN dentro do cenário das políticas públicas de saúde do Brasil e da Colômbia. Métodos: fez-se revisão documental sobre o contexto dos países e o cenário das políticas de alimentação, APS e Promoção da Saúde (PS), nessas incluindo o propósito, foco, atores e articulação de cada uma com a EAN. Coletaram-se dados em São Paulo e Bogotá por meio de três aproximações: questionário online, entrevista semiestruturada e observação sistemática. Para a observação realizou-se análise da atividade em torno da mensagem identificada por grupo e para a entrevista usou-se a técnica do Discurso do Sujeito Coletivo (DSC). Participaram 54 nutricionistas e observaram-se 41 grupos. Resultados: existe um espaço em potencial para a realização de ações encaminhadas à EAN dentro do cenário das políticas públicas com variação no processo de formulação, enfoque teórico e articulação. As temáticas trabalhadas nos grupos de EAN estiveram em concordância com a estrutura de APS, PS, nível de descentralização, conformação dos grupos e referenciais técnicos. Em São Paulo, a liberdade do profissional permite um alto nível de especificidade no direcionamento dos temas, mas é focado principalmente na doença. Em Bogotá, a decisão sobre os temas é centralizada, porém dirigida especialmente à PS. Considerações finais: a configuração da EAN nos cenários das políticas publicas das duas cidades, influencia as temáticas, o processo da sua determinação e referencial técnico utilizado, incluindo os facilitadores potenciais para o suporte das políticas públicas, entre eles a autonomia dos profissionais, a participação da população e o seguimento do processo dos grupos de EAN / Background: Nutrition Education (NE) is a fundamental part of promoting healthy eating within the concept of Primary Health Care (PHC). The prioritization of the themes addressed in EN groups keeps correspondence with the model of PHC services and concerning public policies. Objective: to compare themes, process of obtaining and technical reference used in development EN groups conducted by nutritionists in APS level in São Paulo and Bogotá cities, assuming of EN configuration on public policies context of Brazil and Colombia. Methodology: a literature review was conducted about the country context and policy scenario in relation with food, PHC and Health Promotion (HP), considering the purpose, focus, actors and articulation with EN. Information was collected in São Paulo and Bogotá through three approaches: online questionnaire, semi-structured interview and systematic observation. For analysis was used reported activity around the message from the observation of a group meeting and Collective Subject Discourse (CSD) technique from semistructured interview. Fifty-four interviews and forty-one observations were conducted. Results: there is a potential space for performing actions directed to NE in public policy context, although at different level of formulation, but with increasing recognition by governments. Themes identified were in accordance with structure of PHC, HP, level of decentralization, formation groups and technical reference. In São Paulo, freedom of professional allows a greater level of specificity in addressing content, but focused mainly on the disease. In Bogotá, the decision of topics was centralized, however directed especially to HP. Final comments: the configuration of EAN on public policies context in the two cities, influencing the themes, process of determination and technical reference used, including potential facilitators for the support public policies, for instance professional autonomy, community participation and monitoring of NE groups process

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-05-25T14:58:17Z No. of bitstreams: 1 barbaradanelonandrade.pdf: 2244260 bytes, checksum: 7878cb3b6bba3d25cb8bf47a45bbeaf9 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-25T15:14:49Z (GMT) No. of bitstreams: 1 barbaradanelonandrade.pdf: 2244260 bytes, checksum: 7878cb3b6bba3d25cb8bf47a45bbeaf9 (MD5) / Made available in DSpace on 2017-05-25T15:14:49Z (GMT). No. of bitstreams: 1 barbaradanelonandrade.pdf: 2244260 bytes, checksum: 7878cb3b6bba3d25cb8bf47a45bbeaf9 (MD5) Previous issue date: 2017-02-22 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / Nas últimas décadas, a transição nutricional e o envelhecimento populacional modificaram o perfil de morbimortalidade mundial, uma vez que houve aumento das doenças crônicas não transmissíveis. Aproximadamente, dois milhões de pacientes estão em tratamento dialítico no mundo e o crescimento anual desta população é de 6 a 7% ao ano. A hemodiálise é um procedimento que requer acompanhamento nutricional, uma vez que há intensas modificações no perfil da dieta a partir do seu início. A Educação Alimentar e Nutricional (EAN) pode ser utilizada como instrumento do nutricionista, já que auxilia na melhor compreensão das restrições alimentares associadas à doença, além de promover autonomia do indivíduo sobre suas escolhas. Trata-se de um ensaio clínico controlado, não-randomizado, desenvolvido no Centro de Hemodiálise do Hospital Universitário de Juiz de Fora (HU-UFJF). Os indivíduos foram divididos em Grupo Intervenção (GI) e Grupo Controle (GC), de acordo com os dias de frequência na hemodiálise. A partir desta divisão, foram realizadas as atividades de EAN com o GI, ao longo de dois meses, totalizando cinco atividades realizadas no ano de 2014. Os dados dos prontuários foram coletados para ambos os grupos, na Linha de Base (LB), no Pós-Intervenção Imediato (PII), avaliação realizada logo após o término da última intervenção e no Pós-Intervenção Tardio (PIT) , seis meses após a realização da última atividade, as quais correspondem as três avaliações dos pacientes deste estudo. As intervenções compreenderam atividades dinâmicas, visuais e lúdicas, que valorizaram a participação verbal dos pacientes bem como, a resolução de dúvidas relacionadas à alimentação e suas patologias. Observou-se, em relação aos exames bioquímicos, diminuição (p=0,036) do fósforo sérico no GI. Em longo prazo, estatisticamente, as intervenções não contribuíram para a melhora da alimentação dos indivíduos, tanto sob análise quantitativa quanto qualitativa. A partir dos achados neste estudo, constata-se a relevância das atividades de EAN no cuidado com o paciente em hemodiálise, demonstrando sua influência sobre modificações no perfil nutricional dos indivíduos. Ressalta-se ainda, que esse tipo de intervenção deve fazer parte da rotina dos centros de hemodiálise, para que as mudanças possam ser permanentes, resultando no aumento da qualidade de vida dos pacientes. / In the last decades, the nutritional transition and the aging of the population have modified the world morbidity and mortality profile, since there was an increase in chronic non-communicable diseases. Approximately two million patients are in dialysis treatment in the world and the annual growth of this population is of 6 to 7% per year. Hemodialysis is a procedure that requires nutritional monitoring, since there are intense modifications in the diet profile from the beginning. Food and Nutrition Education (EAN) can help in better understanding about the new eating patterns and the autonomy of the individual about their choices. This is a non-randomized, controlled clinical trial developed at the Hemodialysis (HD) Center of the University Hospital of the Federal University of Juiz de Fora (HU-UFJF). The subjects were divided into IG and CG, according to the days of frequency in the HD. Five nutritional interventions were performed on Fridays, for two months, in 2014. Data were collected for both groups in three moments: Baseline (BL), Post-Intervention Immediate (PII) (shortly after the end of the last intervention), and Post-Intervention Late (PIL) (six months after the last intervention). These correspond to the three evaluations of the patients in this study. The interventions realized were dynamic, visual and recreational, that valued the verbal participation of patients, as well as their solution of questions related to food and about their pathologies. On biochemical tests, there was a significant decrease (p = 0.036) of serum phosphorus in the IG. In long-term, statistically, the interventions did not contribute to an improvement of the feeding of these individuals. It is possible to verify the relevance of the interventions of FNE in the care of HD patients, demonstrating its influence on changing the nutritional profile of the individuals. This type of intervention should be part of the routine of the HD centers, so that the changes can be permanent, resulting in an increase of the quality of life of the patients.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-09-05T19:01:34Z No. of bitstreams: 1 liviabotelhodasilva.pdf: 8120722 bytes, checksum: 750fa22b60b51e73fbc8076625e36499 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-09-06T11:35:21Z (GMT) No. of bitstreams: 1 liviabotelhodasilva.pdf: 8120722 bytes, checksum: 750fa22b60b51e73fbc8076625e36499 (MD5) / Made available in DSpace on 2017-09-06T11:35:21Z (GMT). No. of bitstreams: 1 liviabotelhodasilva.pdf: 8120722 bytes, checksum: 750fa22b60b51e73fbc8076625e36499 (MD5) Previous issue date: 2017-07-19 / Atualmente, observa-se um crescente interesse dos pesquisadores com relação ao Letramento em Nutrição (LN), que é definido como a capacidade do indivíduo de obter, processar e compreender informações básicas de nutrição e habilidades necessárias para tomar decisões alimentares saudáveis. Através da avaliação do LN, é possível a identificação da dificuldade do indivíduo em temas específicos da nutrição, o que, possivelmente, favoreceria as atividades de educação alimentar e nutricional. No entanto, no Brasil, não existe instrumento que avalie LN de maneira abrangente. Diante disso, o presente estudo objetivou a adaptação transcultural de um instrumento de avaliação do LN, desenvolvido originalmente para a população estadunidense. Na primeira etapa foram realizadas tradução e retrotradução por consenso e as adaptações conforme a realidade da população brasileira. A segunda etapa consistiu em validação de conteúdo, que foi realizada por um comitê de seis especialistas, sendo pelo menos um de cada região do Brasil. Logo após, na terceira etapa, foi avaliada a legibilidade, para identificação do nível de leitura do instrumento. E, por fim, na quarta etapa, foi realizado o pré-teste, para o qual foram selecionados usuários com doenças crônicas que foram submetidos a um questionário sociodemográfico, um teste de letramento em saúde (LS), e a uma avaliação cognitiva, além do teste de avaliação do LN para a população brasileira. Após adaptações, o instrumento foi considerado relevante pela maioria dos especialistas e apresentou-se adequado para 8ª a 9ª ano do ensino fundamental. No pré-teste, foram avaliados 30 usuários, dos quais 50% possuíam ensino fundamental incompleto. Foi observado LS inadequado em 60% e déficit cognitivo leve em 83,3%. O tempo médio de aplicação do instrumento foi de 50,57±15,45 minutos. Entre os usuários com LS inadequado, foi observado menor pontuação média no instrumento de avaliação do LN, com exceção do domínio “Medidas Caseiras”. Entre todos os usuários, o domínio “Grupos Alimentares” apresentou menor percentual médio de acertos. Conclui-se que o instrumento foi considerado relevante para a população brasileira, pela maioria dos especialistas, porém, diante do elevado percentual de nível fundamental incompleto, apresentado pelos usuários selecionados para o pré-teste, o presente instrumento apresentou um nível de dificuldade elevado para uma população com baixa escolaridade. Além disso, constitui-se uma limitação do presente estudo o longo tempo de aplicação do instrumento de avaliação do LN. Diante disso, observa-se a necessidade de maiores adaptações e ajustes, para que, após sua validação, o instrumento possa ser útil para atividades de educação alimentar e nutricional. / There is a growing interest among researchers regarding Nutrition Literacy (NL), which is defined as the individual's ability to obtain, process and understand basic nutrition information and skills which are necessary to make healthy eating decisions. Through NL evaluation, it is possible to identify the individual's difficulties in specific nutrition topics, which could favour food and nutritional education activities. However, in Brazil, there is no instrument that evaluates NL comprehensively. Therefore, the present study aimed at the cross-cultural adaptation of an NL evaluation instrument, originally developed for the US population. In the first stage, translation and back-translation were performed by consensus and the adaptations according to the reality of the Brazilian population. The second stage consisted of content validation, which was carried out by a committee of six experts, at least one from each region of Brazil. Then, in the third stage, readability was evaluated, to identify the reading level of the instrument. Finally, in the fourth stage, the pre-test was applied to selected subjects with chronic diseases, who were additionally submitted to a sociodemographic questionnaire, a health literacy test (HL), and a cognitive evaluation, in addition to the NL evaluation test for the Brazilian population. After adaptations, the instrument was considered relevant by the majority of specialists and suitable for 8th and 9th of elementary school. In the pre-test, 30 users were evaluated; 50% of them had incomplete elementary education. Inadequate HL was observed in 60% and mild cognitive deficit in 83.3%. The mean time of application of the instrument was 50.57 ± 15.45 minutes. The users with inadequate HL presented lower mean score in the NL evaluation instrument, except for the "Domestic Measures" domain. Among all users, the "Food Groups" domain had the lowest average percentage of correct answers. It is concluded that the instrument was considered relevant for the Brazilian population, by the majority of specialists, however, given the high percentage of users with incomplete elementary education selected for the pre-test, this instrument presented a high level of difficulty for a low educated population. In addition, a limitation of the present study is the long-time application of the NL evaluation instrument. In view of this, it is observed the need for greater adaptations and adjustments, so that, after its validation, the instrument may be useful for food and nutritional education activities.

Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2015-03-24T16:47:40Z No. of bitstreams: 2 Educação nutricional de pré-escolares consumo de alimentos ricos em ferro e vitamina C.pdf: 1628355 bytes, checksum: bef0095c87d8d1342a37506289a64614 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2015-03-24T18:02:32Z (GMT) No. of bitstreams: 2 Educação nutricional de pré-escolares consumo de alimentos ricos em ferro e vitamina C.pdf: 1628355 bytes, checksum: bef0095c87d8d1342a37506289a64614 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2015-03-24T18:04:03Z (GMT) No. of bitstreams: 2 Educação nutricional de pré-escolares consumo de alimentos ricos em ferro e vitamina C.pdf: 1628355 bytes, checksum: bef0095c87d8d1342a37506289a64614 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-24T18:04:03Z (GMT). No. of bitstreams: 2 Educação nutricional de pré-escolares consumo de alimentos ricos em ferro e vitamina C.pdf: 1628355 bytes, checksum: bef0095c87d8d1342a37506289a64614 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-07-30 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Objetivo Realizar intervenção de educação nutricional com pré-escolares, estimulando o consumo de alimentos que aumentam o aporte de ferro para o organismo e também para o consumo de alimentos fontes de vitamina C, que é um facilitador da absorção desse mineral. Métodos A intervenção foi realizada com 42 crianças, de quatro a seis anos de idade, que estudavam no turno da manhã de uma Escola Municipal de Educação Infantil, da cidade de Capão do Leão, RS. Foram coletados dados socioeconômicos, de saúde da criança e antropométricos. Como estratégia de educação nutricional foram utilizados métodos lúdicos visando o incentivo ao consumo de preparações alimentares ricas em ferro e vitamina C. As crianças foram avaliadas em relação a aprendizagem sobre o tema e a aceitação das preparações oferecidas. Palestras com informações de nutrição e saúde foram repassadas aos pais e/ou responsáveis, professores e merendeiras visando consolidar as práticas de nutrição no ambiente familiar das crianças. Resultados O perfil antropométrico demonstra alta prevalência de risco de sobrepeso (27,3%) para crianças menores de cinco anos de idade e de sobrepeso (31,6%) naqueles com cinco anos ou mais. Foi verificado aumento do conhecimento das crianças em relação aos alimentos que visam prevenir a anemia e aumento no consumo das preparações ricas em ferro e vitamina C inseridas na alimentação escolar. Conclusão A estratégia de educação nutricional de caráter lúdico produziu resultados positivos junto aos pré-escolares quanto à adesão ao consumo de alimentos fontes de ferro e vitamina C para prevenção da anemia, e pode ser usado como modelo para estímulo ao consumo de outros alimentos e o combate a outras deficiências nutricionais. / Objective To conduct nutrition education intervention for preschool children, encouraging the consumption of foods capable of increasing iron level in the body, as well as food sources of vitamin C, since it is an absorption facilitator of that mineral. Methods The intervention was conducted with 42 children aged four to six years old, studying in the morning shift of a Municipal School of Early Childhood Education in the city of Capão do Leão, Rio Grande do Sul, Brazil. Socioeconomic, anthropometric and child health data were collected. Playing methods were used as the nutrition education strategy in order to encourage consumption of meals rich in iron and vitamin C. Children’s learning about the topic and acceptance of the offered meals were assessed. Lectures on nutrition and health information were given to parents and/or guardians, teachers and cooks to consolidate the nutrition practices in the children’s family environment. Results The anthropometric profile shows a high prevalence for risk of overweight (27.3%) in children under five years old and for overweight (31.6%) in those aged five years or more. Increases were noticed in children's knowledge on food items that help preventing anemia and in the consumption of food preparations rich in iron and vitamin C inserted in school meals. Conclusion The nutrition education strategy of playfulness rendered positive results among the preschoolers concerning the adherence to the consumption of foods source of iron and rich in vitamin C to prevent anemia, therefore it can be used as a model for encouraging the consumption of other foods and combat other nutritional deficiencies.

As morbid obesity increasingly affects Hispanic-Americans, the incidence of Roux-en-Y gastric bypass procedures (RYGB) among this population rises. Prospective research on the impact of postoperative educational interventions focused on Hispanic-Americans is needed to prevent premature weight loss plateau, weight regain, nutritional deficiencies, and relapse of obesity-related comorbidities. This randomized-controlled study evaluated the impact of a comprehensive nutrition and lifestyle education intervention (6 biweekly postoperative sessions that incorporated motivational strategies for behavioral change) as compared to a non-comprehensive approach (printed guidelines for healthy lifestyle). The variables to consider are body weight, obesity-related comorbidities (depression, diabetes, dyslipidemia, and others), nutrient status, physical activity, and eating habits in 144 morbidly-obese adult Hispanic-Americans 6 to 12 months following RYGB. Patients were randomly assigned to either the comprehensive intervention (n=72) or the comparison group (n=72). Participants (mean age 44.5 ± 13.5 years) were mainly Cuban-born females (83.3%). Intervention sessions attendance was 64%. At 12 months, both groups lost weight significantly, but those in the comprehensive intervention experienced greater excess weight loss than those in the comparison group (80% vs. 64% from preoperative excess weight, P<.001). Intervention participants were significantly more involved in physical activity (+ 14 min/week vs. – 4 min/week), had decreased depression, joint illness, and required less medication for comorbidities than comparison participants. Additionally, those in the comprehensive intervention had sustained supplement intake experiencing less folate deficiency (P=.014). The non-comprehensive intervention group significantly decreased their protein and supplement intake compared to the intervention group. Patients in the comprehensive intervention had significantly better eating habits reflected by fewer episodes of dumping syndrome, constipation, and night eating, than those in the comparison group who reported greater eating in response to negative emotions (P=.003). These findings support the importance of a comprehensive educational approach to achieve more effective weight reduction and health-related outcomes to prevent relapse of obesity-related comorbidities and nutritional deficiencies in Hispanic-Americans 6 to 12 months following RYGB.

Esta tese apresentou como objetivo geral investigar e capacitar professores na cidade de Petrolina-PE em parceria com a Secretaria Municipal de Educação, mediante uma proposta que levasse em consideração a realidade local para o ensino a respeito da temática alimentação e nutrição na disciplina Ciências, por meio de uma ação de oficinas temáticas, com base na perspectiva Ciência-Tecnologia-Sociedade (CTS). A pesquisa teve como proposta a de averiguar o perfil, os conhecimentos prévios e a percepção dos professores de ciências dos anos finais do Ensino Fundamental a respeito da importância do tema alimentação e nutrição, além de investigar como eles ensinam tal temática e que materiais pedagógicos utilizam. A pesquisa ocorreu entre os anos de 2015 e 2016 e apresenta caráter essencialmente qualitativo. Utilizamos a pesquisa-ação como metodologia, com vistas a interligar conhecimento e a ação, buscando informações sobre situações reais, e como método optamos por utilizar a Análise de Conteúdo, no intuito de melhor analisar o material coletado. Os professores investigados, apesar de reconhecerem a importância de ensinar temáticas relacionadas à alimentação e nutrição, poucos atuam de forma a construir e desenvolver atividades que acrescentem e melhorem o desenvolvimento dos estudantes Os resultados da pesquisa indicam que o tema da alimentação e nutrição merece maior destaque entre os conteúdos de ensino de ciências reservados para o nível fundamental da educação básica. Mediante a investigação realizada, pudemos observar como os professores, após a intervenção da pesquisa, construíram uma melhor compreensão e sentiram-se melhor capacitados para ministrar a temática sobre alimentação e nutrição abordada no curso. A partir dessa visão, ressaltamos que o incentivo dado ao profissional, ao perceber a discussão de temas sociocientíficos, utilizando a metodologia da pesquisa-ação e baseados na perspectiva CTS, fez com que as professoras e os professores despertassem a visão sobre a importância de se ter essas metodologias como aliadas no processo de ensino e de aprendizagem, o que colabora tanto em seu crescimento profissional quanto pessoal, e pode servir como estímulo para inúmeras possibilidades de ressignificação da sua prática pedagógica. / This thesis presented a general objective to investigate and train teachers in the city of Petrolina-PE in partnership with the Municipal Department of Education, by means of a proposal that takes into account the local reality for teaching about the theme of food and nutrition in the discipline of science , through an action of thematic workshops, based on the CTS perspective. The research had the purpose of investigating the profile, the previous knowledge and the perception of science teachers of the final years of Elementary School regarding the importance of the theme of food and nutrition, besides investigating how they teach this subject and what pedagogical materials use. The research occurred between 2015 and 2016 and is essentially qualitative. We use action research as methodology, with a view to linking knowledge and action, seeking information about real situations, and as a method we chose to use Content Analysis in order to better analyze the material collected. The teachers investigated, while recognizing the importance of teaching food and nutrition issues, few act in a way to build and develop activities that add to and improve student development The results of the research indicate that the theme of food and nutrition deserves greater prominence among the contents of science education reserved for the fundamental level of basic education. Through the research carried out we can observe how the teachers, after the intervention of the research, built a better understanding and felt better able to minister the thematic about food and nutrition addressed in the course. Based on this view, we emphasize that the incentive given to the professional, when perceiving the discussion of socio-scientific topics, using the methodology of action research and based on the CTS perspective, caused the teachers and teachers to raise the vision about the importance of having these methodologies as allies in the teaching and learning process, which collaborates both in their professional and personal growth, and can serve as a stimulus for numerous possibilities of reframing their pedagogical practice.

Background: Diabetes self-management education, including nutrition education (NE) is an essential component of diabetes management. Effective NE can assist individuals with type 2 diabetes mellitus (DM) in resource limited settings to improve their dietary self-care; an area cited among the most difficult with consequent improvement in health outcomes. Aim: To develop a NE programme that is tailored to the needs of adults with type 2 DM in a resource limited setting and to evaluate the programme's effectiveness on health outcomes. Setting: Makapanstad and Mathibestad community health centres in the Moretele sub-district, North West Province (South Africa). Methods: The study was done in three phases employing mixed methods research. Qualitative methods, using focus group discussions with 31 diabetic patients (a convenience purposive sample), and an open ended self-administered questionnaire with ten health professionals serving them, assessed the NE needs and preferences (phase 1). The data were analysed according to the framework approach. The results from the needs assessment were used to plan a tailored NE programme (phase 2). A randomised controlled trial (quantitative) with a sample of 82 patients (with HbA1c ≥ 8), allocated to either intervention or control groups, evaluated the effect of the NE programme (phase 3). Outcomes [HbA1c, dietary behaviours, blood lipids, blood pressure, body mass index (BMI), diabetes knowledge and attitudes towards diabetes and its treatment] were assessed at baseline, six months and 12 months respectively. An analysis of covariance (ANCOVA) compared the groups on measured outcomes using baseline values, age, gender, and clinic as covariates. Rank ANCOVA was used for dietary intake. The level of significance for all tests was set at α < 0.05 for a two-tailed test. Results: Needs assessment Diabetes related knowledge deficits and inappropriate dietary practices, including food portion control problems, inadequate intake of vegetables and fruits and unbalanced diets, were observed. Eight barriers and two facilitators to dietary adherence were identified. Financial constraint was the major barrier while social support was the major facilitator. NE recommendations included content related to the disease and diet, group education at the clinic, a competent educator, provision of education materials and inclusion of family members. The planned NE programme consisted of eight weekly training sessions and six follow-up sessions (monthly and bi-monthly), vegetable gardening demonstrations and education materials. Nutrition education programme effects: Seventy six participants (38 per group) completed the study. The differences in HbA1c (primary outcome) between the intervention and control groups were -0.62% (p=0.15) at six months and -0.67% (p=0.16) at 12 months. Few participants, four from the intervention group and one from the control group, achieved HbA1c target (<7%) at both six and 12 months, [(p=0.20), (p=0.36)] respectively. There were no significant between group differences in BMI, lipid profile and blood pressure at six months and 12 months. Starchy foods intake (median servings) were significantly lower in the intervention group compared to the control group, 9.3 vs. 10.8 (p=0.005) at six months and 9.9 vs. 11.9 (p=0.017) at 12 months. The proportion of participants growing own vegetables significantly increased in the intervention group compared to the control group 17/41 vs. 5/40 (p=0.003) at six months and 16/38 vs. 5/38 at 12 months. No significant group differences in the intake of energy, macronutrients, vegetable and fruits, sodium, cholesterol and fibre were observed at six and 12 months. Diabetes knowledge improved in the intervention group +0.95 (p=0.033) and +2.2 (p=0.000) when compared with the control group at six and 12 months respectively. There were no significant group differences in the attitudes towards diabetes and its treatment. Conclusions: The qualitative needs assessment provided insight for planning a tailored NE programme. The NE improved some dietary behaviours (starchy foods portion control and growing own vegetables) and diabetes knowledge. A non-significant lowering of HbA1c was observed. / Thesis (Phd)--University of Pretoria, 2013. / Human Nutrition / unrestricted

M. Tech. (Department of Hospitality, Tourism and PR Management, Faculty of Human Sciences), Vaal University of Technology / The purpose of this study was to determine the contribution of the National School Nutrition Programme (NSNP) has made on the total nutrient intake of Kagiso learners. This was done by investigating the nutrient intake of school children participating in the NSNP (experimental group) and comparing this to the nutrient intake of learners participating in the tuck-shop or lunch box (control group) from one school. The research methodology was undertaken in two phases, namely phase one; planning and phase two; data collection and analysis. The following measuring methods were applied; socio-demographics, household food insecurity assessment scale, anthropometry measurements, food frequency questionnaires (FFQ), 24-hour recall and the observation of the NSNP during the school lunch breaks. Anthropometry measurements were analysed according to the World Health Organization standards (WHO 2008), socio-demographics, and household food insecurity assessment scale and FFQ were captured on an Excel spreadsheet by the researcher and analysed using the Statistical Package for Social Sciences (SPSS) version 22.0 for descriptive statistics such as frequencies, standard deviations and confidence intervals. An expediency sample of 160 primary school children aged 6-13 years, including girls (n=84) and boys (n=76) and 106 caregivers were recruited into the study. The results showed that majority of caregivers (59%) completed secondary level education, followed by 39% with primary level or college completion (2%). The employment rate in the Kagiso households of the sampled group was low with 20% of caregivers being unemployed. Out of the 76% of the employed caregivers, 26% were permanently employed and 51% were temporarily employed with contract work and piece jobs. The highest monthly income (42%) was between R1000-R3000 and the lowest (38%) was less than R1000 with only R101-R200 to spend on food per week. The food insecurity status of Kagiso learners showed that 44% of school children were food secure, and 56% were food insecure – of these, 29% experienced hunger. Heightfor-age, weight-for-age and BMI-for-age were measured for all of the 160 children. The group was categorized as follows; school children participating in the NSNP (n=59) and children using the tuck-shop foods (n=35) and lunch box (n=66). The nutritional status of Kagiso learners from the sampled group showed that more boys were stunted (13%) and wasted (12%) while of the girls, 30% were at risk of being overweight, with only 2% reported to be overweight. The majority of boys reported to be stunted and wasted were from the NSNP group and the girls reported to be overweight or at risk of being overweight were from the tuck-shop group. Thus, the learners from the lunchbox had optimum growth status when compared to the other two groups. The respondents consumed a mainly high carbohydrate diet with a low consumption of vegetable and fruits. The results from the Food Variety Score (FVS) revealed a low individual mean (2.25±1.57) in the legume and nuts group, followed by a medium individual mean (7.9±2.81) in the fruits and other juices group, 7.16±2.68 in the vegetable group, and lastly, the highest individual mean (9.26±3.04) in the cereal, roots and tubers diversity. The results from the top 20 popular food items ranked as follows; maize meal stiff (1st), maize meal porridge (5th), white rice (6th), white bread (7th) brown bread (9th), potato fries (12th), breakfast cereal (13th) and samp and beans (14th). Cabbage (15th) and pumpkin (20th) were the most popular vegetables and there were no fruits within the top 20 popular list of food items. The Nutrient Adequacy Ratio (NAR) of the NSNP (n=59) meals was below the 1/3 (33.3%) and 30% dietary requirements for lunch meals. This was very evident regarding vitamin A (16.85%), energy kilojoules (23.78%), calcium (18%), folate (26.72%), zinc (15.71%), dietary fiber (25.71%) and iodine (4.65%). Iron (38.98%) was slightly above the 1/3 and 30% dietary intake, but there were a high percentage (61%) of respondents who did not meet the EARs of 5.9mg for iron. The results revealed an inadequate contribution by the NSNP to the nutrient intake of Kagiso learners. The poor intake of folate, vitamin A and dietary fiber in this sampled group is linked to the low consumption of vegetable and fruits. Results from this observational study showed that a majority of respondents do not participate in the NSNP when they do not have their own eating utensils. Respondents also revealed that the NSNP meals caused allergies such as skin rash while some mentioned diarrhea as the cause of not eating meals from the NSNP. Hence, a larger percentage (41%) of school children preferred to participate in the lunch box rather than in the NSNP (37%). The high prevalence of inadequate nutrient intake and the poor nutritional status of Kagiso learners in the sampled group, is an indication that strict monitoring of dietary measures needs to be implemented and continuously evaluated to ensure that positive nutritional results are obtained by the NSNP across South Africa

The current exploratory study, as part of the Massachusetts Farm Fresh (MAFF) research project: 1) examined the effect sensory attributes (i.e. taste profile, color, shape, texture, growth pattern) of the target vegetables have on children’s willingness to explore and consumption and 2) compared these outcomes for: facilitator-guided (FG), vs. children’s self-guided (SG) exploration. We conducted a 6-week multi-sensory nutrition education intervention with Western Massachusetts Head Start preschoolers (3-5 years of age; n=94 children) using eight vegetable pairs; outcome measures were recorded by observers. Data were analyzed using SPSS version 20.0. Results are reported for 50 children with complete data at both baseline and follow-up. Willingness improved from baseline (40-50% of children = SCORE O) to follow-up (20-40% = SCORE 0) for all vegetables. Willingness scores (1) increased for “lower-sugar” vegetables (broccoli, cauliflower, green bean, radish) (p=.013) (2) were lower for white vegetables (cauliflower, parsnip) versus the other color categories (red, green, orange) and (3) were higher for both pod (sugar snap peas, green beans) and long-root (carrot, parsnip) versus root vegetables (beet, radish). Pre-post mean (SE) consumption (g) increased for carrots (p=.013) (2.45+/-.39 vs 3.49+/-.43) and radishes (p=.023) ( .90+/-.22; vs 1.45+/-.29) ). At follow-up consumption of ”higher-sugar” vegetables was greater (p=.000) and carrot-parsnip pair was higher than broccoli-cauliflower (mean difference 1.49+/-.51) (p=.005) and beet-radish1.01+/-.55) (p=.071) pairs. Overall, children’s willingness and consumption varied by sensory attributes of the vegetables. The multi-sensory approach successfully activated children’s senses while providing exposure to a variety of local vegetables in the Head Start setting.

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