A adolescência é entendida como um estágio intermediário entre a infância e a idade adulta e caracteriza-se como um período de crescimento físico e desenvolvimento acelerados. Os adolescentes são muitas vezes considerados um grupo exposto ao risco nutricional devido a seus hábitos alimentares e estilo de vida. A promoção de estilos para uma vida saudável pode contribuir para a saúde de crianças e adolescentes, sendo que as unidades de ensino se apresentam como um espaço privilegiado para esse tipo de atividade. Objetivou-se conhecer o estado nutricional, preferências alimentares e estilo de vida de 578 adolescentes, de ambos os gêneros, matriculados em sete escolas públicas da cidade de Piracicaba, estado de São Paulo. Foram analisados os indicadores antropométricos (escore Z de altura para idade – ZAI e escore Z de peso para idade – ZPI) e a distribuição do Índice de Massa Corporal – IMC. Por meio da aplicação de um questionário, foram obtidas, junto aos escolares, informações referentes às práticas alimentares, atividade física e estilo de vida. Adotando-se formulário específico, preenchido pelos pais e/ou responsáveis, foi possível a identificação das condições sócio-econômicas das famílias dos escolares. Professores de ciências e de educação física (n= 26) das escolas foram entrevistados com o objetivo de identificar o grau de conhecimento dos mesmos sobre o tema "alimentação e nutrição". Foram elaboradas tabelas de contingência, acompanhadas dos testes de qui-quadrado e análise de regressão múltipla. Entre os principais resultados, merece destaque a reduzida prevalência (4,0%) de escolares com escore ZAI < &#8722;2. Observou-se 22,1% de escolares com IMC &#8805;85 ° P (indicativo de sobrepeso). Nesta pesquisa não foi possível verificar a associação (estatisticamente significativa) entre as variáveis renda familiar per capita e estado nutricional. Verificou-se que os alimentos mais consumidos diariamente pelos escolares foram: arroz, feijão, pão, leite, frutas, sucos, margarina, café, verduras e achocolatados. Cerca de 70% dos jovens costumavam comprar alimentos na cantina, com predomínio da preferência para alimentos ricos em açúcar e gorduras. Adotando-se a técnica estatística de regressão múltipla, foi possível notar que em cada mês adicional na vida dos meninos há aumento do consumo de 4,33 kcal, enquanto para as meninas o consumo diminui 2,14 kcal por mês. Verificou-se que os adolescentes permanecem, em média, 4 horas assistindo à televisão diariamente e que 78,6% dos entrevistados praticam esportes. Observou-se, tendo por base os dados obtidos junto aos professores, que os temas mais abordados por eles em sala de aula enfocam a relação dos nutrientes e suas funções e a alimentação balanceada. Os docentes reconhecem, unanimemente, a forte influência exercida pela televisão sobre os hábitos alimentares dos escolares. A implementação de programas de educação nutricional dirigidos aos adolescentes tem importância incontestável, como recurso para incentivá-los à adoção de práticas alimentares saudáveis e estilo de vida que favoreçam a qualidade de vida. / Adolescence is understood as an intermediate stage between childhood and adulthood, and is characterized as a period of high growth and development. Adolescents are oftentimes considered as a group exposed to nutritional risk due to their eating habits as well as their lifestyles. The promotion of styles for a healthy life may contribute for the health of children and adolescents, and school life represents a significant space for such an activity. The main objective of this paper was to investigate the nutritional status, food preferences and life style of 578 adolescents, of both genders, registered in the public schools (n= 7) of the city of Piracicaba – SP. Anthropometrical indicators were analyzed (Z-scores of height-for-age – ZAI, and Z-scores for weight-for-age –ZPI), and the distribution of the Body Mass Index – BMI. By applying a questionnaire, information was gathered about the students' eating habits, physical activity and lifestyle. By a specific formulary filled out by a parent or guardian, the social and economic status of the student’s family was identified. Science and physical education teachers (n= 26) of the schools were also interviewed with the purpose of assessing their knowledge on food and nutrition. Tables of contingence were drafted, attached to the chi-square tests and multiple regression analyses performed. The following results were among the main findings: a low percentage (4,0%) of the students showed a ZAI score <– 2, 22,1% of them exhibited BMI &#8804; 85° P (an indication of overweightness). This research effort did not reveal any statistically significant relationship between the family's per-capita income and the student's nutritional status. It was verified that the most consumed daily foods were: rice, dry beans, bread, milk, fruits, juices, margarine, coffee, greens and chocolate. About 70% of the young sujects frequently bought food at the school cafeteria, preferring foods rich in sugar and fat. Using the multiple regression statistics technique, it was possible to notice that at each additional month in the boys’ life there was an additon of 4.33 kcal to his diet, whereas for girls, there was a decrease of 2.14 kcal per month. It was also ascertained that adolescents watch television for an average of 4 hours daily and that 78,6% of the interviewed adolescents practice some kind of sport. Considering the data obtained from the teachers, it was verified that the main subject approached in class was the relationship between nutrients and their functions, and also the concept of a balanced meal. The teachers recognized, collectively, the strong influence from TV on the adolescents' food habits. The implementation of programs for nutritional education addressed to the adolescent should be of unquestionable importance as a means of motivating young citizens to have both healthy foods and lifestyles – thereby upgrading the quality of life.

A universidade é um local de aprendizagem no qual conhecimento acadêmico, social e cultural permeia a relação entre os estudantes, onde estes terão a oportunidade de vivenciar diferentes situações durante o curso. A maior preocupação é como esta experiência influenciará o estado nutricional com a possível mudança dos hábitos cotidianos, como abuso de bebidas alcoólicas, uso irrestrito de suplementos vitamínicos e alimentares e a alimentação inadequada. O consumo alimentar de universitários foi o foco desta pesquisa que teve como objetivo geral identificar as principais mudanças do consumo de alimentos/ bebidas e estilos de vida por meio de estudo de coorte, envolvendo estudantes ingressantes nos cursos de graduação da Escola Superior de Agricultura \"Luiz de Queiroz\" - ESALQ/USP, e como objetivos específicos desenvolver, validar e aplicar um instrumento com a finalidade de identificar medidas comportamentais relacionadas aos hábitos de consumo alimentar, atividade física, situação socioeconômica e relacionar as informações obtidas ao estado nutricional do estudante; descrever o consumo dentro e fora do domicílio. Participaram da pesquisa estudantes com idade entre 18 e 30 anos. Um questionário foi aplicado juntamente com a avaliação antropométrica para mensuração do peso, altura e classificação do estado nutricional por meio do Índice de Massa Corporal (IMC). Este protocolo foi repetido após 8 meses de curso para que fosse identificada a situação do estado nutricional de cada indivíduo relacionada às mudanças do comportamento alimentar. Os dados coletados foram armazenados em base de dados no Microsoft Excel, sendo analisados por meio do Statistical Analysis System. Os dados quantitativos foram expressos em média e desvio-padrão (DP) com cálculos de intervalos de confiança de 95%. O teste do qui-quadrado foi utilizado para comparar a distribuição da prevalência de sobrepeso e obesidade quanto à variável sexo, associando-se ao IMC. Foi utilizado o coeficiente de correlação intraclasse de Pearson para verificação de concordância entre peso e altura aferidos e referidos. Foi realizada análise de regressão múltipla para identificação da mudança de consumo entre as fases, assim como para peso corporal. Utilizou-se o nível de significância de 5%. Observaram-se entre as duas fases quantidades preocupantes de nutrientes ingeridos aquém ou além dos limites preconizados para ambos os sexos; destaque para o elevado consumo de sódio, e insatisfatório de carotenóides. No caso dos carotenóides, houve crescimento significativo da contribuição da categoria 3 para as alunas. O consumo de cafeína na segunda fase foi maior, predominando o fornecimento pelos alimentos ultraprocessados. De forma geral houve aumento do consumo de alimentos processados e ultraprocessados. Observou-se aumento (significativo a 5%) no consumo de lipídios. Constatou-se diminuição na prática de exercícios físicos e aumento na ingestão de bebidas alcoólicas, e destas com energéticos e no tabagismo. Concluiu-se que o ingresso na universidade contribui para a mudança nos hábitos alimentares e estilos de vida de maneira negativa, sendo necessária intervenção adequada visando a promoção da saúde dos estudantes. / The college is a learning place where academic, social and cultural knowledge exists in the relationship between students, where they will have the opportunity to experience different situations during the course. The biggest concern is how this experience will influence on the nutritional status with the possible change in daily habits, such as alcohol abuse, unrestricted use of vitamin and food supplements and inadequate nutrition. Dietary intake of students was the focus of this research aimed to identify the main changes in the consumption of food, beverage and lifestyles through cohort study, involving freshman students in undergraduate courses of the Escola Superior de Agricultura \"Luiz de Queiroz \" - ESALQ/USP, and specific objectives are to develop, validate and apply an instrument in order to identify behavioral measures related to food habits, physical activity, socioeconomic status and relate the information obtained to the nutritional status of the student, describe consumption inside and outside the home. the participants were students, aged between 18 and 30 years. A questionnaire was administered along with the anthropometric for measuring weight, height and classification of nutritional status using the Body Mass Index (BMI). This protocol was repeated after 8-month course to be identified the situation of the nutritional state of each individual related to eating behavior changes. The collected data were stored in a database in Microsoft Excel (2007 version), and analyzed using the Statistical Analysis System software (version 9.3). Quantitative data were expressed as mean and standard deviation (SD) with calculation of 95% confidence intervals. The chi-square test was used to compare the distribution of the prevalence of overweight and obesity and gender, associating with BMI. We used the intraclass correlation coefficient of Pearson to check correlation between weight and height measured and reported. It was performed multiple regression analysis to identify the change in consumption between phases, as well as body weight. Used the significance level of 5%. They were observed between the two phases worrying amounts of nutrient intake below or above the recommended limits for both sexes; especially the high sodium intake, and poor carotenoids. In the case of carotenoids, a significant growth of the category 3 contribution to the students. Caffeine consumption was higher in the second phase, predominantly supply the ultra-processed food. Overall there was an increase in the consumption of processed foods and ultra-processed. There was an increase (significant at 5%) in the consumption of lipids. Found a decrease in physical exercise and increased intake of alcohol, and those with energy and tobacco. It was concluded that entry into the university contributes to the change in eating habits and lifestyles in a negative way, requiring appropriate intervention to combat harmful habits to aiming to promote the health of students.

O trabalho teve por objetivo analisar a disponibilidade domiciliar de energia, nutrientes e carotenóides para as famílias brasileiras residentes nas áreas rurais e urbanas, das Grandes Regiões Geográficas, bem como o estado nutricional dos indivíduos adultos pertencentes a esta população. Utilizou-se como base de dados as informações individuais obtidas por meio da Pesquisa de Orçamentos Familiares (POF 2008-2009) do Instituto Brasileiro de Geografia e Estatística (IBGE). Adotou-se preliminarmente um banco de dados criado a partir dos microdados da POF 2002- 2003. Essa planilha revisada e atualizada gerou um novo banco de dados. Utilizouse como parâmetro para a avaliação da participação de macronutrientes no Valor Energético Total (VET) e disponibilidade de vitaminas e minerais os valores preconizados pelo Institute of Medicine (1997, 1998, 2000, 2001, 2002, 2004). Para a identificação do conteúdo de carotenóides foram adotadas as informações contidas na tabela Nutrient Database for Standard Reference Release 23 - United States of Department Agriculture (USDA). A disponibilidade média diária de energia e nutrientes e estado nutricional foram calculados utilizando o programa Statistical Analysis System SAS. Os resultados evidenciam diferenças da disponibilidade de energia e nutrientes para as famílias brasileiras, discriminadas de acordo com as Grandes Regiões e estratos geográficos (rural e urbano). Com relação à disponibilidade de energia, os maiores conteúdos foram identificados para as famílias das áreas rurais. A distribuição dos macronutrientes energéticos no VET revelou expressiva contribuição dos carboidratos para a totalidade das famílias brasileiras residentes no meio rural. Nos domicílios rurais e urbanos das Grandes Regiões, a contribuição de macronutrientes para o VET mostrou-se em conformidade com os valores preconizados. Com relação à vitamina C, vitamina B6, vitamina B12, folato e ácido pantotênico, os resultados indicaram disponibilidade inferior às recomendações. O conteúdo médio observado para as vitaminas A, B1 e B2 atendeu aos valores de referência para a totalidade das famílias. No tocante aos minerais, a disponibilidade de cálcio, magnésio, zinco, potássio e ferro revelou-se reduzida na maioria dos domicílios brasileiros. Os valores médios observados para os minerais sódio e manganês superaram o recomendado para a totalidade das famílias. A disponibilidade de carotenóides apresentou um aumento importante na última pesquisa (POF 2008-2009) quando em comparação com os valores identificados por meio da POF 2002-2003. Porém, revela-se ainda pouco expressiva nos domicílios brasileiros. Foi observada prevalência de sobrepeso (32,9%) e obesidade (12,5%) entre os adultos. Ressalta-se que os resultados referem-se às estimativas das quantidades de alimentos adquiridos para consumo no domicílio, podendo os mesmos envolver algum grau de subestimação. Os resultados obtidos nesta pesquisa evidenciam diferenças expressivas da disponibilidade de energia e nutrientes para as famílias brasileiras. Maior disponibilidade de carotenóides totais foi observada nos domicílios da Região Sul, com destaque para as famílias residentes nas áreas rurais. O sobrepeso e a obesidade destacaram-se entre os adultos. / The study aimed to analyze the household availability of energy, nutrients and carotenoids to Brazilian families living in rural and urban areas, the Major Geographic Regions, as well as the nutritional status of adults belonging to this population. The individual information from the Household Budget Survey (POF 2008-2009) from the Brazilian Institute of Geography and Statistics (IBGE) were used as a database. We adopted a preliminary database created from the POF microdata from 2002 to 2003. This revised and updated spreadsheet generated a new database. The values recommended by the Institute of Medicine (1997, 1998, 2000, 2001, 2002, 2004) were used as a parameter to assess the participation of macronutrients in total energy (VET) and availability of vitamins and minerals. The identification and content of carotenoids was based on the information contained in the table Nutrient Database for Standard Reference Release 23 - United States Department of Agriculture (USDA). The average daily availability of energy and nutrients and nutritional status were calculated using the Statistical Analysis System - SAS. The results show differences in the availability of energy and nutrients to Brazilian families, broken down by Major Regions and geographic areas (rural and urban). Regarding the availability of energy, the highest contents were identified for families in rural areas. The energy distribution of macronutrients in the VET revealed significant contribution of carbohydrates to the total of Brazilian families living in rural areas. In rural and urban households of Major Regions, the contribution of macronutrients to the VET proved in accordance with the recommended values. With respect to vitamin C, vitamin B6, vitamin B12, folate, and pantothenic acid, the results indicated lower availability of the recommendations. The mean content observed for vitamins A, B1 and B2 met the benchmarks for all families. With regard to minerals, the availability of calcium, magnesium, zinc, potassium and iron proved to be reduced in most Brazilian households. The mean values observed for the minerals sodium and manganese exceeded the recommendations for all families. The availability of carotenoids showed a significant increase in the 2008-2009 survey, when compared with the values of POF 2002-2003, although it continues to be unsatisfactory in Brazilian households. A prevalence of overweightness (32,9%) and obesity (12,5%) was detected among adults. It is emphasized that the results refer to estimates of quantities of food purchased for consumption at home, so they can involve some degree of underestimation. The results obtained in this study show significant differences in the availability of energy and nutrients to Brazilian families. Greater availability of carotenoids was observed in households in the South, especially for families living in rural areas. Overweight and obesity stood out among adults.

A community based survey to determine the nutritional status using anthropometric methods, of children and mothers and to assess certain socio-economic factors was carried out during November and December 1986 in Philippi, a predominantly vegetable farming area. Twenty-one (43%) of the 49 vegetable farms which were included in the study were selected by stratified random sampling. All children in the 0-6 year age group and their parents on the selected farms were included in the sample which consisted of 129 children and 212 parents. Questionnaires were administered and subjects' weights and heights were measured. It was found that 47% of children were below the National Centre for Health Statistics 5th percentile weight for age and 58% were under the 5th percentile height for age. There were 47 child deaths out of 279 births over a six-year period, thirty-four of which had occurred in the first year of life. Twenty eight percent of children had a birth weight of less than 2.5 kg. The number of cases of tuberculosis (10%) and severe diarrhoea (31%) contracted within the first year of life is unacceptably high. Twenty four percent of mothers were malnourished in terms of body mass index and fifty five percent of mothers were illiterate. Fifty nine percent of mothers were regular farm workers who worked for an average of 10.2 hours per day and a wage of R0.44 per hour. Grossly inadequate facilities existed for the care of children while the mothers worked. The average amount spent on food was insufficient to maintain normal nutrition. Although 91.5% of mothers breast fed their children and fed for a mean duration of 13.4 months, breast feeding was not exclusive. Supplementary feeding was introduced on average at 3 months of age. The long working hours of working mothers made it difficult for them to breast feed their children satisfactorily. Acceptance of the family planning services was high and immunisation cover was good. These statistics reflect the effects of extreme poverty and neglect of a community which is totally reliant on its employers for its livelihood. The parents poor educational level, coupled with their meagre financial and other physical resources gives them and their children little opportunity to improve their station in life and leaves them open to the scrounge of malnutrition and disease. Similarly, the dearth of educational and other child care facilities will ensure that this disastrous trend continues. A multidisciplinary approach, including active community involvement of both farmers and workers, to the many physical and social problems is urgently needed if the unacceptable human suffering is to be stopped.

Thesis (M. Sc.(Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

Thesis (M. Sc. (Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

La malnutrition à l’admission en réanimation pédiatrique est fréquente et associée à une augmentation de la morbi-mortalité. Néanmoins, la plupart des études, limitées à une évaluation statique du statut nutritionnel, ne permettent pas une analyse fine de l’impact de la malnutrition. Une approche systémique associerait en plus d’une évaluation nutritionnelle statique, une analyse dynamique dans le temps, une analyse de la composition corporelle et une analyse physiopathologique et étiologique. Cette approche globale a été appliquée dans 4 études prospectives observationnelles, incluant des enfants sévèrement agressés de plus de 36 semaines d’âge corrigé. Il en ressort que la dénutrition globale à l’admission est fréquente (23,7%) et que la cassure des courbes de croissance avant l’admission est associée à une augmentation de la durée de séjour de 3 jours. L’enfant sévèrement agressé présente à l’admission des taux plasmatiques abaissés de 6 micronutriments impliqués dans le stress oxydant (Sélénium, Zinc, Cuivre, Vitamines C, E et bêta-carotène), proportionnellement au nombre de défaillances d’organe. La dénutrition globale et la fonte musculaire acquises en cours de séjour sont des phénomènes fréquents, précoces et importants, associés à une durée de séjour prolongée. Les changements métaboliques liés à l’agression sévère conduisent à une dénutrition. Ces processus adaptatifs sont parfois dépassés et la dénutrition pourra à son tour aggraver le pronostic. La bonne compréhension de la physiopathologie sous-jacente et un suivi systémique et systématique du statut nutritionnel sont les éléments indispensables à l’évaluation des stratégies nutritionnelles / Malnutrition at pediatric Intensive care unit (PICU) admission is frequent and associated with impaired outcomes. However, most studies have focused solely on a static definition. A holistic approach would improve the description of malnutrition: this would include both a static and dynamic assessment of nutritional status, together with body composition assessment and with malnutrition classified based on its patho-physiology and etiology. This holistic assessment of malnutrition has been applied and examined in four observational studies which included critically ill children older than 36 gestational weeks (corrected age). These found that malnutrition was frequent at PICU admission (27.3%) and faltering growth prior to PICU admission was associated with an increased length of PICU stay (+3 days). Critically ill children present at admission with decreased plasma levels of 6 micro-nutrients (Selenium, Copper, Zinc, Vitamin C, E and beta-carotene) involved in anti-oxidative stress pathways. Nutritional status deterioration during PICU stay, and associated muscle mass loss occurred frequently and were intense. This early phenomenon was associated with extended length of PICU stay. A profound critical illness related metabolic shift leads to malnutrition as an adaptive process. However, malnutrition may also negatively impact on outcomes in this setting. These studies have led to a clearer understanding of the underlying patho-physiology. This, combined with a more systematic and holistic nutritional assessment, will enable implementation and assessment of nutritional strategies aiming to improve the functional outcome of critically ill children

Orientador: Ana Carolina Pero Vizoto / Resumo: O período de adaptação funcional com as próteses totais novas envolve uma série de problemas transitórios, e este período está diretamente relacionado com o sucesso ou falha do tratamento. O objetivo deste estudo foi avaliar a influência da altura do rebordo mandibular no padrão de movimentos mandibulares, na máxima força de mordida oclusal, na função mastigatória, na ingestão de nutrientes e na satisfação dos pacientes em diferentes estágios após a instalação de próteses totais convencionais novas. Vinte e oito indivíduos desdentados totais (RN, n=14, rebordos mandibulares normais; RR, n=14, rebordos mandibulares reabsorvidos) receberam novas próteses totais convencionais. Um cinesiógrafo foi utilizado para registrar os movimentos mandibulares durante a abertura e fechamento e a mastigação de um alimento teste. A máxima força oclusal foi mensurada com o auxílio de um gnatodinamômetro digital, o desempenho mastigatório foi avaliado por meio do método dos tamises e a habilidade mastigatória pela aplicação de questionário específico baseado em uma escala visual analógica (EVA de 100,0 mm), a satisfação foi avaliada por meio de um questionário. A ingestão de nutrientes foi avaliada por meio de diário alimentar de três dias, e posteriormente foi traduzido em valores nutricionais por meio da utilização da Tabela Brasileira de Composição de Alimentos. Essas avaliações foram conduzidas em momentos distintos: 24 horas, 30 dias, três meses e seis meses após a instalação das próteses t... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

BScnut / Department of Nutrition

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