Objective. The objective of the current study was to evaluate critical nutrients of industrialized foods and compare them with the technical parameters established in the Peruvian regulations, in its two stages of implementation, referring to front-of-package labeling before the beginning of its validity in June 2019. Methods. Cross-sectional study in which the critical nutrients of sodium, total sugar, saturated fat and transfat were analyzed from data declared in the nutritional labels of 511 processed and ultra-processed foods that were part of the products purchased for the consumption of 88 families of students from one private university in Lima. The technical parameters used to evaluate the critical nutrients are those established in the Regulation of Law 30021. All analyses were carried out with Excel and SPSS version 21, Student’s t-statistics and McNemar’s test were used. Results. 79 processed foods and 432 ultra-processed foods were analyzed. Of the total processed and ultra-processed products evaluated, it was found that for sodium 14.3% and 37.2% respectively exceeded the parameters in the first and second stages established in the regulations; for sugar 54.2% and 62.6%; while for saturated fats 52.8% and 59.5%, respectively. Solid foods are those that will have the greatest changes in front labeling between the first and second stages of implementation, unlike liquids that without changing the composition of their products, their front labeling would not vary significantly. Conclusions. The saturated fat present in solid products (processed and ultra-processed), exceeds the parameters in both stages of implementation in most products. Of the foods compared, regardless of type and category, the critical nutrient sugar was the one that was highly present in most of the products evaluated for the first and second stages of implementation. / Revisión por pares

Submitted by Maike Costa (maiksebas@gmail.com) on 2017-08-31T13:04:34Z No. of bitstreams: 1 arquivototal.pdf: 2272874 bytes, checksum: 93e7a81c9ba6d5726bc15d51fef81b2d (MD5) / Approved for entry into archive by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2017-08-31T15:51:06Z (GMT) No. of bitstreams: 1 arquivototal.pdf: 2272874 bytes, checksum: 93e7a81c9ba6d5726bc15d51fef81b2d (MD5) / Approved for entry into archive by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2017-08-31T15:54:38Z (GMT) No. of bitstreams: 1 arquivototal.pdf: 2272874 bytes, checksum: 93e7a81c9ba6d5726bc15d51fef81b2d (MD5) / Made available in DSpace on 2017-08-31T15:55:28Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2272874 bytes, checksum: 93e7a81c9ba6d5726bc15d51fef81b2d (MD5) Previous issue date: 2017-08-23 / This paper goal was to identify which are the behavioral conditionings that influence the buying intention of ultraprocessed food and beverage, under the social marketing optics. The literature review made possible, through analysis of food consumption researches, to comprehend the factors and their relationship with the dimensions of interest in this paper (ultraprocessed buy-intention, attitude toward the ultraprocessed, subjective norm, self-efficacy and perceived control), resulting in nine hypotheses to empirical verification. The methodological procedures involved the creation of a questionnaire with scales that have been validated in other studies, being just adapted to this one. With the available data, we made an initial exploratory analysis, followed up by descriptive analysis, factor analysis and the use of structural equation modeling in order to verify the hypotheses. We found that convenience and sensorial appeal are the main factors that significantly contribute to a positive attitude regarding ultraprocessed food, and that they influence the buying intention of these products. This last one gets a strong negative influence from the self-efficacy construct, pointing out the importance of the individual's intern control to avoid the consumption of harmful to health food. Another important finding of the paper is the significantly interference of the facilitators construct to self-efficacy, showing that the impossibility to cook and the fact of eating by itself hinders the individual's control over its feeding choices. / Este trabalho objetivou identificar quais são os condicionantes comportamentais que influenciam a intenção de compra de alimentos e bebidas ultraprocessados, sob a óptica do marketing social. A revisão de literatura possibilitou, através da análise de pesquisas sobre o consumo alimentar, compreender os fatores e sua relação com as dimensões de interesse desse estudo (Intenção de compra de ultraprocessados, atitude sobre os ultraprocessados, norma subjetiva, auto-eficácia e controle percebido), resultando em nove hipóteses para a verificação empírica. Os procedimentos metodológicos envolveram a construção de um questionário com escalas que já haviam sido validadas em outros estudos, sendo apenas adaptadas para essa pesquisa. Com os dados disponíveis, realizamos uma análise exploratória inicial, seguido de análises descritivas, fatoriais e, por fim, a utilização da modelagem de equações estruturais para verificar as hipóteses da pesquisa. Nos resultados encontramos que a conveniência e o apelo sensorial são os principais fatores que contribuem, significativamente, para uma atitude positiva em relação aos alimentos ultraprocessados e que, por sua vez, influência a intenção de compra desses produtos. Este último, recebe forte influência negativa do construto auto-eficácia, indicando a importância do controle interno do indivíduo para evitar o consumo de alimentos prejudiciais para a sua saúde. Outro achado importante da pesquisa é a interferência significativa do construto facilitadores para a auto-eficácia, demostrando que a impossibilidade de cozinhar e o fato de comer sozinho dificulta o controle do indivíduo sobre as suas escolhas alimentares.

Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-18T22:38:27Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Ediana_Neitzke_Karnopp.pdf: 588486 bytes, checksum: 37d8863a410e5ecbfc776d5502f42d4a (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-18T22:44:37Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Ediana_Neitzke_Karnopp.pdf: 588486 bytes, checksum: 37d8863a410e5ecbfc776d5502f42d4a (MD5) / Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2018-05-18T22:44:43Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Ediana_Neitzke_Karnopp.pdf: 588486 bytes, checksum: 37d8863a410e5ecbfc776d5502f42d4a (MD5) / Made available in DSpace on 2018-05-18T22:44:43Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Ediana_Neitzke_Karnopp.pdf: 588486 bytes, checksum: 37d8863a410e5ecbfc776d5502f42d4a (MD5) Previous issue date: 2016-04-01 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Introdução: Evidencia-se um consumo alarmante de alimentos com elevada densidade energética e baixa qualidade nutricional - denominados ultraprocessados - em todas as faixas etárias da população brasileira. Entretanto, os adolescentes são considerados um grupo de risco nutricional, por serem vulneráveis a escolhas de alimentos não saudáveis. O presente estudo teve como objetivo avaliar o consumo de alimentos ultraprocessados e sua relação com o perfil lipídico sérico de adolescentes com 18 anos de idade. Métodos: Estudo transversal aninhado a uma coorte de nascimentos de base populacional. A amostra do estudo foi composta pelos participantes da coorte de nascimentos de 1993 da cidade de Pelotas, RS acompanhados aos 18 anos de idade. A informação de consumo alimentar foi obtida por questionário de frequência alimentar semi-quantitativo, autoplicado em versão eletrônica, com período recordatório de um ano. O grau de processamento dos alimentos foi avaliado conforme a classificação proposta pelo Guia Alimentar para População Brasileira de 2014. O consumo de ultraprocessados foi analisado como percentual de contribuição energética da ingestão diária, categorizado em quintis. Foram obtidas informações sobre o sexo, cor da pele, renda familiar, escolaridade materna ao nascimento, fumo atual, atividade física no lazer, peso e altura. Resultados: 3.846 indivíduos foram incluídos no estudo. Quanto à contribuição no total energético, os alimentos in natura ou minimamente processados contribuíram com 54%, seguido pelos alimentos ultraprocessados (41,4%), ingredientes culinários processados (3,3%) e alimentos processados (2%). As proteínas e as fibras dietéticas apresentaram uma tendência ao declínio conforme o aumento nos quintis de contribuição energética dos alimentos ultraprocessados. O contrário foi observado para a ingestão total de energia, carboidratos e gorduras totais. Em relação aos níveis médios de CT, LDL e HDL foram mais elevados em adolescentes do sexo feminino. Tanto o CT, HDL, LDL e TG associaram-se aos maiores quintis de contribuição energética dos alimentos ultraprocessados. Conclusão: Os resultados deste estudo revelam um impacto negativo do consumo de alimentos ultraprocessados, sobretudo nos níveis de CT e TG e na qualidade nutricional da dieta dos adolescentes aos 18 anos idade. Entende-se que a redução no consumo de alimentos ultraprocessados é um dos caminhos para a promoção da alimentação saudável e da saúde. / Introduction: This study highlights an alarming consumption of foods with high energy density and low nutritional quality - called ultraprocessados - in all age groups of the population. However, teenagers are considered a nutritional risk group because they are vulnerable to unhealthy food choices. This study aimed to evaluate the consumption of ultraprocessados food and its relationship with serum lipid profile in adolescents 18 years of age. Methods: Cross-sectional study nested in a cohort of births. The study sample was composed by participants of the 1993 Birth Cohort in Pelotas, RS followed up to 18 years old. The information of food consumption was obtained by questionnaire semi-quantitative food frequency autoplicado in electronic version, with recall period of one year. The degree of food processing was evaluated according to the classification proposed by the Food Guide for the Brazilian Population 2014. The consumption of ultraprocessados was analyzed as energy contribution percentage of the daily intake, categorized into quintiles. They obtained information about sex, skin color, family income, maternal education at birth, current smoking, physical activity during leisure time, weight and height. Results: 3846 subjects were included in the study. As the contribution to the total energetic, foods fresh or minimally processed contributed 54%, followed by ultraprocessados food (41.4%), processed cooking ingredients (3.3%) and processed foods (2%). Protein and dietary fiber showed a tendency to decline as the increase in energy contribution quintiles of ultraprocessados food. The opposite was observed for total energy intake, carbohydrates and total fat. In relation to average levels of TC, LDL and HDL were higher in female adolescents. Both TC, HDL, LDL and TG were associated to higher quintiles of energy contribution of ultraprocessados food. Conclusion: The results of this study show a negative impact of consumption ultraprocessados food, particularly the levels of TC and TG and nutritional quality of the diet of adolescents to 18 years old. It is understood that the reduction in the consumption of ultraprocessados food is one of the ways to promote healthy eating and health.

Introdução: O baixo peso ao nascer (BPN) representa risco crucial para as crianças. Em contrapartida, a amamentação é considerada a estratégia de maior impacto na redução da mortalidade em crianças menores de cinco anos. O aleitamento materno exclusivo (AME) é recomendado até o sexto mês de vida, devendo ser complementado até dois anos de idade ou mais. Crianças com consumo alimentar inadequado desde a infância tendem ao desenvolvimento precoce de sobrepeso e obesidade, além de outras doenças crônicas associadas. Objetivo: Verificar o padrão de aleitamento materno (AM) e as práticas de alimentação complementar de lactentes menores de um ano nascidos com baixo peso e analisar a influência de determinantes individuais e contextuais. Métodos: Estudo transversal com dados de 64 municípios brasileiros (incluindo as capitais e Distrito Federal) que abrangeu 5115 lactentes menores de um ano com BPN da Pesquisa de Prevalência de Aleitamento Materno (PPAM) em Municípios Brasileiros, 2008. O questionário continha questões sobre a prática de AM e sobre o consumo de todos os grupos alimentares nas últimas 24 horas. A tese gerou três manuscritos: 1) Descreve as práticas de aleitamento materno, o consumo de líquidos e alimentos semi-sólidos nas últimas 24 horas e os indicadores de consumo alimentar de lactentes entre seis e 11,9 meses segundo estratos de BPN. 2) Avalia os determinantes individuais e contextuais do AME. 3) Analisa a influência de determinantes individuais e contextual sobre a dieta diversificada e sobre o consumo de alimentos ultraprocessados em lactentes de seis a 11,9 meses com BPN. Nos manuscritos 2 e 3, os determinantes individuais corresponderam às características socioeconômicas (representadas pela proxy escolaridade materna), dos lactentes (idade; sexo), maternas (faixa etária; situação de trabalho; paridade) e aos serviços de saúde (local de acompanhamento ambulatorial). No manuscrito 2 foi incluído também o \'nascimento em Hospital Amigo da Criança (HAC)\'. Os determinantes contextuais corresponderam às características dos municípios, representadas pelas variáveis \'número de Bancos de Leite Humano (BLH) por mil nascidos vivos\' e \'Índice de Desenvolvimento Humano do município\' no manuscrito 2, e \'prevalência estimada de desnutrição infantil\' como proxy de pobreza, no manuscrito 3. Para análise, utilizou-se regressão de Poisson com estrutura multinível e adotou-se nível de significância de 5%. Resultados: Descritos de acordo com cada manuscrito produzido: 1) No estrato de muito BPN o AME até 60 dias e 90 dias foi mais elevado do que nos demais, mas com intervalos de confiança superpostos. A prevalência de AME em menores de seis meses apresentou patamar semelhante nos três estratos de peso ao nascer. A prevalência de AM na primeira hora de vida e o AM foram mais prevalentes entre os nascidos com 2000 a 2499g. Observou-se consumo elevado de alimentos ultraprocessados (AUP) em lactentes de 6|-9 e de 9|-12 meses, sendo esta prevalência maior quanto maior o PN. As prevalências dos indicadores de consumo alimentar estão aquém do recomendado. 2) O AME foi mais prevalente entre lactentes cujas mães tinham de 20 a 35 anos (RP=1,35; IC95%=1,09-1,69), não trabalhavam fora (RP=1,36; IC95%=1,08-1,71) ou estavam em licença maternidade(RP=1,30; IC95%=1,06-1,59); lactentes que nasceram em HAC (RP=1,22; IC95%=1,09-1,37) e que residiam em municípios com maior número de BLH por mil nascidos vivos (RP=1,42; IC95%=1,14-1,76). 3) Aproximadamente 59% dos lactentes consumiram alimentos ultraprocessados, enquanto 29% apresentaram dieta diversificada. Crianças cujas mães residiam em municípios com prevalência de desnutrição infantil inferior a 10% (RP=1,66; IC95%=1,23-2,24), tinham escolaridade superior (RP=1,37; IC95%=1,18-1,60) e trabalhavam fora de casa (RP=1,29; IC95%=1,12-1,49) foram mais propensas a oferecer uma alimentação diversificada. O consumo de alimentos ultraprocessados foi maior entre lactentes cujas mães residiam em municípios com prevalência de desnutrição infantil inferior a 10% (RP=1,17; IC95%=1,04-1,31), eram mais jovens (RP=1,30; IC95%=1,15-1,46) e multíparas (RP=1,16; IC95%=1,03-1,30). Conclusões: A tese evidenciou o efeito independente de estratégias que integram a Política Nacional de Aleitamento Materno. Nascer em HAC, residir em município com maior disponibilidade de BLH e o direito à licença maternidade remunerada exercem influência positiva sobre a prática de AME. Este resultado aponta para a necessidade de expansão da cobertura dessas estratégias com vistas ao cumprimento das metas de AM propostas pela OMS. Foi detectado impacto de fatores individuais e contextuais sobre a qualidade da dieta que demandam o desenvolvimento de estratégias eficazes para aumentar o consumo de alimentos in natura ou minimamente processados e diminuir o consumo de ultraprocessados nesta população vulnerável. / Introduction: Low birth weight (LBW) represents a major risk to children. On the other hand, breastfeeding is recognized as the strategy with the greatest impact on reducing childhood mortality. Thus, exclusive breastfeeding (EBF) is recommended up to the sixth month of the child\'s life and should be complemented up to two years of age or more. Inadequate nutrition during early childhood is associated with early development of overweight, obesity, and other chronic diseases. Objectives: 1) To verify the breastfeeding pattern and complementary feeding practices of infants under one year of age who were born with low weight and, 2) to assess the influence of its individual and contextual determinants. Methods: This cross-sectional analysis included 5,115 infants less than one year of age born with LBW from the Second National Survey of Breastfeeding Prevalence (IIPPAM). The survey evaluated the situation of breastfeeding and complementary feeding in 64 Brazilian municipalities (including capitals and the Federal District). Dietary data was collected using a questionnaire with dichotomous questions about breastfeeding practices and consumption of foods from all food groups in the previous 24 hours. The thesis generated three manuscripts as follows: 1) The first one describes breastfeeding practices, consumption of any liquids (including non-human milk) and semi-solid foods in the last 24 hours, and indicators of young child feeding practices of infants between six and 11.9 months according to birth weight strata. 2) The second manuscript evaluates individual and contextual determinants of exclusive breastfeeding. 3) The third one assesses the influence of individual and contextual factors on dietary diversity and on consumption of ultraprocessed foods in LBW infants between six and 11.9 months of age. The individual-level-factors studied on manuscripts 2 and 3 were: socioeconomic (represented by the proxy maternal education), infants (age, sex), maternal (age range, work situation, parity), and health services (type of outpatient follow-up). The individual-level-factor \'being born in a Baby-Friendly Hospital (BFH)\' was also studied on manuscript 2. The community-level factors studied at the second level in the manuscript 2 included municipalities\' characteristics (number of Human Milk Banks (HMB) per thousand live births in each municipality in 2007, and Human Development Index of the municipality, used as proxy of poverty). The community-level factor studied at the second level in manuscript 3 was municipal prevalence of childhood malnutrition, used as a proxy for poverty. The individualized effect of the study factors on the outcome was evaluated using multilevel Poisson regression analysis. For all manuscripts, a significance level of 5% was adopted. Results: Summary of the findings of each manuscript produced: 1) In the stratum of very LBW, the rates EBF up to 60 and 90 days were higher among very LBW infants compared to others, however with overlapping confidence intervals. The overall prevalence of breastfeeding in infants under six months was similar among the groups. The rates of breastfeeding in the first hour of life and total breastfeeding were both higher among those born with weight between 2000 and 2499g. A high consumption of ultraprocessed foods was observed among infants aged 6|-9 and 9|-12 months, and it was noted that the higher the birth weight the higher was the prevalence of consumption. The prevalence of food groups consumption indicators are below the recommended. 2) EBF was more prevalent among infants born with LBW whose mothers were 20-35 years old, those who did not work outside the home or were on paid maternity leave; those born in a BFH; and those who lived in municipalities with the highest number of HMB per thousand live births. 3) Approximately 59% of infants consumed ultraprocessed foods, while 29% achieved dietary diversity. Mothers with the highest education level, those who worked outside the home, and who lived in municipalities with a prevalence of child malnutrition below 10% were more likely to offer a diverse diet. Consumption of ultra-processed foods was higher among infants whose mothers were younger, multiparous, and who lived in municipalities with a prevalence of child malnutrition below 10%. Conclusions: The thesis augments the evidence that integrated actions of the National Breastfeeding Program already implemented in Brazil - BFH Initiative, Brazilian Network of HMB, and adoption of labor laws for paid maternity leave - are associated with EBF even in the vulnerable population of infants born with LBW. Our results also suggest the need to expand and intensify the coverage of these strategies in order to meet the goals of breastfeeding proposed by the World Health Organization. Our findings also indicate the effects of individual and community-level factors on the dietary quality of this population, suggesting a need for developing effective strategies to increase consumption of unprocessed or minimally processed foods, while decreasing the ultra-processed counterpart for this vulnerable population.