Introdução: A adolescência é uma fase importante para formação e consolidação de hábitos alimentares adequados à promoção da saúde. Entretanto, dados estatísticos recentes indicam enorme comprometimento no padrão alimentar de indivíduos nesse período da vida. Objetivo: Avaliar a qualidade da dieta e identificar seus fatores associados em adolescentes de três regiões administrativas do município de Vitória. Métodos: Estudo transversal de base populacional com 396 adolescentes de ambos os sexos, de 8 a 17 anos, de escolas públicas e privadas de três regiões administrativas de Vitória-ES. Foram coletados dados antropométricos, socioeconômicos, demográficos e alimentares. Para a entrevista alimentar utilizou-se o método de Recordatório de 24h. A qualidade da dieta foi avaliada pelo Índice de Qualidade da Dieta adaptado (IQDa). Análises de regressão logística foram utilizadas para verificar a associação das variáveis independentes sobre a qualidade da dieta dos adolescentes. Resultados: A média do IQDa foi de 35,6 pontos. Os componentes verduras e legumes, leite e derivados e frutas apresentaram os mais baixos valores médios de pontos; e carnes e ovos apresentaram a pontuação média mais alta do IQDa. Na análise de regressão observou-se que quanto maior a idade, menor a pontuação do IQDa e que os adolescentes do sexo masculino apresentaram IQDa maior que as do sexo feminino. Conclusão: A qualidade da dieta está associada ao sexo e a idade e necessita de melhorias. Conhecendo esses fatores associados é possível analisar e identificar as práticas alimentares não saudáveis e abordá-las em programas de educação nutricional, proporcionando melhores condições de saúde a essa população. / Introduction: Adolescence is an important period for the formation and consolidation of proper eating habits for health promotion. However, recent statistics show huge impaired the eating patterns of individuals in this period of life. Objective: Evaluate the quality of diet and identify associated factors in adolescents from three regions of the city of Vitoria. Methods: Cross-sectional population-based study with 396 adolescents of both sexes, 8-17 years, of public and private schools in three administrative regions of Vitória-ES. Were collected anthropometrics, socio economic, demographic and dietary data. For the feed interview used the 24-hour recall method. The diet quality was evaluated by the Health Eating Index adjusted. Logistic regression analyses were used to evaluate the association of independent variables on diet quality of adolescents. Results: The average overall score was 35.6 points. The components leaves and vegetables, dairy products and fruit had the lowest average points; and meat and eggs had the highest average score of the index. The regression analysis showed that the higher the age, the lower the index score and that male adolescents had higher scores than the female. Conclusion: The quality of the diet is associated with sex and age and needs improvement. Knowing these factors associated is possible analyze and identify unhealthy eating habits and to address them in nutrition education programs, providing better health for this population.

Introdução Apesar da importância das habilidades culinárias para a alimentação saudável, estudos sobre este tema são escassos no Brasil. Objetivo Estudar a influência das habilidades culinárias dos pais (ou responsáveis) no consumo alimentar de crianças em idade escolar. Método Estudo epidemiológico observacional transversal seguido de estudo experimental, prospectivo, randomizado e controlado, envolvendo intervenção educativa para aperfeiçoamento das habilidades culinárias dos pais. A população do estudo observacional correspondeu a pares de pais-crianças em idade escolar de nove escolas da rede de ensino Sesi-SP, sendo cinco delas sorteadas como grupo-intervenção e quatro como grupo-controle. Como parte desta tese, desenvolveu-se e avaliou-se o Índice de Habilidades Culinárias - Brasil (IHC-Brasil), que mensura com uma escala entre zero e cem o grau de confiança das pessoas quanto ao desempenho de dez habilidades culinárias consideradas facilitadoras da implementação das recomendações do Guia Alimentar para a População Brasileira. Nas nove escolas, 755 pais responderam por telefone o questionário do IHC-Brasil e questões sobre o consumo alimentar da criança no jantar do dia anterior à entrevista (recordatório alimentar). Todos os pais do grupo-intervenção que responderam o questionário (n=341) foram convidados a participar de curso de dez horas idealizado pela autora desta tese e ministrado por nutricionistas da rede Sesi- SP visando aperfeiçoamento de habilidades culinárias. Os pais que aceitaram participar (n=81) foram pareados a pais do grupo controle segundo variáveis sociodemograficas. Utilizou-se regressão linear para testar a associação transversal entre habilidades culinárias dos pais e participação de alimentos ultraprocessados no jantar da criança, ajustando-se para variáveis sociodemográficas. O impacto da intervenção educativa nas habilidades culinárias dos pais e na alimentação da criança foi avaliado por mudanças temporais intra e inter-grupos utilizando-se modelos de regressão linear brutos e ajustados. Resultados O IHC-Brasil apresentou alpha de Cronbach > 0,70, kappa ponderado de 0,55 e kappa ajustado de 0,89. No estudo transversal, a idade média dos pais foi de 38,3 anos e a dos filhos de 7,8 anos. Os pais eram majoritariamente mulheres, brancos, casados, com ensino superior, empregados e com renda familiar per capita de 1-3 salários mínimos/mês. A média do IHC-Brasil desses pais (78,8) foi relativamente elevada. A média de energia consumida pelas crianças no jantar foi de 672,2kcal, sendo 31,3 por cento de alimentos ultraprocessados. No estudo transversal, evidenciou-se diminuição significativa do percentual de participação de alimentos ultraprocessados no jantar das crianças com o aumento do IHC-Brasil (= -2,9; p= 0,014; ajustado= -2,6; p=0,035). No estudo prospectivo não houve diferença significativa entre os grupos intervenção e controle com relação à mudança nas habilidades culinárias dos pais e à mudança na contribuição de alimentos ultraprocessados no jantar das crianças. Conclusões O IHC-Brasil apresentou elevada consistência interna e alta reprodutibilidade, recomendando-se seu uso em estudos que avaliem habilidades culinárias no Brasil. Os achados do estudo transversal mostram associação significativa e inversa entre habilidade culinária dos pais e consumo de alimentos ultraprocessados pelos filhos, mas a intervenção educativa não resultou em aumento nas habilidades culinárias dos pais nem no padrão alimentar do jantar das crianças / Introduction: Despite the importance of cooking skills for healthy eating, studies on this subject are scarce in Brazil. Objective -To study the influence of parents\' cooking skills on the quality of diet consumed at home among school-age children. Methods -Cross-sectional study, followed by an experimental, randomized and controlled study involving an educational intervention to improve parents\' cooking skills. The study population corresponds to child-parent pairs from nine private schools that provide integrated comprehensive services for students in São Paulo. Five schools were randomly allocated to the intervention group, and four to the control group. As part of this thesis, the Cooking Skills Index (CSI) was developed and evaluated. The CSI is a 0-100 index that measures the confidence regarding the performance of ten cooking skills considered facilitators to the implementation of the Brazilian Dietary Guidelines. Across the nine schools, 755 parents answered by telephone the CSI questionnaire and questions regarding their children food consumption at dinner the day before the interview (dietary recall). All the parents in the intervention group who answered the questionnaire (n=341) were invited to participate in a 10-hour course designed by the author of this thesis and taught by nutritionists from the partner schools in order to improve cooking skills. Parents who agreed to participate (n=81) were paired with parents of the control group according to sociodemographic variables.Linear regression analysis was used to test the association between the parents\' cooking skills and the contribution of ultra-processed foods to the total children\'s dinner energy intake, adjusted for sociodemographic variables. The impact of the educational intervention on parents\' cooking skills and on children\'s diet quality was assessed by temporal changes within and between groups using crude and adjusted linear regression models.Results -The CSIpresented Cronbach\'s alpha > 0.70, weighted quadratic kappa of 0.55, and adjusted kappa of 0.89. In the cross-sectional study the average age of the parents was 38.3 years old and of the children was 7.8. Parents were mostly women, white, married, college-educated, employed, with family per capita income of 1-3 minimum wages per month, and with high scores of cooking skills (CSI=78.8 points). Children\'s average dinner energy intake was 672.2 kcal, with 31.3% coming from ultra-processed foods. The cross-sectional study showed a significant decrease in ultra-processed food consumption at children\'s dinner with an increase of parents\' cooking skillsconfidence (?= -2.9; p= 0.014; adjusted ?=-2.6;p=0.035). Intheprospectivestudy, therewerenosignificantdifferencesbetweentheinterventionandthecontrolgroupregardingthetemporalchangesofparents\'cookingskills,aswellastheshareofultra-processedfoodsat children\'s dinner. Conclusions -The CSI showed high internal consistency and reproducibility, recommending its use in studies to evaluate cooking skills confidence in Brazil. The cross-sectional study indicated that the higher the parents\' cooking skills the lower the consumption of ultra-processed foods by their children, but the educational intervention neither resulted in the increase in parents\' cooking skills nor in changes in the dietary pattern of children\'s dinner.

Introdução. Apesar de consumirmos alimentos combinados e estruturados em refeições, a maioria dos estudos ainda se concentra em nutrientes ou alimentos consumidos isoladamente. Além disso, comparar a alimentação entre países em diferentes fases de transição nutricional e epidemiológica pode fornecer informações relevantes relacionadas à prevenção da obesidade e DCNT. Objetivo. Caracterizar e comparar a qualidade nutricional da principal refeição consumida por adultos residentes no Brasil e Reino Unido. Materiais e Métodos. A primeira etapa do estudo consistiu na revisão sistemática da literatura, que subsidiou a etapa seguinte, o desenvolvimento do Main Meal Quality Index. Para comparar a qualidade das refeições utilizou-se dados dos inquéritos alimentares Inquérito Nacional de Alimentação INA/POF 2008/09 e National Diet and Nutrition Survey - NDNS. Para a identificação e avaliação da qualidade da refeição utilizou-se duas diferentes abordagens: (1) abordagem híbrida, com a descrição da composição das refeições por meio da árvore de decisão de classificação, e (2) abordagem dirigida pela hipótese, através da aplicação do Main Meal Quality Index. Além disto foram analisados modelos de regressão múltipla a fim de identificar os fatores associados. Resultados. Considerando o horário de consumo e a contribuição energética, os eventos alimentares definidos como principal refeição foram o almoço, para o Brasil, e jantar, para o Reino Unido. A refeição principal brasileira (58 pontos) apresentou melhor qualidade nutricional, com maior participação de fibras e carboidratos, e menor teor de gorduras total e saturada, e densidade energética. No entanto, a principal refeição do Reino Unido (54 pontos) foi composta por mais frutas, verduras e legumes. Os ingredientes culinários, como arroz e feijão, foram classificados pelo algoritmo como componentes característicos da refeição brasileira, enquanto os itens de fast food, como batatas fritas, sanduíches e bebidas açucaradas, foram classificados como refeições Britânicas. No Brasil, o escore final do indicador associou-se positivamente com a idade, e negativamente com o gênero, energia consumida, estado nutricional e renda familiar; enquanto que, no Reino Unido, o indicador associou-se apenas com a idade (positivamente). Conclusão. Embora a principal refeição consumida no Brasil, quando comparada ao Reino Unido, apresente melhor qualidade e composição, as refeições consumidas em ambos os países estão aquém do recomendado. / Introduction. Although individuals consume foods combined and structured at meals, most authors still have studied nutrient or single food. Furthermore, compare countries in different stages of nutritional and epidemiological transition can provide relevant information related to the prevention of obesity and NCDs. Objective. To characterize and compare the nutritional quality of meals consumed by adults living in Brazil and UK. Subjects and methods. The first stage of the study consisted of a systematic review of the literature, which subsidized the next step, the development of the Main Meal Quality Index. Data from food surveys \"National Survey of Food - INA / HBS 2008/09\" and \"National Diet and Nutrition Survey - NDNS\" were used to analyzed and compare the main meals quality. Two different approaches for the identification and evaluation of the main meal pattern were used: (1) hybrid approach, to evaluate of the meal patters using data reduction techniques; and (2) hypothesis-driven approach, with the Main Meal Quality Index. Then, regression models were applied to analyzed associated sociodemographic factors. Results. Considering time slot and energy content, the eating events defined as main meal were lunch, for Brazil, and dinner, for UK. Brazilian main meal (58 points) had better nutritional quality, with greater participation of fiber and carbohydrates, and lower content of total and saturated fat, and energy density. However, the main meal consumed in UK (54 points) had more fruits and vegetables. Cooking ingredients, such as rice and beans, were classified as characteristic components of a Brazilian meal, while fast food items, like chips, sandwiches and sugary drinks, were classified as a British meal. In Brazil, the final score was positively associated with age, and negatively correlated with gender, energy consumption, nutritional status and family income; whereas, in the United Kingdom, the indicator is only associated with age (positively). Conclusion. Although Brazilian main meal, when compared with UK main meal, provide best quality and composition, meals consumed in both countries need improvement.

Magister Public Health - MPH / Background: It is gradually being recognized that understanding individual-level socioeconomic and environmental predictors of food purchasing and thus healthy eating, is imperative in order to develop appropriate nutrition and health interventions. Understanding the complex world of food choice requires a meticulous examination of stimuli and deterrents of food choice all of which should be viewed comprehensively to include micro-level compositional socioeconomic aspects of individuals as well as macro-level contextual influences of food cost, availability and accessibility. Aim: This study sought to uncover some of the widely known environmental (contextual) and compositional (individual-level) socioeconomic factors that influence Health Club Members’ (HCMs) ability to access and afford healthy foods within the community where they live. Study design: The research employed both descriptive quantitative and qualitative study designs. [VI] Study population and sample: The target population which was also the sample comprised 50 Health Club Members who were residing in Harare and the surrounding area within Khayelitsha at the time of the study. Data collection and analysis: Data was collected by means of face to face quantitative interviews with 46 HCMs using questionnaires, in-depth interviews with 10 HCMs, Key informant interviews with 2 Community Health Workers, as well as observations of the community food environment. Quantitative data was analyzed using SPSS version 16.0 and MS Excel 2007 for Windows. Qualitative analysis was executed using framework and content analysis techniques. Results and conclusion: The study established that low socioeconomic status, poor access to healthy food choices, and lack of constant availability of such foods were primary challenges facing some of the HCMs in their quest to afford and access healthy food. In order to promote access to and availability of affordable healthy foods in the study setting, there may be a need for addressing not only individual socioeconomic challenges but also more upstream environmental drivers of food purchasing. / Background: It is gradually being recognized that understanding individual-level socioeconomic and environmental predictors of food purchasing and thus healthy eating, is imperative in order to develop appropriate nutrition and health interventions. Understanding the complex world of food choice requires a meticulous examination of stimuli and deterrents of food choice all of which should be viewed comprehensively to include micro-level compositional socioeconomic aspects of individuals as well as macro-level contextual influences of food cost, availability and accessibility.Aim: This study sought to uncover some of the widely known environmental (contextual) and compositional (individual-level) socioeconomic factors that influence Health Club Members’(HCMs) ability to access and afford healthy foods within the community where they live.Study design: The research employed both descriptive quantitative and qualitative study designs.[VI]Study population and sample: The target population which was also the sample comprised 50 Health Club Members who were residing in Harare and the surrounding area within Khayelitsha at the time of the study.Data collection and analysis: Data was collected by means of face to face quantitative interviews with 46 HCMs using questionnaires, in-depth interviews with 10 HCMs, Key informant interviews with 2 Community Health Workers, as well as observations of the community food environment. Quantitative data was analyzed using SPSS version 16.0 and MS Excel 2007 for Windows. Qualitative analysis was executed using framework and content analysis techniques.Results and conclusion: The study established that low socioeconomic status, poor access to healthy food choices, and lack of constant availability of such foods were primary challenges facing some of the HCMs in their quest to afford and access healthy food. In order to promote access to and availability of affordable healthy foods in the study setting, there may be a need for addressing not only individual socioeconomic challenges but also more upstream environmental drivers of food purchasing.

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BACKGROUND: Low health literacy and numeracy are significant problems facing the United States. Recent research focuses heavily on the role health literacy and numeracy play in perception of disease risk, health care costs, all-cause mortality, and access to care; however, there has been relativity little emphasis on the relationships between health literacy or numeracy with health promotion behaviors, such as nutrition or physical activity. As our nation continues to face challenges with the high prevalence of obesity and other chronic diseases, it is increasingly important to understand the role that health literacy and numeracy play in nutrition and physical activity behaviors, as well as in the prevalence and control of chronic disease. PRIMARY AIMS: The proposed research is embedded within a larger randomized-control trial, Talking Health, which is a 2-arm behavioral trial targeting residents in eight counties in southwest Virginia with sugar-sweetened beverage (SSB) consumption as the primary outcome. The primary aims of this cross-sectional study, using baseline Talking Health data, are to 1) examine correlations among health literacy and numeracy measures, namely the Newest Vital Sign (NVS), separated by reading (NVS Reading) and math (NVS Math) scores, the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Subjective Numeracy Scale (SNS); 2) explore the relationships between demographic factors and the NVS, REALM, and SNS scores; 3) determine the relationships between the NVS, REALM, and SNS and dietary quality [i.e. Health Eating Index (HEI) scores], physical activity behaviors, and anthropometric and biological variables (body mass index, blood pressure, fasting blood lipids, and fasting blood glucose); and 4) determine if NVS, REALM, and SNS scores predict metabolic syndrome (MetS), while controlling for relevant demographic factors. METHODS: Eligibility requirements for the study include being 18 years of age or older, having reliable access to a telephone, drinking ≥200 kilocalories of SSB per day, and being a resident of Southwest Virginia. Using previously validated instruments and standardized data collection protocol, a variety of baseline variables was collected on 264 participants. Health literacy was measured using the NVS and REALM and health numeracy was measured using the SNS. Dietary intake was measured via three 24-hour dietary recalls and HEI scores were calculated. Physical activity behaviors were assessed using the Godin Leisure Time Exercise Questionnaire. Weight was measured using a calibrated digital Tanita scale (Model: 310GS), height was measured using a portable research-grade stadiometer, blood pressure measurements were made with an OMRON automated oscillometric device (Model: HEM-907XL), and fasting blood samples were obtained via a finger stick and the CardioChek PA system was used to assess blood glucose, cholesterol, and triglycerides. MetS scores were determined based on an adaptation of the National Cholesterol Education Program guidelines. Statistical analysis included descriptive statistics, simple correlations (Pearson bivariate), one-way ANOVAs, and regression models. RESULTS: Of 264 enrolled participants (mean age 41.1 + 13.5 years; 92.0% Caucasian; 81.8% female; 30.6% > high school education; 42% > $15,000 annual income), 33.7% were classified as having a high probability of low health literacy or possibility of low health literacy as measured by the NVS, 19.7% had less than a high school reading level as measured by the REALM, and 45.4% had low health numeracy as measured by the SNS. Additionally, 78.8% were overweight or obese and 29.0% meet the criteria for metabolic syndrome. Nine of the ten correlations between the NVS Total, NVS Reading, NVS Math, REALM, and SNS were statistically significant (p < .01, two-tailed). NVS scores were found to be significantly different by age (F = 2.36, p = .05), race (F = 4.49, p = .03), education level (F = 20.97, p < .001), and income (F = 13.88, p < .001); while REALM scores were only significantly different by race (F = 3.74, p = .05), education level (F = 21.06, p < .001), and income (F = 6.80, p < .001). SNS scores were significantly different by gender (F = 12.40, p = .001), education level (F = 11.01, p < .001), and income (F = 14.45, p < .001). Only systolic blood pressure, diastolic blood pressure, and strength training activity was found to be significantly different by health literacy and/or numeracy level; however, when controlling for hypertension medication use and/or demographic variables, only the relationship between health literacy (i.e, NVS) and strength training activity remained significant (R2 = 0.09, p = .01). Finally, health literacy and numeracy were not found to be predictive of metabolic syndrome while controlling for demographic variables. DISCUSSION: Although numerous demographic factors were related to baseline health literacy and numeracy levels, anthropometric/biological variables, physical activity behaviors, and diet quality did not differ by health literacy and health numeracy level, with the exception of systolic blood pressure and strength training activity. This research helps to fill the gaps in the literature surrounding the prevalence of health literacy, health numeracy, and health promoting behaviors and chronic disease among rural residents in medically underserved counties in southwest Virginia. While few cross-sectional relationships were found, future research from this RCT should examine if health literacy and health numeracy moderates or mediates intervention changes in anthropometric/biological variables, physical activity behaviors, diet quality, and metabolic syndrome scores. / Master of Science

It is unknown if participation in the Supplemental Nutrition Assistance Program (SNAP) influences the magnitude of improvement in dietary intake in response to dietary interventions. Adults with low socioeconomic status (SES) tend to have lower overall dietary quality as compared to those with higher SES. However, low SES adults are more likely to receive benefits from SNAP, which gives nutrition assistance to millions of eligible Americans. The objective of this investigation is to examine differences in dietary intake between 1) SNAP participants, 2) those eligible for SNAP but not receiving (nonparticipants), and 3) those ineligible for SNAP, in response to an intervention targeting a reduction in sugar-sweetened beverage (SSB) consumption. Adult participants (n=146) from Southwest Virginia were enrolled in a 6-month, community-based trial, SIPsmartER. Participants provided SNAP enrollment status and 3 24-hour dietary recalls at baseline and 6-months. Dietary variables (SSB, macronutrients, etc.) and dietary quality data (Healthy Eating Index [HEI-2010]) were derived from nutritional analysis software (NDS-R 2011). Statistical analyses included descriptives and repeated-measures ANOVA. Although SNAP participation and eligibility status did not impact the overall effectiveness of this dietary intervention, the within group data suggests that those eligible for SNAP but not participating (n=30) may be at a disadvantage to improving their dietary intake as compared to those at a similar household income who receive SNAP benefits (n=56) or ineligible individuals at a higher income level (n=60). Future research is needed to explore if participant's ability to maintain long-term adherence to the dietary changes differs between groups. / Master of Science

Introdução: O comportamento adotado na adolescência é de extrema importância por ser esta uma fase da vida de aprendizagem e formação. Os costumes adquiridos neste estágio constituirão a base da prática alimentar no futuro. Objetivo: Avaliar a qualidade da dieta e seus fatores associados em adolescentes residentes em regiões do Estado São Paulo. Métodos: Estudo transversal de base populacional de uma amostra de 1584 adolescentes, de ambos os sexos, com idade de 12 a 19 anos e 11 meses, incluídos no Inquérito de Saúde de São Paulo - ISA-SP, realizado em 2001-2002. Amostras probabilísticas em dois estágios, setor censitário e domicílio, foram tomadas de cada uma das quatro áreas estudadas (Distrito do Butantã, região sudoeste da grande São Paulo, municípios de Campinas e Botucatu). As informações sobre as características da população de estudo foram obtidas através de questionário e o consumo alimentar pelo Método Recordatório de 24 horas. A qualidade da dieta foi avaliada através do Índice de Qualidade da Dieta (IQD) adaptado para a realidade local. Foi utilizada análise de regressão linear para avaliar a relação entre o IQD e as variáveis independentes. Resultados: A média do IQD foi de 59,7 pontos. Da população estudada, 97,1% apresentou uma dieta inadequada ou que necessita de melhora, sendo que somente 2,9% dos adolescentes possuíam uma dieta considerada saudável de acordo com o IQD. Os valores médios dos componentes do IQD apresentaram-se mais baixos para frutas, leite e derivados e verduras e legumes. Os adolescentes do sexo masculino, praticantes de exercício físico e que residem em casa ou apartamento, apresentaram os maiores escores do IQD. Na análise de regressão linear múltipla, observou-se que quanto maior a idade, menor o IQD e que adolescentes residentes em casa ou apartamento têm um Índice de Qualidade da Dieta maior que os residentes em barraco ou cortiço, independente da idade e ingestão de energia. Conclusão: A qualidade da dieta está associada a melhores condições socioeconômicas e idade. Conhecendo esses fatores associados é possível adaptar políticas e programas de nutrição para atingir as necessidades desta população, prevenindo, principalmente, as doenças crônicas não transmissíveis na idade adulta. / Introduction: The behavior adopting on adolescence is of extreme importance to be a stage of life of learning and formation. The customs acquired in this stage will constitute the base for dietary behavior in the future.Objective: To evaluated the dietary quality and associated factors amog adolescents living in regions of the State of São Paulo.Methods: Cross-sectional population-based study with a sample of 1584 adolescents of both genders, at the age among 12 and 20 years, who were included in the Houschould Health Survey (ISA - SP), performed in 2001-2002. Probabilistic samples were obtained from multi-stage cluster samples (census tracts and homes) of four areas studied (Butantã District, Southwestern sector of the greater São Paulo region and municipality of Campinas and Botucatu). The data about population characteristics were obtained from questionary and the dietary intake by means of the 24- hour recall method. The dietary quality was measured by means of Health Eating Index (HEI), adapted to local realities. Linear regression analyses were performed to evaluated the relationship between HEI and independent variables.Results: Among the population assessed 97.1% presented a poor diet or a diet that needed of improvement and only 2.9% of adolescents had diet respected helthy agreed with the HEI. Average overall score was 59.7 points. Means scores for the index components were lower to fruits, dairy products and leaves and vegetables. Male adolescents, practitioners of physical exercise and residents of house or apartment, presented the major score of the HEI. In the multiple regression analyses, it was observed that the quality of the diet improve with decrease at the age and the adolescents lived in households or apartments have the major HEI than adolescents residents in shack or tenement slum, independent of the age and energy intake.Conclusion: The dietary quality is associated with higher income and age. Knowledge of these associated factors is possible to adapt politics and programs of nutrition to arrive the population´s needs, preventing , mostly, the chronic diseases no transmissible on adult age.

Objective. To determine the relationship between overall psychological well-being and stress on diet quality among young adult women and to examine the potential confounding influence of season, physical activity and sleep on these relationships. Design/Participants. The study used a cross-sectional design. Three hundred and fifty-one women were recruited to participate in the study. All participants were university students (20.2 ± 1.6 y). Overall psychological well-being was assessed using the General Well-being Schedule (GWB) and the Perceived Stress Scale (PSS). Diet intake was measured using three 24-hour recalls over a seven day period. The Healthy Eating Index (HEI) was calculated to assess diet quality. Physical activity (PA) and sleep were both measured objectively using accelerometers over seven consecutive days. Season of assessment was also included as a covariate. Results. The average HEI score was 59.3 ± 12.5 out of 100 and is classified as "Needs Improvement." The average GWB score was 72.8 ± 13.1 out of 110 which is on the border between "moderate distress" (61 to 72) and "positive wellbeing" (73 to 110). Significant relationships were seen with specific aspects of psychological well-being, however global psychological well-being as measured by the General Well-being schedule was not related to any measure of diet quality. Chronic stress was related to low adherence to dietary guidelines (F = 11.46 and p = 0.0008). Chronic stress was also related to low consumption of fruits and vegetables (F = 5.03, p = 0.0256). Feeling in control of emotions and behaviors was related to low consumption of non-nutrient dense foods (NNDF) (F = 3.33, p = 0.0198). Controlling for PA and sleep time reduced the magnitude of all of these relationships between 11% and 42%. Results from the PSS were positively related to the consumption of NNDF (F = 3.97, p = 0.0472). Controlling for PA and sleep time increased the magnitude of this relationship by 34%. Season had a negligible impact on any of the relationships between psychological well-being and any measure of diet quality. Conclusion. Subscales of psychological well-being such as chronic stress, acute stress, emotional behavioral control, and depression were related to diet quality. While these observed relationships were independent of the influence of season, physical activity and sleep, controlling for these variables had a moderating effect.