Eating behaviors, notably eating behaviors conceptualized as appetitive traits, have been suggested as important determinants of individual differences in body weight and thus overweight and obesity. Such appetitive traits include emotional overeating, food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating. Yet little is known about the factors that influence the development of these appetitive traits. Therefore, the current study prospectively investigated a range of predictors of appetitive traits related to both individual child characteristics and parent factors in a large population-based sample of children followed from age 6 to 8 years (N = 689). When adjusting for the initial levels of the specific appetitive trait in question at age 6 and the other predictors, the results showed that instrumental feeding and low levels of effortful control predicted emotional overeating at age 8, whereas instrumental feeding and parental restrained eating predicted food responsiveness at age 8. Enjoyment of food, satiety responsiveness and slowness in eating were not affected by any of the predictors investigated in this study. In conclusion, these findings support low effortful control and instrumental feeding as predictors of emotional overeating, and instrumental feeding and parental restrained eating as predictors of food responsiveness. These findings are relevant in providing a better understanding of the development of children’s eating behaviors, in addition to informing prevention and treatment strategies for childhood obesity.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / INTRODUCTION: Since the start of the Prevention of Mother-to-Child Transmission (PMTCT) Programme at Dr George Mukhari Hospital in 2001, there has been no evaluation of the effect of formula feeding on the growth and dietary intakes of enrolled infants. AIM: The aim of this study was to determine the short-term growth, anthropometry and dietary intake of infants from two to ten weeks of age were entered into the PMTCT Programme at the Department of Human Nutrition at Dr George Mukhari Hospital from two to ten weeks of age. METHODS: This was a descriptive, longitudinal (eight weeks duration) study. Anthropometric assessment including length and head circumference was performed at two weeks of age and thereafter at ten weeks of age. Weight measurement was performed at age two weeks (visit 1), six weeks (visit 2) and ten weeks (visit 3). Anthropometric measurements were compared with CDC 20003 growth charts. Feeding practices and dietary intake (24 hour diet recall interview) were assessed at each of the four week interval visits and evaluated according to the DRIs59. At the third visit, a socio-demographic interview and a usual food intake interview were performed. RESULTS: A total of 151 [male (N = 75) and female (N = 76)] infants completed the study. A total of 110 (72%) mothers resided in the Soshanguve area and 138 (91%) of the mothers had attended high school. The majority (75%) of mothers was not generating an income from employment. Generally, mothers had access to safe drinking water and all (99%) but two mothers used pre-boiled water before preparing infant formula. The accuracy and correctness of reconstituting infant formula decreased with each visit as feeds were increasingly made too dilute. A total of 124 (82%) infants were exclusively formula fed. The remainder received water, water with sugar and/or complementary feeds. Mean energy and macronutrient intakes of both males (N = 65, 87%) and females (N = 61, 80%) were below recommendations at age two weeks. Of all the macronutrients, fats were consumed the least by both males (N = 67, 89%) and females (N = 66, 87%) at visit 1. Catch up growth was evident and nutrient intakes improved as the study progressed. The mean weight gain of all infants from visit 1 to 2 was 1.2 (SD 0.3) kg and 0.9 (SD 0.3) kg from visit 2 to 3 (exceeding the CDC 20003 recommendation for both male and female infants). The incidence of underweight, wasting and head circumference-for-age below the third percentile decreased from visit 1 to 3, but the number of stunted infants increased towards visit 3. The majority of infants in this study grew well in their first ten weeks of life. Growth accelerated as infants became older and growth faltering improved by ten weeks of age. CONCLUSION: Overall, the growth of the infants referred to the PMTCT Programme at the Department of Human Nutrition at Dr George Mukhari Hospital would appear to be adequate but mothers’ approach to formula feeding practices needs to be improved in some aspects of feeding their infants.

Este trabalho avaliou [1] os fatores associados à ocorrência de restrição ao ganho de peso observada na alta hospsitalar e [2] a associação entre as práticas de alimentação e o ganho de peso durante a internação, em recém-nascidos prematuros de muito baixo peso de nascimento (501 a 1.499g) na maternidade do Hsopital Geral de Bonsucesso (Rio de Janeiro). Os dados foram coletados de forma retrospectiva para os nascimetnos do período compreendido entre junho de 2002 a junho de 2004. Do total de 247 recém-nascidos incluídos no estudo, 203 tiveram alta hospitalar. As características ao nascimento, asmorbidades e as práticas de alimentação foram levantadas dos prontuários de acordo com um questionário de pesquisa. O menor peso de nascimento, ser pequeno para idade gestacional-percentil 3, o maior escore CRIB e a ocorrência de sepse foram associados à ocorrência de restrição ao ganho de peso extra-uterino na alta. Das cento e cinquenta e oito crianças com peso adequado ao nascimento, sessenta e nova (43,7%) encontravam-se com peso abaixo do 3 percentil na alta. Nesses casos de restrição ao ganho de peso foram preditores: a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas, embora a capacidade de explicação do modelo tenha sido pequena (14%). Estas situações merecem destaque na prática neonatal, pois podem ser marcadores de um pior desempenho no que diz respeito ao ganho de peso durante a internação. Uma vez que as morbidades explicaram pouco a c]ocorrência de restrição ao ganho de peso extra-uterino, em especial os casos intrahospitalares. Foi analisada a associação entre evolução do peso nos primeiro dois meses de vida e as práticas de alimentação. Utilizando a análise de regressão longitudinal de efeitos mistos foi observado que o número de dias para o início de dieta enteral, de dias para atingir a dieta plena, de dias para início de dieta parenteral e de dias de uso de dieta parenteral, influenciaram a evolução precoce do peso (até 17 dia). O número de dias para início da dieta parenteral não influenciou a evolução do peso após o 17 dia de vida. Os resultados do presente estudo sugerem 1) que o menor peso de nascimento, ser pequeno para idade gestacional, ter maior escore CRIB e a ocorrência de sepse associam-se a ocorrência de restrição ao ganho de peso extra-uterino; 2) dentre os recém-nascidos com peso apropriado ao nascimento, a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas associaram-se a um pior desempenho ponderal; 3) que as práticas de alimentação decididas precocemente associam-se ao ganho de pseo intra-hospitalar e a revisão destas pode melhorar o desempenho ponderal de recém-nascidos prematuros de muito baixo peso de nascimento. / This paper evaluated [1] factors associated to weight gain restriction at discharge and [2] the association between feeding practices and weight gain during hospitalization in very low birth weight infants (501 to 1.499) at Hospital Geral de Bonsucesso (Rio de Janeiro). Data were collected from hospital charts including all births between June 2002 and June 2004. Two hundred forty-seven alive-births were included and 203 of them were discharged from hospital. Birth characteristics, illness and feeding practices were registered. A lower birth weight, small for gestational age (third percentile), a higher CRIB score and sepsis were factor associated to weight gain restriction at discharge. Among those appropriate at birth (158), sixty-nine (43.7%) children were below the third percentile at discharge. Those cases of weight gain restriction were associated to sepsis, metabolic bone disease and higher number of blood transfusions, although the model poorly explained them (14%). These illness (or exposures) may be markers of a worse weight performance during hospitalization. As morbidities poorly explain weight gain restriction at discharge, particularly the inhospital cases. We analyzed the association between feeding practices and inhospital weight gain. By using mixed effects longitudinal regression we observed that the number of days to start enteral feedings, to achieve full enteral feeding, to start parenteral nutrition and days on th parenteral nutrition were associated to the initial weight variation (until the 17day). The number of days to begin parenteral nutrition did not influence weight variation after the 17day of life. This study results suggest 1) that a lower birth weight, small for gestational age, a higher CRIB score and sepsis are associated to weight gain restriction at discharge; 2) among those appropriate at birth, the occurrence of sepsis, metabolic bone disease and higher number of blood transfusion area associated to a worse inhospital weight performance; 3) that feeding practices, decided at the first days of life influence weight gain along the hospitalization and by reviewing those practices we might improve inhospital weight performance of preterm very low birth weight infants.

Este trabalho avaliou [1] os fatores associados à ocorrência de restrição ao ganho de peso observada na alta hospsitalar e [2] a associação entre as práticas de alimentação e o ganho de peso durante a internação, em recém-nascidos prematuros de muito baixo peso de nascimento (501 a 1.499g) na maternidade do Hsopital Geral de Bonsucesso (Rio de Janeiro). Os dados foram coletados de forma retrospectiva para os nascimetnos do período compreendido entre junho de 2002 a junho de 2004. Do total de 247 recém-nascidos incluídos no estudo, 203 tiveram alta hospitalar. As características ao nascimento, asmorbidades e as práticas de alimentação foram levantadas dos prontuários de acordo com um questionário de pesquisa. O menor peso de nascimento, ser pequeno para idade gestacional-percentil 3, o maior escore CRIB e a ocorrência de sepse foram associados à ocorrência de restrição ao ganho de peso extra-uterino na alta. Das cento e cinquenta e oito crianças com peso adequado ao nascimento, sessenta e nova (43,7%) encontravam-se com peso abaixo do 3 percentil na alta. Nesses casos de restrição ao ganho de peso foram preditores: a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas, embora a capacidade de explicação do modelo tenha sido pequena (14%). Estas situações merecem destaque na prática neonatal, pois podem ser marcadores de um pior desempenho no que diz respeito ao ganho de peso durante a internação. Uma vez que as morbidades explicaram pouco a c]ocorrência de restrição ao ganho de peso extra-uterino, em especial os casos intrahospitalares. Foi analisada a associação entre evolução do peso nos primeiro dois meses de vida e as práticas de alimentação. Utilizando a análise de regressão longitudinal de efeitos mistos foi observado que o número de dias para o início de dieta enteral, de dias para atingir a dieta plena, de dias para início de dieta parenteral e de dias de uso de dieta parenteral, influenciaram a evolução precoce do peso (até 17 dia). O número de dias para início da dieta parenteral não influenciou a evolução do peso após o 17 dia de vida. Os resultados do presente estudo sugerem 1) que o menor peso de nascimento, ser pequeno para idade gestacional, ter maior escore CRIB e a ocorrência de sepse associam-se a ocorrência de restrição ao ganho de peso extra-uterino; 2) dentre os recém-nascidos com peso apropriado ao nascimento, a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas associaram-se a um pior desempenho ponderal; 3) que as práticas de alimentação decididas precocemente associam-se ao ganho de pseo intra-hospitalar e a revisão destas pode melhorar o desempenho ponderal de recém-nascidos prematuros de muito baixo peso de nascimento. / This paper evaluated [1] factors associated to weight gain restriction at discharge and [2] the association between feeding practices and weight gain during hospitalization in very low birth weight infants (501 to 1.499) at Hospital Geral de Bonsucesso (Rio de Janeiro). Data were collected from hospital charts including all births between June 2002 and June 2004. Two hundred forty-seven alive-births were included and 203 of them were discharged from hospital. Birth characteristics, illness and feeding practices were registered. A lower birth weight, small for gestational age (third percentile), a higher CRIB score and sepsis were factor associated to weight gain restriction at discharge. Among those appropriate at birth (158), sixty-nine (43.7%) children were below the third percentile at discharge. Those cases of weight gain restriction were associated to sepsis, metabolic bone disease and higher number of blood transfusions, although the model poorly explained them (14%). These illness (or exposures) may be markers of a worse weight performance during hospitalization. As morbidities poorly explain weight gain restriction at discharge, particularly the inhospital cases. We analyzed the association between feeding practices and inhospital weight gain. By using mixed effects longitudinal regression we observed that the number of days to start enteral feedings, to achieve full enteral feeding, to start parenteral nutrition and days on th parenteral nutrition were associated to the initial weight variation (until the 17day). The number of days to begin parenteral nutrition did not influence weight variation after the 17day of life. This study results suggest 1) that a lower birth weight, small for gestational age, a higher CRIB score and sepsis are associated to weight gain restriction at discharge; 2) among those appropriate at birth, the occurrence of sepsis, metabolic bone disease and higher number of blood transfusion area associated to a worse inhospital weight performance; 3) that feeding practices, decided at the first days of life influence weight gain along the hospitalization and by reviewing those practices we might improve inhospital weight performance of preterm very low birth weight infants.

La production porcine européenne fait face à des enjeux économiques et environnementaux. Les outils d’aide à la décision peuvent aider les éleveurs à tester les effets des facteurs d’élevage sur leur système de production. Nous avons développé un modèle individu-centré de l’atelier d’engraissement porcin, qui intègre la variabilité des performances entre individus, la conduite d’élevage, et estime les résultats technico-économiques (ECO) et les impacts environnementaux (ENV) de l’atelier. L’analyse de sensibilité a montré que le comportement du modèle est cohérent et que les variables d’entrée les plus influentes sont les caractéristiques des porcs. La comparaison des valeurs prédites et observées nous a permis de construire un processus de paramétrage et a montré que le modèle fournit des estimations fiables des résultats ECO et ENV de l’atelier.Une expérimentation virtuelle a été effectuée pour évaluer les effets combinés des pratiques d’alimentation, du statut sanitaire du troupeau, et des infrastructures. Le statut sanitaire a un impact majeur sur les résultats ECO et ENV, pouvant être atténué par le choix de la conduite en bandes et de la stratégie d’alimentation. S’approcher au plus près des besoins nutritionnels individuels des porcs semble être une solution appropriée pour améliorer le revenu de l’élevage et réduire ses impacts quel que soit son statut sanitaire. Ce modèle sera inclus dans un outil d’aide à la décision construit en accord avec les résultats de l’analyse de sensibilité et le processus de paramétrage développé. / European pig production is facing economic and environmental challenges. Decision support tools can help farmers testing the effects of rearing factors on their production system. For this purpose, we developed an individual-based model of the pig fattening unit which includes farmers’ practices, individual variability in performance among pigs and, and estimates economic results (ECO) and environmental impacts (ENV) of the unit. Global sensitivity analysis has shown that the model behavior is consistent and that the most influent input variables are related to the pigs’ characteristics. Formal comparison of predicted with observed data has enabled us to produce a process for parameterisation of the model and has shown that the model provides reliable estimates of ECO and ENV.A virtual experiment using the model was designed in order to evaluate the combined effects of feeding practices, health status of the pig herd, and infrastructure on technical performance, ECO and ENV of the unit. Health status has the major impact on unit performance but this effect can be reduced through batch management and feeding strategies. Approaching more closely the individual pigs’ nutritional requirements seems to be an appropriate solution to increase farm income and to reduce environmental impacts regardless the health status. The model will be included into a decision support tool designed according to the influent inputs resulting from the sensitivity analysis and the parameterisation process

A refeição familiar desempenha uma função estruturante das relações sociais, mas os convívios comensais de jovens órfãos com suas famílias podem ser afetados no contexto da orfandade pelo HIV/AIDS. Como parte de um projeto de pesquisa temático sobre Estigma e Discriminação relacionados ao HIV/AIDS, realizou-se um estudo para apreender os aspectos condicionantes das refeições familiares e caracterizar os convívios comensais de jovens órfãos pela AIDS em São Paulo. Portanto, realizou-se um estudo transversal com abordagem qualitativa e quantitativa a partir de perspectiva interdisciplinar entre antropologia da alimentação, saúde pública e ecologia cultural. Na fase qualitativa, foram utilizadas 19 entrevistas com jovens órfãos pela AIDS. As narrativas foram percorridas em busca de categorias contextuais e da sincronia de convívios espaciais e temporais para refeições. Na abordagem quantitativa, utilizou-se amostra com 276 jovens órfãos pela AIDS. Foram realizadas análises descritivas dos dados com distribuição de frequências e posteriormente foi aplicado o teste de Rao Scott. Os testes foram conduzidos em nível de significância de 5% e poder de teste de 80%. Para realização destas análises utilizou-se do programa STATA 10.0. As metodologias foram consideradas complementares e o processo de construção da análise foi desenvolvido a partir da ideia de artesanato intelectual proposta por Wright Mills (2009). Os resultados demonstraram que (1) a refeição familiar reflete a estrutura familiar; (2) a refeição atua como eixo da sincronia familiar em ritmos temporais e espaciais, e (3) as refeições refletem as mudanças nos convívios contemporâneos e os compromissos temporais com a família favorecem a adaptabilidade do jovem órfão em contexto urbano. / The family meal plays a structuring role in social relations, but commensal gatherings of young orphans and their families might be affected in the context of orphaned by HIV/AIDS. As part of a themed research project on Stigma and Discrimination Related to HIV/AIDS, this study was conducted in order to understand all conditioning aspects of family meals and to characterize commensal gatherings of young people orphaned by AIDS in São Paulo. For such, we performed a crosssectional study with qualitative and quantitative approaches from an interdisciplinary perspective between food anthropology, public health and cultural ecology. In the qualitative phase, interviews with 19 young people orphaned by AIDS were used. The narratives were covered in search of contextual categories and synchrony of spatial and temporal gatherings for meals. The quantitative approach was used to sample 276 young people orphaned by AIDS. Descriptive analyzes of the data with frequency distribution were performed and then the Rao Scott test used. Tests were conducted at a significance level of 5% and power of 80%. For these analyzes we used the STATA 10.0 software. The methodologies were complementary and stemmed from the idea of intellectual craft proposed by Wright Mills (2009). The results showed that (1) the family meal reflects the family structure; (2) the meal acts as an axis of family synchrony in spatial and temporal rhythms, and (3) meals reflect changes in contemporary gatherings and family time commitments promote the adaptability of the young orphan in an urban context.

Master of Public Health - MPH / A matched case-control study was carried out to identify the factors associated with the nutritional status of children in Livingstone district, Zambia. A trained field researcher collected data on demographic, feeding practices and socio-economic factors in matched groups of underweight children and normal weight children from the mothers/caregivers of the children. Interviews, using a structured pre-tested questionnaire, were used to obtain the data. All children aged from six to fifty-nine months admitted at Livingstone General Hospital during the months of October to December, 2003 with a weight for age below –2SD from the median of the reference population formed the underweight children (cases). The total was 47 children. The cases were then matched according to sex and age to 47 normal weight children attending the under five clinic at Livingstone General Hospital during the same months, with a weight for age above –2SD from the median of the reference population (controls). The final sample was 94 children. Weights were recorded using the same scale in the outpatient’s department prior to admission and during the under five clinic session. Interviews then took place in a separate room after the clinic nurse had attended them. A separate visit was then made to the homes of the children on a different day. Odds ratios and 95% confidence intervals were used to measure strengths of associations. Results revealed that the basic causes of underweight were the poor economic state of the country, unfavorable policies and insufficient government support in the areas of health, education, agriculture, housing and employment. Underlying causes were inadequate access to food, inadequate care of children, poor access to health services and unhealthy living environments, while immediate causes were poor food intake and disease. Low educational and literacy levels of the mothers/caregivers, unemployment and lack of sufficient finances to access basic necessities such as food, housing and health contributed to underweight. / South Africa

Diversas alterações no âmbito social, cultural, político e econômico no Brasil repercutiram na forma como os serviços de saúde têm se organizado para atender às demandas atuais. A psicologia da saúde tem contribuído para iniciativas de promoção da saúde e o diálogo entre esses dois campos parece promissor. O objetivo deste estudo foi examinar criticamente um processo de grupo de aconselhamento para reeducação alimentar, em curso no Centro de Promoção da Saúde do Serviço de Clínica Geral do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Este estudo qualitativo utilizou: uma entrevista estruturada no início da atividade do grupo, a observação das sessões de grupo, uma entrevista semi-estruturada ao final, e um grupo focal 10 meses depois dos grupos encerrados. A análise dos resultados foi realizada através da categorização do material colhido no diário de campo, nos relatórios e transcrição de grupos e entrevistas, organizados através da análise de conteúdo. A análise crítica dos modos de realização do modelo proposto no serviço foi orientada pelos quadros teóricos da vulnerabilidade (individual, programática e social) e da emancipação psicossocial, e inspirada na metodologia de “cenas”, tal como desenvolvida no campo da prevenção do HIV e da aids. Nos resultados descreveu-se: o perfil dos participantes; as motivações, as definições de saúde e de promoção de saúde, com percebem o HC; o estabelecimento do setting e da coordenação; a linguagem e a dinâmica da interação; o compartilhamento e a importância dos outros significativos; as cenas de adesão ou não adesão às recomendações e o contexto sócio-cultural. Conclui-se com sugestões para a reorganização do programa, o treinamento continuado de profissionais envolvidos na promoção da saúde e para novos estudos relevantes para intervenções afins. / Several changes at the Brazilian social, cultural, political and economical scope have influenced the way health services have been organized in order to attend the present demand. Health psychology has contributed for health promotion initiatives and the dialogue between these areas seems promising. The objective of this study was to critically examine the group counseling process for nutrition reeducation held in the Center of Health Promotion of the General Clinic Service of Medicine School of the University of São Paulo, regarding its aims and the progress as seen by its participants. This qualitative study began with a structured interview at the beginning of the group activities, followed by the observation of all group sessions, a semi-structured interview at the end, and a focus group ten months after the groups were finished. The analysis used the categorization of data collected on the field journal, the reports and the transcription of group sessions and interviews, organized through content analysis. The frameworks for critical analysis of the implementation of the proposed model were the notion of vulnerability (individual, programmatic and social) linked to a psychosocial emancipatory approach, inspired by the use of scenes as a data collection and intervention procedure, as in the field of HIV/aids prevention. The results sessions described: the participants’ profile; the motivations and the definitions of health and health promotion, and how they perceive the HC; the setting establishment and the coordination; the language and the interaction dynamic; the sharing and the relevance of significant others; adherence and non- adherence scenes and the socio-cultural context. The present study concluded with suggestions for the reorganization of the program, for the ongoing training of professionals involved in health promotion, and for new studies aiming similar interventions.