Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-27T13:21:42Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Nicolly Patrícia Gregório.pdf: 1566405 bytes, checksum: 77cabf76d8cbb32a6ed2bab269b9b347 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-28T10:59:46Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Nicolly Patrícia Gregório.pdf: 1566405 bytes, checksum: 77cabf76d8cbb32a6ed2bab269b9b347 (MD5) / Made available in DSpace on 2015-01-28T10:59:46Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Nicolly Patrícia Gregório.pdf: 1566405 bytes, checksum: 77cabf76d8cbb32a6ed2bab269b9b347 (MD5) Previous issue date: 2014-03-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study aimed to characterize the exercise of professional nutritionist in the National School Feeding Program and its association with food and nutrition education. Is an analytic cross-sectional descriptive study realized in 432 municipalities in the North, Northeast, Midwest, Southeast and South regions, by telephone interview, from April 2012 to November 2013. Interviews were conducted with the nutritionist responsible for school feeding in the municipalities, in the absence, was replaced by the coordinator of school feeding or municipal secretary of education. For writing this dissertation became a division of the study and considered only the interviews with the nutritionist. Descriptive analyzes were performed, to verify the association between the dependent variable and the explanatory variables the values of the correlation coefficient Cramer's V were estimated. To verify the hypothesis, the Pearson’s chi-square test or Fisher's Exact was conducted. We considered statistical significance level of 5%. Of the 384 study participants nutritionists, the principal information in relation to this observed in professional school feeding were: 84,9% had food and nutrition education, 50,2% had worked for more than two years, 56% were gazetted and 59,6 % worked with higher workload to 30 hours/week. The dedication in other sectors of the municipality besides school feeding was reported by 23,7% of interviewees being most prevalent (89%), the health sector. The presence of other nutritionists in school feeding, besides the technical manager, was found in only 20% of municipalities. These were found in 54% of the municipalities the presence of more than two professionals in the technical framework. Among them was founded the presence of more than two professionals in the technical framework in 54%. Analyses indicated relatively strong association, statistically significant, between the realization of food and nutrition education to employment in the North region (Cramér V = 0.42, p = 0.02). We conclude that most nutritionists school feeding worked for more than two years in school feeding with higher workload to 30 hour week and are public employees. These elements tend to contribute positively to the realization of food and nutrition education in school feeding. / Este estudo teve como objetivo caracterizar o exercício profissional do nutricionista no Programa Nacional de Alimentação Escolar e sua associação com a educação alimentar e nutricional. Trata-se de um estudo transversal, descritivo e analítico, realizado em 432 municípios das regiões Norte, Nordeste, Centro-Oeste, Sudeste e Sul, por meio de entrevista telefônica, no período abril de 2012 a novembro de 2013. As entrevistas foram realizadas com o nutricionista responsável pela alimentação escolar do município, na ausência, era substituído pelo coordenador da alimentação escolar ou secretário municipal de educação. Para a escrita desta dissertação fez-se um recorte do estudo e considerou somente as entrevistas realizadas com o nutricionista. Foram realizadas análises descritivas e para verificar a associação entre a variável dependente e as variáveis explicativas foram estimados os valores do coeficiente de correlação V de Cramér. Para verificar a hipótese foi realizado o teste de qui-quadrado de Pearson ou Exato de Fischer. Considerou-se o nível de significância estatística de 5%. Dos 384 nutricionistas participantes do estudo, as principais informações observadas em relação a estes profissionais que atuam na alimentação escolar foram: 84,9% realizavam educação alimentar e nutricional; 50,2% atuavam há mais de dois anos; 56% eram concursados e 59,6% trabalhavam com carga horária superior a 30 horas/semanais. A dedicação em outros setores da prefeitura, além da alimentação escolar foi relatada por 23,7% dos entrevistados, sendo, mais prevalente (89%), o setor da saúde. A presença de outros nutricionistas na alimentação escolar, além do responsável técnico, foi constatada em apenas 20% dos municípios. Destes foi verificada em 54% dos municípios a presença de mais de dois profissionais no quadro técnico. As análises indicaram associação relativamente forte, estatisticamente significativa, entre a realização de educação alimentar e nutricional e o vínculo empregatício na região Norte (V Cramér=0,42; p=0,02). Conclui-se que a maioria dos nutricionistas da alimentação escolar atuava há mais de dois anos na alimentação escolar com carga horária superior a 30 horas semanais e são servidores concursados. Estes elementos tendem a contribuir positivamente para a realização de educação alimentar e nutricional na alimentação escolar.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-03-06T18:52:52Z No. of bitstreams: 2 Dissertação - Géssica Mercia de Almeida - 2014.pdf: 2301540 bytes, checksum: 2d9e1272b61b9b77b357379d444ddf1f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-03-06T18:53:09Z (GMT) No. of bitstreams: 2 Dissertação - Géssica Mercia de Almeida - 2014.pdf: 2301540 bytes, checksum: 2d9e1272b61b9b77b357379d444ddf1f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-06T18:53:09Z (GMT). No. of bitstreams: 2 Dissertação - Géssica Mercia de Almeida - 2014.pdf: 2301540 bytes, checksum: 2d9e1272b61b9b77b357379d444ddf1f (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-12-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study aimed to analyze the actions of food and nutrition education at the National School Feeding Programme in Brazilian towns. It is a cross-sectional descriptive and analytical study, conducted through telephone interviews during the period from April 2012 to November 2013. The survey was developed with school feeding’s nutritionists from 388 towns distributed proportionally between the North, Northeast, Southeast, South and Midwest regions. The studied variables included: actions of food and nutrition education and their frequency, social actors involved, form of guidance for achieving food and nutrition education, inclusion of food and nutrition theme in Political Pedagogical Project and the difficulties in achieving food and nutrition education. Statistical analyses were performed using the χ2 Fisher’s test or Pearson’s exact test, beyond the multivariate logistic regression, with a significance level of 5% model. Out of the 388 interviewed nutritionists, 85.1% perform actions of food and nutrition education in schools and day care centers, with the highest frequency in the South region (94.6%) and lowest in the Northeast (79.2%) (p = 0.04). The actions of food and nutrition education are predominantly developed through lectures, with biannual frequency, with the participation of the pedagogical coordinator and teacher in the planning and execution of these practical activities. In less than half of the towns, the food and nutrition issues are worked into the school curriculum, with emphasis on the discipline of Sciences. When nutritionists orient the social actors in schools and day care centers through training activities on healthy eating, reduce the chances by 61% of inclusion of food and nutrition education in the Pedagogical Political Project. It is possible to suggest that these formations present weaknesses and limitations and is not a satisfactory strategy for entering these educational practices at school. The actions of food and nutrition education are focused on a traditional model of education, punctually and with little articulation with the school curriculum. It is hoped that the information presented can support nutritionists, school community and trainers and regulatory agencies of the profession, in the search for new approaches in order to encourage and qualify the actions of food and nutrition education in schools. / Esse estudo objetivou analisar as ações de educação alimentar e nutricional do Programa Nacional de Alimentação Escolar de municípios brasileiros. Trata-se de um estudo transversal, descritivo e analítico, realizado por meio de entrevistas telefônicas, no período de abril de 2012 a novembro de 2013. A pesquisa foi desenvolvida com nutricionistas da alimentação escolar de 388 municípios brasileiros distribuídos proporcionalmente entre as regiões Norte, Nordeste, Sudeste, Sul e Centro-Oeste. As variáveis estudadas incluíram: ações de educação alimentar e nutricional e sua frequência, atores sociais envolvidos, forma de orientação para realização da educação alimentar e nutricional, inserção do tema alimentação e nutrição no Projeto Político Pedagógico e as dificuldades para a realização da educação alimentar e nutricional. As análises estatísticas foram realizadas utilizando o teste χ2 de Person ou Exato de Fisher, além do modelo de regressão logística multivariada, com um nível de significância de 5%. Dos 388 nutricionistas entrevistados, 85,1% realizam ações de educação alimentar e nutricional nas escolas e creches, sendo a frequência maior na região Sul (94,6%) e menor na Nordeste (79,2%) (p=0,04). As ações de educação alimentar e nutricional são desenvolvidas predominantemente por meio de palestras, com frequência semestral, contando com a participação do coordenador pedagógico e do professor nas atividades de planejamento e execução dessas práticas. Em menos da metade dos municípios, os temas alimentação e nutrição são trabalhados no currículo escolar, com destaque para a disciplina de Ciências. Quando os nutricionistas orientam os atores sociais nas escolas e creches por meio de atividades de formação sobre alimentação saudável, diminuem as chances em 61% de inserção da educação alimentar e nutricional no Projeto Político Pedagógico. É possível sugerir que essas formações apresentem fragilidades e limitações, não sendo uma estratégia satisfatória para a inserção dessas práticas educativas na escola. As ações de educação alimentar e nutricional estão voltadas para um modelo tradicional de educação, de modo pontual e com pouca articulação com o currículo escolar. Espera-se que as informações apresentadas possam subsidiar nutricionistas, comunidade escolar e órgãos formadores e fiscalizadores da profissão, na busca de novas abordagens com o intuito de fomentar e qualificar as ações de educação alimentar e nutricional na escola.

A educação alimentar é uma abordagem reconhecidamente eficaz para transformação, recuperação e promoção de hábitos saudáveis, sendo muito utilizada no manejo dietético do tratamento da obesidade. No entanto, a manutenção da perda de peso nem sempre é satisfatória, dada a dificuldade de incorporação de novos hábitos como rotina de vida. O objetivo deste estudo foi investigar mudanças comportamentais em adultos com excesso de peso após um programa educativo e os fatores associados à sua manutenção. Para tanto, dados sociodemográficos, antropométricos, de imagem corporal, fatores comportamentais e relativos à saúde foram coletados de 94 adultos com excesso de peso, de ambos os sexos, participantes do Programa de Educação Alimentar da Universidade de São Paulo - PRAUSP, no período de 2005 a 2009. Os indivíduos foram divididos nos grupos intervenção - GI (frequência mínima de 70%; n=64) e abandono - GA (frequência inferior a 30%; n=30) sendo que as informações foram obtidas no início (GI e GA) e final da intervenção (GI) por meio de um banco de dados, e no momento atual (GI e GA) por entrevista estruturada. Comparações intra-grupos foram realizadas para avaliar alterações ocorridas no decorrer do tempo e comparações entre-grupos para identificar as mudanças resultantes da intervenção e os fatores associados. Como resultados, houve predomínio de mulheres (71,8%), casadas (68,2%), com idade média de 43,5 anos e elevado nível de escolaridade (91,8% com nove anos ou mais de escolaridade), sem diferença entre os grupos. Os sujeitos do GI aumentaram o consumo de álcool, a mastigação e o fracionamento da alimentação, e reduziram a compulsão alimentar, as medidas antropométricas imediatamente após a intervenção (IMC = -1,4kg/m 2 ; circunferência da cintura = -5,5cm), e o risco de doenças cardiovasculares a longo prazo. Ambos os grupos apresentaram frequências elevadas de percepção corporal superestimada e insatisfação (GI=75% e 85,9%; GA= 81% e 95,2%, respectivamente). De modo geral, os participantes do GA apresentaram mudanças comportamentais pontuais, demonstrando grande heterogeneidade entre o grupo. Entre os fatores associados à manutenção das mudanças encontram-se a motivação para a perda de peso e melhora da imagem corporal, a presença de doenças associadas e do histórico familiar de obesidade, e a percepção distorcida e a insatisfação corporais. Como aspectos facilitadores foram apontados as melhoras obtidas e a força de vontade, e como dificultadores, os resultados lentos, a falta de tempo, a vida social muito ativa e o custo elevado dos alimentos. Conclui-se que indivíduos que finalizaram o protocolo (GI) realizaram mais mudanças comportamentais do que aqueles que abandonaram (GA), mas as alterações nem sempre foram mantidas no período posterior. O programa mostrou-se eficaz em promover modificações comportamentais, sendo recomendado considerar as características sociodemográficas e antropométricas dos participantes no planejamento das atividades a fim de subsidiar ações mais específicas e melhor prognóstico. A manutenção dos resultados constitui-se em um grande desafio aos profissionais de saúde devido à influência de fatores ambientais e culturais inerentes ao proceso de mudança. / Nutrition education is recognized as an effective approach for changing, recovering and promoting healthy habits, commonly used in nutritional management of obesity. However, the maintenance of weight loss is not always satisfactory, due to the difficulty in incorporating new habits as daily life routine. This study aimed to investigate behavioral changes in adults with excess weight after an educational program and the factors associated with its maintenance. Sociodemographic and anthropometric data, body image and behavioral factors and health-related data were collected from 94 adults with excess weight, of both sexes, participants in the University of Sao Paulo Nutrition Education Program - PRAUSP, between 2005 and 2009. Participants were divided into two groups: IG (intervention group) (minimum frequency of 70%, n = 64) and AG (abandonment group) (frequency less than 30%, n = 30), with information being obtained at baseline (IG and AG) and at the end of the intervention (IG) through a database, and at present (IG and AG) by structured interview. Intra-group comparisons were performed to assess changes occurred over time and comparisons between groups to identify changes resulting from the intervention and associated factors. As results, there was a predominance of women (71.8%), married (68.2%), with a mean age of 43.5 years and a high level of education (91.8% with nine or more years of school education), without difference between the groups. Participants of IG increased alcohol consumption, chewing and fractionating of food, and reduced binge eating, anthropometric measures immediately after intervention (BMI = -1.4 kg/m 2 , waist circumference = -5.5 cm), and the risk for cardiovascular disease in the long term. Both groups had high rates of overestimated body perception and dissatisfaction (IG = 75% and 85.9%, AG = 81% and 95.2%, respectively). In general, participants of AG showed specific behavioral changes, showing great heterogeneity among the group. Among the factors associated with maintenance of the changes, there are the motivation for weight loss and improved body image, the presence of associated diseases and family history of obesity, as well as distorted perception and body dissatisfaction. Facilitating factors were identified as the improvements obtained and willpower, and as difficulties were the slow results, lack of time, a very active social life and high cost of food. It is concluded that individuals who completed the protocol (IG) had more behavioral changes than those who dropped (AG), but the changes were not always maintained thereafter. The program was effective in promoting behavioral changes, being recommended to consider the socio-demographic and anthropometric characteristics of participants in planning activities, in order to support more specific actions and a better prognosis. The maintenance of the results is a great challenge to health professionals due to the influence of environmental and cultural factors inherent to the process of change.

Introducción: El etiquetado nutricional ayuda a los consumidores a realizar elecciones más saludables, sin embargo, este es poco leído, mal interpretado o no usado. Objetivos: Evaluar la frecuencia y factores asociados a la lectura, uso e interpretación de etiquetas nutricionales en usuarios de gimnasios en la ciudad de Huancayo, Perú. Materiales y métodos: Estudio de corte transversal en 385 usuarios de una cadena de gimnasios. Se midió la interpretación con un test a partir de dos etiquetas, lectura reportada (frecuentemente o no) y el uso reportado para elegir un producto (frecuentemente o no), así como variables demográficas, dietéticas y relacionadas al gimnasio. Se evaluó la asociación calculando las razones de prevalencias ajustadas en base a las variables significativas del modelo bivariado. Resultados: Los participantes tuvieron una edad media de 27,8 + 9,3 años, 44,7% fueron varones, 49,4% contaron con educación universitaria. El 27,5% reporta leer frecuentemente y dentro de estos el 55,7% reporta usarlas frecuentemente, asimismo el 17,4% sabe interpretar. La lectura se asoció con factores dietéticos y de uso de gimnasio y la interpretación con capacitación previa de lectura de la etiqueta. El uso fue principalmente para seleccionar productos bajos en grasa total (65,1%), alto en proteínas (64,2%) y en menor proporción, productos bajo en sodio (47,2%). Conclusiones: La frecuencia de lectura, uso e interpretación de etiquetas nutricionales es baja. La capacitación previa de lectura es un factor necesario para una elección saludable. Es necesario establecer estrategias educativas para enseñar a interpretar en forma adecuada las etiquetas nutricionales. / Introduction: The nutritional labeling helps users to make healthier choices, nevertheless, this is overseen, misunderstood or not used at all. Objectives: To evaluate the frequency and the factors associated with the reading, interpretation and use of nutritional labels by fitness center users in the city of Huancayo, Peru. Materials and methods: A cross-sectional survey was conducted on 385 users of a fitness center chain. Interpretation was measured by using a test with 2 labels, reported reading (frequently or not) and the reported use to choose a product (frequently or not), as well as demographic, dietetic and fitness-center-related variables. The association was evaluated by calculating the prevalence ratios adjusted based on the significant variables from bivariate model. Results: The participants had an average age of 27,8± 9,3 years, 44,7% were men and 49,4% had college degree. 27,5% report reading frequently and 55,7% of them reports use frecuently, furthermore 17,4% know how to interpret. The reading was associated with dietetic factors and gym use, and interpretation with prior training of reading labeling. The use was mainly high to select low fat products (65,1%), high in protein (64,2%) and was mainly low in low sodium products (47,2%). Conclusions: The reading, use and interpretation frequency of nutritional labels is low. The prior training of reading labeling is a required factor to make healthier choices. It is necessary to establish educative strategies for teaching to interprete the nutrition labels in an adequate way.

Orientador: Marcos Franke Pinto / Banca: Isa de Pádua Cintra Sampaio / Banca: Adriane Cristina Garcia Lemos / Resumo: O ritmo acelerado da vida moderna vem contribuindo para o aumento da demanda por alimentos industrializados e de rápida preparação. O produto cárneo tipo hambúrguer é um alimento bastante apreciado pela população em geral, pelas suas características sensoriais e de praticidade. Esses alimentos podem conter elevadas concentrações de aditivos químicos, gorduras saturadas, amido e açúcares refinados. Diante disso, este experimento objetivou elaborar produtos cárneos tipo hambúrguer à base de carne de frango e carne bovina magra enriquecidos nutricionalmente, pela adição de ingredientes funcionais, mantendo ou aumentando sua aceitação pelos consumidores. Foram elaboradas duas formulações de hambúrgueres, uma de carne bovina enriquecida com cerca de 1,6% de farinha de batata doce e uma de carne de frango enriquecida com aproximadamente 3,2% de aveia em flocos. Foi realizada a caracterização físico-química e sensorial e avaliada a aceitabilidade das amostras experimentais, em comparação a hambúrgueres industrializados de carne de frango e bovina, disponíveis comercialmente no mercado. As amostras foram analisadas por 50 provadores não treinados, escolhidos em função de apreciarem e serem consumidores habituais do produto. Foi observado que o hambúrguer composto por carne de frango e aveia obteve os maiores escores de aceitação na análise sensorial, além da composição nutricional ter se mostrado mais adequada, por apresentar menor teor de lipídeos totais em relação às demais amostra... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The fast pace of modern life has been contributing to the increasing demand for industrialized foods and fast preparation. The hamburger type meat product is a food that is appreciated by the general population for its sensorial characteristics and practicality. These foods may contain high concentrations of chemical additives, saturated fats, starch and refined sugars. The objective of this experiment was to produce hamburger-based meat products based on meat and poultry meat nutritionally enriched by the addition of functional ingredients, maintaining or increasing their acceptance by consumers. Two formulations of burgers were made, one of beef enriched with about 1.6% sweet potato flour and one chicken meat enriched with approximately 3.2% oat flakes. The physicochemical and sensorial characterization was performed and the acceptability of the experimental samples was evaluated, compared to commercially available hamburgers of chicken and beef meat commercially available on the market. The samples were analyzed by 50 untrained tasters, chosen because they like and are habitual consumers of the product. It was observed that the hamburger composed of chicken and oats had the highest acceptance scores in the sensory analysis, besides the nutritional composition was more adequate, since it presented lower total lipid content in relation to the other samples. The beef burger enriched with sweet potato flour was also well accepted by the tasters and presented lower lipid conten... (Complete abstract click electronic access below) / Mestre

The Expanded Food and Nutrition Education Program (EFNEP) is a federal program designed to improve the nutritional status of the population and provide employment for paraprofessional aides from the indigenous target population and an example of a change agency. Diffusion and change literature offer many models and possible personality characteristics that may be associated with effective change agents. The purpose of the study was to examine characteristics of paraprofessionals employed in the Adult phase of Virginia EFNEP and their relationship to paraprofessional effectiveness and how well they fit the diffusion model. Effectiveness for the paraprofessional was measured as homemaker success (change in nutrient intake and food behavior) and as paraprofessional performance (workload and home visit evaluation). Personality, training, and demographic characteristics of the 40 paraprofessionals were obtained through a mailed Paraprofessional Questionnaire and the Sixteen Personality Factor (16PF) Test. Demographics, food behavior and knowledge, and nutrient intake for a sample of three homemakers per paraprofessional (N=116) were obtained from EFNEP Family Records. Homophily, the measure of correspondence, was calculated by comparing each paraprofessional with their sample of three homemakers. Three personality factors (concrete thinking, impulsivity, and self-discipline) along with homophily were correlated with change in food behavior, none with change in nutrient intake, and two (concrete thinking and low tension) along with perfect match homophily were correlated with workload. There were no apparent difference in training. When all factors were analyzed by stepwise multiple regression, homophily along with three of the second-order personality factors were related to change in food behavior. One second order factor, low anxiety along with perfect match, was related to workload. Implications for practice include: (a) EFNEP paraprofessionals, in part, appear to be fitting the model of change agent effectiveness, in that homophily is influencing the homemakers and (b) low anxiety and low tension appear to be related to effectiveness and could be used in employee selection and future training. Recommendations for future study include: (a) further study into quantification of homophily and (b) investigation of relationship of characteristics to supervisor view of effectiveness. / Ph. D.

Dietary improvement was assessed using 24-hour food recall in a sample of 180 homemakers who had completed six to 18 months of instruction in the Virginia Expanded Food and Nutrition Education Program (EFNEP) to determine whether they retained dietary improvement six to 36 months after leaving the program. These homemakers provided additional information on Perceived Educational Gains and Program Benefits received from participating in EFNEP. Family factors were explored which were believed to be related to dietary change - Family Composition, Family Resource Assistance, Household Roles and Responsibilities, Family Support, and Family Diet Control. Diet Scores increased significantly (p<.01) from program Entry to Exit; greatest increases were in average daily servings from milk and fruit-vegetable groups. Slight but significant (p<.01) regression occurred in average Diet Score and servings of milk from Exit to Follow-up. Homemakers with higher Diet Scores at program Entry had higher scores at program Exit and Follow-up, and higher Program Benefit Scores. Length of time in program was not significantly associated with Dietary Improvement or Retention. High average Educational Gain and Program Benefit Scores at Follow-up were evidence that EFNEP was successful from the perspective of homemakers served. Family Composition was not associated with Dietary Improvement. Family Support emerged as the only family measure related to diet; higher Family Support Scores were associated not only with greater Perceived Educational Gains and Program Benefits, but also with higher Diet Scores at program completion and follow-up. Results of the study confirmed the Virginia EFNEP to be effective in improving diets of homemakers and sustaining these changes, and suggested a key role for family support in influencing dietary outcome and program success from the view of participants. / Ph. D.

In 1981, President Ronald Reagan issued Executive Order 12291 which requires Federal agencies to perform benefits assessments of proposed major regulations and prohibits them from taking regulatory action unless potential benefits exceed potential costs to society. A review of welfare economics literature and applications of the CBA model to health, education, and nutrition is presented. CBA for use in the Cooperative Extension Service Expanded Food and Nutrition Education Program (EFNEP) is then systematically examined using the following criteria: 1) theoretical considerations - can the economic criterion appropriately be applied to EFNEP?; and 2) application of the CBA model - can it be made operational? Following the critique of application of CBA to EFNEP, conclusions are drawn as to the appropriate use of CBA or alternative techniques in evaluating EFNEP and similar programs. / Doctor of Philosophy

Yes / The use of foodbanks has risen sharply in the UK; however, the epidemiology of UK food insecurity is undeveloped. This study contributes to the field by analysing socio-demographic risk factors for food insecurity in a female, ethnically diverse population. Methods Data from the Born in Bradford (BiB) cohort were matched with data on food insecurity from the nested BiB1000 study (N = 1280). Logistic regression was used to model food insecurity in relation to ethnicity and socio-demographic factors. Results Food insecurity, reported by 13.98% of the sample, was more likely among White British than Pakistani women (crude Odds Ratio (OR) 1.94, 95% CI: 1.37; 2.74, adjusted OR 2.37, 95% CI: 1.57; 3.59). In fully adjusted analyses, food insecurity was associated with a range of socio-economic measures, particularly the receipt of mean-tested benefits (adjusted OR 2.11, 95% CI: 1.41; 3.15) and perception of financial insecurity (adjusted OR 8.91, 95% CI: 4.14; 19.16 for finding it difficult/very difficult compared to living comfortably). Conclusions The finding that food insecurity prevalence may be higher than previously thought and that food insecurity is highly associated with socio-economic status, notably benefit receipt, is a cause for concern necessitating an urgent policy response.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-07-03T17:48:43Z No. of bitstreams: 1 LiviaRudakoff.pdf: 7973238 bytes, checksum: 8d0a23b2d605ce777dab04064f7226bc (MD5) / Made available in DSpace on 2017-07-03T17:48:43Z (GMT). No. of bitstreams: 1 LiviaRudakoff.pdf: 7973238 bytes, checksum: 8d0a23b2d605ce777dab04064f7226bc (MD5) Previous issue date: 2016-07-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Objective: To evaluate the food environment of municipal schools of São Luís, Maranhão as food security and nutrition promoter. We analyzed the nutritional quality of the menu offered to students, the hygienic and sanitary conditions of school canteens, and the microbiological quality of water from drinking fountains and food served in schools. Methods: This is a cross-sectional quantitative study. The survey was conducted in 40 public schools in urban and rural municipal schools, attended by the PNAE, chosen randomly. We analyzed 160 menus offered between February and September 2015, based on the Resolution 26/2013 FNDE recommendations. For the analysis of nutritional quality, we used the method Qualitative Assessment of School Menu Preparations - AQPC School. The Good Checklist Practices in School Feeding was used to evaluate the hygienic and sanitary conditions of schools. The quantification of coliforms at 35ºC and 45ºC, determining the presence / absence of Escherichia coli, Staphylococcus coagulase positive enumeration, search, and Salmonella spp. 57 samples of school meals. 64 water samples were evaluated from drinking fountains and the results analyzed according to the parameters of the current legislation. Results: The kilocalories content, carbohydrates, fiber, calcium, iron, vitamin A and sodium of the food served are lower than those recommended by the legislation. The average weekly supply of fruits and vegetables was 229g, and the items of family farming were key to achieving these values. There is no supply of whole foods, fish or any kind of salad. Almost one third of available feature menus preparations with sugar and / or added sugar (33.8%), feed concentrates or dried powders (27.5%), biscuits (35.6%), flatulent food and / or difficult digestion (30.0%), monotone color (31.9%) and fried foods, fatty meats and fatty sauces (28.8%). With regard to good practices, all school canteens were classified as having regular health risk. The average conformities found was 69.7% (± 3.83). The buildings block and facilities of food preparation area obtained 48% of compliance; equipment for temperature controlled, 45%; handlers, 92%; receiving, 100%; processes and products, 41%; and environmental hygiene, 84%. According to microbiological parameters, no food was deemed unfit for human consumption. However, there was a high rate of contamination of water from drinking fountains, given that 48.43% of the samples were positive for total coliforms and 12.50% for Escherichia coli. Conclusion: There are barriers to the PNAE to take effect fully, especially with regard to nutritional inadequacies of the menu and situations that compromise the nutritional quality. Even if the microbiological quality of school meals has been satisfactory, it is necessary to correct non-conformities in the use of BP. In addition, there is an urgent need for action to ensure the microbiological quality of water from drinking fountains, given their impact on the health of schoolchildren. / Objetivo: Avaliar o ambiente alimentar da rede municipal de educação de São Luís, Maranhão como promotor de segurança alimentar e nutricional. Analisou-se a qualidade nutricional do cardápio oferecido aos estudantes,as condições higienicossanitárias das Unidades de Alimentação e Nutrição Escolares, e a qualidade microbiológica da água dos bebedouros e da alimentação servida nas escolas. Métodos: Trata-se de um estudo transversal de natureza quantitativa. A pesquisa foi conduzida em 40 escolas públicas da zona urbana e rural da rede municipal de ensino, atendidas pelo Programa Nacional de Alimentação Escolar - PNAE, escolhidas aleatoriamente. Foram analisados 160 cardápios ofertados entre os meses de fevereiro a setembro de 2015, com base nas recomendações da Resolução FNDE 26/2013. Para análise da qualidade nutricional, utilizou-se o método Avaliação Qualitativa das Preparações do Cardápio Escolar - AQPC Escola. A Lista de Verificação de Boas Práticas na Alimentação Escolar foi utilizada para avaliar as condições higienicossanitárias das escolas. Foram realizadas a quantificação de coliformes a 35ºC e a 45ºC, determinação da presença/ausência de Escherichia coli, enumeração de Staphylococcus coagulase positivo, e a pesquisa de Salmonella spp. de 57 amostras da alimentação escolar. Foram avaliadas 64 amostras de água dos bebedouros e os resultados analisados segundo os parâmetros da Legislação vigente. Resultados: Os teores de quilocalorias, carboidratos, fibras, cálcio, ferro, vitamina A e sódio da alimentação servida encontram-se aquém do preconizado pela legislação. A média de oferta semanal de frutas e hortaliças foi de 229g, sendo que os itens da agricultura familiar foram fundamentais para o alcance desses valores. Não há oferta de alimentos integrais, pescados,nem de nenhum tipo de salada. Quase um terço dos cardápios oferecidos apresentam preparações com açúcar e/ou açúcar adicionado (33,8%), alimentos concentrados em pó ou desidratados (27,5%), biscoitos (35,6%), alimentos flatulentos e/ou de difícil digestão (30,0%), monotonia de cores (31,9%) e frituras, carnes gordurosas e molhos gordurosos (28,8%). Em relação às Boas Práticas, todas as cantinas escolares foram classificadas como apresentando risco sanitário regular. A média de conformidades encontrada foi de 69,7% (±3,83). O bloco edifícios e instalações da área de preparo de alimentos obteve 48% de conformidades; equipamentos para temperatura controlada, 45%; manipuladores, 92%; recebimento, 100%; processos e produções, 41%; e higienização ambiental, 84%. De acordo com os parâmetros microbiológicos, nenhum alimento foi considerado impróprio para o consumo humano. Entretanto, verificou-se um alto índice de contaminação da água dos bebedouros, haja vista que 48,43% das amostras apresentaram positividade para coliformes totais e 12,50% para Escherichia coli. Conclusão:Existem entraves para que o PNAE seja efetivado de forma plena, principalmente no que diz respeito às inadequações nutricionais do cardápio e situações que comprometem a qualidade nutricional do mesmo. Mesmo que a qualidade microbiológica da alimentação escolar tenha sido satisfatória, faz-se necessária a correção das não conformidades na utilização de BP. Além disso, urge a necessidade de ações que garantam a qualidade microbiológica da água dos bebedouros, haja vista o impacto que exercem sobre a saúde dos escolares.