Behavioral weight loss programs have been shown to be effective for short-term weight loss, however the impact of these programs on dietary changes is unclear. This study examined the changes in participant’s diet and physical activity over the course of a 16-week Internet behavioral weight-loss program. A single-center randomized controlled trial was conducted from August 2008 to December 2008 in Lexington, KY, and sixty-six women whose mean (SD) age was 48.6 (10.8) years and body mass index was 31.8 (3.7) kg/m2 completed all dietary and physical measures. Participants received two face-to-face group sessions with a dietitian, at baseline and 4-weeks, in addition to 16 weekly behavioral weight loss lessons delivered via an Internet website. Participants showed a significant reduction in energy intake (1879.2±771.7 vs. 1372.9±423.7; p<0.001), dietary energy density (2.1±0.5 vs. 1.9±0.5; p=0.002) and a significant increase in diet quality score as measured by the HEI-2005 (53.9±9.9 vs. 57.4±10.6; p =0.002). Participants did not show significant differences in physical activity intensity, duration or energy expenditure. However, post hoc analysis revealed that those who adopted a healthy life style, such as eating more fruits and vegetables and being physically active, achieved greater weight loss than those who did not adopt a healthy lifestyle. Participation in this Internet behavioral weight loss program significantly improved dietary intake in adult women and did not significantly improve daily physical activity levels.

Athletes appear healthy according to weight for height and body fat standards. Though athletes appear to be healthy, little is known about their diets. Research states there is a connection between athletic performance and nutrition. The objective of this study was to determine the diet quality of 138 collegiate athletes. Data were collected in a laboratory. Demographics were collected via survey. Anthropometrics were assessed using a free standing stadiometer and the BodPod® for body fat assessment. Block 2005 Food Frequency Questionnaire© was used to assess diets. The Healthy Eating Index (HEI) 2005 was used to calculate diet quality scores. The average BMI was 23.2 (2.3) kg/m2 and the average body fat was17.8 % (6.5). The average HEI score was 51.2 (8.8). Higher HEI scores were correlated with higher body fat percentage in this sample. Diets were adequate in: calcium, iron, and vitamin C. Diets were inadequate in: fiber, fruits and vegetables intakes. The athletes had excessive intakes of sodium and total percent fats. These findings demonstrate the need for nutrition education for collegiate athletes.

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.

No description available.

<p>Food insecurity, or limited access to enough foods for an active, healthy life, characterizes the situation of 65% of US food pantry clients. Food insecurity is associated with poor dietary intake of key food groups and nutrients, diet-related chronic disease, poor physical and mental health, and reduced quality of life. Although food pantry clients are prevalently food insecure, there is a sizeable proportion of clients who are classified as food secure (FS), or report having adequate access to healthy foods. Previous studies suggest that food secure pantry clients may use pantry resources differently, and have diets that differ in quality and intake, compared to food insecure clients (including low food secure [LFS] and very low food secure [VLFS] clients). </p><p>Food pantries may be an important venue for interventions to improve food security and dietary outcomes. Since dietary intake and use of food pantries may differ by food security status, the efficacy of such interventions may also differ by food security status. A social ecological modeled (SEM), community-based intervention in the food pantry setting is promising in sustaining local change efforts and may facilitate long-term implementation of strategies to improve diet-related outcomes among food pantry clients. Therefore, the aims of this dissertation were to 1) characterize differences in diet quality and intake between FS, LFS and VLFS pantry clients; 2) explore associations between the nutritional quality of the pantry food environment (foods in stock and foods distributed to clients) and client diet quality by food security status; and 3) evaluate the intermediate effects of a SEM, community-based intervention to improve diet-related outcomes among pantry clients with comparison by food security status.</p><p>Aim 1 was addressed by examining associations between food security and both diet quality and usual intake (in separate mixed multiple linear regression models) in a cross-sectional analysis of adult food pantry clients at baseline. FS status was associated with a higher Healthy Eating Index-2010 (HEI-2010) whole grains score, as well as a higher mean usual intakes of whole grains and iron, compared to LFS status. FS status was also associated with higher mean usual intakes of dark green vegetables and total dairy compared to LFS and VLFS status.</p><p>Aim 2 was addressed by evaluating the relationship between the quality of the mix of foods in stock (pantry inventories) and distributed (client food bags) at food pantries with client diet quality, and investigating how these relationships varied by food security status, in a cross-sectional analysis of adult food pantry clients at baseline. Client food bag HEI-2010 scores were positively associated with client diet scores for the total vegetables, total fruit, total protein foods, and sodium components, while pantry inventory HEI-2010 scores were negatively associated with client diet scores for the total score and for the total fruit and fatty acids components. VLFS clients consumed more whole grains from client food bags compared to FS clients, and consumed more greens and beans from pantry inventories compared to LFS clients.</p><p>Aim 3 was addressed by evaluating longitudinal changes in adult food security, diet quality and usual intake over the first two years (baseline to midpoint) of a three-year SEM, community-based food pantry intervention‒ Voices for Food (Clinical Trial Registry: NCT0356609). Adult food security score improved in the intervention group, while HEI-2010 total score and several component scores improved in the comparison group. When comparing the change in main outcomes over time between the intervention and comparison groups, no favorable differences were observed at this intermediate time point.</p><p> </p><p>Food pantries do not comprise a homogeneous population of clients. Pantry clients have different quality diets and rely on pantries to acquire different types of foods depending on their food security status. Food pantries may be an important venue to target interventions that improve diet-related outcomes, with consideration for the complex interplay between food security status, the pantry food environment and availability of resources to prepare healthy foods. Evaluation of the final study time point, as well as further investigation of the dose-dependent effect of each intervention component and other individual community characteristics, may elucidate the relationship between the intervention and client outcomes.</p><p></p>

Introdução: O consumo alimentar inadequado é causa de deficiências nutricionais, especialmente na infância e adolescência, fases em que o organismo está em pleno crescimento e desenvolvimento. Portanto, é fundamental que sejam validados instrumentos que identifiquem o consumo alimentar de crianças e adolescentes e subsidiem o entendimento do processo saúde-doença. Objetivos: Avaliar a validade da estimativa do consumo de nutrientes e das pontuações total e por componentes do Índice de Qualidade da Dieta Revisado (IQD-R), ambas obtidas a partir de um Questionário Semiquantitativo de Frequência Alimentar (QSFA), utilizando biomarcadores dietéticos como métodos de referência, em crianças e adolescentes de 9 a 13 anos de idade do município de Ribeirão Preto - SP. Métodos: Estudo metodológico de validação. O consumo alimentar foi estimado por um QFSA e calculado no software Nutrition Data System for Research (NDSR) ®, sendo os seguintes nutrientes estimados: ácidos graxos mirístico (C14:0), palmítico (C16:0), margárico (C17:0), esteárico (C18:0), ?-linolênico (C18:3; ALA), eicosapentaenoico (C20:5 ; EPA) e docosahexaenóico (C22:6 ; DHA); ?- caroteno; retinol; ?-tocoferol e vitaminas D, B1, B2, B3, B5, B6, folato e B12. O consumo alimentar estimado pelo QSFA foi utilizado para calcular as pontuações do IQD-R. Além dos componentes originais do IQD-R, foram calculados os componentes modificados denominados Vegetais Totais sem Leguminosas (Vegetais Totais SL) e Vegetais Verde-Escuros e Alaranjados sem Leguminosas (Veveal SL), nos quais o excedente de leguminosas do Grupos Carnes, Ovos e Leguminosas não foi incluído. Os biomarcadores foram analisados em amostras de plasma: ?-caroteno, ?-caroteno/colesterol total (CT), retinol, ?-tocoferol, ?-tocoferol/CT, 25-hidroxivitamina D3 [25(OH)D3], tiamina, riboflavina, nicotinamida, nudifloramida, ácido pantotênico, piridoxamina 5-fosfato (PMP), piridoxal, piridoxal 5-fosfato (PLP), 5- metiltetrahidrofolato (5-MTHF), folato, vitamina B12, creatina; ou eritrócitos: C14:0, ácido pentadecanóico (C15:0), C16:0, C17:0, C18:0, ALA, EPA e DHA. As associações da estimativa do consumo de nutrientes e das pontuações do IQD-R com as concentrações de biomarcadores foram analisadas por correlação de Spearman e correlação parcial ajustada para energia, sexo, idade e escore-z de índice de massa corporal para idade. Todos os indivíduos foram classificados em quartis de acordo com a estimativa do consumo de nutrientes, as pontuações do IQD-R e os biomarcadores e os dados foram analisados para concordância entre quartis de biomarcadores vs. consumo, diferença das médias dos biomarcadores entre o primeiro e o último quartil de consumo e análise de tendência das médias dos biomarcadores entre os quartis de consumo. As análises estatísticas foram realizadas no software Statistical Package for the Social Sciences (SPSS) ®, versão 20.0, com nível de significância de 5%. Resultados: A amostra foi constituída de 177 indivíduos com média de 11,5 (DP 1,1) anos de idade, sendo 52,0% do sexo feminino. Os biomarcadores ?-caroteno (r=0,168), ?-caroteno/CT (r=0,171), 25(OH)D3 (r=0,209), C14:0 (r=0,211) e EPA (r=0,166) apresentaram correlações ajustadas com os respectivos consumos estimados pelo QSFA. Após ajuste para variáveis de confusão, o biomarcador DHA apresentou correlação com o consumo estimado de DHA apenas no sexo feminino (r=0,280). Quanto ao IQD-R, os componentes de vegetais foram correlacionados aos biomarcadores de ?-caroteno e ?-caroteno/CT (r = 0,230 a 0,340), enquanto os componentes modificados Vegetais Totais SL e Veveal SL foram correlacionados aos biomarcadores vitamina B12 (r=0,194) e 5-MTHF (r=0,201), respectivamente. Todos os componentes ricos em proteínas de origem vegetal (leguminosas) e animal (carnes e ovos) foram correlacionados à creatina plasmática (r=0,205 a 0,327). O componente Leite e Derivados foi correlacionado aos biomarcadores C14:0 (r=0,169), ácido pantotênico (r=0,233), PLP (r=0,283) e vitamina B12 (r=0,265). Biomarcadores de vitaminas do complexo B foram inversamente correlacionados aos componentes Cereais Totais; Carnes, Ovos e Leguminosas e Gordura Saturada (r= -0,178 a -0,282). Não houve correlações entre biomarcadores e a pontuação total do IQD-R. As associações entre biomarcadores e os nutrientes estimados pelo QSFA e os componentes Vegetais Totais SL, Veveal SL, Leite e Derivados e Gordura Saturada foram corroboradas por concordância entre quartis >70%, diferença de média de biomarcador entre primeiro e último quartil de consumo e tendência de média biomarcador entre quartis de consumo. Conclusão: A estimativa de nutrientes e os componentes do IQD-R, ambos obtidos por meio do QSFA, foram validados conforme as associações acima descritas e podem ser utilizados em estudos clínicos e epidemiológicos que investiguem a associação entre desfechos em saúde e consumo alimentar de crianças e adolescentes de 9 a 13 anos da região de Ribeirão Preto, SP. / Introduction: Inadequate dietary intake is a cause of nutritional deficiencies, especially in childhood and adolescence, when the body is experiencing rapid growth and development. Therefore, it is fundamental to validate instruments that identify the dietary intake of children and adolescents and support the understanding of the health-disease process. Objectives: To assess the validity of nutrient intake estimate and total and component scores from Brazilian Healthy Eating Index - Revised (BHEI-R), both obtained from a semiquantitative food frequency questionnaire (SFFQ), using dietetic biomarkers as a reference method, in children and adolescents aged 9 to 13 years in Ribeirão Preto - SP. Method: Methodological and validation study. Dietary intake was estimated by a SFFQ and calculated using the software Nutrition Data System for Research (NDSR) ®, and the following nutrients were estimated: myristic acid (C14:0), palmitic acid (C16:0), margaric acid (C17:0), stearic acid (C18:0), ?- linolenic acid (C18:3 ; ALA), eicosapentaenoic acid (C20:5 ; EPA), docosahexaenoic acid (C22 : 6; DHA), ?-carotene, retinol, ?-tocopherol, and vitamins D, B1, B2, B3, B5, B6, folate, and B12. The dietary intake estimated by SFFQ was used to generate the BHEI-R scores. In addition to the original components of the BHEI-R, the modified components Total Vegetables without Legumes and Dark Green and Orange Vegetables without Legumes were calculated, in which the excess legumes from Meat, Eggs and Legumes component was not included. Biomarkers were analyzed in plasma: ?-carotene, ?-caroteno/total cholesterol (TC), retinol, ?- tocopherol, ?-tocopherol/TC, 25-hydroxyvitamin D3 [25(OH)D3], thiamine, riboflavin, nicotinamide, nudifloramide, pantothenic acid, pyridoxamine 5-phosphate (PMP), pyridoxal 5-phosphate (PLP), 5-methyltetrahydrofolate (5-MTHF), folate, vitamin B12, and creatine; or erythrocytes samples: C14:0, pentadecanoic acid (C15:0), C16:0, C17:0, C18:0, ALA, EPA e DHA. The associations of the nutrient intake estimate and BHEI-R scores with biomarkers concentrations were analyzed by Spearman correlation and partial correlation adjusted for energy, sex, age, and z-score for body mass index-for-age. Subjects were classified into quartiles according to nutrient intake estimates, BHEI-R scores and biomarkers and data were analyzed for quartile agreement between biomarkers vs. intake, comparison of biomarkers averages between the first and last intake quartiles, and trend analysis of biomarkers averages among the intake quartiles. Statistical analyzes were performed in software Statistical Package for Social Sciences (SPSS) ®, version 20.0, with a significance level of 5%. Results: The sample was composed of 177 subjects, the mean age was 11.5 (SD 1.1) years old and 52% were female. The biomarkers ?- carotene (r=0,168), ?-carotene/TC (r=0,171), 25(OH)D3 (r=0,209), C14:0 (r=0,211), and EPA (r=0,166) showed positive adjusted correlations with their respective intakes estimated by SFFQ. After adjusting for confounding variables, DHA showed correlation only in females (r=0,280). Regarding BHEI-R, vegetable components were correlated with biomarkers ?- carotene and ?-carotene/TC, while the modified components Total Vegetables without Legumes and Dark Green and Orange Vegetables without Legumes were correlated with the biomarkers vitamin B12 (r=0,194) and 5-MTHF (r=0,201), respectively. All components rich in vegetable (legumes) and animal protein (meat, eggs) were correlated with plasma creatine (r=0,205 a 0,327). The component Milk was correlated with biomarkers C14:0 (r = 0,169), pantothenic acid (r = 0,233), PLP (r = 0,283), and vitamin B12 (r = 0265). Biomarkers of Bcomplex vitamins were inversely correlated with the components Whole Grains; Meat, Eggs and Legumes; and Saturated Fat (r= -0,178 a -0,282). There was no correlation between biomarkers and total IQD-R score. The associations between the biomarkers and the nutrients estimated by the SFFQ and the components Total Vegetables without Legumes, Dark Green and Orange Vegetables without Legumes, Milk, and Saturated Fat were confirmed by quartiles agreement >70%, difference between biomarker average between first and last quartile of intake and trend of biomarker average among quartiles of intake. Conclusion: The nutrient estimates and the BHEI-R components, both obtained through the SFFQ, were validated according to the associations described above and can be used in clinical and epidemiological studies investigating the association between health outcomes and dietary intake of children and adolescents age 9 to 13 years in Ribeirão Preto - SP.

Introdução: Padrões alimentares estabelecidos na adolescência têm sido associados a fatores de risco para o desenvolvimento de doenças crônicas, tais como diabetes, doenças cardiovasculares e câncer. Objetivo: Avaliar os padrões da dieta de adolescentes e seus fatores associados. Metodologia: Utilizaram-se dados de adolescentes provenientes do estudo de base populacional do município de São Paulo. Foram utilizadas duas abordagens distintas na identificação dos padrões da dieta: o Índice de Qualidade da Dieta Revisado (IQD-R) e a análise fatorial. Para estimar a ingestão usual, foram coletados de um a cinco Recordatório de 24 horas (R24h), sendo o primeiro obtido no domicílio, juntamente com o Questionário de Frequência Alimentar (QFA), e os demais por telefone. Na primeira abordagem, o método proposto pelo National Cancer Institute estimou a distribuição da pontuação dos componentes do IQD-R, com base na ingestão usual e nas características da população. Na identificação dos padrões da dieta pela análise fatorial, primeiramente estimou-se o consumo usual pelo Multiple Source Method. Neste, além dos R24h, foram utilizadas informações complementares dos QFA, melhorando o modelo de probabilidade e consumo. Posteriormente à análise fatorial, modelos de regressão multivariada identificaram os fatores associados aos padrões da dieta. Resultados: A pontuação média do IQD-R (47,1), ajustada por sexo e escolaridade do chefe da família, foi semelhante entre homens (46,3) e mulheres (48,0). Observou-se um baixo consumo de Cereais integrais (0,3), Vegetais totais (1,0), Frutas totais (1,3) e inteiras (0,4); e um elevado consumo de Sódio (2,2), Gordura saturada (5,8) e GordAA (4,5), que representa as calorias provenientes de gordura sólida, álcool e açúcar de adição. Na análise fatorial, os dois padrões dietéticos retidos explicaram 17,1 por cento da variância total da ingestão. O padrão Tradicional, caracterizado pelo consumo de feijões, arroz, café/chá, açúcar, manteiga/margarina, carne bovina e bolacha doce, se associou negativamente ao sexo masculino, maior renda familiar e maior escolaridade do chefe da família. O padrão Dual, caracterizado pelo consumo de achocolatado, vegetais, leite integral, temperos (salada), queijo, carne processada/frios, pães/torradas, bala, suco e carne branca, se associou positivamente ao estado matrimonial (com companheiro) e maior escolaridade do chefe da família e à maior renda. Conclusão: Os adolescentes apresentam baixo consumo de fibras, principalmente sob a forma de frutas e cereais integrais, e alta ingestão de sódio, gorduras e açúcares. As duas abordagens forneceram informações consistentes e complementares sobre o comportamento alimentar dos adolescentes, podendo ser utilizadas para o desenvolvimento de programas de saúde pública que visem previnir e tratar doenças crônicas relacionadas com a dieta e que ocorrem ao longo da vida / Background: Adolescent dietary patterns have been associated with increased risk factors for chronic diseases, including diabetes, coronary heart disease and cancer. Objectives: To evaluate the dietary patterns among adolescents living in the municipally of São Paulo. Methods: Data of adolescents from a cross-sectional survey were analyzed. Two different approaches were used to evaluate the dietary patterns: the Brazilian Healthy Eating Index Revised (BHEI-R) and the factors analysis. To estimate the usual intake, it was collected a minimum of one and a maximum of five 24-hour dietary recall (24HR), in which the first one was obtained in the adolescents home, together with a Food Frequency Questionnaire (FFQ), and the others records were collected by phone. In the first approach, the method proposed by the American National Cancer Institute was used to estimate the distribution of the components of the BHEI-R, according to the usual intake and adjusted by the sociodemographic, anthropometric and lifestyle characteristics. To access the dietary patterns using the factor analysis, initially, the usual intake that was estimated by the Multiple Source Method. Beside the 24HR data, the FFQ was used as covariate information to improve the modeling of consumption probability and intake amount. After the factor analysis, multivariate linear regressions models identified the characteristics associated with the dietary patterns. Results: The estimated mean BHEI-R score (47.1 points), adjusted for gender and family heads schooling, was, being similar between males (46.3) and females (48.0). The results indicated lower consumption of Whole grains (0.3), Total vegetables (1.0), Total fruit (1.3) and Whole fruit (0.4); and higher intake Sodium (2.2), Saturated fat (5.8) and; SoFAAS (4.5), that comprise the calories from solid fat, alcohol intake and added sugar. The factor analysis identified two dietary patterns that together explained 17.1 per cent of the total variation in food intake. The Traditional diet, characterized by the consumption of beans, rice, coffee/tea, sugar, butter/margarine, beef and cookies, was inversely associated with be male, higher income and higher family heads schooling. The Dual diet, characterized by the consumption chocolate powder, vegetables, whole milk, salada dressings, cheeses, processed meats/cold cuts, breads/toasts/crackers, candies, juices and white meat (chicken and fish), was directly associated with higher income, family heads marital status (living with someone) and higher family heads schooling. Conclusion: The adolescents have lower dietary fiber intake, especially fruits and whole grains and higher intake of sodium, fats and sugars. Thus, the results of the two approaches provide consistent and complementary information about the adolescent dietary behavior that can be used to the development of public health programs, in order to prevent and treat dietrelated chronic diseases throughout the life course

Physical inactivity and unhealthful diet are major risk factors for noncommunicable diseases, and strategies worldwide now focus on improving diet and encouraging physical activity (PA). Participation in PA lowers the risk for numerous chronic diseases, while a healthful diet also offers resistance to disease. However, practicing both behaviors offers greater protection than practicing either behavior alone. Research evaluating the relationship of diet and PA has focused primarily on nutrients or food groups. Little research exists on PA and overall diet quality, and no research has used the Healthy Eating Index 2005 (HEI-2005) to assess diet quality in healthy young adults, the objective of the current study. To this end, a convenience sample of 70 healthy, young adults was recruited from a university community in 2005-2006. Dietary intake was measured with 7-d weighed food records and HEI-2005 scores were computed to assess diet quality. PA was obtained from 7-d activity records accounting for all minutes of each day. Linear regression models were used to assess the association of HEI-2005 scores to participation in moderate- and vigorous-intensity PA. In this sample, HEI-2005 scores increased as weekly minutes of PA increased (p=0.006, B=0.007). When PA was examined categorically, only the VeryHighPA (≥841 min/week) group had diet quality scores significantly higher than the LowPA (≤420 min/week) group, independent of age, BMI, and gender (p=0.033, B=7.987). Further studies are warranted to clarify the relationship of these health behaviors, an especially important topic as prevalence of obesity and chronic disease continues to rise. / Graduation date: 2013

Introdução: O consumo alimentar inadequado é causa de deficiências nutricionais, especialmente na infância e adolescência, fases em que o organismo está em pleno crescimento e desenvolvimento. Portanto, é fundamental que sejam validados instrumentos que identifiquem o consumo alimentar de crianças e adolescentes e subsidiem o entendimento do processo saúde-doença. Objetivos: Avaliar a validade da estimativa do consumo de nutrientes e das pontuações total e por componentes do Índice de Qualidade da Dieta Revisado (IQD-R), ambas obtidas a partir de um Questionário Semiquantitativo de Frequência Alimentar (QSFA), utilizando biomarcadores dietéticos como métodos de referência, em crianças e adolescentes de 9 a 13 anos de idade do município de Ribeirão Preto - SP. Métodos: Estudo metodológico de validação. O consumo alimentar foi estimado por um QFSA e calculado no software Nutrition Data System for Research (NDSR) ®, sendo os seguintes nutrientes estimados: ácidos graxos mirístico (C14:0), palmítico (C16:0), margárico (C17:0), esteárico (C18:0), ?-linolênico (C18:3; ALA), eicosapentaenoico (C20:5 ; EPA) e docosahexaenóico (C22:6 ; DHA); ?- caroteno; retinol; ?-tocoferol e vitaminas D, B1, B2, B3, B5, B6, folato e B12. O consumo alimentar estimado pelo QSFA foi utilizado para calcular as pontuações do IQD-R. Além dos componentes originais do IQD-R, foram calculados os componentes modificados denominados Vegetais Totais sem Leguminosas (Vegetais Totais SL) e Vegetais Verde-Escuros e Alaranjados sem Leguminosas (Veveal SL), nos quais o excedente de leguminosas do Grupos Carnes, Ovos e Leguminosas não foi incluído. Os biomarcadores foram analisados em amostras de plasma: ?-caroteno, ?-caroteno/colesterol total (CT), retinol, ?-tocoferol, ?-tocoferol/CT, 25-hidroxivitamina D3 [25(OH)D3], tiamina, riboflavina, nicotinamida, nudifloramida, ácido pantotênico, piridoxamina 5-fosfato (PMP), piridoxal, piridoxal 5-fosfato (PLP), 5- metiltetrahidrofolato (5-MTHF), folato, vitamina B12, creatina; ou eritrócitos: C14:0, ácido pentadecanóico (C15:0), C16:0, C17:0, C18:0, ALA, EPA e DHA. As associações da estimativa do consumo de nutrientes e das pontuações do IQD-R com as concentrações de biomarcadores foram analisadas por correlação de Spearman e correlação parcial ajustada para energia, sexo, idade e escore-z de índice de massa corporal para idade. Todos os indivíduos foram classificados em quartis de acordo com a estimativa do consumo de nutrientes, as pontuações do IQD-R e os biomarcadores e os dados foram analisados para concordância entre quartis de biomarcadores vs. consumo, diferença das médias dos biomarcadores entre o primeiro e o último quartil de consumo e análise de tendência das médias dos biomarcadores entre os quartis de consumo. As análises estatísticas foram realizadas no software Statistical Package for the Social Sciences (SPSS) ®, versão 20.0, com nível de significância de 5%. Resultados: A amostra foi constituída de 177 indivíduos com média de 11,5 (DP 1,1) anos de idade, sendo 52,0% do sexo feminino. Os biomarcadores ?-caroteno (r=0,168), ?-caroteno/CT (r=0,171), 25(OH)D3 (r=0,209), C14:0 (r=0,211) e EPA (r=0,166) apresentaram correlações ajustadas com os respectivos consumos estimados pelo QSFA. Após ajuste para variáveis de confusão, o biomarcador DHA apresentou correlação com o consumo estimado de DHA apenas no sexo feminino (r=0,280). Quanto ao IQD-R, os componentes de vegetais foram correlacionados aos biomarcadores de ?-caroteno e ?-caroteno/CT (r = 0,230 a 0,340), enquanto os componentes modificados Vegetais Totais SL e Veveal SL foram correlacionados aos biomarcadores vitamina B12 (r=0,194) e 5-MTHF (r=0,201), respectivamente. Todos os componentes ricos em proteínas de origem vegetal (leguminosas) e animal (carnes e ovos) foram correlacionados à creatina plasmática (r=0,205 a 0,327). O componente Leite e Derivados foi correlacionado aos biomarcadores C14:0 (r=0,169), ácido pantotênico (r=0,233), PLP (r=0,283) e vitamina B12 (r=0,265). Biomarcadores de vitaminas do complexo B foram inversamente correlacionados aos componentes Cereais Totais; Carnes, Ovos e Leguminosas e Gordura Saturada (r= -0,178 a -0,282). Não houve correlações entre biomarcadores e a pontuação total do IQD-R. As associações entre biomarcadores e os nutrientes estimados pelo QSFA e os componentes Vegetais Totais SL, Veveal SL, Leite e Derivados e Gordura Saturada foram corroboradas por concordância entre quartis >70%, diferença de média de biomarcador entre primeiro e último quartil de consumo e tendência de média biomarcador entre quartis de consumo. Conclusão: A estimativa de nutrientes e os componentes do IQD-R, ambos obtidos por meio do QSFA, foram validados conforme as associações acima descritas e podem ser utilizados em estudos clínicos e epidemiológicos que investiguem a associação entre desfechos em saúde e consumo alimentar de crianças e adolescentes de 9 a 13 anos da região de Ribeirão Preto, SP. / Introduction: Inadequate dietary intake is a cause of nutritional deficiencies, especially in childhood and adolescence, when the body is experiencing rapid growth and development. Therefore, it is fundamental to validate instruments that identify the dietary intake of children and adolescents and support the understanding of the health-disease process. Objectives: To assess the validity of nutrient intake estimate and total and component scores from Brazilian Healthy Eating Index - Revised (BHEI-R), both obtained from a semiquantitative food frequency questionnaire (SFFQ), using dietetic biomarkers as a reference method, in children and adolescents aged 9 to 13 years in Ribeirão Preto - SP. Method: Methodological and validation study. Dietary intake was estimated by a SFFQ and calculated using the software Nutrition Data System for Research (NDSR) ®, and the following nutrients were estimated: myristic acid (C14:0), palmitic acid (C16:0), margaric acid (C17:0), stearic acid (C18:0), ?- linolenic acid (C18:3 ; ALA), eicosapentaenoic acid (C20:5 ; EPA), docosahexaenoic acid (C22 : 6; DHA), ?-carotene, retinol, ?-tocopherol, and vitamins D, B1, B2, B3, B5, B6, folate, and B12. The dietary intake estimated by SFFQ was used to generate the BHEI-R scores. In addition to the original components of the BHEI-R, the modified components Total Vegetables without Legumes and Dark Green and Orange Vegetables without Legumes were calculated, in which the excess legumes from Meat, Eggs and Legumes component was not included. Biomarkers were analyzed in plasma: ?-carotene, ?-caroteno/total cholesterol (TC), retinol, ?- tocopherol, ?-tocopherol/TC, 25-hydroxyvitamin D3 [25(OH)D3], thiamine, riboflavin, nicotinamide, nudifloramide, pantothenic acid, pyridoxamine 5-phosphate (PMP), pyridoxal 5-phosphate (PLP), 5-methyltetrahydrofolate (5-MTHF), folate, vitamin B12, and creatine; or erythrocytes samples: C14:0, pentadecanoic acid (C15:0), C16:0, C17:0, C18:0, ALA, EPA e DHA. The associations of the nutrient intake estimate and BHEI-R scores with biomarkers concentrations were analyzed by Spearman correlation and partial correlation adjusted for energy, sex, age, and z-score for body mass index-for-age. Subjects were classified into quartiles according to nutrient intake estimates, BHEI-R scores and biomarkers and data were analyzed for quartile agreement between biomarkers vs. intake, comparison of biomarkers averages between the first and last intake quartiles, and trend analysis of biomarkers averages among the intake quartiles. Statistical analyzes were performed in software Statistical Package for Social Sciences (SPSS) ®, version 20.0, with a significance level of 5%. Results: The sample was composed of 177 subjects, the mean age was 11.5 (SD 1.1) years old and 52% were female. The biomarkers ?- carotene (r=0,168), ?-carotene/TC (r=0,171), 25(OH)D3 (r=0,209), C14:0 (r=0,211), and EPA (r=0,166) showed positive adjusted correlations with their respective intakes estimated by SFFQ. After adjusting for confounding variables, DHA showed correlation only in females (r=0,280). Regarding BHEI-R, vegetable components were correlated with biomarkers ?- carotene and ?-carotene/TC, while the modified components Total Vegetables without Legumes and Dark Green and Orange Vegetables without Legumes were correlated with the biomarkers vitamin B12 (r=0,194) and 5-MTHF (r=0,201), respectively. All components rich in vegetable (legumes) and animal protein (meat, eggs) were correlated with plasma creatine (r=0,205 a 0,327). The component Milk was correlated with biomarkers C14:0 (r = 0,169), pantothenic acid (r = 0,233), PLP (r = 0,283), and vitamin B12 (r = 0265). Biomarkers of Bcomplex vitamins were inversely correlated with the components Whole Grains; Meat, Eggs and Legumes; and Saturated Fat (r= -0,178 a -0,282). There was no correlation between biomarkers and total IQD-R score. The associations between the biomarkers and the nutrients estimated by the SFFQ and the components Total Vegetables without Legumes, Dark Green and Orange Vegetables without Legumes, Milk, and Saturated Fat were confirmed by quartiles agreement >70%, difference between biomarker average between first and last quartile of intake and trend of biomarker average among quartiles of intake. Conclusion: The nutrient estimates and the BHEI-R components, both obtained through the SFFQ, were validated according to the associations described above and can be used in clinical and epidemiological studies investigating the association between health outcomes and dietary intake of children and adolescents age 9 to 13 years in Ribeirão Preto - SP.

Introdução: Padrões alimentares estabelecidos na adolescência têm sido associados a fatores de risco para o desenvolvimento de doenças crônicas, tais como diabetes, doenças cardiovasculares e câncer. Objetivo: Avaliar os padrões da dieta de adolescentes e seus fatores associados. Metodologia: Utilizaram-se dados de adolescentes provenientes do estudo de base populacional do município de São Paulo. Foram utilizadas duas abordagens distintas na identificação dos padrões da dieta: o Índice de Qualidade da Dieta Revisado (IQD-R) e a análise fatorial. Para estimar a ingestão usual, foram coletados de um a cinco Recordatório de 24 horas (R24h), sendo o primeiro obtido no domicílio, juntamente com o Questionário de Frequência Alimentar (QFA), e os demais por telefone. Na primeira abordagem, o método proposto pelo National Cancer Institute estimou a distribuição da pontuação dos componentes do IQD-R, com base na ingestão usual e nas características da população. Na identificação dos padrões da dieta pela análise fatorial, primeiramente estimou-se o consumo usual pelo Multiple Source Method. Neste, além dos R24h, foram utilizadas informações complementares dos QFA, melhorando o modelo de probabilidade e consumo. Posteriormente à análise fatorial, modelos de regressão multivariada identificaram os fatores associados aos padrões da dieta. Resultados: A pontuação média do IQD-R (47,1), ajustada por sexo e escolaridade do chefe da família, foi semelhante entre homens (46,3) e mulheres (48,0). Observou-se um baixo consumo de Cereais integrais (0,3), Vegetais totais (1,0), Frutas totais (1,3) e inteiras (0,4); e um elevado consumo de Sódio (2,2), Gordura saturada (5,8) e GordAA (4,5), que representa as calorias provenientes de gordura sólida, álcool e açúcar de adição. Na análise fatorial, os dois padrões dietéticos retidos explicaram 17,1 por cento da variância total da ingestão. O padrão Tradicional, caracterizado pelo consumo de feijões, arroz, café/chá, açúcar, manteiga/margarina, carne bovina e bolacha doce, se associou negativamente ao sexo masculino, maior renda familiar e maior escolaridade do chefe da família. O padrão Dual, caracterizado pelo consumo de achocolatado, vegetais, leite integral, temperos (salada), queijo, carne processada/frios, pães/torradas, bala, suco e carne branca, se associou positivamente ao estado matrimonial (com companheiro) e maior escolaridade do chefe da família e à maior renda. Conclusão: Os adolescentes apresentam baixo consumo de fibras, principalmente sob a forma de frutas e cereais integrais, e alta ingestão de sódio, gorduras e açúcares. As duas abordagens forneceram informações consistentes e complementares sobre o comportamento alimentar dos adolescentes, podendo ser utilizadas para o desenvolvimento de programas de saúde pública que visem previnir e tratar doenças crônicas relacionadas com a dieta e que ocorrem ao longo da vida / Background: Adolescent dietary patterns have been associated with increased risk factors for chronic diseases, including diabetes, coronary heart disease and cancer. Objectives: To evaluate the dietary patterns among adolescents living in the municipally of São Paulo. Methods: Data of adolescents from a cross-sectional survey were analyzed. Two different approaches were used to evaluate the dietary patterns: the Brazilian Healthy Eating Index Revised (BHEI-R) and the factors analysis. To estimate the usual intake, it was collected a minimum of one and a maximum of five 24-hour dietary recall (24HR), in which the first one was obtained in the adolescents home, together with a Food Frequency Questionnaire (FFQ), and the others records were collected by phone. In the first approach, the method proposed by the American National Cancer Institute was used to estimate the distribution of the components of the BHEI-R, according to the usual intake and adjusted by the sociodemographic, anthropometric and lifestyle characteristics. To access the dietary patterns using the factor analysis, initially, the usual intake that was estimated by the Multiple Source Method. Beside the 24HR data, the FFQ was used as covariate information to improve the modeling of consumption probability and intake amount. After the factor analysis, multivariate linear regressions models identified the characteristics associated with the dietary patterns. Results: The estimated mean BHEI-R score (47.1 points), adjusted for gender and family heads schooling, was, being similar between males (46.3) and females (48.0). The results indicated lower consumption of Whole grains (0.3), Total vegetables (1.0), Total fruit (1.3) and Whole fruit (0.4); and higher intake Sodium (2.2), Saturated fat (5.8) and; SoFAAS (4.5), that comprise the calories from solid fat, alcohol intake and added sugar. The factor analysis identified two dietary patterns that together explained 17.1 per cent of the total variation in food intake. The Traditional diet, characterized by the consumption of beans, rice, coffee/tea, sugar, butter/margarine, beef and cookies, was inversely associated with be male, higher income and higher family heads schooling. The Dual diet, characterized by the consumption chocolate powder, vegetables, whole milk, salada dressings, cheeses, processed meats/cold cuts, breads/toasts/crackers, candies, juices and white meat (chicken and fish), was directly associated with higher income, family heads marital status (living with someone) and higher family heads schooling. Conclusion: The adolescents have lower dietary fiber intake, especially fruits and whole grains and higher intake of sodium, fats and sugars. Thus, the results of the two approaches provide consistent and complementary information about the adolescent dietary behavior that can be used to the development of public health programs, in order to prevent and treat dietrelated chronic diseases throughout the life course