Submitted in fulfillment of the requirements of the Masters of Applied Science in Food and Nutrition, Durban University of Technology, 2015. / AIM: The aim of the study was to identify the need, develop, implement and determine the effect of a Grade R Nutrition Education Programme (NEP) in order to make recommendations to the South African Department of Basic Education (DBE) to include an effective NEP in the pre-primary school education curriculum. OBJECTIVES: The objectives for this study is in two phases, The objective of the baseline study was to assess the need for nutrition education (NE) in Grade R in suburban areas of Durban and identify the most suitable nutrition education tools (NETs) for this age group. For the intervention study the objectives were 1) to develop a nutrition knowledge questionnaire (NKQ) to determine the existing nutrition knowledge of Grade R learners in suburban government and private schools in Durban, 2) to develop a nutrition education programme (NEP) for Grade R based on the South African Food-Based Dietary Guidelines (FBDGs) and the food groups, 3) to implement the NEP in Grade R in a government and private school, 4) to determine the effect of the NEP on the retention of FBDGs (Section one) and food group (Section two) knowledge, and 5) to compare the results between the control group (CG) and the government (EGG) and private (EPG) experimental school groups, and between genders. METHODS: A self-administered nutrition education needs questionnaire was completed by 20 Grade R teachers in Durban suburban schools. Nutrition education material was identified based on the results from the pilot study and a Nutrition education programme developed. The classroom-based intervention study involved 120 Grade R learners in three schools, two experimental schools: government (n=37) and private (n=40), with a control school (n=43), with 35 percent (n= 42) male and 65 percent (n=78) female participants, ranging in age from five to seven years. A validated questionnaire assessed baseline nutrition knowledge of these children. A qualified foundation phase teacher was trained to implement the NEP. The experimental school groups received eight one hour nutrition education (NE) lessons over an eight week period; the control group did not receive any NE. During the lesson firstly theory was covered then the children worked on the related fun activities in the Healthy Eating Activity Book (HEAB) and lastly involved in the nutrition educational games. These included a food group plate puzzles, a NEP board game, a card game and ‘My little story books’. A post-test determined the impact of the intervention. RESULTS: The baseline study confirmed the need for NE in Grade R and identified suitable NETs that were used in the intervention. At pre-test, the nutrition knowledge of Grade R children in the two experimental groups (EG) and one CG was very similar with knowledge of FBDGs greater than knowledge relating to the food groups. Both Grade R EGs showed a significant increase in knowledge for the whole test immediately after the intervention with the CG, achieving similar post-to pre-test results. The intervention had a significant impact on nutrition knowledge of Grade R children in both experimental schools (EGG p=0.004 and EPG p=0.001). The EPG were most knowledgeable regarding FBDGs with no significant difference in knowledge of the EGG. Food group knowledge in all schools was poor at baseline and the NEP resulted in the EGG obtaining the highest post-test results. Post-intervention for the whole test the EGG were marginally (0.80 percent) more knowledgeable than the EPG. The knowledge of boys and girls were very similar in pre-and post-test results. However, the boys were fractionally more knowledgeable than the girls in relation to the whole post-test. In Section two, relating to food group knowledge, girls were slightly more knowledgeable than boys although both genders lacked knowledge in relation to which foods belonged to a particular food group. CONCLUSION: The primary aim of formal NE was met as the statistical significance between the CG and experimental group post-test results was evident in the majority of Section one questions and in all questions in Section two. The NEP resulted in similar increase in knowledge of Grade R learners in the government and private experimental school groups in Durban. In addition, the boys and girls showed a minimal difference in nutrition knowledge.

The purpose of this study was to explore the incentives and barriers perceived by low-income women of child-bearing age related to their participation in nutrition education programs. The specific programs of concern in this study are the Expanded Food and Nutrition Education Program (EFNEP) and the Food Stamp Nutrition Education (FSNE) program. This qualitative study sought to hear the voices of the women so that nutrition programs can be made more successful in reaching this population. Personal interviews were conducted with 23 women in their homes or appropriate local sites, and transcripts were analyzed to identify categories and themes. People of low socioeconomic status and those with the least education have higher rates of obesity and overweight and suffer disproportionately from poor health. Women receiving Temporary Assistance to Needy Families (TANF) also receive Medicaid. Medicaid costs have escalated due to the obesity rate, which is currently estimated at 64% of the adult population. In addition, 30% of American children are experiencing obesity or are overweight. It is important for parents to understand the causes of obesity and the effects of the chronic diseases related to obesity. Prevention programs are more cost effective than medical treatment of the diseases associated with obesity, and proper nutrition can reduce the incidence of chronic diseases. Findings of this study suggest that isolation is the main impediment to participating in nutrition education programs. Missing from the interviewed women's circumstances are social capital, human capital, and economic capital. Social capital relates to the connections and relationships that are important in life. Human capital involves the knowledge and skills acquired through life experiences. Economic capital refers to individual wealth or economic resources available to an individual or community. Nutrition education programs should be refined to incorporate opportunities for socialization that will develop trust and reciprocity, as well as nutrition knowledge. Based on the results of this study, Virginia Cooperative Extension programs will be adapted to incorporate weight control and cooking classes with nutritious recipes. The learning environment will be safe, learner-centered, and fun. New marketing tools that are more appealing to the prospective clients will be developed. / Ed. D.

D. Tech. (Food Service Management, Department of Hospitality, Tourism and PR Management, Faculty of Human Sciences)|, Vaal University of Technology| / Background South Africa is one of the developing countries faced with the co-existence of undernutrition and overnutrition, often experienced within the same household. On the one hand, hunger, undernutrition and micronutrient deficiencies are linked to poverty and household food insecurity. Simultaneously, South Africans are exposed to ‘nutrition in transition’, where overweight and chronic diseases of lifestyle, such as diabetes mellitus, cardiovascular diseases and cancer are on the rise as part of the overnutrition profile. Sound nutrition is important throughout the lifecycle to combat under- and overnutrition and nutrition-related diseases. In urban areas, the grandmother or another senior female family member is often responsible for caring for the children in the household during the day. This includes physical, emotional and nutritional care. It is therefore essential for the caregiver to have good nutrition knowledge, to provide not only in her own needs, but also in those of the children. A nutrition education programme is one strategy for improving the nutrition knowledge of caregivers of children. Objective The primary objective in this study was to develop, tailor, implement and evaluate a nutrition education programme (NEP) for Sesotho-speaking females and caregivers of children in the Boipatong Township in the Vaal Region of South Africa and to test its impact in the short and longer term. Nutrition knowledge regarding four South African food-based dietary guidelines (FBDGs) was empirically tested before and after the intervention and then compared to a control group. In addition, dietary intake was assessed to detect any changes after the intervention in the medium term. Methodology In this both quantitative and qualitative methodologies were applied. Two frameworks, the United Nations Children’s Fund (UNICEF) Framework of Malnutrition (2004) and the Food and Agriculture Organisation (FAO) Framework for Nutrition Education (1997), gave structure to the planning, implementation and evaluation of the research project. This study’s nutrition education programme was based on a socio-ecological model to guide behavioural change in terms of healthy food choices. In the preparation phase, a situational analysis was performed by means of a cross-sectional analytical design using descriptive statistics. Socio-demographic and self-reported health information was obtained. Nutrition knowledge, based on the South African food-based dietary guidelines (FBDGs), was measured, and dietary intake was assessed and compared with the estimated average requirements (EARs) for their age categories. Phase two, the formulation phase, used an experimental design. The acceptability and understanding of the existing national nutrition education (NE) material for individuals with low living standards (LSM) was investigated in this phase of the nutrition education programme (NEP). A culturally tailored booklet was developed in English, translated into Sesotho, pilot tested and implemented as part of the nutrition education programme. Lesson plans were developed and pilot tested. A non-randomised control trial was used in the implementation and evaluation phases. The effect of the nutrition education programme on nutrition knowledge was quantitatively measured in a pre- and post-test design at each discussion session in the short term, using paired t-tests in the experimental group of caregivers. The evaluation phase tested the impact of the nutrition education in the longer term. Nutrition knowledge was measured quantitatively in a before-after intervention test design by means of a self-completed structured questionnaire, based on the four South African FDBGs included in the programme. A control group who was not subjected to any intervention was used to complete the same questionnaire before and after the intervention in the same time period as the experimental group. In the experimental group, dietary intake was assessed before and after the intervention to detect changes in dietary intake. No dietary intake was measured in the control group, as changes could be attributed to influences beyond the control of this study. Two randomly selected focus groups of the experimental group were run to provide deeper insight into their perceptions regarding the acceptability and understanding of the NEP and NE material. Results The situational analysis of the preparation phase revealed a poor community that displayed typical patterns of nutrition in transition, at risk of malnutrition. The median age of the sample of caregivers was 44 years (IQR 32-62). Income and consumption poverty was confirmed by 80.5 percent of households spending R300 or less on food, with 75 percent of households having between four and seven people living in the dwelling. Dietary results were indicative of food poverty and poor food choices, possibly due to monetary constraints. A low energy intake (median 5323 kJ/day; IQR 3369-7949), was observed. Only 13.9 percent reached the estimated energy requirement (EER) of 7855 kJ per day for their age category. The overall mean average requirements of the diet was 0.7 but the possiblity of micronutrient deficiencies could not be excluded with a MAR of 0.6 for vitamins and minerals respectively. The median nutrition knowledge was 50 percent (IQR 42-54%) The lowest score was obtained for the FBDG ‘Enjoy a variety of food’ (33.4%; 95% CI 1.1), followed by the FBDG on animal protein (40.3%; 95% CI 1.0). It was decided to augment these two FBDGs with the plant protein FBDG (54.3%; 95% CI 1.8). Despited a relatively good knowledge measured in the caregivers, none of the plant protein food items appeared in the top 20 food items most frequently consumed. The formulation phase included the testing of existing nutrition education material. Messages were well understood (60.5%). However, caregivers found the images contained in the pamphlets and the design of the pamphlets confusing. A definite need was identified for new, culturally acceptable NE material in the caregivers’ home language, Sesotho (74%). During the implementation phase the lectures were presented and the change in the short-term nutrition knowledge of the FBDGs was measured at every session by means of a pre-post-test design. The median age of the caregivers was 63 years (52-78). A significant change in nutrition knowledge was found for each FBDG in terms of the mean number of questions answered correctly by the participants between the results of each pre- and post-test. In the evaluation phase, the impact of the NEP was measured in the Boipatong experimental group and compared, regarding nutrition knowledge, to a control group in the longer term (three months after completion of the intervention). Median nutrition knowledge before the intervention was 49 percent (IQR 46-57) compared to 70 percent (IQR 68-73) after the intervention – an increase of 21 percent. In contrast, the control group showed an increase of only five percent. The results showed that the eating habits of many of the caregivers still fell substantially short of internationally recognised standards (estimated energy requirement (EER) and estimated average requirement (EAR)), and this could contribute to undernutrition as well as to an increased risk of diet-related chronic disease. A median kilojoule intake of 4788 kJ (IQR 3415-6596) per day before and 4651 kJ (IQR 3369-6664) per day after the intervention was registered. Carbohydrate foods remained an important source of energy. Calcium presented a major concern, as none of the participants reached the EAR despite a slight increase in the intake of milk (volume and frequency) after the intervention, as validated by the top 20 food lists and as measured by a nutrient average requirement (NAR) of 0.1 to 0.7 before and after the intervention respectively. The mean average requirements (MAR) remained relatively stable, at 0.7 (median) before the intervention and 0.6 after the intervention. The NEP thus had an insignificant positive effect on dietary intake, except for calcium, iodine and vitamin C intake, which showed significant increases. No relationships could be found between the MAR as an indicator of dietary quality and nutrition knowledge. However, this does not mean that an NEP is not a suitable strategy. Changes in food choices and dietary intake should be measured in the longer term, since lifestyle changes are challenging to adopt when people, especially those in deprived communities, do not have the financial means to make healthy food choices. Conclusion When planning nutrition education strategies to improve the health status of communities in deprived areas, one is faced with the difficulty of households with a low socio-economic status and poor dietary intake, which increases the risk of food and nutrition insecurity. The nutrition education programme, developed, tailored and implemented as an intervention strategy to address an identified need of caregivers, was effective in improving nutrition knowledge. Four of the South African dietary guidelines were used in the nutrition education programme tailored to the specific profile that emerged from the situational analysis and the development of supportive nutrition education material. Lesson plans and the Sesotho and English booklets are available for use in other nutrition education programmes. The study contributed to the understanding of food choices of the urban community of Boipatong as well as of the nutrient inadequacies observed. Nutrition knowledge alone is not enough to bring about changes in food choices when the means to do so are lacking. Poverty and nutrition are closely linked and thus difficult to separate.

This descriptive study examines the relationship between nutritional practices and academic performance among school-age children as suggested in the literature review.

This study was conducted to determine the impact of nutrition edu cation on participants of the Supplemental Food Program for Women, Infants and Children (WIC) and the Expanded Food and Nutrition Education Program (EFNEP). The specific objectives were to: 1) determine the impact of participation in EFNEP on iron status as assessed by hematocrit (hct) and ferritin levels; 2) determine the effect of nutrition knowledge on hct and ferritin values; and 3) determine the effect dietary behavior has on hct and ferritin levels for both WIC and EFNEP participants. Each study participant completed a 24-hour dietary recall record plus food frequency record, medical history, validated nutrition knowledge test, and finger stick blood sample prior to program enrollment or nutrition education, and again six months later. There were 42 WIC, 26 EFNEP, 23 WIC-control, and 23 EFNEP-control participants. Paired t-tests were used to find differences between preprogram and postprogram evaluation scores for the variables of nutrition knowledge score, hematocrit level, ferritin level, and levels of several nutrients. Nutrition knowledge test scores increased significantly from preprogram to postprogram for both WIC and EFNEP participants (14.2 ± 3.27 to 15.5 ± 2.89 for WIC, 14.2 ± 3.77 to 15.6 ± 2.79 for EFNEP). EFNEP participants also increased significantly in hct levels (38.5% ± 3.78 to 40.7% ± 2.13). Hematocrit levels did not change significantly for the WIC or control groups and nutrition knowledge did not increase for the control group between preprogram and postprogram evaluations. Mean intakes of vitamin A, vitamin c, calcium, and protein were above the RDA at preprogram and postprogram evaluations, yet the percentage of individual participants who consumed less than 67% of the RDA in this study was higher than in the continuing survey of Food Intake of Individuals - 1985. Improvement in nutrient intake at postprogram evaluations was encouraging. Regression analysis indicated that nutrition education classes in college, income level, and level of formal education each had a positive effect on nutrient intake and nutrition knowledge.

No description available.

xxi, 199 leaves: ill. / Introduction and purpose: This empirical study was carried out to determine the nutritional status and level of nutritional knowledge amongst orphaned children. A cycle menu will be developed after sensory evaluations of all protein enhanced dishes. Method: Anthropometric measures were used to determine the nutritional status and to measure the nutrition knowledge of 100 orphaned children aged 9 to 13 years old in Boipatong, Vaal region. A nutritional knowledge questionnaire was administered to the study group. Furthermore the anthropometric measurement was carried out and analysed with World Health Organization software (AnthoPius) using ±2 standard deviations cut off points, and data on nutritional knowledge were captured on Microsoft Excel and analysed for frequencies, mean and standard deviation (SD) using the Statistical Package for Social Science (SPSS) version 1'7. Results: The results for nutritional status revealed that 59% of the population studied were underweight, 40% were stunted and 25% were wasted. Most of the respondents (70%) scored less than 50% on the nutrition knowledge questionnaire. The mean correct answer for multiple choice questions was 29.65% and for true/false question was 50.34%. Conclusion: The orphaned children are under-nourished and wasted. Further to this, the nutrition knowledge of the orphans is poor. It is recommended that a nutrition education programme be implemented so as to address the issue of poor food choices and malnutrition. / National Research Foundation (NRF), VUT and Hubbs and Spokes Model

A obesidade é problema de saúde que afeta diversas sociedades. Seu tratamento deve ter abordagem multiprofissional e interdisciplinar. No entanto, tratamentos crônicos têm, em geral, menor adesão, pelo fato de exigirem muito empenho do sujeito para modificar seus hábitos de vida e atingir as metas propostas. O objetivo deste estudo foi investigar a taxa de abandono do tratamento da obesidade e seus aspectos motivacionais, com vistas a contribuir para o planejamento de estratégias terapêuticas mais eficazes que diminuam o impacto das consequências dessa doença para a saúde pública. O estudo foi realizado a partir de informações contidas no banco de dados do Programa de Reeducação Alimentar (PRAUSP), com informações de 192 adultos com excesso de peso, de ambos os sexos, que participaram de 14 grupos formados no período de 2004 a 2009, concluindo ou não a estratégia. Foi considerado abandono quando o indivíduo apresentou 30% ou mais de faltas nos 10 encontros realizados e não participou da avaliação final do programa. Com esses sujeitos, foi realizada uma entrevista para coleta de dados sociodemográficos, realização de medidas de circunferência da cintura, além de peso e estatura para cálculo do índice de massa corporal (IMC). Nesse momento, foi investigado o motivo do abandono e aplicada a Escala de Silhuetas para avaliação da imagem corporal. Como resultados, 82 pessoas abandonaram o programa (43,8%) e 50 delas aceitaram participar do estudo. A maioria era do sexo feminino (n=35; 70%) com idade média de 46,8 anos, casada (n=30; 60%) e ensino médio completo (n=28; 56%). Quase metade deles (n=23; 46%) tinha renda familiar mensal de quatro salários-mínimos. O motivo mais frequente do abandono citado pelos sujeitos foi o horário inadequado (46%). Depois da participação no PRAUSP, 80% (n=40) relataram alguma tentativa de redução de peso; 64% (n=32) obtiveram sucesso, mas 88% (n=44) referem que ainda precisam emagrecer. Mais da metade deles (n=26; 52%) participaria novamente do programa. O IMC médio antes do PRAUSP e atualmente foi de 33,4kg/m2±5,9kg/m2 e 33,8kg/m2±6,8kg/m2, respectivamente. Oito por cento (n=4) estão eutróficos e a porcentagem de obesidade grave aumentou de 12 para 18%. A circunferência da cintura média antes do PRAUSP e atualmente foi de 112,5cm±15,1cm e 109,7cm±14,4 cm para os homens e 102,4cm±13,1cm e 96,3cm±14,7 cm para as mulheres, respectivamente. Houve superestimação do tamanho corporal nas mulheres (p=0,00), ao se comparar o IMC atual (33,1kg/m²) com aquele relativo à silhueta que elas achavam que possuíam (IMC real=37,4kg/m²). A insatisfação corporal foi encontrada em todos indivíduos (p=0,00), ao escolherem silhuetas mais magras (IMC desejado= 27,4kg/m² para mulheres e 24,5kg/m² para homens (amostra total: 26,5kg/m²). Conclui-se que a taxa de abandono é alta e o motivo citado (horário incompatível com o trabalho) merece reflexão cuidadosa, visto que os indivíduos já tinham essa informação ao decidirem participar do programa. Nesse sentido, outros estudos são necessários para melhor compreensão dos fatores que interferem na adesão a estratégias para perda de peso. / Obesity is a health problem which affects many societies; its treatment should have a multiprofessional and interdisciplinary approach. However, chronic treatments have, in general, lower adherence because they require much individuals\' effort to modify their lifestyle and achieve proposed goals. This study aimed to investigate the dropout rate in treatment of obesity and its motivational aspects in order to contribute to the planning of more effective therapeutic strategies that reduce the impact of consequences of this disease to public health. The study was conducted based on information contained in the Food Retraining Program (PRAUSP) database with information about 192 overweight adults, men and women who participated in 14 groups formed in the period from 2004 to 2009, concluding or not the strategy. It was considered dropout when the individual had 30% or more absences during the 10 meetings and did not attend the final evaluation of the program. With these subjects, an interview was conducted to collect demographic data; the measures of waist circumference, weight and height to calculate body mass index (BMI) were performed. At this point, the reason for dropout was investigated and the Silhouettes Scale for assessment of body image was applied. As a result, 82 people left the program (43.8%) and 50 of them agreed to participate in the study. Most were female (n=35; 70%) with mean age of 46.8 years old, married (n=30, 60%) and with completed high school (n=28; 56%). Almost half of them (n=23, 46%) had monthly family income of four Brazilian minimum wages. The most frequent reason for dropout reported by subjects was the inadequate time (46%). After participation in PRAUSP, 80% (n=40) reported some attempt at weight reduction; 64% (n=32) were successful but 88% (n=44) state that they still need to lose weight. More than half of them (n=26; 52%) would participate in the program again. The mean BMI before PRAUSP and currently was 33.4kg/m2±5.9kg/m2 and 33.8kg/m2±6.8kg/m2, respectively. Eight percent (n=4) were eutrophic and the percentage of severe obesity increased from 12 to 18%. The average waist circumference before PRAUSP and currently was 112.5cm±15.1cm and 109.7cm±14.4 cm for men and 102.4cm± 13.1cm and 96.3cm±14.7 cm for women, respectively. There was overestimation of body size in women (p=0.00) when comparing the current BMI (33.1kg/m²) with the silhouette that they thought they had (real BMI=37.4 kg/m²). The body dissatisfaction was found in all subjects (p=0.00) by choosing leaner silhouettes (desired BMI=27.4 kg/m² for women and 24.5kg/m² for men (total sample: 26.5kg/m²). It was concluded that the dropout rate is high and the reason reported (time incompatible with the work) deserves careful consideration, since the individuals had this information when they decide to participate in the program. Thus, further studies are needed to better understanding of the factors that influence adherence to strategies for weight loss.

Introdução: Brasil e Colômbia têm investido na Atenção Primária à Saúde (APS) por meio do fortalecimento das ações educativas. Aponta-se a Educação Nutricional (EN) como uma estratégia de ação baseada em um processo de aprendizagem constante e dinâmico, que contribui para a formação de indivíduos autônomos, sendo os grupos uma ferramenta de trabalho. Entretanto, devido à falta de respaldo metodológico, verificou-se a importância de conhecer e analisar os grupos de EN, entre as duas maiores cidades destes países. Além disso, pretende-se explorar possíveis estratégias para a prática. Objetivo: Analisar as práticas e as teorias educativas utilizadas nos grupos de alimentação e nutrição, na Atenção Primária à Saúde, em São Paulo (Brasil) e Bogotá (Colômbia). Métodos: Estudo descritivo comparativo com abordagem qualitativa, realizado com nutricionistas da APS, constituído por cinco momentos: identificação dos nutricionistas, aplicação do questionário online, entrevista semiestruturada, elaboração da comparação e reflexão sobre possíveis estratégias. Aplicou-se a técnica do Discurso do Sujeito Coletivo para a análise das percepções sobre a EN. Para a comparação, segmentaram-se os dados por cidade e a contextualizou-se os achados na ótica da EN, grupo e APS. Resultados: Verificou-se semelhança no perfil dos entrevistados, entre São Paulo e Bogotá, porém com diferença na formação e na autonomia de trabalho. Obtiveram-se 17 Ideias Centrais da EN, classificadas em seis eixos temáticos. Observou-se que os eixos associam-se com as características grupais, que por sua vez, possuem diferenças relacionadas aos programas. Constatou-se que teoria e prática da EN estão em transição da abordagem tradicional para outra mais humanista. Entretanto, em uma velocidade lenta comparada às políticas e necessidades de saúde. Por meio da reflexão sobre estratégias para os grupos de EN, recomenda-se como metodologia de trabalho, especialmente para São Paulo, a articulação dos conceitos de Grupo Operativo, Problematização e Planejamento, dado que enfocam o aprendizado, a transformação e a autonomia. Considerações: Identificou-se que São Paulo e Bogotá, possuem uma herança conceitual das ações educativas, associada a sequelas políticas, como ausência de teoria e metodologias educacionais na construção da APS. Apresenta-se uma necessidade de investimento político e de gestão na formação dos profissionais de saúde que estão educando a população / Introduction: Brazil and Colombia have invested in the Primary Health Care (PHC) through the strengthening of educational activities. Points to Nutrition Education (NE) as an action strategy which based on a constant and dynamic learning process, which contributes to the formation of autonomous individuals, groups being a working tool. However, due to lack of methodological support, it is of importance to know and to analyze the groups of NE, between the two major cities of these countries. Furthermore, intend to explore possible strategies for practice. Objective: To analyze the practices and theories educational used in groups of food and nutrition, in Primary Health Care, in São Paulo (Brazil) and Bogota (Colombia). Methods: Descriptive and comparative study with qualitative approach performed with PHC nutritionists. Comprising five stages: identification of nutritionists, application of the online questionnaire, semi structured interview, development of the comparison and reflection about possible strategies. The technique applied was of the Discourse of the Collective Subjective, so to analyze the perceptions about NE. For comparison, the data was segmented by city and the findings contextualized in the optical of the NE, the group and PHC. Results: There was similarity in the profile of the respondents, between Sao Paulo and Bogotá, although with distinction in training and working autonomy. We obtained 17 Main Ideas of NE, classified into six themes. It was observed that the themes are associated with the group characteristics, which in turn, have differences related to the programs. It was found that the NE theory and practice are in transition from the traditional approach to a more humanistic. However, at a slow speed compared to policies and health needs. Through reflection about strategies for groups of NE, it is recommended as a work methodology, especially for São Paulo, the articulation of the concepts of Operative Group, Questioning and Planning, as focus on learning, the transformation and the autonomy. Considerations: We identified that Sao Paulo and Bogotá have a conceptual heritage of the educational activities, associated the policies fallout as the lack of educational theory and methodology in the construction of the PHC. Thus, presents a need for political investment and management in the training of health professionals who are \"educating\" the population

Objetivo: avaliar uma intervenção nutricional educativa desenvolvida para alunos de Universidades Abertas à Terceira Idade. Metodologia: a população de estudo foi constituída por indivíduos com 45 anos de idade ou mais, freqüentadores de quatro instituições de ensino no Município de São Paulo. O delineamento consistiu em estudo quase experimental do tipo \"antes\" e \"depois\", sem grupo controle. A ação educativa (quatro aulas de três horas cada; distribuição de uma apostila com o conteúdo das aulas e de guia alimentar com orientações gerais) era parte das atividades oferecidas pelas instituições e foi desenvolvida por nutricionistas durante o segundo semestre de 1996. Os dados pessoais, morbidade referida e de conhecimentos sobre nutrição foram coletados por meio de questionário autoaplicado. O conhecimento foi identificado aplicando-se teste especialmente elaborado. As práticas alimentares, identificadas por meio de registro de alimentos de três dias, tiveram como variáveis analisadas: valor energético total, proporção de macro nutrientes. teor de colesterol, de vitamina A, de cálcio e de ferro. O estado nutricional foi diagnosticado pelo Índice de Massa Corpórea. Resultados: a população inicial era constituída de 121 indivíduos, a maioria do sexo feminino, com idade inferior a 60 anos e situação sócio-cultural privilegiada quando comparada com a média da população brasileira; perfil de morbidade identificando sobrepeso, problemas de coluna, hipertensão arterial e hipercolesterolemia. Os temas de nutrição com maior porcentagem de respostas adequadas relacionaram-se aos cuidados preventivos da osteoporose e do envelhecimento precoce, à substituição de alimentos reguladores, número de refeições da dieta e à fonte de nutrientes antioxidantes. O desconhecimento maior foi sobre a função das gorduras dietéticas, alimentos ricos em colesterol e alimentos que colaboram no controle da hipercolesterolemia. A maioria desses indivíduos apresentou dieta adequada em termos de vitamina A, ferro e colesterol; e inadequada em termos de energia e distribuição calórica dos macro nutrientes (proteínas, carboidratos e lipídios). O consumo adequado apresentou associação estatística significativa entre percentual de gorduras e presença de doença cardíaca; percentual de gorduras e conhecimento sobre função dos lipídios; consumo de colesterol e sexo; consumo de vitamina A e responsabilidade pelas despesas no domicílio. A população estudada após a intervenção educativa constituiu-se de 44 indivíduos. Para esse grupo de indivíduos, as modificações identificadas foram: aumento dos conhecimentos sobre nutrição, diminuição de consumo de lipídios, de proteínas e de colesterol. As modificações citadas referiram-se ao tipo de alimento consumido, ingestão de água e maneira de preparar os alimentos. Estas modificações ocorreram por motivos de saúde, sendo as fontes de informações sobre nutrição mais citadas, a Universidade Aberta e o médico pessoal. Conclusão: apesar das limitações do estudo, concluiu-se que a intervenção nutricional educativa foi uma atividade importante para a promoção da saúde do grupo populacional analisado e que foi uma fonte de informação para as modificações realizadas. / Objective: to evaluate an educational nutrition intervention developed for students of Open Universities to the Third Age. Methodology: the studied population was constituted by individuals with 45 years or older, who frequent four teaching institutions in São Paulo County. The general plan consisted of quasi experimental study of the kind pre/test and post/test, with no control group. The educational action (four classes of three hours each; distribution of a study outline with the classes contents and a food guide with general information) was part of the activities offered by the institutions and was developed by nutritionists during the second term of 1996. The personal data, referred morbidity and concerning knowledge about nutrition were gathered by a self-applied questionnaire. The knowledge was identified applying specially elaborated test. The alimentary practices, identified by three days\' food diary, had as analyzed variables: total energetic value. macronutrient proportion. cholesterol. vitamin A, calcium and iron content. The nutrition status was diagnosed by the Body Mass Index. Results: the initial population was constituted of 121 individuals, mostly female, with age under 60 years old and privileged socio-cultural situation when compared with the average of Brazilian population; morbidity profile indicating overweight, column problems, arterial hypertension and hypercholesterolemia. The nutrition subject with greater percentage of adequate answers related to the preventive care of the osteoporosis and early aging, to the replacement of regulators foods, number of the meals and the sources of antioxidant nutrients. The greater lack of knowledge was about the function of the dietary fats, foods riches in cholesterol and foods that contribute to hypercholesterolemia control. Most ofthese individuaIs presented an adequate diet in terms of vitamin A, iron, calcium and cholesterol; and inadequate in terms of energy and caloric distribution of the nutrients (proteins, carbohydrates and lipids). The appropriate intake presented a significant statistical association among percentage of fats and presence of heart disease; percentage of fats and knowledge about function of the lipids; intake of cholesterol and sex; intake of vitamin A and responsibility for domestic expenses. After the educational intervention the studied population consisted of 44 individuais. For this group of individuals, the identified modifications were: increase of the knowledge about nutrition, decrease of consumption of lipids, protein and cholesterol. The mentioned modifications referred to the kind of food consumed, ingestion of water and ways of preparing the foods. These alterations occurred for health reasons, with the most mentioned information sources being the Open University and the personal doctor. Conclusion: despite of the limitations of the study, it was concluded that the educational nutritional intervention was an important activity for the health promotion to the analyzed population group besides being an information source for accomplished alterations.