Malnutrición y desigualdades en la España del franquismo; el impacto del complemento alimenticio lácteo en el crecimiento de los escolares españoles (1954-1978)

A lo largo del siglo XX, la población española fue consolidando su proceso de transición nutricional y alimentaria. En la etapa pre-transicional, se produjo un renovado interés por las deficiencias que mostraba la alimentación de los niños y se apostó por la educación alimentaria-nutricional para superarlas. El objetivo del trabajo es analizar el estado nutricional, a través de la talla como parámetro antropométrico, que mostraba la población escolar del ámbito rural español, entre las décadas de 1950 y 1970, su evolución y las diferencias que existían entre regiones. Los resultados ponen de manifiesto que al inicio de la década de 1960 se apreciaban dos patrones: un primer grupo donde la estatura de los niños de la costa cantábrica, zona de Levante, Cataluña y Baleares, mostraba niveles similares a los de niños bien alimentados; y un segundo grupo donde las tallas eran inferiores, en el que se encontraban las regiones de Andalucía, Extremadura y Galicia. Entre 1954 y 1977, las tallas de los niños bien alimentados mostraron un incremento que fue especialmente intenso entre 1954 y la primera mitad de la década de 1960. En el caso de los niños y niñas que acudían a las escuelas nacionales del ámbito rural, también se produjo un significativo incremento en la talla, además de corregirse las diferencias regionales que existían al principio de los años sesenta. En todos aquellos avances habrían influido tanto el complemento alimenticio, como las actividades de educación alimentación y nutrición que se llevaron a cabo en el marco del Programa EDALNU.

Estudio bibliométrico de programas e intervenciones sobre educación alimentaria y nutricional en el medio escolar en España

Introducción: La obesidad en la población infantil y juvenil en España se sitúa actualmente en el 13,9%, y el sobrepeso se encuentra en el 26,3%. Esto hace que sea fundamental la adopción en los primeros años de vida de unos hábitos alimentarios correctos, donde la educación alimentaria y nutricional, desarrollada dentro de los programas de educación para la salud en el medio escolar, juega un papel fundamental. El objetivo del presente trabajo fue analizar, mediante revisión bibliométrica, la producción científica existente sobre programas o intervenciones de educación alimentaria y nutricional desarrollados en el medio escolar en España que muestran influencia en la salud y/o en los hábitos alimentarios de los escolares. Material y Métodos: Estudio descriptivo transversal de los resultados obtenidos en la búsqueda bibliográfica de las bases de datos Medline, Cochrane Library Plus en Español, Cuiden, Excelencia clínica, IBECS, Scielo, CSIC (ICYT, ISOC e IME), Lilacs, Cuidatge y Teseo. Se estudiaron indicadores bibliométricos: bases de datos, revistas, documentos publicados, idiomas, autoría, Índice de colaboración y grado de obsolescencia (Semiperíodo de Burton y Kebler e Índice de Price), entre otros. Resultados: La búsqueda proporcionó un total de 148 registros. La tasa final de artículos pertinentes fue de 49 (33,11%). La base de datos que más registros pertinentes proporcionó fue Medline con 24 (48,98%). 42 de los registros seleccionados (85,71%) pertenecían a artículos originales. La revista Nutrición Hospitalaria fue la que presentó mayor número de publicaciones, con 11 (22,45%). El Semiperíodo de Burton y Kebler fue de 6 años y el Índice de Price fue de 42,86%. Conclusiones: Existe una gran producción de artículos científicos relacionados con programas de educación alimentaria y nutricional en el medio escolar en España, lo cual es un indicador de la importancia de la adquisición de hábitos alimentarios saludables en la población infantil y juvenil y del interés que despiertan.

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

DESAFIOS E REFLEXÕES NA IMPLANTAÇÃO DE UM PROGRAMA DE EDUCAÇÃO ALIMENTAR E NUTRICIONAL (EAN) EM INDIVÍDUOS COM EXCESSO DE PESO

Objetivo: Relatar a experiência das atividades de educação alimentar e nutricional (EAN) desenvolvidas em pacientes com sobrepeso e obesidade. Síntese de dados: Realizaramse sessões de educação alimentar e nutricional (EAN) com pacientes com sobrepeso e obesidade graus I e II atendidos no ambulatório do Hospital Universitário da Universidade Federal de Juiz de Fora (HU/UFJF), integrantes do projeto de extensão “Saúde na Balança”. As sessões ocorreram em grupo, semanalmente no 1º mês, quinzenalmente no 2º e 3º mês e mensalmente até o 6º mês, no período de setembro de 2012 a setembro de 2013. Durante um ano de atividades, foram realizados 4 grupos, com um total de 46 integrantes, que aceitaram participar das sessões. Nestas, foram abordados temas em nutrição que apoiavam o atendimento individual. A equipe identificou que local, horário, periodicidade das sessões, disponibilidade de tempo e falta de recursos financeiros eram fatores que influenciavam a adesão do paciente ao tratamento, sendo alguns deles modificados, já se observando melhora da adesão no último grupo. Entretanto, ainda foram registradas 17 desistências. Com o autorrelato dos pacientes, foi possível perceber mudanças positivas nos hábitos alimentares e na forma de se relacionar com a obesidade e as comorbidades associadas. Conclusão: No decorrer das atividades, criou-se vínculo entre equipe e participantes, permitindo identificação de demandas e de formas efetivas de atuação nos grupos, demonstrando que a EAN auxilia a abordagem individual, na medida em que permite troca de experiências e informações, ampliando o poder de escolha por hábitos de vida saudáveis.

AN ANALYSIS OF THE RELATIVE INFLUENCE OF RACE, INCOME, EDUCATION, AND FOOD STAMP PROGRAM PARTICIPATION/NONPARTICIPATION ON THE FOOD AND NUTRIENT CONSUMPTION OF A NORTH FLORIDA URBAN CLINIC POPULATION IN CONJUNCTION WITH A SURVEY OF NUTRITION RELATED HABITS AND ATTITUDES

The relative influence of race, income, education, and Food Stamp Program participation/nonparticipation on the food and nutrient intake of 102 fecund women ages 18-45 years in a Florida urban clinic population was assessed using the technique of multiple regression analysis. Study subgroups were defined by race and Food Stamp Program participation status. Education was found to have the greatest influence on food and nutrient intake. Race was the next most influential factor followed in order by Food Stamp Program participation and income. The combined effect of the four independent variables explained no more than 19 percent of the variance for any of the food and nutrient intake variables. This would indicate that a more complex model of influences is needed if variations in food and nutrient intake are to be fully explained.^ A socioeconomic questionnaire was administered to investigate other factors of influence. The influence of the mother, frequency and type of restaurant dining, and perceptions of food intake and weight were found to be factors deserving further study.^ Dietary data were collected using the 24-hour recall and food frequency checklist. Descriptive dietary findings indicated that iron and calcium were nutrients where adequacy was of concern for all study subgroups. White Food Stamp Program participants had the greatest number of mean nutrient intake values falling below the 1980 Recommended Dietary Allowances (RDAs). When Food Stamp Program participants were contrasted to nonparticipants, mean intakes of six nutrients (kilocalories, calcium, iron, vitamin A, thiamin, and riboflavin) were below the 1980 RDA compared to five mean nutrient intakes (kilocalories, calcium, iron, thiamin and riboflavin) for the nonparticipants. Use of the Index of Nutritional Quality (INQ), however, revealed that the quality of the diet of Food Stamp Program participants per 1000 kilocalories was adequate with exception of calcium and iron. Intakes of these nutrients were also not adequate on a 1000 kilocalorie basis for the nonparticipant group. When mean nutrient intakes of the groups were compared using Student's t-test oleicacid intake was the only significant difference found. Being a nonparticipant in the Food Stamp Program was found to be associated with more frequent consumption of cookies, sweet rolls, doughnuts, and honey. The findings of this study contradict the negative image of the Food Stamp Program participant and emphasize the importance of education. ^

Foods for health : report of the pilot program : a pilot nutrition education program by Giant Food Inc. in cooperation with the National Heart, Lung, and Blood Institute /

"August 1983."

Food Fury: Online Casual Game Development for Nutrition Education

Introduction: The United States is currently experiencing increased prevalence of obesity. This is a particular problem amongst children who require dietary and activity behavioral change to mitigate this problem. The use of computer games as channels to motivate health behavior in children is increasing. Casual games are a subset of computer games that are simple in design, easy to access and play, popular with children, and have the potential to be effective for drill and practice learning. [See PDF for complete abstract]

Development and evaluation of a nutrition education program designed to increase fruit and vegetable consumption in girls, ages 9--12

The purpose of this study is to evaluate the theory-based Eat 5 nutrition badge. It is designed to increase fruit and vegetable (F&V) intake in 4th-6th grade junior Girl Scouts. Twenty-two troops were recruited and randomized by grade level (4th, 5th, 6th, or mixed) into either the intervention or control conditions. The leaders in the intervention condition received a brief training and the materials and conducted the program with their troops during four meetings. The Girl Scouts in the intervention condition completed 1-day Food Frequency Questionnaires and Nutrition Questionnaires both before and after completing the Eat 5 badge, and a third measurement of F&V intake three months after the posttest. Girl Scouts in the control condition were only evaluated at the three time periods.^ The primary hypotheses were that the Girl Scouts in the intervention condition would increase their daily intake of fruits and vegetables at both the posttest and three months later, compared to the Girl Scouts in the control condition. Other study questions investigated the impact of the Eat 5 program on intervening variables such as knowledge, self-efficacy, barriers, norms, F&V preference, and F&V selection and preparation skills.^ A nested ANOVA, with troop as the unit of analysis nested within condition, was used to assess the effects of the program. Pretest F&V intake and grade level were used as covariates. Pretest mean F&V intake for the total sample of 210 girls was 2.50 servings per day; 3.0 for the intervention group (n = 101). Significant increases in F&V intake (to 3.4 servings per day), knowledge, and fruit and vegetable preference were found for the intervention condition troops compared to the troops in the control condition. Three months later, the mean F&V intake had returned to pretest levels.^ This study indicates that social groups such as Girl Scouts can provide a channel for nutrition education. Long term effects were not sustained by the intervention; a possible cause was the lack of change in self-efficacy. Therefore, additional interventions are recommended such as booster lessons to maintain increased F&V intake by Girl Scouts. ^

Impact of nutrition education on knowledge and eating patterns in HIV-infected individuals

Acquired Immune Deficiency Syndrome (AIDS) and impaired or threatened nutritional status seem to be closely related. It is now known that AIDS results in many nutritional disorders including anorexia, vomiting, protein-energy malnutrition (PEM), nutrient deficiencies, and gastrointestinal, renal, and hepatic dysfunction (1-7, 8). Reversibly, nutritional status may also have an impact on the development of AIDS among HIV-infected people. Not all individuals who have tested antibody positive for the Human Immunodeficiency Virus (HIV) have developed AIDS or have even shown clinical symptoms (9, 10). A poor nutritional status, especially PEM, has a depressing effect on immunity which may predispose an individual to infection (11). It has been proposed that a qualitatively or quantitatively deficient diet could be among the factors precipitating the transition from HIV-positive to AIDS (12, 13). The interrelationship between nutrition and AIDS reveals the importance of having a multidisciplinary health care team approach to treatment (11), including having a registered dietitian on the medical team. With regards to alimentation, the main responsibility of a dietitian is to inform the public concerning sound nutritional practices and encourage healthy food habits (14). In individuals with inadequate nutritional behavior, a positive, long-term change has been seen when nutrition education tailored to specific physiological and emotional needs was provided along with psychological support through counseling (14). This has been the case for patients with various illnesses and may also be true in AIDS patients as well. Nutritional education specifically tailored for each AIDS patient could benefit the patient by improving the quality of life and preventing or minimizing weight loss and malnutrition (15-17). Also, it may influence the progression of the disease by delaying the onset of the most severe symptoms and increasing the efficacy of medical treatment (18, 19). Several studies have contributed to a dietary rationale for nutritional intervention in HIV-infected and AIDS patients (2, 4, 20-25). Prospective, randomized clinical research in AIDS patients have not yet been published to support this dietary rationale; however, isolated case reports show its suitability (3). Furthermore, only nutrition intervention as applied by a medical team in an institution or hospital has been evaluated. Research is lacking concerning the evaluation of nutritional education of either non-institutionalized or hospitalized groups of persons who are managing their own food choice and intake. This study compares nutrition knowledge and food intakes in HIV-infected individuals prior to and following nutrition education. It was anticipated that education would increase the knowledge of nutritional care of AIDS patients and lead to better implementation of nutrition education programs.

Children’s food and activity patterns following a six-month child weight management program

Objective To describe the impact of a parent-led, family focused child weight management program on the food intake and activity patterns of pre-pubertal children. Methods n assessor-blinded, randomized controlled trial involving 111 (64% female) overweight, pre-pubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Study outcomes were assessed at baseline, 6 months, and 12 months. This paper presents data on food intake assessed via a validated 54-item parent completed dietary questionnaire and activity behaviours assessed via a parent-report 20-item activity questionnaire. Results Intake of energy-dense nutrient poor foods was lower in both intervention groups at 6 months (mean difference, P+DA -1.5 serves [CI -2.0;-1.0]; P -1.0 serves [-2.0;-0.5]) and 12 months (mean difference P+DA -1.0 serves [CI -2.0;-0.5]; P -1.0 serves [-1.5; 0.0]) compared to baseline. Intake of vegetables, fruit, breads and cereals, meat and alternatives and dairy foods remained unchanged. Regardless of study group there were significant reductions over time in the reported time spent engaged in small screen activities and an increase in the time reported spent in active play. Conclusion Child weight management intervention that promotes food intake in line with national dietary guidelines achieves a reduction in children’s intake of energy dense, nutrient poor foods. This was achieved without compromising intake of nutrient-rich food and changes in were maintained even once the intervention ceased.

Productivity and time use during occupational therapy and nutrition/dietetics clinical education : a cohort study

Background: Currently in the Australian higher education sector higher productivity from allied health clinical education placements are a contested issue. This paper will report results of a study that investigated output changes associated with occupational therapy and nutrition/dietetics clinical education placements in Queensland, Australia. Supervisors’ and students’ time use during placements and how this changes for supervisors compared to when students are not present in the workplace is also presented. Methodology/Principal Findings: A cohort design was used with students from four Queensland universities, and their supervisors employed by Queensland Health. There was an increasing trend in the number of occasions of service delivered when the students were present, and a statistically significant increase in the daily mean length of occasions of service delivered during the placement compared to pre-placement levels. For project-based placements that were not directly involved in patient care, supervisors’ project activity time decreased during placements, with students undertaking considerably more time in project activities. Conclusions/Significance: A novel method for estimating productivity and time use changes during clinical education programs for allied health disciplines has been applied. During clinical education placements there was a net increase in outputs, suggesting supervisors engage in longer consultations with patients for the purpose of training students, while maintaining patient numbers. Other activities are reduced. This paper is the first time these data have been shown and form a good basis for future assessments of the economic impact of student placements for allied health disciplines.

The political economy of food in schools : the case of Queensland State education

Food in schools is typically understood from a biomedical perspective. At practical, ideational and material levels, whether addressed pedagogically or bureaucratically, food in schools is generally considered from a natural sciences perspective. This perspective manifests as the bioenergetic principle of energy in versus energy out and appears in policy focused on issues such as obesity and physical activity. Despite the considerable literature on the sociology of food and eating, little is understood about food in schools from a sociological perspective. This oversight of one of the most fundamental requirements of the human condition--namely, food--should be of concern for educators. Investigating food through a political economy lens means understanding food in schools as part of broader economic, political, social and cultural conditions. Hence, a political economy of food and schooling is concerned with the formation of ideas about food relative to political, economic, and cultural ideologies in social practice. From a critical sociology study of food messages students receive in the primary school curriculum, this paper reports on some of the official food messages of an Australian state's education policy, as a case to highlight the current political economy of food in Australia. It examines the role of the corporate food industry in the formation of Australian food policy and how that policy created artefacts infused with competing messages. The paper highlights how food and nutrition policy moved from solely a health concern to incorporate an economic dimension and links that shift with the quality of food available in Queensland schools.

Reported consumption of takeaway food and its contribution to socioeconomic inequalities in body mass index

The aim of this study was to examine whether takeaway food consumption mediated (explained) the association between socioeconomic position and body mass index (BMI). A postal-survey was conducted among 1500 randomly selected adults aged between 25 and 64 years in Brisbane, Australia during 2009 (response rate 63.7%, N=903). BMI was calculated using self-reported weight and height. Participants reported usual takeaway food consumption, and these takeaway items were categorised into "healthy" and "less healthy" choices. Socioeconomic position was ascertained by education, household income, and occupation. The mean BMI was 27.1kg/m(2) for men and 25.7kg/m(2) for women. Among men, none of the socioeconomic measures were associated with BMI. In contrast, women with diploma/vocational education (β=2.12) and high school only (β=2.60), and those who were white-collar (β=1.55) and blue-collar employees (β=2.83) had significantly greater BMI compared with their more advantaged counterparts. However, household income was not associated with BMI. Among women, the consumption of "less healthy" takeaway food mediated BMI differences between the least and most educated, and between those employed in blue collar occupations and their higher status counterparts. Decreasing the consumption of "less healthy" takeaway options may reduce socioeconomic inequalities in overweight and obesity among women but not men.

Porosity: Establishing the relationship between drying parameters and dried food quality [SpringerBriefs in Food, Health, and Nutrition]

The preservation technique of drying offers a significant increase in the shelf life of food materials, along with the modification of quality attributes due to simultaneous heat and mass transfer. Variations in porosity are just one of the microstructural changes that take place during the drying of most food materials. Some studies found that there may be a relationship between porosity and the properties of dried foods. However, no conclusive relationship has yet been established in the literature. This paper presents an overview of the factors that influence porosity, as well as the effects of porosity on dried food quality attributes. The effect of heat and mass transfer on porosity is also discussed along with porosity development in various drying methods. After an extensive review of the literature concerning the study of porosity, it emerges that a relationship between process parameters, food qualities, and sample properties can be established. Therefore, we propose a hypothesis of relationships between process parameters, product quality attributes, and porosity.

Nutrition and Nutritional Care of Elderly People in Finnish Nursing Homes and Hospitals

Background: Malnutrition is a common problem for residents of nursing homes and long-term care hospitals. It has a negative influence on elderly residents and patients health and quality of life. Nutritional care seems to have a positive effect on elderly individuals nutritional status and well-being. Studies of Finnish elderly people s nutrition and nutritional care in institutions are scarce. Objectives: The primary aim was to investigate the nutritional status and its associated factors of elderly nursing home residents and long-term care patients in Finland. In particular, to find out, if the nursing or nutritional care factors are associated with the nutritional status, and how do carers and nurses recognize malnutrition. A further aim was to assess the energy and nutrient intake of the residents of dementia wards. A final objective was to find out, if the nutrition training of professionals leads to changes in their knowledge and further translate into better nutrition for the aged residents of dementia wards. Subjects and methods: The residents (n=2114) and patients (n=1043) nutritional status was assessed in all studies using the Mini Nutritional Assessment test (MNA). Information was gathered in a questionnaire on residents and patients daily routines providing nutritional care. Residents energy and nutrient intake (n=23; n=21) in dementia wards were determined over three days by the precise weighing method. Constructive learning theory was the basis for educating the professionals (n=28). A half-structured questionnaire was used to assess professionals learning. Studies I-IV were cross-sectional studies whereas study V was an intervention study. Results: Malnutrition was common among elderly residents and patients living in nursing homes and hospitals in Finland. According to the MNA, 11% to 57% of the studied elderly people suffered from malnutrition, and 40-89% were at risk of malnutrition, whereas only 0-16% had a good nutritional status. Resident- and patient-related factors such as dementia, impaired ADL (Activities of Daily Living), swallowing difficulties and constipation mainly explained the malnutrition, but also some nutritional care related factors, such as eating less than half of the offered food portion and not receiving snacks were also related to malnutrition. The intake of energy and some nutrients by the residents of dementia wards were lower than those recommended, although the offered food contained enough energy and nutrients. The proportion of residents receiving vitamin D supplementation was low, although there is a recommendation and known benefits for the adequate intake of vitamin D. Nurses recognized malnutrition poorly, only one in four (26.7%) of the actual cases. Keeping and analysing food diaries and reflecting on nutritional issues in small group discussions were effective training methods for professionals. The nutrition education of professionals had a positive impact on the energy and protein intake, BMIs, and the MNA scores of some residents in dementia wards. Conclusions: Malnutrition was common among elderly residents and patients living in nursing homes and hospitals in Finland. Although residents- and patient related factors mainly explained malnutrition, nurses recognized malnutrition poorly and nutritional care possibilities were in minor use. Professionals nutrition education had a positive impact on the nutrition of elderly residents. Further studies describing successful nutritional care and nutrition education of professionals are needed.