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Los actuales procesos de globalización que caracterizan a las sociedades más desarrolladas llevan implícitos altos niveles de conectividad y la proliferación de interrelaciones inimaginables hasta ahora. Ese proceso de globalización ha generado grandes avances sociales y económicos a nivel internacional, sin ser España una excepción. Nuestro país ha alcanzado altas cotas de desarrollo en las últimas décadas, lo que convierte a la sociedad española en una de las más avanzadas del mundo. Esta circunstancia revierte en ella misma, ofreciéndole un amplio abanico de posibilidades para la mejora de los niveles de calidad de vida y bienestar. No obstante, del grado de desarrollo social y económico también se derivan situaciones que dificultan el pleno desarrollo personal y los estilos de vida saludable. En este sentido, es indudable que los ritmos de vida, donde lo laboral parece primar sobre lo social, y la consecuente y creciente dificultad para la conciliación de la vida laboral y la vida familiar, hacen que esa misma sociedad que se beneficia de altos niveles de desarrollo económico, se vea perjudicada a la hora de encontrar tiempo para el desarrollo de la individualidad de las personas. En ese proceso de desarrollo y plenitud individual la salud juega un papel fundamental y, dentro de ésta, el conocimiento del propio cuerpo, la práctica habitual de ejercicio físico, la adecuada gestión emocional y la adquisición de ciertos hábitos de alimentación desempeñarán un rol fundamental para el mantenimiento de niveles saludables en nuestra sociedad. Obviamente, de una sociedad que encuentra dificultades para conciliar vida laboral y vida familiar, se puede deducir que los grandes perjudicados serán niños y adolescentes en lo que respecta a su calidad de vida. Es cierto que en las sociedades desarrollas, una vez que niños y adolescentes finalizan sus periodos escolares, desempeñan una gran cantidad de actividades extraescolares, ya sean deportivas o académicas. Sin embargo, ¿qué lugar ocupa la educación nutricional para la adquisición de hábitos de alimentación saludables? ¿Qué ocurre con el consumo responsable de alimentos frente al consumo impulsivo y descontrolado? A este respecto, los últimos estudios sobre alimentación infantil señalan que todavía hoy en España existe una prevalencia de un 23,2% de sobrepeso y un 18,1% de obesidad infantil, lo que implica un alto riesgo para el desarrollo de diversas enfermedades en el futuro de niños y niñas en edad escolar (ALADINO, 2015). Ante estos datos tan negativos, ¿qué medidas adoptan ámbitos tan dispares como las administraciones públicas, los centros educativos y las familias? El presente trabajo tiene por objeto abordar los retos a los que se enfrenta la sociedad actual en términos de alimentación, así como la situación real de la población en edad escolar desde la perspectiva de sus hábitos de alimentación, aportando además coherencia a las diversas propuestas que surgen desde la política educacional y que tratan de hacer partícipes a los principales agentes educativos, es decir, administraciones, familias y escuelas. Asimismo, se pretende analizar la importancia que tiene la colaboración de los principales agentes educativos en la adquisición de estilos de alimentación saludables, así como proponer programas y actuaciones educativas aplicables en el ámbito escolar que podrían aportar claridad e, incluso, orientar diversos proyectos dentro del marco de las instituciones educativas existentes en España. The current globalization processes that characterize the most developed societies imply high levels of connectivity and the proliferation of interrelationships unimag-inable until now. This process of globalization has generated great social and eco-nomic advances at the international level, and Spain is no exception. Our country has reached high levels of development in recent decades, making Spanish society one of the most advanced in the world. This circumstance is reflected in the country it-self, offering a wide range of possibilities for improving quality of life and well-being. However, the degree of social and economic development also gives rise to situations that hinder full personal development and healthy lifestyles. In this sense, there is no doubt that the rhythms of life, where the work seems to take precedence over the social, and the consequent and growing difficulty in reconciling work and family life, mean that the same society that benefits from high levels of economic development is harmed when it comes to finding time for the development of people’s individuality. In this process of individual development and fulfilment, health plays a fundamental role and, within this, knowledge of one’s own body, regular physical exercise, adequate emotional management and the acquisition of certain eating habits will play a fun-damental role in maintaining healthy levels in our society. Obviously, from a society that finds it difficult to reconcile work and family life, it can be deduced that the great-est sufferers will be children and adolescents with regard to their quality of life. It is true that in developing societies, once children and adolescents have finished their schooling, they engage in a large number of extracurricular activities, whether they be sporting or academic. However, what place does nutritional education occupy in the acquisition of healthy eating habits? What happens with the responsible consumption of food as opposed to impulsive and uncontrolled consumption? In this respect, the latest studies on child nutrition indicate that even today in Spain there is a prevalence of 23.2% of overweight and 18.1% of child obesity, which implies a high risk for the de-velopment of various diseases in the future of school-age children (ALADINO, 2015). In view of these negative data, what measures are being taken by areas as diverse as public administrations, educational centres and families? This paper aims to address the challenges facing society today in terms of nutrition, as well as the real situation of the school-age population from the perspective of their eating habits, also providing coherence to the various proposals arising from educational policy and trying to in-volve the main educational agents, ie, administrations, families and schools. Likewise, the aim is to analyse the importance of the collaboration of the main educational agents in the acquisition of healthy eating styles, as well as to propose educational programmes and actions applicable in the school environment that could provide clar-ity and even guide various projects within the framework of the existing educational institutions in Spain.

School-based obesity prevention programs are key to promoting healthy habits. The aim of this study was to evaluate the effect of the Planet Nutrition program on BMI z-score and other parameters compared to a control group of Mexican schoolchildren after 9 weeks of intervention. The effect of the summer holidays on the BMI z-score was also evaluated at 23 weeks. A pilot randomized controlled trial design was used and 41 schoolchildren were randomized (21 intervention group and 20 control). The program included 18 nutrition education sessions, 20 physical activity classes and six brochures for parents. At 9 weeks, no significant differences were found between the intervention and control groups in the change in BMI z-score (&minus, 0.11, 95% CI &minus, 0.23, 0.01). Significant differences were observed in some secondary outcomes: body fat percentage (&minus, 1.72, 95% CI &minus, 3.42, &minus, 0.02), waist circumference (&minus, 3.45, 95% CI &minus, 5.55, &minus, 1.36), physical activity (0.44, 95% CI 0.01, 0.88) and nutrition knowledge (1.15, 95% CI 0.27, 2.03). Summer holidays negatively affected the BMI z-score in both groups, reducing the difference observed between groups at 9 weeks (&minus, 0.07, 95% CI &minus, 0.22, 0.07). The Planet Nutrition program showed favorable effects in some obesity and lifestyle parameters in the short term.

Made available in DSpace on 2021-06-25T11:03:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Contemporary living conditions present opportunities that promote obesity. In addition, traditional nutritional intervention have been considered inefficient, and there is a demand for the development and evaluation of strategies not based on the traditional paradigm of diets. Aim: The aim of this study is to describe the Food and Nutrition Education Program with Sensory and Cognitive Exercises (PESC), which seeks to promote consciousness of eating experience and body signals appreciation to adult women and thus to make them less vulnerable to food consumption stimuli. Method: This protocol outlines a randomized study that will include 60 adult women. PESC is based on the sensory influence for eating behavior and on the Triple-Aspect Monism theory of consciousness. It is composed of exercises that explore sensory, cognitive and emotional aspects of food experience in order to promote it into a conscious process. The program consists of four weekly workshops that explore themes related to the current obesogenic environment problematic. The intervention group (n=30) will be evaluated at the beginning of the first workshop and after the last one. The control group (n=30) will not participate on the workshops and will be evaluated twice, with a one-month interval. Conclusions: This study will contribute substantially to the development of nutritional interventions based on sensory aspects and consciousness of food experience. Therefore, PESC is considered an innovative approach with regard to improving individuals’ eating behavior. Trial registry: This clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC), http://www.ensaiosclinicos.gov.br/rg/RBR-4qgpg5/,numberRBR-4qgpg5. Internal Medicine Department Ribeirão Preto Medical School University of São Paulo (USP) Laboratory of Food Practices and Behavior – PrátiCA University of São Paulo (USP) Department of Education Biosciences Institute São Paulo State University (UNESP) Nutrition and Metabolism Health Sciences Department Ribeirão Preto Medical School University of São Paulo (USP) Department of Education Biosciences Institute São Paulo State University (UNESP)

Background The study evaluates children in schools that participate in the School Health Program in the Northern region of Brazil with the objective of assessing whether their schools interfered in the development of overweight/obesity and how individual and school environment variables behave according to contextual analysis. Methods The analyses were carried out with 1036 children from 25 municipal public schools in Northern Brazil that participated in the School Health Program. We evaluated both individual characteristics and scholar environment through univariate and multivariate logistic regressions to identify which of these factors were related to overweight/obesity as well as the effect of varying such associations. Results The considered individuals had an median age of 8 years, being 54.9% female and 27.8% presenting overweight/obesity. In multivariate logistic regression, the overweight/obesity variance in schools was 0.386 (individual variables) and 0.102 (individual and school variables), explaining 23.7% of the variation, reduction of ICC and MOR. The Akaike Information Criterion between the models was reduced and the likelihood ratio indicated better adequacy of the latter model. The investigated children had a greater chance of developing overweight/obesity when they performed 2+ sedentary activities/day, depending on school location as well as whether or not candies were sold in the school surroundings. On the other hand, a lower chance of developing overweight/obesity was identified in children that ate 5+ meals/day and practiced dance at school. Conclusion We observed that the variables inherent to both individuals and schools favored the development of overweight/obesity in children. It is relevant that scholar curriculums incorporate healthy eating interventions and encourage body practices associated with policies that restrain the sale of ultra-processed food in schools as well as the development of intersectoral actions between education and health to control childhood obesity.

Background and aims: Fasting of Ramadan leads to changes in dietary habits, physical activity, sleep and time of drug intake for diabetics. The objective of this study was to evaluate the effect of pre-Ramadan education on dietary intake and anthropometry of two groups of patients.Material and methods: The entire cohort was divided in a group (G1; n=86) which attended nutritional education sessions and group that did not attend these sessions (G2; n=72). The protocol included three visits before, during and after the month of Ramadan.Results. Total energy intake of the G1 did not differ significantly between visits, unlike the G2. Patients in the G1 reduced their carbohydrate intake during Ramadan with 32.5g, compared to the G2 which decreased their consumption with17.2g. The intake of saturated fatty acids was significantly higher in the G2 (p=0.001) after Ramadan. The number of obese class 2 of the G1 decreased after Ramadan, however for the G2, the number increased. The waist-to-hip ratio and the body fat (%) were unchanged between the three periods.Conclusion. The management of diabetes should be multidisciplinary to ensure better continuity of care. Specialized and individual educational actions must be concrete in diabetics wishing to fast.

Los actuales procesos de globalización que caracterizan a las sociedades más desarrolladas llevan implícitos altos niveles de conectividad y la proliferación de interrelaciones inimaginables hasta ahora. Ese proceso de globalización ha generado grandes avances sociales y económicos a nivel internacional, sin ser España una excepción. Nuestro país ha alcanzado altas cotas de desarrollo en las últimas décadas, lo que convierte a la sociedad española en una de las más avanzadas del mundo. Esta circunstancia revierte en ella misma, ofreciéndole un amplio abanico de posibilidades para la mejora de los niveles de calidad de vida y bienestar. No obstante, del grado de desarrollo social y económico también se derivan situaciones que dificultan el pleno desarrollo personal y los estilos de vida saludable. En este sentido, es indudable que los ritmos de vida, donde lo laboral parece primar sobre lo social, y la consecuente y creciente dificultad para la conciliación de la vida laboral y la vida familiar, hacen que esa misma sociedad que se beneficia de altos niveles de desarrollo económico, se vea perjudicada a la hora de encontrar tiempo para el desarrollo de la individualidad de las personas. En ese proceso de desarrollo y plenitud individual la salud juega un papel fundamental y, dentro de ésta, el conocimiento del propio cuerpo, la práctica habitual de ejercicio físico, la adecuada gestión emocional y la adquisición de ciertos hábitos de alimentación desempeñarán un rol fundamental para el mantenimiento de niveles saludables en nuestra sociedad. Obviamente, de una sociedad que encuentra dificultades para conciliar vida laboral y vida familiar, se puede deducir que los grandes perjudicados serán niños y adolescentes en lo que respecta a su calidad de vida. Es cierto que en las sociedades desarrollas, una vez que niños y adolescentes finalizan sus periodos escolares, desempeñan una gran cantidad de actividades extraescolares, ya sean deportivas o académicas. Sin embargo, ¿qué lugar ocupa la educación nutricional para la adquisición de hábitos de alimentación saludables? ¿Qué ocurre con el consumo responsable de alimentos frente al consumo impulsivo y descontrolado? A este respecto, los últimos estudios sobre alimentación infantil señalan que todavía hoy en España existe una prevalencia de un 23,2% de sobrepeso y un 18,1% de obesidad infantil, lo que implica un alto riesgo para el desarrollo de diversas enfermedades en el futuro de niños y niñas en edad escolar (ALADINO, 2015). Ante estos datos tan negativos, ¿qué medidas adoptan ámbitos tan dispares como las administraciones públicas, los centros educativos y las familias? El presente trabajo tiene por objeto abordar los retos a los que se enfrenta la sociedad actual en términos de alimentación, así como la situación real de la población en edad escolar desde la perspectiva de sus hábitos de alimentación, aportando además coherencia a las diversas propuestas que surgen desde la política educacional y que tratan de hacer partícipes a los principales agentes educativos, es decir, administraciones, familias y escuelas. Asimismo, se pretende analizar la importancia que tiene la colaboración de los principales agentes educativos en la adquisición de estilos de alimentación saludables, así como proponer programas y actuaciones educativas aplicables en el ámbito escolar que podrían aportar claridad e, incluso, orientar diversos proyectos dentro del marco de las instituciones educativas existentes en España. The current globalization processes that characterize the most developed societies imply high levels of connectivity and the proliferation of interrelationships unimag-inable until now. This process of globalization has generated great social and eco-nomic advances at the international level, and Spain is no exception. Our country has reached high levels of development in recent decades, making Spanish society one of the most advanced in the world. This circumstance is reflected in the country it-self, offering a wide range of possibilities for improving quality of life and well-being. However, the degree of social and economic development also gives rise to situations that hinder full personal development and healthy lifestyles. In this sense, there is no doubt that the rhythms of life, where the work seems to take precedence over the social, and the consequent and growing difficulty in reconciling work and family life, mean that the same society that benefits from high levels of economic development is harmed when it comes to finding time for the development of people’s individuality. In this process of individual development and fulfilment, health plays a fundamental role and, within this, knowledge of one’s own body, regular physical exercise, adequate emotional management and the acquisition of certain eating habits will play a fun-damental role in maintaining healthy levels in our society. Obviously, from a society that finds it difficult to reconcile work and family life, it can be deduced that the great-est sufferers will be children and adolescents with regard to their quality of life. It is true that in developing societies, once children and adolescents have finished their schooling, they engage in a large number of extracurricular activities, whether they be sporting or academic. However, what place does nutritional education occupy in the acquisition of healthy eating habits? What happens with the responsible consumption of food as opposed to impulsive and uncontrolled consumption? In this respect, the latest studies on child nutrition indicate that even today in Spain there is a prevalence of 23.2% of overweight and 18.1% of child obesity, which implies a high risk for the de-velopment of various diseases in the future of school-age children (ALADINO, 2015). In view of these negative data, what measures are being taken by areas as diverse as public administrations, educational centres and families? This paper aims to address the challenges facing society today in terms of nutrition, as well as the real situation of the school-age population from the perspective of their eating habits, also providing coherence to the various proposals arising from educational policy and trying to in-volve the main educational agents, ie, administrations, families and schools. Likewise, the aim is to analyse the importance of the collaboration of the main educational agents in the acquisition of healthy eating styles, as well as to propose educational programmes and actions applicable in the school environment that could provide clar-ity and even guide various projects within the framework of the existing educational institutions in Spain.

RESUMEN En Paraguay, más del 50% de la población adulta presenta sobrepeso y obesidad, lo cual a su vez es un detonante para la génesis de otras afecciones como la diabetes y las enfermedades cardiovasculares. Hacer hincapié en la prevención es importante para disminuir la incidencia de las enfermedades crónicas no trasmisibles. Es importante desarrollar intervenciones que incidan en la formación de hábitos alimentarios saludables en niños y adolescentes de manera a que contribuyan a la prevención de enfermedades. El objetivo del estudio fue evaluar el impacto de la entrega de frutas con educación nutricional sobre el estado nutricional y consumo de frutas, además de evaluar la aceptabilidad de la intervención en adolescentes del séptimo grado de la Escuela Héroes Luqueños. Estudio cuasi-experimental en el que se realizó la evaluación de una intervención educativa que consistió en talleres sobre la importancia de consumir frutas para alumnos, docentes y padres con posterior entrega de frutas. Se realizó la evaluación pre y post intervención del estado nutricional y del conocimiento sobre consumo de frutas. Se hallaron diferencias significativas (p

Resumen Objetivo Describir los resultados sobre el estado nutricional de niños/as de 8 a 14 años con sobrepeso u obesidad y poco activos/as, antes y después de una intervención nutricional con promoción de la actividad física (Programa ACTIVA’T). Método Estudio antes-después en población infantil (8-14 años) de Vilafranca del Penedès (Barcelona) con sobrepeso u obesidad y poco activos, aleatorizados en grupo control (n = 51, 47,1% niñas, intervención nutricional y actividad física ≤3h/sem) y en grupo ACTIVA’T (n = 45, 37,8% niñas, intervención nutricional y actividad física ≥5h/sem). Se determinaron el índice de masa corporal, el índice cintura/altura y la calidad de la dieta mediante el test KIDMED al inicio y al final del estudio. Durante la intervención, cada participante estuvo acompañado/a por un familiar (padre o madre) que realizó las mismas actividades que los/las niños/as. Resultados Las recomendaciones dietéticas han cambiado positivamente los hábitos del grupo ACTIVA’T y del grupo control. La reversión en la prevalencia de sobrepeso y obesidad ha sido del 93,8% y el 58,6%, respectivamente, en el grupo ACTIVA’T, frente al 25,0% y el 35,8% en el grupo control. La obesidad abdominal se redujo del 42,2% al 17,8% en el grupo ACTIVA’T y del 47,1% al 27,5% en el grupo control. Conclusiones El programa de educación nutricional y promoción de la actividad física ACTIVA’T mejora la calidad de la dieta y revierte la prevalencia de sobrepeso y obesidad en la población infantil poco activa. Abstract Objective To assess a 6-month nutritional and physical activity intervention program on the nutritional status of overweight or obese and not very active 8-14 years old children by means of a controlled pre-post design (ACTIVA’T program). Method Pre-post study in 8-14 years old overweight or obese and low active children from Vilafranca del Penedès (Barcelona, Spain) randomized in control group (n = 51, 47.1% girls, nutritional intervention and ≤3h/wk physical activity) and ACTIVA’T group (n = 45, 37.8% girls, nutritional and physical activity ≥5h/wk intervention). Body mass index, waist/height index, and diet quality by means of KIDMED test at the beginning and at the end of the program were assessed. During the intervention, each participant was accompanied by a relative (father or mother) who performed the same activities as the children. Results Dietary recommendations have positively changed the habits of both ACTIVA’T and control group. The reversion in the prevalence of overweight and obesity was 93.8% and 58.6%, respectively, in the ACTIVA’T group, compared to 25.0% and 35.8% in the control group. Abdominal obesity was decreased from 42.2% to 17.8% in the ACTIVA’T group and from 47.1% to 27.5% in the control group. Conclusions The program ACTIVA’T (nutritional education and physical activity promotion) improves the quality of diet and reverses the prevalence of overweight and obesity in the underactive child population.

International audience; Although current guidelines for obesity treatment endorse lifestyle modifications to achieve weight loss, energy-restricted diets are still the most commonly used method for the management of overweight. Diet restriction, however, not only is ineffective in promoting long-term weight loss but also may have more costs than benefits, predisposing the individual to fat regain. Several physiological and psychological mechanisms protect the body against starvation and explain how food restriction can promote paradoxically the opposite of what it is planned to achieve, triggering changes in energy metabolism, endocrine function and, thus, body composition. New approaches that focus on behavioral treatment without diet restriction, such as nutritional coaching, are showing strong growth that arises as an innovative way to create sustainable and effective lifestyle changes.

Introduction: Obesity is becoming an obstacle to global public health. Given the wide relationship between obesity and morbidities, such as diabetes, hypertension and dyslipidemias, the most commonly found solution for treating this condition is bariatric surgery. However, after surgery, some individuals report problems resulting from the adaptation of the food re-education process. Objective: to apply food and nutritional education intervention in individuals undergoing bariatric surgery. Methods: Face-to-face meetings were held with individuals undergoing bariatric surgery, with the aim of applying the Arch de Maguerez method, which through this method can identify what was the biggest problem that participants reported about food adherence. Results: From the discussions during the group meetings, it was verified that the main problems that the participants reported were the desire to consume foods containing simple carbohydrates and difficulties in choosing a product through the labels. From the definition of the problem, the participants received two interventions: "Supermarket Dynamics" and "Dynamics of Preparations ". Conclusion: The methodology applied in this public showed to be effective, considering that, the participants claimed that the technique used was satisfactory to solve the problems reported during the project. Introducción: Actualmente, la obesidad se ha convertido en un obstáculo para la salud pública mundial. Dada la amplia relación entre la obesidad y las morbilidades, como la diabetes, la hipertensión y la dislipidemia, la solución más común para el tratamiento de esta situación es la cirugía bariátrica. Sin embargo, después de la cirugía, algunos individuos refieren problemas derivados de la adaptación del proceso de reeducación alimentaria. Objetivo: aplicar una intervención de educación alimentaria y nutricional en individuos sometidos a cirugía bariátrica. Método: Se realizaron encuentros presenciales con sujetos sometidos a cirugía bariátrica, con el fin de aplicar el método del Arco de Maguerez, que a través de este, se logra identificar cuál fue el mayor problema que los participantes relataron sobre la adherencia alimentaria. Resultados: A partir de las discusiones realizadas durante las reuniones grupales, se verificó que los mayores problemas que los participantes relataron fueron el deseo de consumir alimentos que contienen carbohidratos simples y las dificultades en la elección de un producto a través de las etiquetas. Después de definir el problema, los participantes recibieron dos intervenciones: la "Dinámica del Supermercado" y la "Dinámica de Preparaciones". Conclusión: La metodología aplicada a esta audiencia demostró ser efectiva, dado que los participantes afirmaron que la técnica utilizada fue satisfactoria para solucionar los problemas reportados durante el proyecto. Introduzione: Attualmente, l'obesità è diventata un ostacolo alla salute pubblica globale. In considerazione della vasta relazione tra obesità e morbilità, come diabete, ipertensione e dislipidemia, la soluzione più comunemente trovata per il trattamento di questa situazione è la chirurgia bariatrica. Tuttavia, dopo l'intervento chirurgico, alcuni individui riferiscono problemi derivanti dall'adattamento del processo di rieducazione alimentare. Obiettivo: applicare l'intervento di educazione alimentare e nutrizionale nei soggetti sottoposti a chirurgia bariatrica. Metodo: Si sono svolti incontri faccia a faccia con soggetti sottoposti a chirurgia bariatrica, al fine di applicare il metodo dell'Arco di Maguerez, che attraverso questo, è possibile identificare quale sia stato il problema più grande che i partecipanti hanno segnalato in merito all'aderenza alimentare. Risultati: Dalle discussioni svolte durante gli incontri di gruppo, si è verificato che i maggiori problemi segnalati dai partecipanti erano il desiderio di consumare cibi contenenti carboidrati semplici e la difficoltà nella scelta di un prodotto attraverso le etichette. Dopo aver definito il problema, i partecipanti hanno ricevuto due interventi: la "Dinamica del Supermercato" e la "Dinamica degli allestimenti". Conclusione: la metodologia applicata a questo pubblico si è rivelata efficace, dato che i partecipanti hanno affermato che la tecnica utilizzata era soddisfacente per risolvere i problemi segnalati durante il progetto. Introdução: Atualmente a obesidade vem se tornando um obstáculo a saúde pública mundial. Tendo em vista a vasta relação entre a obesidade a as morbidades, como: diabetes, hipertensão e dislipidemias, a solução mais comumente encontrada para o tratamento desta situação, é a cirurgia bariátrica. Todavia, após a cirurgia, alguns indiví­duos relatam problemas decorrentes da adaptação do processo de reeducação alimentar. Objetivo: aplicar intervenção de educação alimentar e nutricional em indiví­duos submetidos a cirurgia bariátrica. Metodo: Foram realizados encontros presenciais com indiví­duos submetidos à bariátrica, com o intuito de se aplicar o método do Arco de Maguerez, que através deste, pode se identificar qual era o maior problema que os participantes relataram acerca da adesão alimentar. Resultados: A partir das discussões realizadas durante os encontros em grupos, foram verificados que os maiores problemas que os participantes relataram foram à vontade de consumir alimentos contendo carboidratos simples e a dificuldades em escolher um produto através dos rótulos. A partir da definição do problema, os participantes receberam duas intervenções: a "Dinâmica do Supermercado" e a "Dinâmica das Preparações". Conclusão: A metodologia aplicada neste público apresentou ser eficaz, tendo em vista que, os participantes alegaram que a técnica utilizada foi satisfatória para solucionar os problemas relatados durante o projeto. Introdução: Atualmente a obesidade vem se tornando um obstáculo a saúde pública mundial. Tendo em vista a vasta relação entre a obesidade a as morbidades, como: diabetes, hipertensão e dislipidemias, a solução mais comumente encontrada para o tratamento desta situação, é a cirurgia bariátrica. Todavia, após a cirurgia, alguns indiví­duos relatam problemas decorrentes da adaptação do processo de reeducação alimentar. Objetivo: aplicar intervenção de educação alimentar e nutricional em indiví­duos submetidos a cirurgia bariátrica. Metodo: Foram realizados encontros presenciais com indiví­duos submetidos à bariátrica, com o intuito de se aplicar o método do Arco de Maguerez, que através deste, pode se identificar qual era o maior problema que os participantes relataram acerca da adesão alimentar. Resultados: A partir das discussões realizadas durante os encontros em grupos, foram verificados que os maiores problemas que os participantes relataram foram à vontade de consumir alimentos contendo carboidratos simples e a dificuldades em escolher um produto através dos rótulos. A partir da definição do problema, os participantes receberam duas intervenções: a "Dinâmica do Supermercado" e a "Dinâmica das Preparações". Conclusão: A metodologia aplicada neste público apresentou ser eficaz, tendo em vista que, os participantes alegaram que a técnica utilizada foi satisfatória para solucionar os problemas relatados durante o projeto.

La obesidad es considerada un verdadero problema de salud pública, que afecta enormemente a la población infantil. El contexto escolar constituye un marco idílico para establecer propuestas de intervención que causen en el alumnado la adquisición de hábitos de vida saludable, en una edad crucial para ellos. El objetivo es evaluar el efecto de un programa de educación nutricional en la mejora de la calidad de la dieta y la adherencia a la dieta mediterránea en la población escolar. El estudio ha sido realizado sobre una muestra total de 179 escolares de segundo y tercer ciclo de Educación Primaria del C.E.I.P. Ortiz de Zúñiga. Obesity is considered a real public health problem, which greatly affects the child population. The school context constitutes an idyllic framework to establish intervention proposals that cause in the students the acquisition of healthy habits life, at a crucial age for them. To evaluate the effect of a nutritional education program on improving the quality of diet and adherence to the Mediterranean diet in the school population. The study has been carried out a total sample of 179 schoolchildren of the second and third cycle of Primary Education of the C.E.I.P. Ortiz de Zúñiga. L'obesitat és considerada un veritable problema de salut pública, que afecta enormement a la població infantil. El context escolar constitueix un marc idíl·lic per establir propostes d'intervenció que causin en l'alumnat l'adquisició d'hàbits de vida saludable, en una edat crucial per a ells. L'objectiu és avaluar l'efecte d'un programa d'educació nutricional en la millora de la qualitat de la dieta i l'adherència a la dieta mediterrània en la població escolar. L'estudi ha estat realitzat sobre una mostra total de 179 escolars de segon i tercer cicle d'Educació Primària del C.I.I.P. Ortiz de Zúñiga.

The obesity is a disease whose acceptance is difficult. It presents low uptake to treatment, maintenance and nutritional accompaniment. Currently, most of the health-care services in the country, especially private care, are not able to serve all patients, due to the high demand for cost. Facing the need for new services repair, users are compelled to search for other distinguished services, of high quality and low cost. Therefore, the purpose of this study was to verify the main reasons for abandonment of the nutritional treatment proposed in a nutrition clinic-school. The research was a cross-sectional descriptive study carried out through records of the clinic-school and telephone survey, answered by 150 obese people, male and female, from 21 to 60 years old, who have attended at least two nutrition appointments that constituted the sample of this study. The results indicated that the female gender prevailed (78%), classified as first degree of obesity (64%) and age from 41 to 50 years old (29,9%), treated for less than 30 days (56,41%). 84,61% declared having followed nutrition recommendations and never having gone through psychological treatment. The most cited reasons for abandonment were: lack of time, transportation and self-confidence. It is concluded thereupon that the abandonment of nutrition planning occurred mainly for issues related to the patients' lack of time and their financial and travel difficulties. La obesidad, al ser una enfermedad de difícil aceptación, tiene baja adherencia al tratamiento, mantenimiento y seguimiento nutricional, actualmente la mayoría de los tratamientos de salud que se encuentran en el país, especialmente en la red privada de salud, difícilmente alcanzan a todos los públicos, debido a la alta demanda de costo, en Ante la necesidad de nuevas reparaciones del servicio, los usuarios se ven obligados a buscar otros lugares que ofrezcan un servicio diferenciado, de buena calidad y bajo costo. Por ello, el objetivo de este estudio fue verificar las principales razones de abandono del tratamiento nutricional propuesto en una clínica escolar de nutrición. La investigación fue un estudio transversal y descriptivo, realizado a través de fichas médicas de la clínica escolar, y se apoyó con la aplicación telefónica de un cuestionario respondido por 150 obesos de ambos sexos, con edades entre 21 y 60 años, que participaron en al menos dos consultas nutricionales que constituyeron la muestra de este estudio. Indicaron mayor prevalencia del sexo femenino (78%), clasificada como obesidad clase I (64%) y con edad entre 41 y 50 años (29,9%), tratada por menos de 30 días (56,41%). El 84,61% respondió que había seguido las recomendaciones nutricionales y nunca había realizado tratamiento psicológico. Los motivos de abandono más citados fueron: falta de tiempo, transporte y confianza en uno mismo. Se concluye que el abandono de la planificación nutricional ocurrió principalmente por cuestiones relacionadas con la falta de tiempo de los pacientes y sus dificultades económicas y de desplazamiento. L'obesità, essendo una malattia di difficile accettazione, ha una bassa aderenza alle cure, al mantenimento e al monitoraggio nutrizionale, attualmente la maggior parte dei trattamenti sanitari presenti nel paese, in particolare nella rete sanitaria privata, difficilmente soddisfano tutte le fasce di pubblico, a causa dell'elevata domanda di costi, in vista la necessità di nuovi servizi di riparazione, gli utenti sono costretti a cercare altri luoghi che offrano un servizio differenziato, di buona qualità ea basso costo. Per questo motivo, l'obiettivo di questo studio è stato quello di verificare le ragioni principali dell'abbandono del trattamento nutrizionale proposto in un ambulatorio scolastico di nutrizione. La ricerca è stata uno studio trasversale e descrittivo condotto attraverso le cartelle cliniche dell'ambulatorio scolastico, e assistito dall'applicazione telefonica di un questionario a cui hanno risposto 150 soggetti obesi di entrambi i sessi, di età compresa tra 21 e 60 anni, che hanno partecipato ad almeno due consultazioni nutrizionali che hanno costituito il campione di questo studio. Hanno indicato una maggiore prevalenza di femmine (78%), classificate come obesità di classe I (64%) e di età compresa tra 41 e 50 anni (29,9%), trattate per meno di 30 giorni (56,41%). L'84,61% ha risposto di aver seguito le raccomandazioni nutrizionali e di non aver mai subito un trattamento psicologico. I motivi più citati dell'abbandono sono stati: mancanza di tempo, mezzi di trasporto e fiducia in se stessi. Si conclude che l'abbandono della pianificazione nutrizionale è avvenuto principalmente a causa di problemi legati alla mancanza di tempo dei pazienti e alle loro difficoltà finanziarie e di spostamento. A obesidade sendo uma doença de difí­cil aceitação, apresenta baixa adesão ao tratamento, manutenção e acompanhamento nutricional, atualmente a maior parte dos tratamentos em saúde encontrados no paí­s, principalmente na rede privada de saúde dificilmente atendem a todos os públicos, devido à alta demanda de custo, frente a necessidade de novos reparos dos serviços, os usuários são obrigados a procurarem por outros locais que oferecem atendimento diferenciado, de boa qualidade e baixo custo. Por esta razão, o objetivo do trabalho foi verificar os principais motivos do abandono ao tratamento nutricional proposto em uma clí­nica-escola de nutrição. A pesquisa foi um estudo transversal e descritivo realizado através de prontuários da clí­nica escola, e auxiliado com a aplicação por telefone de um questionário respondido por, 150 indiví­duos obesos de ambos os sexos, de 21 a 60 anos que participaram de no mí­nimo duas consultas nutricionais que constituí­ram a amostra deste estudo. Indicaram maior prevalência do sexo feminino (78%), classificados com obesidade classe I (64%) e idade de 41 a 50 anos (29,9%), tratados por um perí­odo inferior a 30 dias (56,41%). 84,61% responderam ter seguido as recomendações nutricionais e nunca ter passado por tratamento psicológico. Os motivos de abandono mais citados foram: falta de tempo, transporte e autoconfiança. Conclui-se que o abandono ao planejamento nutricional ocorreu principalmente por questões relacionadas à falta de tempo dos pacientes e suas dificuldades financeiras e de deslocamento. A obesidade sendo uma doença de difí­cil aceitação, apresenta baixa adesão ao tratamento, manutenção e acompanhamento nutricional, atualmente a maior parte dos tratamentos em saúde encontrados no paí­s, principalmente na rede privada de saúde dificilmente atendem a todos os públicos, devido à alta demanda de custo, frente a necessidade de novos reparos dos serviços, os usuários são obrigados a procurarem por outros locais que oferecem atendimento diferenciado, de boa qualidade e baixo custo. Por esta razão, o objetivo do trabalho foi verificar os principais motivos do abandono ao tratamento nutricional proposto em uma clí­nica-escola de nutrição. A pesquisa foi um estudo transversal e descritivo realizado através de prontuários da clí­nica escola, e auxiliado com a aplicação por telefone de um questionário respondido por, 150 indiví­duos obesos de ambos os sexos, de 21 a 60 anos que participaram de no mí­nimo duas consultas nutricionais que constituí­ram a amostra deste estudo. Indicaram maior prevalência do sexo feminino (78%), classificados com obesidade classe I (64%) e idade de 41 a 50 anos (29,9%), tratados por um perí­odo inferior a 30 dias (56,41%). 84,61% responderam ter seguido as recomendações nutricionais e nunca ter passado por tratamento psicológico. Os motivos de abandono mais citados foram: falta de tempo, transporte e autoconfiança. Conclui-se que o abandono ao planejamento nutricional ocorreu principalmente por questões relacionadas à falta de tempo dos pacientes e suas dificuldades financeiras e de deslocamento.

Objective: To assess a 6-month nutritional and physical activity intervention program on the nutritional status of overweight or obese and not very active 8-14 years old children by means of a controlled pre-post design (ACTIVAT program). Method: Pre-post study in 8-14 years old overweight or obese and low active children from Vilafranca del Penedes (Barcelona, Spain) randomized in control group (n = 51, 47.1% girls, nutritional intervention and = 5 h/wk intervention). Body mass index, waist/height index, and diet quality by means of KIDMED test at the beginning and at the end of the program were assessed. During the intervention, each participant was accompanied by a relative (father or mother) who performed the same activities as the children. Results: Dietary recommendations have positively changed the habits of both ACTIVAT and control group. The reversion in the prevalence of overweight and obesity was 93.8% and 58.6%, respectively, in the ACTIVAT group, compared to 25.0% and 35.8% in the control group. Abdominal obesity was decreased from 42.2% to 17.8% in the ACTIVAT group and from 47.1% to 27.5% in the control group. Conclusions: The program ACTIVAT (nutritional education and physical activity promotion) improves the quality of diet and reverses the prevalence of overweight and obesity in the underactive child population.

Introduction. Prenatal care is considered an important tool for promoting a healthy lifestyle, but has not been studied as a predictor for maternal weight gain during pregnancy, especially in Romania, where evidence about pregnancy and nutrition is scarce. Objective. This study has aimed to explore the relationship between pre-gestational body mass index (BMI), adequacy of prenatal care and weight gain during pregnancy. Methods. We carried a cross-sectional study on a sample of 400 pregnant women admitted at the ?Cuza Voda? Obstetrics and Gynecology Hospital in Iasi. Information regarding demographic characteristics, number of prenatal visits, date of the initial hospital record, nutritional education during pregnancy were registered throughout a questionnaire filled out by means of a direct interview. The anthropometric indicators analyzed were the pre-gestational BMI and the pregnancy weight gain. Data on caloric intake were obtained using a food frequency questionnaire. Results. Weight gain within the limits of the Institute of Medicine recommendations was noticed at 44.35% of the women who declared that they received nutritional advice compared to 40.7% of those who did not receive advice regarding diet during pregnancy. Overweight (53.1%) and obese women (66.7%) had a larger weight gain than those with a normal pre-pregnancy BMI (29.8%) (p

O presente estudo avaliou a eficácia de dois métodos de intervenção nutricional educativa entre mulheres praticantes de atividade física regular visando à adoção de práticas alimentares saudáveis. A população foi constituída de 52 mulheres de 19 a 59 anos, frequentadoras do Programa Academia da Cidade (Aracaju, SE). O estudo teve delineamento de comparação de dois grupos de intervenção e foi do tipo pré-teste/pós-teste. As ações educativas foram baseadas em dois protocolos, uma com ação menos intensiva (Grupo P1) e outra mais intensiva (Grupo P2), num período de dois meses. As variáveis analisadas foram as de conhecimento nutricional, medidas antropométricas e mudanças nos hábitos alimentares. As modificações identificadas foram melhora nos hábitos alimentares e redução do peso e Índice de Massa Corpórea para o Grupo P2. As modificações citadas referiram-se, principalmente, ao aumento do consumo de frutas, verduras e legumes, redução de gordura das preparações, redução do volume do alimento ingerido por refeição e aumento do fracionamento da dieta. Em relação aos conhecimentos em nutrição apenas 2 das 12 perguntas apresentaram aumento significativo da nota. A intervenção nutricional mais intensiva mostrou-se eficaz para mudanças de hábitos alimentares com repercussão na perda de peso corporal.The scope of this study was to evaluate the effectiveness of two methods of educational nutritional intervention together with women who practice regular physical activities by fostering the adoption of healthy eating habits. The study population consisted of 52 women aged between 19 and 59 who frequented the Academia da Cidade Program in Aracaju in the State of Sergipe. The study was a randomized comparison of two intervention groups and was of the pre-test/post-test variety. The educational activities were based on two protocols - one less intensive (P1 Group) and one more intensive (P2 Group) - over a period of two months. The variables analyzed were nutritional knowledge, anthropometric measurements and changes in eating habits. The changes identified were improvement in eating habits and reduction in weight and Body Mass Index for the P2 group. The modifications identified referred mainly to increased consumption of fruit and vegetables, reduction of fat in cooking, reduction in the volume of food eaten per meal and increased meal frequency. In relation to nutritional knowledge, only 2 of the 12 questions showed significant changes. The most intensive method proved effective in changing dietary habits leading to weight loss.

Resumen Objetivo: Evaluar los resultados de un programa de educación nutricional desarrollado con recursos locales para mejorar la calidad de la dieta y reducir la prevalencia de sobrepeso y obesidad en la población infantil. Método: Estudio longitudinal de intervención por educación nutricional (INFADIMED) en población infantil (3-7 años) de Vilafranca del Penedès (Barcelona) reclutada en centros de educación infantil y primaria, con grupo de intervención o INFADIMED (n = 319; 50,2% niñas) y grupo control (n = 880; 49,8% niñas). En ambos grupos se determinaron el peso, la talla y el índice de masa corporal al inicio y al final del programa. También se evaluó la adherencia al patrón dietético mediterráneo mediante el test KIDMED. Resultados: INFADIMED incrementó el porcentaje de sujetos que consumían fruta o zumos, vegetales, yogures o queso, pasta o arroz, y frutos secos; disminuyó el porcentaje de quienes no desayunaban o consumían bollería para desayunar, así como el consumo de dulces o caramelos varias veces al día. INFADIMED cambió, de inicio a final, los porcentajes de adherencia a la dieta mediterránea: alta (39,2% a 70,5%), aceptable (49,2% a 28,2%) y baja (11,6% a 1,3%). Los/las participantes que al inicio del estudio presentaron sobrepeso u obesidad y evolucionaron a normopeso fueron un 2,6% en el grupo control y un 11,3% en INFADIMED (odds ratio: 4,08; intervalo de confianza del 95%: 2,37-7,04). Conclusiones: INFADIMED es un programa de educación nutricional con incidencia positiva sobre la calidad de la dieta y la prevalencia de sobrepeso y obesidad en la población infantil. Abstract Objective: To assess the results of a nutritional education programme developed by using available local resources to improve diet quality and decrease overweight and obesity prevalence among children. Method: A longitudinal intervention study by means of nutritional education (INFADIMED) in children (aged 3-7 years) from Vilafranca del Penedès (Barcelona, Spain), recruited from preschool centres and primary schools, with an intervention or INFADIMED group (n = 319; 50.2% female) and a control group (n = 880; 49.8% female). Weight, height and body mass index were measured in both groups at the beginning and at the end of the programme. Adherence to the Mediterranean diet was also assessed using the KIDMED test. Results: Consumption of fruit or juices, vegetables, yogurt and/or cheese, pasta or rice, and nuts increased, while skipping breakfast, consumption of bakery products for breakfast, and/or consumption of sweets several times per day decreased in the INFADIMED group. INFADIMED also changed, from the beginning to the end of the study, the adherence to a Mediterranean diet: high (39.2% to 70.5%), acceptable (49.2% to 28.2%), and low (11.6% to 1.3%). Approximately 2.6% of the participants in the control group and 11.3% of the participants in the INFADIMED group who were overweight and obese changed to normal weight (odds ratio: 4.08; 95% confidence interval: 2.37-7.04). Conclusions: INFADIMED is a nutritional education programme with benefits on both diet quality and overweight and obesity prevalence among children.

Es necesario identificar las estrategias pedagógicas que se utilizan en la educación nutricional, que permitan a los profesionales y en especial a los Nutricionistas Dietistas establecer intervenciones nutricionales efectivas con los niños, adolescentes y sus familias quienes sufren de sobrepeso u obesidad con el fin de controlar el peso, disminuir y prevenir las consecuencias de este problema de salud pública. El objetivo principal de esta revisión fue identificar y analizar los métodos y estrategias educativas que subyacen en la literatura internacional sobre la atención y educación nutricional del niño y adolescente con sobrepeso u obesidad. Se utilizó la metodología de investigación documental con un análisis cualitativo y se incluyeron 40 documentos sobre el tratamiento y la prevención del sobrepeso y la obesidad en la niñez y la adolescencia realizados en diferentes países. Los resultados mostraron que las estrategias educativas se sustentan en las teorías de cambio conductual y cognitivo así como en los enfoques de la teoría cognitiva social y en las teorías y modelos de la educación para la salud. Las principales estrategias de la educación nutricional fueron: el establecimiento de objetivos, el auto monitoreo, la solución de problemas, el reforzamiento y el control de estímulos. En los escenarios clínicos las principales estrategias se relacionan con la consejería nutricional, la entrevista motivacional. Las intervenciones dirigidas a la familia incluyen el entrenamiento de padres y en los establecimientos educativos la estrategia más importante es el plan de estudio o “El currículo” de educación en nutrición y actividad física. También se presentan métodos y estrategias educativas inmersas en las políticas y planes dirigidos a la comunidad y la población para prevenir la obesidad en los niños y los adolescentes. Se sugiere llevar a la práctica de forma efectiva estas estrategias en todos los escenarios de tratamiento y en los centros educativos ya que se ha demostrado que estas metodologías tienen efectos positivos sobre los cambios de hábitos y las conductas alimentarias como a su vez en el incremento de la actividad física y por ende en la prevención y manejo de los niños y adolescentes con sobrepeso u obesidad. Abstract. Identification of pedagogic strategies in nutritional education is needed to allow healthcare professionals and mainly Nutritionist and Dietitians to establish effective nutritional interventions for treating overweight, obese children and their families in order to control weight, to reduce and to prevent the consequences of this public health problem. The main aim of this review was to identify and to assess educational methods and strategies that underlie in the international literature about the attention and the nutritional education of overweight and obese children and adolescents. A documental review and qualitative analysis methodology was used to carry out this review. Forty documents were included about the treatment and the prevention of overweight and obesity during the childhood and adolescence. The documents came from different countries. Results indicated that educational strategies are based on the behavior and cognitive change theories, the social cognitive theory approaches and in health education theories and models. The main nutritional education strategies found were: goal-setting, self-monitoring, problem solving, reinforcement and stimulus control. Nutrition counseling and motivational interview were the main strategies in the clinic setting. The family-based interventions include strategies as parenting skills training, and in the school setting the main strategies are nutrition and physical education “Curriculum”. There are methods and strategies also immerse in population and community based interventions to child and adolescence obesity prevention. It is suggested to include and put into practice effectively these strategies into all the treatment and school setting in Colombia so it has been showed that many of these methodologies have had positive results regarding healthy eating habits and behaviors changes and activity so in the prevention and management of overweight and obese children and adolescents. Maestría

L’article s’intéresse aux modalités de diffusion, à un niveau local, d’une campagne nationale française en matière de prévention de l’obésité. Il met en évidence les difficultés rencontrées par les promoteurs d’un groupe d’éducation nutritionnelle dans leur tentative d’imposer de nouvelles normes en matière de comportement alimentaire. Leurs préceptes se heur­tent aux représentations que les femmes en surpoids se font de leur propre comportement alimentaire et des moyens prescriptifs pour parvenir à les modifier. Cette incompréhension se renforce quant aux objectifs des séances. L’arrière‑plan de lutte contre l’obésité, notamment infantile, que poursuivent les promoteurs du groupe, concourt à l’élaboration d’un dis­cours substituant aux principes du régime individuel des recommandations en matière d’hygiène alimentaire familiale. L’article conduit à s’interroger sur les conditions de possibilité d’une éducation alimentaire à grande échelle. This article examines the means through which a national obesity prevention campaign in France was implemented at a local level. It highlights the difficulties encountered by the promoters of a nutrition education group in their attempt to impose new norms as regards food behaviour. Their precepts ran up against the representations that overweight women had of their own food behaviour and of the prescriptive means to successfully modify them. This incomprehension increased regarding the objectives of the sessions. The background aim of fighting obesity, particularly among children, pursued by the promoters of the group contributed to the elaboration of a discourse that substituted family food hygiene advice for individual diet principles. This leads the article to question the conditions of possibility of large-scale food education.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:05:09Z No. of bitstreams: 1 S1415-52732004000400008.pdf: 870323 bytes, checksum: 2acb445fa21f86b4aefedab296df7a7d (MD5) Made available in DSpace on 2013-08-22T19:05:09Z (GMT). No. of bitstreams: 1 S1415-52732004000400008.pdf: 870323 bytes, checksum: 2acb445fa21f86b4aefedab296df7a7d (MD5) Previous issue date: 2004-12-01 Made available in DSpace on 2013-09-30T20:08:53Z (GMT). No. of bitstreams: 2 S1415-52732004000400008.pdf: 870323 bytes, checksum: 2acb445fa21f86b4aefedab296df7a7d (MD5) S1415-52732004000400008.pdf.txt: 38217 bytes, checksum: 5b56038594bfb2f1e6f60c41335316b0 (MD5) Previous issue date: 2004-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:17:33Z No. of bitstreams: 2 S1415-52732004000400008.pdf: 870323 bytes, checksum: 2acb445fa21f86b4aefedab296df7a7d (MD5) S1415-52732004000400008.pdf.txt: 38217 bytes, checksum: 5b56038594bfb2f1e6f60c41335316b0 (MD5) Made available in DSpace on 2014-05-20T15:17:33Z (GMT). No. of bitstreams: 2 S1415-52732004000400008.pdf: 870323 bytes, checksum: 2acb445fa21f86b4aefedab296df7a7d (MD5) S1415-52732004000400008.pdf.txt: 38217 bytes, checksum: 5b56038594bfb2f1e6f60c41335316b0 (MD5) Previous issue date: 2004-12-01 OBJETIVO: Foi avaliar o efeito de programa misto de intervenção nutricional e exercício físico sobre a composição corporal e hábitos alimentares de mulheres obesas em climatério. MÉTODOS: Trabalhou-se com 2 grupos de 15 pessoas por 40 semanas: Grupo Dieta (intervenção nutricional) e Grupo Exercício (intervenção nutricional e exercício). RESULTADO: As reduções do peso (-2,3kg para Grupo Dieta e -5,3kg para o Grupo Exercício) e da circunferência da cintura (-4,8cm para Grupo Dieta e -7,6cm para Grupo Exercício), foram maiores para o Grupo Exercício. Foi verificada evolução positiva na classificação do Índice de Massa Corporal para ambos os grupos, sendo que o Grupo Exercício respondeu melhor ao tratamento. O padrão alimentar foi considerado monótono e com baixo consumo de alimentos regionais. CONCLUSÃO: O programa foi efetivo para perda de peso, em maior intensidade na presença de exercício. A educação alimentar proposta foi capaz de acarretar mudanças nos hábitos alimentares. OBJECTIVE: The effects of a mixed program of nutrition intervention and physical exercise on body composition and feeding habits were evaluated in obese climacteric women. METHODS: Thirty participants were randomly assigned in 2 groups during 40 weeks: Diet Group (nutritional intervention) and Exercise Group (nutritional intervention and exercise). RESULTS: Weight reductions (Diet Group 2,3kg/Exercise Group -5,3kg) and waist circunference (Diet Group -4,8cm/Exercise Group 7,6cm) were greater in Exercise Group. A positive evolution was noticed in the Body Mass Index in both groups, with Exercise Group having better answer to treatment. It was observed a monotonous feeding pattern and low compliance to the consumption of regional typical foods. CONCLUSION: We concluded that the program was effective for weight loss at a higher intensity in the presence of exercise and the feeding education was able to modify the feeding habits. Centro Universitário Nilton Lins Curso de Nutrição Universidade Federal do Amazonas Faculdade de Educação Física Universidade Estadual Paulista Faculdade de Medicina Departamento de Clínica Médica Universidade Estadual Paulista Faculdade de Medicina Departamento de Clínica Médica

OBJETIVO: Foi avaliar o efeito de programa misto de intervenção nutricional e exercício físico sobre a composição corporal e hábitos alimentares de mulheres obesas em climatério. MÉTODOS: Trabalhou-se com 2 grupos de 15 pessoas por 40 semanas: Grupo Dieta (intervenção nutricional) e Grupo Exercício (intervenção nutricional e exercício). RESULTADO: As reduções do peso (-2,3kg para Grupo Dieta e -5,3kg para o Grupo Exercício) e da circunferência da cintura (-4,8cm para Grupo Dieta e -7,6cm para Grupo Exercício), foram maiores para o Grupo Exercício. Foi verificada evolução positiva na classificação do Índice de Massa Corporal para ambos os grupos, sendo que o Grupo Exercício respondeu melhor ao tratamento. O padrão alimentar foi considerado monótono e com baixo consumo de alimentos regionais. CONCLUSÃO: O programa foi efetivo para perda de peso, em maior intensidade na presença de exercício. A educação alimentar proposta foi capaz de acarretar mudanças nos hábitos alimentares.OBJECTIVE: The effects of a mixed program of nutrition intervention and physical exercise on body composition and feeding habits were evaluated in obese climacteric women. METHODS: Thirty participants were randomly assigned in 2 groups during 40 weeks: Diet Group (nutritional intervention) and Exercise Group (nutritional intervention and exercise). RESULTS: Weight reductions (Diet Group 2,3kg/Exercise Group -5,3kg) and waist circunference (Diet Group -4,8cm/Exercise Group 7,6cm) were greater in Exercise Group. A positive evolution was noticed in the Body Mass Index in both groups, with Exercise Group having better answer to treatment. It was observed a monotonous feeding pattern and low compliance to the consumption of regional typical foods. CONCLUSION: We concluded that the program was effective for weight loss at a higher intensity in the presence of exercise and the feeding education was able to modify the feeding habits.

肥満治療のための栄養指導では、その患者に応じたオーダーメイド栄養指導が必要であり、坂田式食行動質問表を用いた食行動の把握と栄養素摂取量の把握を併用することで、より個人に応じた適切な栄養指導が行なえることを明らかにした。

Objetivos: Comparar os efeitos de dois programas de exercícios, treinamento concorrente e corrida em piscina funda, associados à orientação nutricional, na perda de peso e composição corporal de obesos. Métodos: Cinquenta indivíduos foram divididos em dois grupos, conforme o tipo de programa de treinamento físico. Um dos grupos, composto por 23 indivíduos, foi submetido a um treinamento concorrente (aeróbico e força); e 27 foram submetidos a corrida em piscina funda (aeróbico). Todos receberam a mesma orientação nutricional. Os participantes foram avaliados quanto ao peso, altura, circunferências, índice de massa corporal e composição corporal (massa gorda e massa magra), antes e após 45 dias do programa. Para análise das variáveis entre os grupos foi aplicado o teste t de Student e para avaliar o efeito da perda de peso nas demais variáveis, a correlação linear de Pearson. O nível de significância adotado foi de menos de 0,05. Resultados: A idade média dos participantes foi 48,1±12 anos, sendo 42 (84%) do gênero feminino. Após 45 dias de intervenção, 42 indivíduos perderam em média 2,96% do peso inicial, com redução significativa em todas as variáveis antropométricas, exceto da massa magra. Não houve diferença significativa na perda de peso e na composição corporal entre os indivíduos que praticaram o treinamento concorrente e os que praticaram corrida em piscina funda. Conclusões: Os dois grupos submetidos a treinamento físico e intervenção nutricional apresentaram perda de peso e alteração positiva na composição corporal, sem predomínio de efeito entre os tipos de exercício. Aims: To compare the effects of two exercise programs, concurrent training and running in deep water, associated with nutritional counseling, in weight loss and body composition in obese individuals. Methods: Fifty subjects were divided into two groups according to the type of physical training program. One group, composed of 23 individuals, underwent a concurrent training (aerobic and strength); and 27 underwent deep water running (aerobic). All received the same nutritional counseling. Participants were assessed for weight, height, girth, body mass index and body composition (fat mass and lean mass) before and after 45 days of the program. Student’s t test was applied for analysis of variables between groups and Pearson correlation test was used to evaluate the effect of weight loss in the other variables. The significance level was set at less than 0.05. Results: The mean age of participants was 48.1±12 years and 42 (84%) were female. After 45 days of intervention, 42 individuals lost a medium of 2.96% of initial weight, with significant reductions in all anthropometric variables, except the lean mass. There was no significant difference in weight loss and body composition among individuals who practiced concurrent training or practiced running in deep water. Conclusions: Both groups that underwent physical training and nutritional intervention showed weight loss and a positive change in body composition, without predominant effect between the exercise types.

En Chile la obesidad infantil es un creciente problema de salud pública. Los programas de intervención al interior de las escuelas han mostrado resultados variables, con mejores resultados cuando se incluyen diversas variables y a toda la comunidad educativa. El objetivo del estudio fue evaluar el efecto sobre el estado nutricional de un programa realizado al interior de las escuelas, de 2 años de duración (Programa Vive Sano). Se estudiaron 2.527 escolares de primero a cuarto año de educación básica, de 3 comunas de la Región Metropolitana de Chile, que fueron intervenidos en alimentación, nutrición, actividad física y autocuidado de la salud con un equipo de Nutricionistas y Profesores de educación física. Se evaluó peso y talla al ingreso al programa y al final del primer y segundo año de intervención, en condiciones estandarizadas. Se calculó puntaje Z del IMC y estado nutricional según la referencia OMS 2007. Al final del segundo año 1.453 niños fueron reevaluados. Hubo una disminución significativa en puntaje Z del IMC-edad en los escolares obesos (-0,3 DE) y la prevalencia global de obesidad disminuyó de 21,8% a 18,4% al final de la intervención. El 75% de los escolares con obesidad y 60,5% con sobrepeso disminuyó su Z score IMC, siendo mayor la reducción en el sexo masculino y en los cursos superiores. El 51,9% de los estudiantes con peso normal aumentó su puntaje Z de IMC-edad, aunque mayoritariamente menos de 0,5 DE. Se puede concluir que la educación en alimentación y actividad física realizada por profesionales fue efectiva en reducir la prevalencia de obesidad (-3,4 puntos porcentuales). El gran desafío es buscar mecanismos para darle continuidad al programa y evaluar los efectos a largo plazo. In Chile childhood obesity is a growing public health problem. Intervention programs within schools have shown variable results, with better impacts when multiple aspects are involved and included the entire educational community. The objective of the study was to evaluate the effect on the nutritional status of children in intervention schools within 2 years of duration (Healthy Living Program). The sample included 2,527 students first through fourth grade of 3 counties of Santiago. The students were intervened and followed for a period of two years in their food and nutrition habits, physical activity and self-care practices, by a team of nutritionists and physical education teachers. Weight and height were measured at start of program, end of the first and second years of intervention, under standardized conditions and calculated the Z score of BMI and nutritional status according to the WHO reference 2007. At the end of the second year 1,453 children were reassessed. There was a significant decrease in BMI Z score in obese children (-0.3 SD) and obesity decreased from 21.8% to 18.4% at the end of the intervention. 75% of schoolchildren obese and 60.5% overweight decreased their BMI Z score, reduction that was greater in men and students in the upper grades. 51.9% of normal weight children increased their BMI Z-score age, although most less than 0.5 SD. The intervention in education, nutrition and physical activity among schoolchildren in three communes of Greater Santiago was effective in reducing the prevalence of obesity (-3.4 percentage points). The big challenge is to find mechanisms to give continuity to the program and evaluate long-term effects.

O presente estudo avaliou a eficácia de dois métodos de intervenção nutricional educativa entre mulheres praticantes de atividade física regular visando à adoção de práticas alimentares saudáveis. A população foi constituída de 52 mulheres de 19 a 59 anos, frequentadoras do Programa Academia da Cidade (Aracaju, SE). O estudo teve delineamento de comparação de dois grupos de intervenção e foi do tipo pré-teste/pós-teste. As ações educativas foram baseadas em dois protocolos, uma com ação menos intensiva (Grupo P1) e outra mais intensiva (Grupo P2), num período de dois meses. As variáveis analisadas foram as de conhecimento nutricional, medidas antropométricas e mudanças nos hábitos alimentares. As modificações identificadas foram melhora nos hábitos alimentares e redução do peso e Índice de Massa Corpórea para o Grupo P2. As modificações citadas referiram-se, principalmente, ao aumento do consumo de frutas, verduras e legumes, redução de gordura das preparações, redução do volume do alimento ingerido por refeição e aumento do fracionamento da dieta. Em relação aos conhecimentos em nutrição apenas 2 das 12 perguntas apresentaram aumento significativo da nota. A intervenção nutricional mais intensiva mostrou-se eficaz para mudanças de hábitos alimentares com repercussão na perda de peso corporal. The scope of this study was to evaluate the effectiveness of two methods of educational nutritional intervention together with women who practice regular physical activities by fostering the adoption of healthy eating habits. The study population consisted of 52 women aged between 19 and 59 who frequented the Academia da Cidade Program in Aracaju in the State of Sergipe. The study was a randomized comparison of two intervention groups and was of the pre-test/post-test variety. The educational activities were based on two protocols - one less intensive (P1 Group) and one more intensive (P2 Group) - over a period of two months. The variables analyzed were nutritional knowledge, anthropometric measurements and changes in eating habits. The changes identified were improvement in eating habits and reduction in weight and Body Mass Index for the P2 group. The modifications identified referred mainly to increased consumption of fruit and vegetables, reduction of fat in cooking, reduction in the volume of food eaten per meal and increased meal frequency. In relation to nutritional knowledge, only 2 of the 12 questions showed significant changes. The most intensive method proved effective in changing dietary habits leading to weight loss.