Search

Objective: To identify the prevalence and factors associated with the consumption of ultra-processed foods by Brazilian adolescents., Methods: The sample was representative of adolescents and participants in the cross-sectional population-based study National Survey of School Health, 2015 edition (PeNSE-2015). A self-administered questionnaire was used for data collection. The variable weekly consumption of ultra-processed foods was considered, and consumption more than seven times a week was considered excessive. Descriptive and inferential analyses of demographic, socioeconomic, behavioral and environmental characteristics potentially associated with the outcome were performed. Poisson's multiple regression model was adjusted to control for confounding factors., Results: The prevalence of excessive consumption of ultra-processed foods among 16,324 adolescents in Brazil was 75.4%. Nine factors independently associated with this outcome were identified: age under 15 years (RR 1.08; p<0.001), daily sitting time greater than four hours (RR 1.13; p<0.001), eating while watching TV or studying more than four days a week (RR 1.09; p<0.001), daily TV time greater than three hours (RR 1.08; p<0.001), breakfast frequency less than four days a week (RR 1,03; p=0.001), having a cell phone (RR 1.12; p<0.001), absent maternal education (RR 0.88; p<0.001), being enrolled in a private school (RR 1.05; p=0.002) located in the urban area (RR 1.13; p=0.002)., Conclusions: The results express the multifactorial characteristic of excessive consumption of ultra-processed foods and suggest the need for the development and implementation of health policies to guide the consumption of these foods and the importance of adopting healthy behaviors for this population group in both school and home environments.

Objective: To identify the prevalence and factors associated with inadequate milk consumption among adolescents., Methods: This was a cross-sectional study based on secondary data from the National School Health Survey (2012), a Brazilian survey carried out using a self-administered questionnaire in a representative sample of 9th-grade students from public and private schools. The frequency of milk intake and its association with socio-demographic characteristics, food consumption and physical activity were estimated. A descriptive and inferential analysis of factors associated with inadequate milk consumption (no consumption at least one of the seven days of the week) was performed. A multiple logistic model was adjusted to control confounders., Results: The sample included 108,828 adolescents and inadequate milk consumption ocurred in 58.9%. The final model included nine variables independently associated with inadequate milk intake: breakfast frequency less than 4 days per week (odds ratio [OR]=2.40; p<0.001), unprocessed or minimally processed foods intake less than 5 days per week (OR=1.93; p<0.001), living in the northeast region (OR=1.39; p<0.001), less maternal schooling (OR=1.35; p<0.001), physical inactivity (OR=1.33; p<0.001), attending public school (OR=1.26; p<0.001), not being white (OR=1.14; p<0.001), being older than 14 years old (OR=1.13; p<0.001) and having a habit of eating meals while watching TV or studying (OR=1.04; p=0.036)., Conclusions: Inadequate milk consumption is prevalent among Brazilian adolescents. The identification of associated factors suggests the need to develop nutritional guidance strategies for the prevention of diseases that result from low calcium intake.

Objective: To identify factors associated with asthma in Brazilian adolescents., Methods: Cross-sectional study based on data from the 2012 National Adolescent School-based Health Survey (PeNSE), a Brazilian survey applied by a self-reported questionnaire in a representative sample of 9th-grade students. Descriptive and inferential analysis was made based on the demographic, socioeconomic, clinical, food consumption and environmental characteristics potentially associated with asthma. Adolescents who presented wheezing in the last 12 months were considered asthmatic. A multiple logistic regression model was adjusted for confounding factors. Significance was defined as p≤0.05., Results: A total of 106,983 adolescents were studied. The prevalence of asthma was 23.2%. The final model was composed of 11 variables that were independently associated with asthma: female sex (OR=1.17), <14 years old (OR=1.12), not living with parents (OR=1.06), the highest number of days consuming ultra-processed foods (OR=1.16), lunch or dinner time without presence of parents or guardians (OR=1.13), meals in front of the TV or while studying (OR=1.18), not having breakfast frequently (OR=1.22), having smoked cigarettes (OR=1.36), having tried alcoholic beverage (OR=1.37), having used illicit drugs (OR=1.29) and having sought health care in the last year (OR=1.67)., Conclusions: The results of the present study reinforce the multifactorial characteristic of asthma diagnosis. Prevention and control strategies should focus on groups of adolescents living in inadequate conditions when it comes to family dynamics, food consumption and behavior (drug use).

Maternal pressure for the child to eat may have counterproductive effects on child's eating behavior, such as impairing their ability to self-regulate intake and generating greater refusal of the pressured foods. Associated factors with this feeding practice are still poorly studied. The aim of this study was to investigate the relationship between the use of pressure to eat by mothers and anthropometric, sociodemographic and behavioral characteristics of mothers and their children. Nine hundred and twenty seven mothers of 2-to-8-year-old children participated in the study. The maternal use of pressure to eat was measured using the Brazilian version of the Comprehensive Feeding Practices Questionnaire (CFPQ) along with supplementary questions on maternal responsibility and concern about child feeding and child weight status, and anthropometric and sociodemographic information. Data was analyzed using descriptive, bivariate and multivariate analyses. The final multivariate logistic regression model revealed that maternal use of pressure to eat was independently associated with maternal greater concern about the child eating too little when the mother was not around (OR = 2.40, p ≤ 0.001), and child (OR = 0.86, p = 0.008) and mother lower BMI weight (OR = 0.93, p = 0.001). The results found in this study point out to the importance of interventions in the routine of pediatric health services, directed to the maternal behavior of pressure for the child to eat. The actions should mainly consider maternal concerns about child feeding, and maternal and child weight status. These findings also contribute to the expansion of data in the literature on the factors associated with this food practice and for future research on the subject. The results found in this study are risk factors for maternal practice of pressure to eat and support the construction of new ways to deepen the knowledge of the subject in future research, such as the influence of mother and child weight and subjective aspects in the practice of pressure to eat., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Eating habits formed in early childhood are influenced by parental feeding behaviors, warranting investigation of predictors and correlates of parent feeding. We aimed to describe relationships between parental feeding practices and parent and child characteristics in a sample of Brazilian preschoolers., Methods: Four hundred and two parents of preschoolers enrolled in private schools of São Paulo and Campinas, Brazil, completed a Brazilian version of the Comprehensive Feeding Practices Questionnaire, as well as questions about parental attitudes, child food intake, other obesity-associated behaviors, and socioeconomic and demographic characteristics. We ran bivariate logistic regression models examining associations between independent variables and each feeding practice. Next, we ran multiple logistic regression models predicting each parental feeding practice., Results: Greater 'Restriction for Weight Control' and 'Restriction for Health' were associated with lower maternal education (OR = 2.42 (CI 95% 1.07-5.48) and 2.79 (CI 95% 1.25-6.22), respectively), and with higher concern about child overweight (OR = 2.46, CI 95% 1.64-3.69 for 'Restriction for Weight Control', only), while greater 'Pressure' was associated with greater concern about child underweight (OR = 2.30, CI 95% 1.53-3.47) and lower maternal BMI (OR = 0.94, CI 95% 0.88-1.00). Greater use of 'Emotion Regulation/ Food as Reward' was associated with lower maternal education (OR = 2.22, CI 95% 1.05-4.71). In analyses of positive feeding practices, lesser use of 'Healthy Eating Guidance' and 'Monitoring' was associated with greater intake of less healthy foods in children (OR = 1.53 (CI 95% 1.01-2.32) and OR = 1.94 (CI 95% 1.27-2.97), respectively), and greater use of screen devices (OR = 1.59 (CI 95% 1.04-2.44) and OR = 1.57 (CI 95% 1.03-2.39), respectively). Lesser use of 'Healthy Eating Guidance' was additionally associated with higher maternal BMI (OR = 1.09, CI 95% 1.03-1.16), and lesser use of 'Monitoring' with lesser perceived parent responsibility for child feeding (OR = 1.68, CI 95% 1.12-2.52)., Conclusions: Our results demonstrate diverse socioeconomic, anthropometric and behavioral correlates of parent feeding in a large Brazilian sample of parents of preschoolers.

Objective: The present study aimed to identify food patterns among 2-9-year-olds and investigate sociodemographic, anthropometric and behavioural predictors of less healthy dietary patterns., Design: Cross-sectional study. Parents of 2-9-year-olds completed an FFQ and factor analysis was applied to identify dietary patterns. Parents also completed questionnaires assessing sociodemographic, anthropometric and behavioural characteristics of parents and children, including parental feeding practices., Setting: Participants were recruited from private schools of Campinas and São Paulo, SP, Brazil, between April and June 2014., Subjects: Parents of 2-9-year-olds (n 929)., Results: Two dietary patterns emerged: 'traditional food' and 'ultra-processed food'. Lower maternal education (OR=2·05, P=0·010) and higher maternal weight status (OR=1·43, P=0·044) were associated with a greater likelihood of the ultra-processed food pattern. Lower perceived parental responsibility for adequacy of food group intake (OR=2·41, P=0·020), and lower scores on the parental feeding practices of 'Healthy Eating Guidance' (OR=1·83, P<0·001) and 'Monitoring' (OR=2·52, P<0·001), were also associated with the presence of this pattern, as was higher child's screen use during mealtimes (OR=1·61, P=0·004)., Conclusions: The present study is the first to evaluate associations between less healthy dietary patterns of Brazilian 2-9-year-olds and parental feeding practices. Our findings highlight sociodemographic, anthropometric and behavioural factors within families that could be used to target tailored policies to at-risk populations.

Background: Recent national surveys in Brazil have demonstrated a decrease in the consumption of traditional food and a parallel increase in the consumption of ultra-processed food, which has contributed to a rise in obesity prevalence in all age groups. Environmental factors, especially familial factors, have a strong influence on the food intake of preschool children, and this has led to the development of psychometric scales to measure parents' feeding practices. The aim of this study was to test the validity of a translated and adapted Comprehensive Feeding Practices Questionnaire in a sample of Brazilian preschool-aged children enrolled in private schools., Methods: A transcultural adaptation process was performed in order to develop a modified questionnaire (43 items). After piloting, the questionnaire was sent to parents, along with additional questions about family characteristics. Test-retest reliability was assessed in one of the schools. Factor analysis with oblique rotation was performed. Internal reliability was tested using Cronbach's alpha and correlations between factors, discriminant validity using marker variables of child's food intake, and convergent validity via correlations with parental perceptions of perceived responsibility for feeding and concern about the child's weight were also performed., Results: The final sample consisted of 402 preschool children. Factor analysis resulted in a final questionnaire of 43 items distributed over 6 factors. Cronbach alpha values were adequate (0.74 to 0.88), between-factor correlations were low, and discriminant validity and convergent validity were acceptable., Conclusions: The modified CFPQ demonstrated significant internal reliability in this urban Brazilian sample. Scale validation within different cultures is essential for a more comprehensive understanding of parental feeding practices for preschoolers.

Background: Vitamin A deficiency is prevalent among infants, primarily in undeveloped communities, compromising immune system competence and raising morbidity and mortality rates. Understanding the risk factors associated with vitamin A deficiency is essential to create informed health policies., Objective: To identify and quantify risk factors for vitamin A deficiency in a probabilistic sample of children under 2 years of age participating in a national survey in Brazil and to provide a comprehensive risk factor model to inform health strategies and policies., Methods: We analyzed data from a cross-sectional study of 1,436 children from the 2006 Brazilian National Survey on Demography and the Health of Women and Children. Vitamin A deficiency was defined as retinol levels below 0.70 μg/dL., Results: The prevalence of vitamin A deficiency was estimated at 16.1% (95% CI, 12.7 to 20.2). The Poisson regression model identified three risk factors for vitamin A deficiency: urban residence (prevalence ratio [PR] = 1.47, p = .023), no consumption of animal meat within the past week (PR = 1.41, p = .031), and a mother older than 25 years (PR = 1.31, p = .048)., Conclusions: Strategies to control infant vitamin A deficiency should include health promotion and nutrition education for families from all socioeconomic levels. Improvements in lifestyle quality, based on adequate food consumption by all infants, must be achieved by communities, especially in urban areas and for older mothers.

Low birth weight is associated with increased risk of dying in the first year of life. This study was motivated by recent changes in the determination of birth weight patterns with the advent of the perinatal epidemiological transition. We analyzed data from the Brazilian National Survey of Demographic and Health of Children and Women including only children < 24 months. Prevalence of low birth weight in Brazil was 6.1%. Risk factors included female gender, residence in the South and Southeast geographic regions, low maternal education, and maternal smoking. The low birth weight profile changed, with higher prevalence in more economically developed regions, reflecting the neonatal epidemiological transition determined by changes in patterns of childbirth care and incorporation of perinatal life support technologies, in addition to the previously known biological risks associated with poverty and misinformation.