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Introduction Feeding skills (FS) are important to child development, as the delay in their presence could suggest feeding difficulties (FD) symptoms. The aim of the present study was to compare the development of three types of FS (autonomy to eat, posture at meals, and adequate use of cutleries) among children with FD and without FD. Methods This was a case-control retrospective observational study. The sample consisted of 316 children from case and control groups in accordance with the presence (or not) of FD. The control group was recruited by convenience (verbal approaching at the emergency care unit), and the case group was based on the medical records collected at the reference center. A same-structured questionnaire was used for both groups. Results Children with FD (63.2%) used baby-bottles in an inadequate way with a higher frequency after 24 months of age. Inadequate posture at meals was observed with higher frequency in children with FD (78.1%). Children without FD (89.1%) had more autonomy to eat. In children > 18 months old, this frequency was higher (90.6%). Conclusion Children with FD showed changes on the development of FS. Inadequate posture at meals was associated with a 36-fold higher risk of having FD. Not eating alone after the age of 18 months was associated with a 6-fold higher risk of having FD, while not using baby bottles was associated with a lower risk (52%) of FD complaints. Delays in FS can be predictors of FD during childhood.

The American Heart Association Diet Score (AHA-DS) defines the cardiovascular health, and the Brazilian Cardioprotective Nutritional Program Dietary Index (BALANCE DI) was designed to evaluate diet quality in secondary cardiovascular prevention settings. Our aim was to assess the absolute and relative agreement between both tools in Brazilian adults after a myocardial infarction (MI). In this cross-sectional study, 473 individuals were included and had their diet assessed by a 24 h food recall and a semi-quantitative Food Frequency Questionnaire. The weighted Kappa between BALANCE DI and primary AHA-DS was 0.66 (95% CI: 0.08–0.21), and between BALANCE DI and total AHA-DS was 0.70 (95% CI: 0.20–0.32). To improve the agreement between the tools, modifications were made to the BALANCE DI scoring system. The weighted Kappa between New BALANCE DI and primary AHA-DS was 0.77 (95% CI: 0.36–0.48), and between BALANCE DI and total AHA-DS was 0.76 (95% CI: 0.34–0.46). The mean bias observed between the New BALANCE DI as compared to the primary and total AHA-DS was −16% (−51 to 19) and −8% (−41 to 24), respectively. Our results suggest that the New BALANCE DI may be a useful tool to evaluate diet quality in post MI patients.

Introducao: Com o aumento da obesidade infantil, torna-se necessaria intervencao educacional nutricional desde a infância. Durante o periodo escolar, a escola se torna, portanto, o melhor local para a implementacao de um programa de educacao nutricional. Objetivo: O presente estudo foi realizado em uma escola publica e uma particular, com o objetivo de avaliar e comparar o resultado da intervencao do Programa “Nutriamigos®” no conhecimento sobre alimentacao e nutricao, de criancas de diferentes niveis socioeconomicos, sexo, idade e Indice de Massa Corporal (IMC). Metodo: Estudo longitudinal comparativo, antes e apos intervencao educacional. Para a avaliacao da intervencao foram selecionadas uma escola publica (escola 1) e uma particular (escola 2). Esta foi uma amostra de conveniencia aleatoria, comparando alunos de diferentes niveis sociais e economicos, consistindo de 242 (escola 1) e 99 criancas (escola 2), respectivamente, totalizando 341 criancas, de 6 a 10 anos de idade. O Indice de Massa Corporal foi utilizado para mensurar o estado nutricional. O conhecimento sobre nutricao e alimentacao foi avaliado por meio de um questionario de conhecimento, aplicado pre e pos intervencao. A intervencao nutricional constou de 12 aulas de 50 minutos cada. Resultados: A melhora no conhecimento sobre alimentacao e nutricao entre os estagios de pre e pos intervencao foi estatisticamente significante. Conclusao: O Programa “Nutriamigos®” atingiu o objetivo proposto, comprovando que e efetivo em escolas publicas e particulares e nao deve ser diferenciado para meninos ou meninas, ou para criancas com peso normal ou excessivo.

Resumo Objetivos Investigar os fatores associados à presença de dificuldades alimentares (DAs) na infância, dentre dinâmicas de refeições e práticas parentais. Métodos Trata-se de um estudo observacional caso-controle. Para o grupo de crianças com queixas de DA, as informações foram retiradas dos prontuários dos pacientes. Para o grupo de crianças sem queixas de DA, a amostragem foi constituída por conveniência (abordagem de famílias nas unidades de pronto atendimento). As entrevistas foram baseadas em questionário estruturado e aplicado na mesma versão para grupo caso e grupo controle. Resultados O grupo caso foi composto majoritariamente por indivíduos do sexo masculino, enquanto o grupo controle apresentou-se dividido igualmente entre os gêneros. A média de idade foi menor no grupo caso quando comparado ao controle. Verificou-se menor frequência de refeições compartilhadas nas famílias de crianças com DA, especialmente por motivos de estresse, assim como maior ocorrência de refeições mais longas. Observou-se ainda maior risco de desenvolver DA em crianças que realizavam refeições em ambientes inadequados, com menor autonomia, e os cuidadores do grupo caso demonstraram maior chance de não respeitar os sinais de fome da criança, de usarem estratégias como coerção e distração durante as refeições. Conclusão O estilo autoritário foi associado à presença de DA. Práticas parentais e todos os fatores que envolvem a dinâmica das refeições devem ser avaliados e acompanhados. A dinâmica familiar e de refeições apresentou-se modificada no grupo com DA. Tais comportamentos devem ser avaliados e orientados durante o acompanhamento da queixa alimentar, pois compõem o cenário da queixa.

To determine the consumption of micronutrients and dietary fiber and prevalence of inadequacy in relation to the recommendations for age in children with feeding difficulties (FD) and predictive factors (related to FD) of dietary intake. This retrospective observational study of medical records included 91 children diagnosed with FD, with age ranging from 1 to 13 years, without dietary supplementation or breast milk. Growth indicators were analyzed according to age criteria, and dietary micronutrient intake was evaluated based on age recommendations from the Institute of Medicine, adjusted for total caloric intake. For fiber consumption, the recommendations from American Health Foundation were used. There was a high rate of inadequate consumption of all evaluated micronutrients, with fiber, vitamin A, and calcium having the highest prevalence of inadequacy and iron with the lowest. The age groups that presented the most inadequate intake in both sexes were children aged 9–13 years. The use of distractions during meals, the number of family meals taken weekly, the volume of milk ingested, the style of parental care at meals, and the child’s autonomy at meals were predictive variables of children’s nutrient intake. The prevalence of inadequate micronutrient and fiber intake among children with FD was high in both sexes, with a tendency to increase with age. Some characteristics of FD were predictive of nutrient intake in children. The results of this study indicate the nutritional risk in children with FD and the importance of reversing the condition as early as possible.

RESUMO Objetivo: Revisar evidências atuais da relação entre transtorno obsessivo compulsivo e dificuldades alimentares. Métodos: Revisão das bases Science Direct e PubMed no período entre 2007 e 2017 em inglês, português e espanhol, com os termos em associação “transtorno obsessivo compulsivo” e “picky eating/dificuldade alimentar”. Foram selecionados apenas estudos de coorte, caso controle ou transversal, realizados em qualquer país, com crianças, adolescentes e/ou adultos e de qualquer tamanho amostral. Foram excluídos os artigos de opinião. Resultados: Cerca de 245 artigos foram selecionados e apenas 4 foram incluídos no estudo, segundo critérios de seleção. Os trabalhos descrevem essencialmente que há diferença no comportamento seletivo entre os sujeitos com e sem transtorno obsessivo compulsivo, com tendência para exacerbação de sintomas como nojo, ansiedade e escore de inflexibilidade de comportamento alimentar nos pacientes com esse transtorno. Conclusões: Existem sintomas compartilhados entre transtorno obsessivo compulsivo e dificuldade alimentar. O estudo alerta aos profissionais que acompanham pacientes com dificuldades alimentares para a importância da investigação de possíveis comorbidades psiquiátricas. ABSTRACT Objective: To review current evidence on the relationship between obsessive-compulsive disorder and feeding difficulties. Methods: Review the Science Direct and PubMed databases between 2007 and 2017 in English, Portuguese and Spanish. The search terms, used in association, were “obsessive compulsive disorder” and “picky eating/feeding difficulty”. Cohort, case control and cross sectional studies were included that analyzed children, adolescents and/or adults of any sample size from any country in the world. Opinion articles were excluded. Results: Around 245 articles were selected, and only 4 were included in this review, according to previous criteria. Results from the studies essentially described that there is indeed a difference in “picky” behaviors between subjects with and without obsessive-compulsive disorder. Patients with obsessive-compulsive disorder tend to have exacerbated symptoms of disgust, anxiety and a higher eating behavior inflexibility score. Conclusions: Obsessive-compulsive disorder and feeding difficulties patients share common symptoms. The present study alerts health professionals who follow patients with feeding difficulties as to the importance of investigating possible psychiatric comorbidities.

Background Given the positive influence of responsive caregiving on dietary habits in childhood, to raise awareness of caregivers regarding their behavior is crucial in multidisciplinary care on infant feeding. Objectives To identify the most common responsive and non-responsive feeding practices in mothers of children with feeding complaints, as well as to seek associations between practices and caregivers' profile. Methods Cross-sectional study with 77 children under 18 years old, with complaints of feeding difficulties. Data were collected during interviews with mothers: child age, gender, duration of exclusive breastfeeding, presence of organic disease, dynamics of bottle use, self-feeding practices and posture at meals, use of appropriate feeding equipment; basic information about the mothers (parity and level of education), caregiver feeding style, presence of coercive feeding, frequency and characteristics of family meals. Statistical analysis considered significance level at 5%. Results The non-responsive profile predominated among mothers (76.2%, with the Authoritarian style being the most prevalent-39.7%). The responsive profile was characterized by absence of coercive feeding, stimulation of self-feeding practices, use of appropriate feeding equipment and meal environment, with interaction at meals. Non-responsive profile consisted of both inadequate environment and posture at meals, use of distraction and coercive feeding, lack of shared meals, and disregard for children's hunger signals. Only the habit of sharing meals with children was associated with mothers' profile, and considered a protection factor against non-responsive care (OR 0.23; 95% CI 0.06-0.88). Both Authoritarian (p = 0.000) and indulgent mothers (p = 0.007) breastfed exclusively for longer time than negligent ones. There was a higher level of interaction with children in "responsive" parental style (OR 0.056; p = 0.01) compared to other feeding styles. Conclusion Results highlight the need for educational interventions focused on caregivers' behaviors.

Yogurt has been a part of the human diet for several millennia and goes by many names throughout the world. The word "yogurt" is believed to have come from the Turkish word "yoğurmak," which means to thicken, coagulate, or curdle. While references to the health-promoting properties of yogurt date back to 6000 BC in Indian Ayurvedic scripts, it was not until the 20th century that Stamen Grigorov, a Bulgarian medical student, attributed the benefits to lactic acid bacteria. Today, most yogurt is fermented milk that is acidified with viable and well-defined bacteria (Lactobacillus bulgaricus and Streptococcus thermophiles). While patterns of yogurt consumption vary greatly from country to country, consumption is generally low. In the United States and Brazil, for example, only 6% of the population consume yogurt on a daily basis. Low consumption of yogurt represents a missed opportunity to contribute to a healthy lifestyle, as yogurt provides a good to excellent source of highly bioavailable protein and an excellent source of calcium as well as a source of probiotics that may provide a range of health benefits.

O presente artigo relata o caso clínico de paciente de dois anos e seis meses atendida por equipe multidisciplinar. A paciente apresentou dificuldades alimentares caracterizadas por recusa alimentar, tempo prolongado das refeições, defesa sensório-oral, reflexo de vômito anteriorizado e dificuldade mastigatória. Não se alimentava sozinha, nem participava das refeições em família. Apresentava refluxo gastroesofágico, alergia a proteína do leite de vaca e tosse seguida por vômito. Não apresentou comprometimento pondero-estatural. Foi utilizado o Programa de Refeição Compartilhada. Após acompanhamento médico, a conduta de trabalho foi definida e iniciada pelo trabalho sensório-oral, seguido do trabalho com a mastigação, associados ao trabalho de orientação familiar. A paciente passou a realizar as refeições com a família e participar das rotinas sociais de alimentação. O tempo de refeição foi reduzido e a recusa alimentar eliminada. Os aspectos sensório-motores-orais melhoraram significantemente. Após a alta e reavaliação em três meses, apresentou melhora no refluxo gastro-esofágico e a medicação foi suprimida. A nutricionista iniciou a introdução de derivados do leite, com boa aceitação por parte da paciente. O programa utilizado mostrou-se eficaz para o diagnóstico e tratamento da dificuldade alimentar apresentada pela paciente. A equipe multidisciplinar foi capaz de ter uma visão ampliada da dificuldade alimentar apresentada pela paciente, compreendendo as questões motoras, orais, orgânicas e nutricionais da alimentação da criança inseridas no seu contexto familiar.

To review current evidence on the relationship between obsessive-compulsive disorder and feeding difficulties.Review the Science Direct and PubMed databases between 2007 and 2017 in English, Portuguese and Spanish. The search terms, used in association, were "obsessive compulsive disorder" and "picky eating/feeding difficulty". Cohort, case control and cross sectional studies were included that analyzed children, adolescents and/or adults of any sample size from any country in the world. Opinion articles were excluded.Around 245 articles were selected, and only 4 were included in this review, according to previous criteria. Results from the studies essentially described that there is indeed a difference in "picky" behaviors between subjects with and without obsessive-compulsive disorder. Patients with obsessive-compulsive disorder tend to have exacerbated symptoms of disgust, anxiety and a higher eating behavior inflexibility score.Obsessive-compulsive disorder and feeding difficulties patients share common symptoms. The present study alerts health professionals who follow patients with feeding difficulties as to the importance of investigating possible psychiatric comorbidities.Revisar evidências atuais da relação entre transtorno obsessivo compulsivo e dificuldades alimentares.Revisão das bases Science Direct e PubMed no período entre 2007 e 2017 em inglês, português e espanhol, com os termos em associação “transtorno obsessivo compulsivo” e “picky eating/dificuldade alimentar”. Foram selecionados apenas estudos de coorte, caso controle ou transversal, realizados em qualquer país, com crianças, adolescentes e/ou adultos e de qualquer tamanho amostral. Foram excluídos os artigos de opinião.Cerca de 245 artigos foram selecionados e apenas 4 foram incluídos no estudo, segundo critérios de seleção. Os trabalhos descrevem essencialmente que há diferença no comportamento seletivo entre os sujeitos com e sem transtorno obsessivo compulsivo, com tendência para exacerbação de sintomas como nojo, ansiedade e escore de inflexibilidade de comportamento alimentar nos pacientes com esse transtorno.Existem sintomas compartilhados entre transtorno obsessivo compulsivo e dificuldade alimentar. O estudo alerta aos profissionais que acompanham pacientes com dificuldades alimentares para a importância da investigação de possíveis comorbidades psiquiátricas.

Background Delays in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere in the development of feeding skills (FS); and—therefore—in the success of the process of feeding a child. Children with feeding difficulties (FD) commonly present inadequacy of FS. Objectives Assessment of five FS in Brazilian children with FD, and search of associations with types of FD. Methods Cross-sectional study with 70 children below 10 years old. Data were obtained from medical records: age, gender, age at texture transitions, feeding phase (breastfeeding, weaning to solids or full solids) at first complaint; characteristics of the meal (duration, environment, and shared meals with adults), self-feeding practices, use of feeding equipment and bottle, mouthing, feeding position and FD diagnosis. Skills were categorized according to standards for age. Chi-Square, Anova Test (or non-parametric equivalent) and Multinomial logistic regression tests were used, with a significance level of 5%. Results There was no difference in FS (p > 0.05) or in the number of FS inadequateness (p = 0.84) according to FD diagnosis. The majority (94%) of children presented at least one delayed development of FS; 1/3 presented delays in more than half of the FS. The most prevalent inadequacies in FS were inadequate feeding position (73.5%), prolonged bottle feeding (56.9%), and inadequate self-feeding practices (37.9%). Feeding complaints first appeared at 10.9 ± 11.4 months, and picky eating was the most prevalent type of FD (37.1%). Most children were fed in inadequate environments (55.2%), without the company of adults (78%). Transition to solid foods occurred at 16 ± 5.6 months. Multinomial logistic regression showed no difference in likelihood of presenting any type of FD compared to picky eating, according to FS. Age at texture transition both from breastfeeding to complementary feeding (p = 0.95), and from complementary feeding to solid foods (p = 0.43) did not vary according to FD diagnosis. Conclusion FS development or number of FS inadequateness did not vary according to FD diagnosis. Identification of these inadequacies could help the discussion for multi-professional treatment of patients with FD.

Background Iron deficiency anemia and feeding difficulties (FD) are common issues in childhood, reinforcing the concern about the risk of micronutrient deficiencies. FD do not necessarily reflect nutritional deficiencies, since they may or may not relate to specific nutrient sources. The objective of the study is to describe the prevalence of iron depletion and iron deficiency anemia in children with FD and to seek associations with diagnosis and its markers. Methods This is a cross-sectional study with 68 patients (convenience sample). The following data were assessed through medical records: age (months), gender, exclusive breastfeeding duration (months), birth weight (kg), iron supplementation, hemoglobin (Hb), ferritin, and C-reactive protein (CRP) levels, repertory of foods consumed (food inventory and 3-day food record analysis), and diagnosis of FD. Data were classified according to references for age and were analyzed using correlation tests, Student’s t test, ANOVA and chi-square test, or its nonparametric equivalents. A significance level of 5% was considered. Results Iron depletion and anemia were identified in 10.1 and 6% of children, respectively. Picky eating was diagnosed in 35.3%. Food repertory consisted on average of 21 foods, with null correlation to Hb and ferritin. The average fortified milk intake was 517 ml/day, with null correlation to Hb. There was no effect of diagnosis of FD on Hb (p = 0.18) or ferritin (p = 0.52). The same was verified in the children without supplementation, to both Hb (p = 0.54) and ferritin (p = 0.08). Conclusions No evidence of association between diagnosis of FD or repertory of foods to anemia or iron depletion was found, which could be a reassuring factor for caregivers. Reproduction in large scale as well as inclusion of dietary intake variables is suggested for further research.

Introdução: O consumo excessivo de bebidas açucaradas na infância é uma preocupação no acompanhamento das dificuldades alimentares, visto que pode gerar inadequações do estado nutricional. Objetivo: Estimar o perfil do consumo de alimentos de consistência líquida em crianças com dificuldades alimentares atendidas em um centro especializado e, verificar a associação entre a quantidade ingerida e a contribuição energética de bebidas açucaradas e idade e índice de massa corporal por idade. Métodos: Estudo transversal com 119 crianças de 0 a 18 anos, realizado em ambulatório especializado no atendimento de dificuldades alimentares. Os dados foram coletados de prontuários e diário alimentar. Resultados: A maioria da amostra era do gênero masculino (66,1%), considerada eutrófica quanto ao IMC/idade (77,3%), com média de idade de 4,1 anos (± 3,25). Houve diferença estatisticamente significativa para ingestão total de sucos, sendo que os meninos tiveram maior média de ingestão. A média de contribuição energética tanto para o sexo masculino quanto para o feminino é maior em relação ao consumo de leite. No entanto, não houve diferenças estatisticamente significativas entre os resultados (p > 0,05). Foram encontradas correlações muito fracas ou fracas entre volume ingerido e contribuição energética de bebidas açucaradas e idade e índice de massa corporal por idade. Conclusão: Crianças com dificuldades alimentares apresentam consumo elevado de bebidas açucaradas, havendo maior ingestão de sucos por crianças do sexo masculino e o leite foi o líquido que apresentou maior contribuição energética na dieta total deles. As associações encontradas entre volume consumido e contribuição energética de bebidas, idade e índice de massa corporal são fracas ou muito fracas não correspondendo à correlação entre as mesmas. Palavras-chave: Alimentação infantil; bebidas; crianças.

Summary Background & aims Maternal adequate micronutrient storage contributes to reducing morbidity and mortality of their children during the first two years of life. This study aimed at identifying hypovitaminosises among Brazilian HIV infected pregnant women and investigating their association with nutritional status, CD4 + cell counts, viral load and HAART use. Methods Cross-sectional study with 49 HIV infected pregnant women. Inclusion criteria followed: (1) HIV infection laboratory confirmation (HIV and HIV RNA); (2) Confirmed pregnancy, (3) Age above 14 years old; (4) Written consent. Exclusion criteria consisted of at least one of the following: (1) Use of any nutritional/multivitamin supplement (except iron or folinic acid); (2) Presence of nutritional counseling during the current pregnancy; (3) Presence of acute phase opportunistic diseases associated with HIV infection. Patients were evaluated according to anthropometric (gestational BMI, based on the curve of weight gain corrected for gestational age) and laboratory parameters (analysis of vitamin A, E, C, D, B6 and B12, CD4 + cell count, viral load, lipid profile, homocysteine and C-reactive protein). Blood samples were collected in 5 mL dry tubes with separating gel, after 12 h fasting. Vitamin profile was measured by HPLC. Results were classified according to abnormal ranges proposed for pregnant women. Results Low gestational weight was higher in women with CD4 + 3 [OR = 12.5; 95% CI 2,00,77,89; p = 0.007]. Prevalence of abnormal serum concentrations was 38.8% for vitamin D, 14.3% for vitamin A, 22.4% for vitamin E, 12.2% for vitamin C, 53.2% for vitamin B6 and 32.6% for vitamin B12. C-reactive protein was associated with vitamin E [OR = 0.23, 95% CI 0.053, 1.01, p = 0.03] and A [OR = 0.15, 95% CI 0.028, 0.84, p = 0.03]. Homocysteine was not associated with lower vitamin concentrations. Women with optimal B12 levels were 4.3 times more likely to have CD4 + >200 cells/mm³ [OR = 0.23, 0.58 to 0.905, 95% CI, p = 0.03]. HIV viral load has not been significantly associated with vitamin concentrations. Conclusions There was high prevalence of abnormal concentrations of vitamin A, D, B6 and B12. Nutritional status was associated with CD4 + cell count and vitamins were associated with immune function and inflammatory markers. There is need for more studies on this matter in Brazil. Vitamin serum levels should be monitored in these patients during prenatal care, and results underscore the importance of early nutritional intervention to ensure favorable pregnancy and birth outcomes, specially regarding the vitamin profile described here.

HIV mother-to-child transmission (MTCT) is significantly reduced if antepartum viral load (apVL) is50 copies/mL assigned to the conventional dose group, 45% (95% confidence interval [CI] 62.5–27.5%) had a apVL>50 copies/mL compared with 10.5% (95% CI 21.6–0.6%) of those assigned to the increased dose group (p=0.01). There was no significant difference found for the patients with a baseline VL50 copies/mL, it may be warranted to initiate LPV/r dosing at 600/150 mg, whereas the conventional dose is sufficient for pregnant women with a baseline VL

Objective: To describe and compare data on nutritional awareness regarding FV among adolescents from fi ve Brazilian regions, according to demographics, physical activity levels, screen time and BMI. Method: Cross-sectional study with 1.190 males aged 10-12 in fi ve Brazilian regions, enrolled in a football tournament, with parental consent. BMI, weekly physical activity and daily screen time in minutes, awareness of FV recommendations in daily servings and recognition of food groups, home region, and residents of the household were obtained through self-administered questionnaire, adapted from a previously validated tool. ANOVA, Spearman correlation and chi-squared tests were performed, with a signi fi cance level of 5%. Results: Analysis showed 29% of overweight and obesity, less than 2 hours of daily screen time (70%) and insuf fi cient levels of weekly physical activity (mean 226 minutes). Most (95%) lived with parents and with siblings (73%). About 29% of the sample were aware of FV recommendations and 60% recognized food groups. Awareness was not associated with BMI (p = 0.95), home region (p = 0,88), physical activity (p = 0.21), screen time (p = 0.46) or housing characteristics (p = 0.33). Conclusions: Data found on awareness of food groups are consistent with national and international studies, suggesting patterns of poor awareness worldwide. To our knowledge, there are no other Brazilian reports of level of awareness on recommendations of FV in this age group. The importance of behavioral interventions is acknowledged for stimulating healthy habits, which renders the results useful for the development of educational activities for this age group in Brazil.

Objectives: To present the results of the implementation of a multidisciplinary approach to feeding dif fi culties in childhood and adolescence in a reference service. Method: The protocol was designed for outpatient patients aged from zero to 19 years old, with complaints of feeding dif fi culties and without psychiatric diagnoses, with signed parental consent. The protocol consists of paediatrician, speech therapist and nutritionist assessment in the same appointment, with common observation of evaluations and following multidisciplinary discussion. Diagnoses were categorized according Kerzner et al (2015), and parenting styles according to Hughes (2005). Statistical analysis was conducted via SPSS v21 through frequency distribution (%), mean ± standard deviation, Chi-square test and ANOVA. Signi fi cance level was considered at 5%. Results: Sample consisted of 56 children, 67.9% of males, most (75%) younger than 5 years old. The most frequent diagnosis was selectivity (30%). There was association between diagnoses and organic diseases in 30%. Start of complaints occurred at 18 months old. Speech-therapy alterations were detected mostly in speech (29%) and oral-motor skills (32%). Anthropometric assessment showed average normal growth patterns and average dietary assessment of protein intake derived from dairy products was above recommendations (18g/day). Conclusions: Results herein justify the presence of the multidisciplinary team in monitoring feeding dif fi culties in childhood and adolescence, and highlight the importance of longitudinal research nationwide.

Introduction: Obesity affects more than half of the adult population and correlates with the development of chronic and psychosocial diseases. The consumption of fruits and vegetables (FV) is a protective factor for obesity, but their consumption is often below the recommendations. Objective: To identify the level of fruit consumption in human development cycles, as well as the data on the association of fruit consumption with excess weight in Brazil. Methods: A non-systematic literature review on the Virtual Health Library (VHL) databases for the period 2005 to 2015. A total of 23 studies were selected in the English and Portuguese languages, according to the study design and population group. Only cohorts and cross sections studies in Brazil were selected. Appropriate FV consumption was considered to be 400 g/day or a frequency of 5 servings/day (3 servings/day of fruits), and overweight was evaluated according to each age group and development cycle. Results: The average consumption for pregnant women was found to be 350 g/day; an inverse relationship was found between total fi bre consumption and gestational weight gain. The average consumption of FV for children and adolescents has remained between 30% and 40%, consumption falling with increasing age. Vigitel data between 2006 and 2014 shows an increase in the prevalence of adequate consumption of FV for adults and seniors according to gender, age and education. Appropriate consumption tripled during this period. There was an association between fruit consumption and weight loss, increased risk of obesity, abdominal obesity, hypertriglyceridemia and presence of metabolic syndrome (SM). Conclusions: The prevalence of adequate consumption of FV is low in all regions of Brazil and among all age groups, the highest prevalence is among women and increases with the advance of age, higher education level and higher socioeconomic status. Adequate fruit consumption correlates to weight loss and/or weight gain control of individuals.

Objectives: to review the prevalence of family meals and its impact on BMI and eating habits during childhood and adolescence. Methods: reviews are from Bireme / Lilacs / Scielo / Cochrane and Pubmed, between 2000-2016 with descriptors "family meal or mealtime", "behavior", "nutrition or diet or consumption or eating", and "child or children or adolescence"; performed by two independent examiners, according to the systematic steps in English and Portuguese. The articles were selected based on prevalence and/ or discussion between nutritional variables. 2,319 articles were found, which 15 were selected all in English: systematic reviews (n=2), cross-sectional studies (n=8), longitudinal studies (n=8); all related to children (n=5), adolescents (n=6) and both (n=5). Results: the mean of shared meals was 1x/day, with a prevalence of 27 to 81%. Most studies (n=13) reported the beneficial impact on BMI, higher consumption of fruit and vegetables, protein, calcium and a lower consumption of sweets and sugar sweetened beverages, family union and self-regulation of appetite. Conclusions: having daily family mealtime has beneficial effect on the nutritional status and children and adolescents' eating behavior.