RESUMEN
OBJECTIVE: Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde - PAS). DESIGN: A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis. SETTING: Belo Horizonte - Brazil. PARTICIPANTS: 3372 adults (≥20 years). RESULTS: Users in the third tertile of PAS (24·4-61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1-24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0-10 months). CONCLUSIONS: Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.
Asunto(s)
Manipulación de Alimentos , Calidad de Vida , Adulto , Brasil , Estudios Transversales , Dieta , Ingestión de Alimentos , Ingestión de Energía , Comida Rápida , Promoción de la Salud , HumanosRESUMEN
OBJECTIVE: Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city. DESIGN: Cross-sectional study. SETTING: Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS: Totally, 3372 participants. RESULTS: UPF were found to contribute to 27·7 % of the diet's total energy. The highest consumption was associated with higher values for energy intake (1561·8 v. 1331·8 kcal/d; P < 0·01), energy density (1·7 v. 1·4 kcal/g; P < 0·01), total (32·5 v. 27·3 %; P < 0·01) and trans-fats (2·1 v. 1·2 %; P < 0·01) and Na (1001·6 v. 758·9 mg/1000 kcal; P < 0·01) and with lower values for proteins (14·9 v. 19·6 %; P < 0·01), mono-unsaturated fats (16·1 v. 20·1 %; P = 0·02), n-3 (0·9 v. 1·1 %; P < 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P < 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population. CONCLUSIONS: Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.
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Comida Rápida , Manipulación de Alimentos , Estudios Transversales , Dieta , Ingestión de Energía , Promoción de la Salud , Humanos , Atención Primaria de SaludRESUMEN
BACKGROUND: Obesity is an increasingly prevalent chronic condition. Its multiple causes and the complexity of its treatment pose challenges for health professionals. OBJECTIVE: To explore and describe the challenges for obesity management in the Brazilian Unified Health System according to health professionals. METHODS: An exploratory quantitative web-based study, carried out in 2018 with health professionals, developed from the first stage of a national project that aims to examine the management of obesity in Brazil. The questionnaire was self-applied. Invitations to participate in the research were sent by the Ministry of Health, Health Department of Minas Gerais and members of the research group. We collected data on sex, age, professional category, region and level of care. The challenges were investigated using a Likert scale and categorized into structure and work process. RESULTS: We evaluated 1323 professionals, of which about 45% were dietitians, 90.2% were women, and 83.1% self-reported working in primary health care. The main barriers cited included a high demand for curative and individual assistance, the presence of comorbidities, and the absence or insufficient access to instructional materials, professional qualification and lack of support. CONCLUSION: Obesity management is a critical challenge for all professionals. Barriers were related to the work process and structural aspects and reinforce the need to empower health teams. We propose that permanent education activities should be established, as well as the development of instructional materials that are applicable to routine work. Finally, the results may be used to develop policies and strategies to improve obesity management.
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Manejo de la Obesidad , Brasil , Femenino , Personal de Salud , Humanos , Atención Primaria de Salud , Encuestas y CuestionariosRESUMEN
OBJECTIVES: Obesity has been identified as an important risk factor for cardiovascular disease and other chronic diseases. However, dietary treatment of obesity is far from being a closed issue. Therefore, it is critical to identify the most appropriate obesity management approaches. The aim of this review was to summarize the effects, potentialities, and limitations of nutritional interventions aimed at managing obesity in primary and secondary health care settings, highlighting the most effective strategies and theories. METHODS: This systematic review of randomized controlled trials evaluated nutritional interventions aimed at achieving weight loss in primary and secondary health care patients. All screening and extraction processes were conducted according to PRISMA. RESULTS: From an initial 7816 studies that were identified, 28 met the criteria and were included in the review. Most studies were conducted in a developed country in primary care, with a higher proportion of women. Most of the nutrition interventions maintained continuous contacts during follow-up, and telephone calls were the most commonly used technology. A physical activity component was included in most studies, and the most common dietary approaches used were energy restrictions, changes in macronutrient distribution, and diet self-monitoring. Regarding theories, interventions mainly incorporated Social Cognitive Theory and Motivational Interviewing. Most trials presented significant and moderate weight loss (~5%), in which the key contributors were behavioral theories, the dietary approach of calorie restriction, and interventions delivered by dietitians and psychologists. CONCLUSIONS: Most trials presented better weight loss results with the association of calorie restrictions and theory-based interventions delivered by dietitians or psychologists. We identified the need to develop interventions in other contexts, such as low- and middle-income countries; further trials comparing a theory- versus not-theory-driven intervention; group-based versus individually based intervention; and intervention using or not using technology.