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Reference growth curves are viable tools for monitoring somatic growth. Therefore, the objective of this study was to develop reference growth curves for body mass, height, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in Brazilian children and adolescents aged 7-14 years. The reference growth curves were constructed from a cross-sectional panel study using data from four surveys conducted in 2002, 2007, 2012/2013 and 2018/2019, with 9675 children and adolescents aged 7-14 years, of both sexes from Florianopolis, Southern Brazil. Growth curves were constructed using the LMS method, based on anthropometric indicators and indices (body mass, height, BMI, WC and WHtR), measured according to standardised norms. There was an increase in body mass, height, BMI and WC values with increasing age in both sexes and percentiles (P5, P10, P25, P50, P75, P85 and P95). The girls presented higher values of body mass, BMI and WC in the analysed percentiles, compared to the boys. Regarding height, there was a higher value from 10 to 11 years old in girls and from 12 to 14 years old in boys. WHtR decreased with increasing age in both sexes and analysed percentiles. Region-specific reference growth curves can enable the monitoring of somatic growth of particular paediatric populations, expanding discussions in different regions of the world.

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Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.

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OBJECTIVE: To analyze the obesity, overweight, and thinness trends among Brazilian schoolchildren by sex, age group, and type of school according to World Health Organization (WHO) and International Obesity Task Force (IOTF) criteria. METHODS: We conducted four surveys between 2002 and 2018/19 involving schoolchildren aged 7-14 years from a state capital in southern Brazil. Weight status was classified using both WHO and IOTF criteria. RESULTS: In the total sample, obesity prevalence based on the IOTF and the WHO criteria were 72% and 44% higher in 2018/19 compared with 2002, respectively. Over the whole period, the obesity prevalence increased among children (WHO: 10.1% vs. 14.1%; IOTF: 5.0% vs. 8.3%), and those from public schools (WHO: 10.5% vs. 16.4%; IOTF: 5.6% vs. 10.1%). There was no significant reduction in thinness prevalence over the analyzed period. CONCLUSION: Obesity prevalence remains on an upward trend in a state capital in southern Brazil, especially among children from public schools. A higher prevalence of overweight and obesity was observed using the WHO criteria compared with IOTF criteria.

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OBJECTIVE: The aim of this study was to investigate the association between dietary patterns and biochemical markers related to diabetes mellitus (DM): glucose, insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance index from 35 454 Brazilian adolescents 12 to 17 y of age. METHODS: Dietary patterns were derived using factor analysis by the principal components method. The data originated from the school-based study ERICA (Study of Cardiovascular Risk in Adolescents) carried out between 2013 and 2014. Linear regression models analyzed the associations. RESULTS: Three dietary patterns were found: traditional Brazilian, bread and coffee, and Western. An inverse association was found in young girls between the traditional Brazilian pattern and fasting glucose (ß = -0.76; P = 0.005) and HbA1c in the second and third tertiles (ß = -0.04; P = 0.002; ß = -0 .06; P < 0.001), and the Western pattern with HbA1c (ß = -0.02; P = 0.035). In boys, a positive association was found between the second tertile of the dietary pattern and insulin (ß = 0.48; P = 0.009) and homeostasis model assessment of insulin resistance index (ß = 0.11; P = 0.012). CONCLUSIONS: This study showed that the traditional Brazilian pattern was inversely associated with blood glucose and HbA1c values in girls. Furthermore, the data suggest that there is an important difference between boys and girls in the association of dietary patterns and the markers used.

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ABSTRACT Objective This study analyzes the results of evaluative research on the Brazilian Food and Nutritional Security System. Method Was conducted a scoping review by collecting information from four bibliographic databases: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (MEDLINE/PubMed), and Web of Science. Three researchers systematically selected the studies and extracted data. The researchers categorized the studies included according to an evaluative approach to the topics of financing, social participation, decentralization and government management, and monitoring and evaluation. Results Were found 1,987 references, 17 of which were selected for analysis. It is presented the evaluation of the System and of its public policy as a developing field permeated by different types of research and methods and which needs to be better qualified in relation to its theoretical and methodological approaches. The results and recommendations of the studies analyzed point out important elements to guide decision-making in relation to the System and its public policy. Conclusion In view of the recent weakening of the governance structure of this public policy at a national level, this study contributes to the debate on food and nutritional security and its reintegration into the Brazilian governmental agenda.

RESUMO Objetivo Este estudo analisou os resultados de pesquisas avaliativas sobre o Sistema Nacional de Segurança Alimentar e Nutricional no Brasil. Método Foi realizado uma revisão a partir da coleta de informações em quatro bancos de dados bibliográficos: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (MEDLINE/PubMed), e Web of Science. Três pesquisadores selecionaram sistematicamente os estudos e extraíram os dados. Os pesquisadores categorizaram os estudos incluídos de acordo com uma abordagem avaliativa sobre os temas de financiamento, participação social e controle, descentralização e gestão governamental, e monitoramento e avaliação. Resultado Foram encontradas 1.987 referências, das quais 17 foram selecionadas para análise. Apresenta-se a avaliação do Sistema e de sua política pública como um campo em desenvolvimento permeado por diferentes tipos de pesquisa e métodos, e que precisa ser mais bem qualificado em relação às suas abordagens teóricas e metodológicas. Os resultados e recomendações dos estudos analisados apontam elementos importantes para orientar a tomada de decisão em relação ao Sistema e sua política pública. Conclusão Diante da recente fragilização da estrutura de governança dessa política pública em nível nacional, este estudo contribui para o debate sobre segurança alimentar e nutricional e sua reinserção na agenda governamental brasileira.

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BACKGROUND & AIMS: Fatty acids (FAs) of the omega-3 and omega-6 family are considered essential, and adequate intake seems to be associated with lower risk of developing chronic non-communicable diseases. The objective was to evaluate the association of omega-3 and omega-6 FAs dietary intake with the prevalence of MS and its components waist circumference (WC), blood pressure (BP), fasting blood glucose, triglycerides and High Density Lipoprotein - cholesterol (HDL-c) in Brazilian adolescents aged 12-17 years. METHODS: This is a school-based cross-sectional investigation, using data from the Study of Cardiovascular Risks in Adolescents (ERICA), carried out between 2013 and 2014. The following variables were collected and assessed: 1) sociodemographic (sex, age, type of school, school location whether urban or rural and region of the country); 2) food consumption was measured through a 24-h Food Recall (24 hR), and a second 24 hR was applied to 7% of the total sample; 3) anthropometrics (weight, height, WC), BP and biochemical (glycemia, triglycerides and HDL-c) were also assessed. Logistic regression analysis was performed according to gender and age group. RESULTS: A total of 36,751 adolescents participated in the study. The intake of omega-3 FAs in the total population was 1.71 g/day and of omega-6 FAs, 13.56 g/day, with an omega-6/omega-3 ratio of 7.93:1. It was found that higher intake of omega-3 FAs was associated with an 53% lower chance of low HDL-c. For omega-6 FAs, no significant results were found. CONCLUSIONS: The findings indicated an association between omega-3 FAs and HDL-c. More studies are needed to elucidate the effects of omega-6 FAs.

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PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

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ABSTRACT Objective Evaluate the contribution of Popular Restaurants in promoting Food and Nutrition Security and fighting hunger. Methods This is an integrative review with searches performed in Scopus, Virtual Health Library, Directory of Open Access Journals, Scientific Electronic Library Online, Web of Science, PubMed and Google Scholar databases. The capture of studies was limited to the period from 2011 to 2021. The articles were categorized according to the focus of the evaluation carried out, conceptualization and thematic analysis procedures, and aggregated into five categories of analysis: 1) users' profile; 2) food handlers; 3) leftovers, food loss and waste; 4) physical-functional structure; and 5) promotion of the human right to adequate food. Results 35 articles were included. There was a predominance of a quantitative approach and, among the focus of the studies, the most recurrent was related to the "users' profile" (54%), followed by the categories: "food handlers" (14%), "Leftovers, food loss and waste" (14%), "promotion of the Human Right to Adequate Food" (12%), and "physical-functional structure (6%). 88.5% of the studies discuss the equipment in a sectored way, evaluating specific items of the equipment and/or the population served. Only four studies discussed Popular Restaurants as promoters of the Human Right to Adequate Food. Conclusion There was a scarcity of the analyzed literature, attesting to the existing gap in the role of Popular Restaurants in the promotion of Food and Nutrition Security. It is recommended to carry out evaluative studies that can contribute to the qualification and expansion of Popular Restaurants as instruments to promote the Human Right to Adequate Food and fight hunger.

RESUMO Objetivo Avaliar a contribuição dos Restaurantes Populares na promoção da Segurança Alimentar e Nutricional e combate à fome. Métodos Trata-se de revisão integrativa com buscas nas bases de dados Scopus, Biblioteca Virtual em Saúde, Directory of Open Access Journals, Scientific Electronic Library Online, Web of Science, PubMed e Google Acadêmico. A captura de estudos limitou-se ao período entre 2011 e 2021. Os artigos foram categorizados segundo o enfoque da avaliação realizada, conceituação e procedimentos de análise temática e agregados em cinco categorias de análise: 1) perfil dos usuários; 2) manipuladores de alimentos; 3) resíduos, perdas e desperdício; 4) estrutura físico-funcional; e 5) promoção do direito humano à alimentação adequada. Resultados Foram incluídos 35 artigos. Observou-se predominância de abordagem quantitativa e, dentre os focos dos estudos, o mais recorrente foi relacionado ao "perfil dos usuários" (54%), seguido pelas categorias: "manipuladores de alimentos" (14%), "resíduos, perdas e desperdício" (14%), "promoção do Direito Humano à Alimentação Adequada" (12%), e "estrutura físico-funcional (6%). 88,5% dos estudos discute o equipamento de forma setorizada, avaliando itens pontuais do mesmo e/ou da população atendida. Apenas quatro estudos discutiram os Restaurantes Populares como promotores do Direito Humano à Alimentação Adequada. Conclusão Verificou-se escassez da literatura analisada, atestando a lacuna existente sobre o papel dos Restaurantes Populares na promoção da Segurança Alimentar e Nutricional. Recomenda-se a realização de estudos avaliativos que possam contribuir com a qualificação e a ampliação dos Restaurantes Populares como instrumentos de promoção do Direito Humano à Alimentação Adequada e combate à fome.

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Introdução: O I Plano Municipal de Segurança Alimentar e Nutricional (PLAMSAN) é uma ferramenta de planejamento, gestão e implementação da Política de Segurança Alimentar e Nutricional. Em Duque de Caxias, RJ, o I PLAMSAN foi sancionado em 2016. Objetivo: Realizar avaliação do I PLAMSAN-DC (2017-2020), utilizando como procedimentos metodológicos uma aproximação do "Ciclo de Políticas Públicas". Métodos: Estudo de avaliação usando elementos da ferramenta "ciclo de políticas públicas" com base nos seguintes procedimentos metodológicos: 1) Análise documental; 2) Revisão de literatura; 3) Avaliação do cumprimento das metas com base nas respostas advindas das Secretarias que compõem a Câmara Intersetorial de Segurança Alimentar e Nutricional. Resultados: Verificou-se que, dentre as 42 metas do Plano, 14,7% foram cumpridas, 34,1% foram parcialmente cumpridas, e 51,2% não foram cumpridas. Conclusões: Observou-se que ainda não há acentuado papel por parte do nível municipal para a concretude de inúmeras ações que necessitam de recursos financeiros. Além disso, verifica-se a necessidade de superação de entraves, sobretudo em relação ao alcance da intersetorialidade e fortalecimento das estruturas componentes do sistema de segurança alimentar e nutricional.

Introduction: The I Plano Municipal de Segurança Alimentar e Nutricional (PLAMSAN, I Municipal Plan for Food and Nutrition Security) is a planning, managing and implementing tool of the Food and Nutrition Security Policy. In Duque de Caxias, RJ, the I PLAMSAN was sanctioned in 2016. Objective: To carry out an evaluation of the I PLAMSAN-DC (2017-2020), using as methodological procedures an approximation of the "Public Policies Cycle". Methods: Evaluation study using elements of the "Public Policies Cycle" tool based on the following methodological procedures: 1) Document analysis; 2) Literature review; 3) Assessment of achievement of goals based on responses from the secretariats that make up the Intersectoral Chamber for Food and Nutrition Security. Results: Among the 42 goals of the Plan, 14.7% were met, 34.1% were partially met, and 51.2% were not met. Conclusions: The municipality still does not play an important role in the implementation of a number of food and nutrition initiatives that require financial resources. In addition, there is a need to overcome barriers, especially in terms of achieving intersectoriality and of strengthening the structures that make up the food and nutrition security system.

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Introdução: O ambiente alimentar que a comunidade está inserida pode influenciar, positiva ou negativamente no acesso à alimentação de qualidade e consequentemente na sua saúde. Objetivo: Identificar a presença de desertos alimentares em um distrito sanitário de uma capital brasileira. Métodos: Estudo descritivo, transversal e exploratório, utilizando dados secundários de diferentes fontes institucionais para mapear a distribuição espacial de estabelecimentos de comercialização de alimentos: restaurantes, padarias, supermercados, minimercados/mercearias, hortifrutigranjeiros, vendedores ambulantes e lanchonetes/fastfood. Os estabelecimentos foram agrupados nas categorias in natura, ultraprocessados e mistos, de acordo com a predominância do tipo de alimentos comercializados. Para a análise, a densidade de estabelecimentos in natura juntamente com os mistos por mil habitantes (usuários cadastrados nos centros de saúde) foram calculadas.  Resultados: Foram investigados 111 estabelecimentos, sendo 20% que comercializavam alimentos in natura (saudáveis), 27% alimentos ultraprocessados (não saudáveis) e 53% considerados mistos. Conclusões: Foram observadas áreas que podem ser consideradas desertos alimentares, locais onde há pouca (ou ausência) de oferta de alimentos in natura, e por consequência dificultando o acesso a alimentos saudáveis.

Introduction: The communities' food environment can positively or negatively influence access to quality food and consequently, people's health. Objective: Identify the presence of food deserts in a health district of a Brazilian capital. Methods: Descriptive, cross-sectional and exploratory study, using secondary data from different institutional sources to map the spatial distribution of food establishments such as restaurants, bakeries, supermarkets, minimarkets/grocery stores, fruit and vegetable stores, street vendors and cafeterias/fast food. The establishments were grouped into fresh, ultra-processed and mixed food categories, according to the predominance of the type of food offered. For the purpose of analysis, the density of fresh food establishments together with mixed food establishments per thousand inhabitants (as registered in the health centers) was calculated.  Results: A total of 111 establishments were investigated, 20% selling fresh foods (healthy), 27% ultra-processed foods (unhealthy) and 53% considered mixed food sellers. Conclusions: Areas that can be considered food deserts were found, i.e. places where there is little (or absence) of fresh food supply, and consequently making access to healthy foods difficult.

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AIMS: To conduct a systematic review of the literature on the scientific evidence of the oral intake of omega-3 and omega-6 FAs and metabolic syndrome (MS) in adolescents. DATA SYNTHESIS: The study was registered in PROSPERO (number 42020185370). Studies were carried out with adolescents aged 10-19 years, who presented as intervention/exposure the oral intake of omega-3 and/or omega-6 fatty acids (FAs), in the databases PubMed, Scopus, Web of Science, LILACS, CENTRAL, and PQDT Global e BDTD. The tools used to assess the risk of bias were RoB 2.0, Agency for Healthcare Research and Quality (AHRQ), and Newcastle-Ottawa Scale. Fifteen papers retrieved published from 2010 to 2019 were included (n = 3534); nine were randomized studies and controlled clinical trials, four were cross-sectional studies, one was a retrospective cohort study, and one case-control study. No studies have evaluated the effect or association of omega-3 and/or of omega-6 FAs with actual MS, only with its components. The randomized clinical trials identified the effects of omega-3 FA on the decrease in blood pressure (n = 1 out of six), glycemia (n = 2 out of seven), and triglycerides (n = 5 out of eight), and the increase in HDL-c (n = 2 out of eight) considering the comparison between the group that received omega-3 FA and the control group. CONCLUSIONS: Scientific evidence is controversial on the association between oral intake of omega-3 FAs and MS in adolescents, due to the heterogeneity between studies and the divergence of results for the same MS component.

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This study aims to describe the time trend of age at menarche in Brazilian schoolgirls evaluated in 2007, 2012/2013 and 2018/2019, and to assess its association with having overweight, including obesity and socio-economic conditions. Three cross-sectional studies were carried out in 2007, 2012/2013 and 2018/2019 in schoolchildren enrolled between the second and ninth years of elementary school and comprising 838, 688 and 326 schoolgirls, respectively. Body mass index Z scores were calculated and categorised as either without overweight or with overweight (including obesity). The type of school (a proxy of socio-economic condition) was categorised as either public or private. Menarche data were collected using the status quo and recall methods. The mean age at menarche was estimated by survival analysis. Differences in age at menarche according to the year of survey, weight status and type of school were verified by the Log-Rank test and Cox's univariate and multiple regression. There was an increase in the prevalence of overweight in girls throughout the surveys, with 21.4% in 2007, 27.2% in 2012 and 28.5% in 2018 (p = 0.007) having overweight. There was a decrease in the mean age at menarche between 2007 and 2018/2019 (12.3 vs. 11.9 years, respectively). The mean age at menarche in girls with overweight was lower in the three time periods when compared to girls without overweight (11.9, 11.8 and 11.5 vs. 12.4, 12.4 and 12.1, respectively). Girls with overweight were more likely to have had earlier age at menarche than girls without overweight (Hazard Ratio 1.57; 95% CI 1.36; 1.80). There were no differences in the age at menarche according to the type of school. The increase in the prevalence of girls with overweight (including obesity) may be associated with the age at menarche. Girls with overweight had a higher risk of earlier age at menarche than girls without overweight.

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We aimed to evaluate the association of overweight/obesity based in BMI and purgative behaviours with body image (BI). Methods: Cross-sectional study, with probabilistic sample of 976 adolescents, aged 11-14 years, from the city of Florianópolis, Brazil. Multivariate analyses were performed. Overweight (including obesity) and four variables related to purgative methods for body weight control or eating behaviour were evaluated as outcomes, while BI satisfaction was the primary independent variable in each model. Models were controlled for age, sex, type of school (public or private), intake of fruit and vegetables, number of daily meals, and physical activity scores levels. A total of 31·4 % of adolescents wanted to enlarge their silhouette and 45·6 % wanted to reduce it. Among overweight/obese adolescents, 9·6 % were satisfied with their bodies, while 89·8 % wanted to reduce it, while among the not overweight/obese adolescents, 45·4 % wanted to enlarge their silhouette (P < 0·001). Multivariate analysis showed that the odds for overweight/obesity is higher among adolescents who wanted to reduce their silhouette (OR = 11·20; 95 % CI = 5·55, 22·58). Adolescents who want to reduce their silhouette are more likely to use diuretics (OR = 3·08; CI = 1·78, 5·32) and to use laxatives (OR = 2·10; CI = 1·20, 3·68). A significant association was also found between dissatisfaction with BI and overeating (among those who want to enlarge their silhouette: OR = 1·78; CI = 1·12, 2·85 and among those who want to reduce their silhouette: OR = 1·81; CI = 1·03, 3·19). Conclusion: BI dissatisfaction was associated with overweight/obesity, as well with overeating, and the use of purgative methods.

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Conditional cash transfer programs are strategies used by countries over the past two decades, and they play a key role in reducing income inequalities and expanding access to basic services such as health and education. The Brazilian Cash Transfer Program (Bolsa Família), the largest conditional cash transfer program in the world, aims to bring immediate poverty alleviation and eradicate hunger. The objective of this study was to analyse the contributions of the Brazilian Cash Transfer Program for reducing social inequalities and ensuring the right to health, food, education and social assistance in Brazil. A review of the scientific literature published between 2003 and 2020 was conducted, associated with documentary research on government websites. There was a relationship between the Brazilian Cash Transfer Program, reduction of child mortality and increase in access to Primary Health Care services; increased access to food, including in natura; higher school attendance and reduced dropout. However, no improvement in the nutritional status of the families entitled to the program was observed, nor the interruption of the intergenerational cycle of poverty was ensured. The Brazilian Cash Transfer Program continues as a potent intersectoral policy for reducing inequities, which reinforces the need to strengthen and combine complementary policies to expand its effects.

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We sought to analyze the processes of formulation, updating and implementation of the Brazilian National Food and Nutrition Policy (PNAN), from 1999 to April 2020. This is a discussion paper, using institutional documentary sources, bibliographic search in national and international databases, as well as theses and dissertations. The theory of the cycle of public policies was adopted to systematize and present the set of information. PNAN was established in 1999 and updated ten years later, in a participatory process, based on an innovative approach centered on the paradigms of healthy food practices, the human right to food and nutritional security, aligned with the Brazilian Unified National. Regarding implementation, there are advances related to the publication of Food Guides with national guidelines; to the promotion of research in food and nutrition; to collective action to build the regulatory agenda, even if with disputes, and to the decentralization of financial resources for the execution of PNAN actions. The monitoring and evaluation focused on the food and nutritional situation; we found that there were insufficient mechanisms to feed back the policy. After 20 years, PNAN maintains the challenge of effectively fulfilling its historic commitment: the universal guarantee of the human right to adequate and healthy food.

Objetivou-se analisar aspectos dos processos de formulação, atualização e implementação da Política Nacional de Alimentação e Nutrição (PNAN), de 1999 a abril de 2020. Trata-se de artigo de debate, utilizando-se de fontes documentais institucionais, busca bibliográfica em base de dados nacionais e internacionais, teses e dissertações. Adotou-se a teoria do ciclo das políticas públicas para sistematizar e apresentar o conjunto das informações. A PNAN foi instituída em 1999 e atualizada 10 anos depois, em processo participativo, fundamentando-se em abordagem inovadora centrada nos paradigmas das práticas alimentares saudáveis, do direito humano à alimentação e da segurança alimentar e nutricional, alinhados ao Sistema Único de Saúde. Quanto à implementação, verificam-se avanços relativos à publicação dos Guias Alimentares com diretrizes nacionais; ao fomento à pesquisa em alimentação e nutrição; à ação coletiva para construção da agenda regulatória, ainda que com embates, e à descentralização de recursos financeiros para execução das ações da PNAN. O monitoramento e a avaliação focaram-se na situação alimentar e nutricional; constatou-se a insuficiência de mecanismos para retroalimentar a política. Após 20 anos, a PNAN mantém o desafio de cumprimento efetivo do seu compromisso histórico: a garantia universal do direito humano à alimentação adequada e saudável.

El objetivo fue analizar aspectos de los procesos de formulación, actualización e implementación de la Política Nacional de Alimentación y Nutrición (PNAN), de 1999 a abril de 2020. Se trata de un artículo de debate, donde se utilizaron fuentes documentales institucionales, búsqueda bibliográfica, en base de datos nacionales e internacionales, tesis y disertaciones. Se adoptó la teoría del ciclo de las políticas públicas para sistematizar y presentar el conjunto de la información. La PNAN se instituyó en 1999, y se actualizó 10 años después, en un proceso participativo, fundamentándose en un abordaje innovador, centrado en los paradigmas de las prácticas alimentarias saludables, del derecho humano a la alimentación y de la seguridad alimentaria y nutricional, alineados en el Sistema Único de Salud. Respecto a la implementación, se verifican avances relacionados con la publicación de las Guías Alimentarias con directrices nacionales; al fomento a la investigación en alimentación y nutrición; a la acción colectiva para la construcción de la agenda regulatoria, aunque con complicaciones, y a la descentralización de recursos financieros para la ejecución de las acciones de la PNAN. El monitoreo y la evaluación se centraron en la situación alimentaria y nutricional; se constató la insuficiencia de mecanismos para retroalimentar la política. Tras 20 años, la PNAN mantiene el desafío de cumplimiento efectivo de su compromiso histórico: la garantía universal del derecho humano a una alimentación adecuada y saludable.

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The association between body image and eating behaviors or weight control strategies has been demonstrated in the scientific literature, but there is a lack of evidence on the association between weight misperception and food consumption indicators in adolescents. This study aimed to evaluate the association between weight misperception and dietary patterns (DPs) in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). It was a national school-based cross-sectional study conducted among students aged 12-17 years. Data were collected in the form of anthropometric measurements, responses in self-answered questionnaires, and 24-h dietary recall. The following variables were assessed: weight underestimation and overestimation (independent variables), which were defined as the presence of a disagreement between nutritional status and self-perceived weight; dietary patterns (dependent variables), defined by a posteriori method using principal component factor analysis; and individual and demographic variables (covariates). Data analysis was performed using the Poisson regression models method, stratified by sex. A total of 52,038 adolescents with normal weights were evaluated. The weight misperception prevalence was 34.0% (95% confidence interval [CI]: 33.0, 35.0). Three DPs were identified: "Traditional Brazilian," "Processed meat sandwiches and coffee," and "Ultra-processed and sweet foods." In girls, weight underestimation was directly associated with the "Traditional Brazilian" (1.24; 95% CI: 1.08, 1.43) and "Ultra-processed and sweet foods" DPs (1.29; 95% CI: 1.09, 1.54), and overestimation was inversely associated with all the DPs. In boys, a direct association between underestimation and the "Ultra-processed and sweet foods" DP (1.29; 95% CI: 1.10, 1.51) was found. Overestimation was inversely associated with the "Traditional Brazilian" DP (0.79; 95% CI: 0.63, 0.99). The inverse association between overestimation and the "Traditional Brazilian" DP, and the direct association between underestimation and the "Ultra-processed and sweet foods" DP indicated that weight misperception was related to unhealthy eating habits in Brazilian adolescents.

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OBJECTIVE: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. METHODS: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (

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BACKGROUND & AIMS: Childhood and adolescent obesity is one of the most important issues in the global health of the population and has been increasing dramatically in recent decades. The aim of this study was to evaluate the association between overweight/obesity and the Dietary Approaches to Stop Hypertension (DASH) diet score in a representative sample of Brazilian adolescents. METHODS: Data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based survey, were used. A total of 71,553 adolescents (12-17 years old), of both sexes, participated in the study; they had their anthropometric measurements taken and responded to a 24-h dietary recall. Eight food components of the DASH score were evaluated. 1) fruits (except fruit juices), 2) vegetables (except potatoes and beans), 3) pulses/nuts, 4) whole grains, 5) low-fat and diet/light dairy products, 6) sodium, 7) red and processed meats, and 8) sugary drinks and fruit juices. A higher score was indicative of greater accordance with the DASH diet, with a final score ranging from eight to 40 points. The association between overweight/obesity and the DASH score was assessed using Poisson regression models. RESULTS: The highest prevalence of overweight/obesity was observed among boys aged 12-14 years (28.2%), white (27.7%), enrolled in private schools (32.4%) and among those who practiced ≥300 min physical activity/week (26.1%). The food groups most frequently consumed were sugary drinks, pulses and nuts, and red and processed meats. No association was found between overweight/obesity and the DASH diet score in Brazilian adolescents, in the adjusted analysis models. CONCLUSIONS: Low consumption of foods considered protective and high consumption of health-risk foods, even among adolescents with greater accordance with the DASH diet, may have contributed to these findings. Public health measures are needed to prevent/reduce the prevalence of overweight/obesity in adolescence, as it is a risk for overweight/obesity in adulthood as well as other complications, leading to loss of quality of life for the individual and increased health spending.

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Introdução: A identificação precoce de imprecisões nas estimativas do tamanho corporal pode ser fundamental para planejar e realizar ações de prevenção e tratamento mais eficazes relacionadas à percepção e distúrbios da imagem corporal. Objetivo: Estimar a prevalência de superestimação e subestimação do tamanho corporal em escolares com magreza, peso normal e obesidade e os fatores associados. Métodos: Estudo transversal e de base escolar realizado em Florianópolis, Santa Catarina, Brasil. O estudo foi realizado com uma amostra de 1.530 escolares de sete a dez anos matriculados em escolas públicas e privadas de Florianópolis. Foram analisados dados sociodemográficos e antropométricos, bem como suas percepções sobre a imagem corporal. As percepções do tamanho corporal foram avaliadas utilizando-se as Escalas de Silhuetas para Crianças Brasileiras. Foi utilizada regressão logística para análise das associações. Resultados: A prevalência de magreza ou de peso normal em escolares que se consideravam com obesidade foi de 10%. Nenhum dos escolares com obesidade se consideraram magros ou com peso normal. Nos escolares magros, a imagem corporal desejada referente à obesidade manteve-se associada à percepção de considerar-se obeso (odds ratio = 2,64, p < 0,05). O sobrepeso, no sexo feminino, se manteve associado à condição de considerar-se magro (odds ratio = 3,07, p < 0,05). Conclusões: A superestimação e subestimação do tamanho corporal foram observadas entre crianças de 7 a 10 anos, particularmente do sexo feminino. Outros estudos utilizando diferentes variáveis e abordagens metodológicas são necessários para identificar, em profundidade, as causas da distorção da imagem corporal.

Introduction: Early identification of inaccuracies in body size estimations can be fundamental to plan and accomplish more effective prevention and treatment actions related to body image perception and disorders. Objective: To assess the prevalence of overestimation and underestimation of body size in thin, normal-weight, and obese schoolchildren and the factors associated. Methods: Cross-sectional and school-based study conducted in Florianópolis, Santa Catarina, Brazil. The study was conducted with a sample of 1,530 schoolchildren from seven to ten years old enrolled at public and private schools in Florianópolis-SC, Brazil. Sociodemographic and anthropometric data, as well as their perceptions on body image, were analyzed. Perceptions of body size were evaluated using the Figure Rating Scales for Brazilian Children. Logistic regression was used to analyze associations. Results: The prevalence of thinness or normal-weight schoolchildren who considered themselves with obesity was 10%. None of the schoolchildren with obesity considered themselves thin or normal-weighted. Considering thin and normal-weight schoolchildren, a desired body image equivalent to obesity was associated with an overestimation of their own obesity (odds ratio = 2.64, P < 0.05). Overweight in female schoolchildren was associated with an underestimation of self-thinness (odds ratio = 3.07, P < 0.05). Conclusions: Self-overestimation and underestimation of body sizes were observed among 7-10 year-old schoolchildren, particularly females. Further studies using different variables and methodological approaches are needed to know in depth the causes of distorted body image.

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