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OBJECTIVE: To understand the potential and limits of care for childhood obesity from the perspective of comprehensiveness, in the context of Primary Health Care, in Brazilian municipalities. METHODS: A qualitative approach was adopted, with an electronic form of a dissertative nature being applied in 11 municipalities in the five Brazilian regions, derived from the four axes of comprehensiveness defined by Ayres (needs, purposes, articulations, and interactions). RESULTS: Among the strengths for comprehensive care, the following were observed: the provision of services at different levels of care; the relevance of intersectoral programs in the development of actions aimed at the multidimensionality of childhood obesity; the implementation of strategies for systematizing care and tools that encourage the expansion of dialogue and humanization; and intersectoral coordination to create appropriate responses to the expanded needs of children and their families. Limitations include: the centralization of actions in nutrition professionals and in the care sphere; the failure to prioritize childhood obesity in health agendas; and the lack of trained professionals to deal with the complexity of obesity. CONCLUSIONS: The findings suggest that child obesity care practices, in order to be transformative, need to be understood in the context of comprehensiveness. And this includes (re)thinking public policies, professional practices, and the organization of work processes so that they are, in fact, more inclusive, participatory, dialogical, humanized, supportive, fair, and, therefore, effective.

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ABSTRACT OBJECTIVE To understand the potential and limits of care for childhood obesity from the perspective of comprehensiveness, in the context of Primary Health Care, in Brazilian municipalities. METHODS A qualitative approach was adopted, with an electronic form of a dissertative nature being applied in 11 municipalities in the five Brazilian regions, derived from the four axes of comprehensiveness defined by Ayres (needs, purposes, articulations, and interactions). RESULTS Among the strengths for comprehensive care, the following were observed: the provision of services at different levels of care; the relevance of intersectoral programs in the development of actions aimed at the multidimensionality of childhood obesity; the implementation of strategies for systematizing care and tools that encourage the expansion of dialogue and humanization; and intersectoral coordination to create appropriate responses to the expanded needs of children and their families. Limitations include: the centralization of actions in nutrition professionals and in the care sphere; the failure to prioritize childhood obesity in health agendas; and the lack of trained professionals to deal with the complexity of obesity. CONCLUSIONS The findings suggest that child obesity care practices, in order to be transformative, need to be understood in the context of comprehensiveness. And this includes (re)thinking public policies, professional practices, and the organization of work processes so that they are, in fact, more inclusive, participatory, dialogical, humanized, supportive, fair, and, therefore, effective.

RESUMO OBJETIVO Compreender potencialidades e limites do cuidado em obesidade infantil na perspectiva da integralidade, no contexto da Atenção Primária à Saúde, em municípios brasileiros. MÉTODOS Adotou-se a abordagem qualitativa, com aplicação, em 11 municípios das cinco regiões brasileiras, de um formulário eletrônico de caráter dissertativo, derivado dos quatro eixos da integralidade definidos por Ayres (necessidades, finalidades, articulações e interações). RESULTADOS Dentre as potências para o cuidado integral, observou-se: a oferta de serviços em diferentes níveis de atenção; a relevância de programas intersetoriais no desenvolvimento de ações voltadas à multidimensionalidade da obesidade infantil; a implementação de estratégias de sistematização do cuidado e ferramentas que estimulem a ampliação do diálogo e a humanização; e a articulação intersetorial para criação de respostas adequadas às necessidades ampliadas das crianças e suas famílias. Enquanto limitações, estão: a centralização das ações nos profissionais nutricionistas e no âmbito assistencial; a não priorização da obesidade infantil nas agendas da saúde; e a insuficiência dos profissionais capacitados para lidar com a complexidade da obesidade. CONCLUSÕES Os achados sugerem que as práticas no cuidado da obesidade infantil, para que sejam transformadoras, precisam ser entendidas no âmbito da integralidade. E isso inclui (re)pensar políticas públicas, práticas profissionais, organização dos processos de trabalho para serem, de fato, mais inclusivas, participativas, dialógicas, humanizadas, solidárias, justas e, portanto, eficazes.

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A transição nutricional indica um consumo alimentar inadequado na população brasileira sendo necessária a adoção de estratégias educativas com a finalidade de favorecer comportamentos saudáveis. O objetivo deste trabalho foi avaliar a influência de um programa de intervenção nutricional educativa no hábito alimentar e indicadores antropométricos de alunos da primeira fase do ensino fundamental. Estudo quantitativo prospectivo, realizado em uma escola federal de Goiânia/Goiás, com 92 alunos. Realizou-se caracterização sociodemográfica, avaliação do peso, altura e Índice de Massa Corporal (IMC) e, para a identificação do hábito alimentar, aplicou-se o Questionário Alimentar do Dia Anterior (QUADA), previamente validado. Um programa de intervenção nutricional educativa foi implantado, sendo desenvolvidas três atividades em cada turma de alunos. A média de idade dos alunos foi de 9,61±1,17 anos, sendo que a maioria eram meninas (55,44%), da classe social "B" (54,38%); pardos (57,90%); católicos (54,39%), moravam com pais (68,42%) e tinha um a dois irmãos (71,94%). A maioria dos participantes apresentou eutrofia, antes e após a intervenção, e 20,00% apresentou excesso de peso. Após cinco meses da intervenção educativa, observou-se aumento de peso e IMC, sem significância estatística, ganho estatural significativo...

The nutritional transition indicates inadequate food intake in our population and it requires the adoption of educational strategies in order to promote healthy behaviors. This study evaluated the influence of an educational intervention program in dietary habits and anthropometric indicators in elementary school students. This was a prospective quantitative study developed in a public school in Goiânia, Goiás, with 92 students. Sociodemographic characteristics were analyzed as well as weight, height and body mass index (BMI) measurements. In order to identify the feeding habits, the already validated Previous Day Food Quiz (PDFQ) was used. An educational intervention program was implemented and three activities were developed in each classroom. The students' average age was 9.61 ± 1.17 years old, and the majority were girls (55.44%), social class "B" (54.38%); brown skin (57.90%); catholics (54.39%), living with their parents (68.42%) and they had one to two brothers (71.94%). Most participants had normal weight before and after the intervention, and 20.00% were overweight. After five months of the educational intervention, there was an increase in weight and BMI, although not statistically significant, and a significant height increase…

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