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Introducción. Etimológicamente la palabra íleo proviene del griego eileos que significa rodando o girando; es descrito como el retraso temporal de la motilidad gastrointestinal. Mundialmente es reconocido que el íleo postoperatorio es una de las principales complicaciones después de cirugía y representa un problema importante por su elevado costo sanitario. Se ha investigado respecto al uso preventivo de medidas físicas y farmacológicas, como los procinéticos, para el manejo del íleo postoperatorio. Métodos. Investigación clínico-terapéutica, comparativa, de corte longitudinal prospectivo de seguimiento, con muestreo no probabilístico por conveniencia, conformado por cuatro grupos con 25 pacientes cada uno, atendidos en el Servicio de Cirugía General entre mayo y agosto de 2021. Resultados. Los pacientes presentaron una media de edad de 49,4 ± 19,6 años y el 53 % fueron hombres. El 86 % de los pacientes presentaron ruidos intestinales antes de 24 horas posteriores a la operación. La primera evacuación en los pacientes que ingirieron café tipo espresso fue a las 42,6 horas y para aquellos en el grupo de café americano fue a las 43,4 horas en comparación con 89,4 horas en el grupo control (p < 0,001). Conclusión. Se recomienda el uso del café como una medida segura y económica para el inicio de la dieta, como una alternativa al esquema tradicional, constituyéndose en una opción para el manejo del íleo postoperatorio

Introduction. Etymologically the word ileus comes from the Greek eileos, which means rolling or turning. It is described as the temporary delay of gastrointestinal motility. It is recognized worldwide that postoperative ileus is one of the main complications after surgery and represents an important problem due to its high healthcare cost. Research has been done regarding the preventive use of physical and pharmacological measures, such as prokinetics, for the management of postoperative ileus.Methods. Clinical-therapeutic, comparative, prospective longitudinal follow-up research, with non-probabilistic convenience sampling, made up of four groups with 25 patients each, treated in the General Surgery Service between May and August 2021. Results. The patients had a mean age of 49.4 ± 19.6 years and 53% were male; 86% of patients had bowel sounds within 24 hours after the operation. The first bowel movement in patients who ingested espresso coffee was 42.6 hours and for those in the American coffee group it was at 43.4 hours compared to 89.4 hours in the control group (p < 0.001). Conclusion. The use of coffee is recommended as a safe and economical measure to start the diet as an alternative to the traditional fashion, becoming an option for the management of postoperative ileus.

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Resumo O objetivo foi analisar a qualidade dos dados antropométricos de crianças menores de cinco anos em dois sistemas de informação no estado de São Paulo. A amostra compreendeu 2.117.108 crianças do Sistema de Vigilância Alimentar e Nutricional (Sisvan) e 748.551 do Projeto Estadual do Leite (Vivaleite). Inicialmente, avaliamos a frequência de valores faltantes e fora do espectro do equipamento, e calculamos o índice de preferência de dígito para peso. Após calcular os índices de altura para idade (A-I), peso para idade (P-I) e índice de massa corporal para idade (IMC-I), identificamos os valores biologicamente implausíveis (VBI) e calculamos o desvio-padrão (DP). Para cada município, calculamos a média e o DP de A-I, P-I e IMC-I; e plotamos os valores de DP em função da média. A preferência de dígito no peso foi maior em crianças de 24 a 59 meses no Sisvan. A frequência de VBI para A-I (SISVAN 2,56%; Vivaleite 0,98%) foi maior do que para P-I (Sisvan 2,10%; Vivaleite 0,18%). Para o índice A-I as variações entre os municípios foram mais acentuadas no Vivaleite do que no Sisvan. A variável altura apresentou baixa confiabilidade nos dois sistemas. A variável peso apresentou qualidade satisfatória no Vivaleite e insatisfatória no Sisvan.

Abstract This paper involves the analysis of the quality of anthropometric data on children under five years of age in two information systems in the State of São Paulo. The sample included 2,117,108 children from the Food and Nutrition Surveillance System (SISVAN), and 748,551 from the State Milk Project (VIVALEITE). Initially, we evaluated the frequency of missing values and others outside the equipment spectrum and calculated the digit-to-weight preference index. After calculating height-for-age (HAZ), weight-for-age (WAZ), and body mass index-for-age (BAZ), we flagged the biologically implausible values (BIV) and calculated the standard deviation (SD). For each municipality, we calculated the mean and the SD of HAZ, WAZ, and BAZ; and plotted the SD values as a function of the mean. The digit-to-weight preference index was greater among children aged between 24 and 59 months in SISVAN. The frequency of BIV for HAZ (SISVAN 2.56%; VIVALEITE 0.98%) was higher than for WAZ (SISVAN 2.10%; VIVALEITE 0.18%). For HAZ, variations among municipalities were more pronounced in VIVALEITE than in SISVAN. The height variable presents low reliability in both systems. The weight variable reveals satisfactory quality in VIVALEITE and unsatisfactory quality in SISVAN.

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Purpose: This work sought to describe the experience of managers and caregivers with feeding and nutrition for older adults with dementia, in Colombian gerontological services. Participants and Methods: This is a qualitative focus group study with fourteen gerontological care centers for people with dementia. Results: The study reveals that care related to food and nutrition for people with dementia is organized based on the comprehensive assessment of the resident. Although there are basic support strategies, each caregiver requires specific knowledge, attitudes, behaviors, and institutional support, to generate a context that favors the health and quality of life of those involved. Conclusion: The experience of caring for people with dementia in aspects related to their food and nutrition, seen from the perspective of managers and caregivers of gerontological services in a developing country, strengthens specific strategies and public policies. This, in turn, reduces the burden on caregivers.

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OBJECTIVE: To investigate the impact of the Nutrition and Culinary in the Kitchen (NCK) Program on the cooking skills of Brazilian individuals with type 2 diabetes mellitus (T2DM). METHODS: A randomized controlled intervention study was performed, with intervention and control groups. The intervention group participated in weekly sessions of the NCK Program for six weeks (including two in-person practical cooking and three online cooking workshops). The cooking recipes were adapted by replacing high glycemic index ingredients with low and medium glycemic index alternatives. Of note, the recipes did not contain added sugars or sweeteners, were based on the use of fresh or minimally processed foods, herbs, and spices, and were sensorially tested by individuals with T2DM before use in the intervention. The study outcomes were participant score changes on the seven scales. A validated online instrument was administered to the control and intervention groups at baseline (T1) and post-intervention (T2). Parametric and non-parametric tests were used to assess the differences between the T1 and T2 parameters. RESULTS: Of the 60 individuals enrolled, 44 answered the questionnaire at both times. The findings revealed a 45.37% ± 93.57% increase in Knowledge of Cooking Terms in the intervention group, whereas the control group showed a 3.82% ± 16.17% reduction (p = 0.008). There was an increase in all the other cooking skills and healthy eating scales from T1 to T2 in the intervention group, but the differences were not significant. CONCLUSIONS: The development of cooking skills can contribute to increasing culinary knowledge and the availability of time to cook at home. The results contribute to the planning of health actions aimed at individuals with DM2 through culinary interventions and public food and nutrition policies.

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Resumo Este ensaio explora as convergências e singularidades do diálogo entre a educação popular (EP) e a educação alimentar e nutricional (EAN) a partir de fragmentos biográficos do percurso formativo da graduação em Nutrição de três docentes universitários que constituíram as suas trajetórias acadêmico-profissional mediados pela Educação Popular. Inspirando-se na autobiografia, as narrativas revelaram que as indignações iniciais com as desigualdades sociais foram mobilizadoras do percurso formativo, possibilitando a compreensão dos fenômenos da fome, do sofrimento e do cuidado humano. Assim, o exercício de buscarem espaços e oportunidades na qual pudessem conhecer e experienciar o trabalho social em contextos de vulnerabilidades mostrou-se decisivo nas construções pessoais e profissionais, revelando as contradições dos modelos tradicionais de formação e foram o ponto de partida para a gênese do pensamento crítico. Assim, pretende-se oferecer pistas para compreender as interfaces entre EP e EAN, na convergência de ações em torno da luta contra a fome e pelo Direito à Alimentação, sem, entretanto, reduzir-se uma à outra, quando a alimentação e nutrição se projetam no horizonte das práticas.

Abstract This essay explores the convergences and singularities of popular education and Food and Nutrition Education based on biographical fragments of the undergraduate training program in Nutrition of three university professors who established their academic and professional trajectories at these crossroads of knowledge and actions mediated by popular education. Inspired by the autobiographical method, the narratives revealed that the initial indignations with social inequalities were mobilizing the routes in the formative path toward understanding hunger, suffering, and human care. To this end, seeking spaces and opportunities to learn about and experience social work in contexts of vulnerabilities was a decisive factor in their personal and professional constructions, revealing the contradictions of traditional training models and the starting point for the genesis of critical thinking. Thus, clues are offered to understand the interfaces of Popular Education (PE) and Food and Nutrition Education (FNE) in the converging actions around the fight against hunger and the right to food without, however, reducing one to the other when food and Nutrition are projected on the horizon of practices.

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Resumo Este estudo visa reportar desenvolvimento e validação de materiais educativos digitais baseados nas dimensões de habilidades culinárias domésticas (HCD) avaliadas por escala destinada aos profissionais da APS, nas recomendações do Guia Alimentar Para a População Brasileira e no Marco de Educação Alimentar e Nutricional (EAN) para Políticas Públicas. Foram desenvolvidos 5 vídeos e materiais gráficos com propostas de atividades para desenvolvimento de HCD e estímulo à sua implementação em ações e orientações junto à comunidade e em atendimentos profissionais. O conteúdo dos materiais foi avaliado por especialistas utilizando técnica Delphi de 2 rounds e análises estatísticas para evidência de consenso. Especialistas proferiram comentários para aprimoramento dos produtos e sua aplicabilidade. Os materiais apresentaram linguagem decodificada, ilustrações lúdicas, com personagens representativos da população-alvo. Apresentaram evidência de validade de conteúdo satisfatória e podem ser utilizados em ações de educação permanente, visando a qualificação da força de trabalho, e em ações de EAN junto aos sujeitos de direito. Os materiais gráficos possibilitam associar o conteúdo dos vídeos à prática, em contextos condizentes com a realidade dos sujeitos.

Abstract This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale destined for PHC professionals, following the recommendations of The Dietary Guidelines for the Brazilian Population and on The Food and Nutrition Education Framework (FNE) for Public Policies. Five videos and graphic materials were developed with proposals for activities to develop HCS and encourage its implementation in actions and guidelines in the community and in professional care. The content of the materials was evaluated by experts using the Two-Round Delphi-based technique and statistical analyses for evidence of consensus. Specialists presented comments to improve the products and their applicability. The materials presented decoded language and playful illustrations with characters representative of the target population. Evidence of satisfactory content validity was presented and can be used in permanent education actions, seeking the qualification of the workforce and in FNE actions within the scope of the law. The graphic materials make it possible to associate the content of the videos with practice in contexts consistent with the reality of the individuals.

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Serious games emerge as teaching tools with a purpose beyond entertainment, aiming to improve some aspect of the teaching-learning process. Given the high prevalence of chronic noncommunicable diseases in the Brazilian population, this study aimed to evaluate, through a systematic literature review, the potential of serious games as a tool for Food and Nutrition Education. To this end, we searched the PubMed, Biblioteca Virtual de Saúde, and SciELO databases for articles published in the last five years in english and portuguese. A total of 63 studies were identified, of which only 10 met the inclusion and exclusion criteria established for this review. Most studies reported positive outcomes with the use of serious games as an educational tool, finding positive effects on the retention of knowledge learned about food and nutrition, and their use showed promise as an alternative to traditional teaching methodologies. Despite this, the studies had limitations regarding the duration of the interventions and the representativeness of their sample sizes, indicating the need for future studies with methodological designs that fill such gaps. This review shows that gamified approaches to nutrition education seem promising in the context of the teaching-learning process but still lack methodological standardization for interventions based on serious games to be validated as a tool for Food and Nutrition Education.

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BACKGROUND: Exclusion diets are common practices among individuals with Inflammatory Bowel Disease (IBD). Reports that certain foods trigger or worsen symptoms are recurrent but lack evidence. The aim of the study was to identify which foods were most frequently avoided by patients with Crohn's Disease (CD) and Ulcerative Colitis (UC) and whether the consumption of any food group was associated with disease activity. METHODS: Cross-sectional study with adult patients seen at an outpatient clinic in a tertiary public hospital. Dietary intake and eating habits were accessed through questionnaires administered via telephone interview. Disease activity and symptoms were assessed using the Harvey-Bradshaw Index (IHB) for CD and the Lichtiger Index (LI) for UC. Poisson regression with a robust variance estimator was used to estimate prevalence ratios. Analyzes were performed using SPSS - Statistical Package for the Social Sciences. RESULTS: The study included 145 patients. Of these, 69.7% avoided certain foods, with citrus fruits and raw vegetables among the most avoided (16.8% and 13.8%, respectively). Regular consumption of fruits (PR = 0.56; CI 95% 0.32-0.97; p = 0.042) and vegetables (PR = 0.56; CI 95% 0.32-0.98; p = 0.045) was associated with a 44% lower prevalence of the active phase of the disease, compared to those who do not consume these foods, adjusted for age, sex and type of disease. Other food items did not present significant associations in the adjusted model. CONCLUSIONS: Fruit and vegetable intake appears to have a protective role in the recurrence of IBD. Excluding foods is a common practice, even among patients in remission, and this should be combated as it can lead to nutritional losses. It is important to reinforce with patients the benefits of a varied and less restrictive diet.

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Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.

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Objective: To create and evaluate a digital educational game (DEG) for preschool children for the prevention of iron deficiency and iron deficiency anemia. Methodology: The DEG software was developed by a multidisciplinary team, according to Chandler's methodology, in Engine Unity. The game is a 2D platformer, for Android, with three different phases. A quiz was developed for parents/caregivers about iron absorption and anemia. The quiz content was evaluated by experts. The evaluation of the game was carried out through a questionnaire applied in the school for children from 4 to 6 years of age. Results: For the construction of the game, programming, team planning, art, and soundtrack were necessary. The game was registered at the National Institute of Industrial Property. The quiz was evaluated by 14 experts and all questions had more than 80% agreement. The questionnaire was answered by 32 children with a mean age of 5.0 ± 0.7 years, and ∼70% evaluated the game positively. Thus, the acceptability of the software was favored by most players. Conclusion: The "O Jardim do Ferro" software, from its conception to evaluation, proved to be a promising tool to contribute to food and nutrition education actions, providing opportunities for the construction of knowledge about iron-rich foods for the prevention of iron deficiency and iron deficiency anemia in childhood.

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BACKGROUND: The literature contains scarce data on inequalities in growth trajectories among children born to mothers of diverse ethnoracial background in the first 5 years of life. OBJECTIVE: We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database. METHODS: A population-based retrospective cohort study employed linked data from the CIDACS Birth Cohort and the Brazilian Food and Nutrition Surveillance System (SISVAN). Children born at term, aged 5 years or younger who presented two or more measurements of length/height (cm) and weight (kg) were followed up between 2008 and 2017. Prevalence of stunting, underweight, wasting, and thinness were estimated. Nonlinear mixed effect models were used to estimate childhood growth trajectories, among different maternal ethnoracial groups (White, Asian descent, Black, Pardo, and Indigenous), using the raw measures of weight (kg) and height (cm) and the length/height-for-age (L/HAZ) and weight-for-age z-scores (WAZ). The analyses were also adjusted for mother's age, educational level, and marital status. RESULTS: A total of 4,090,271 children were included in the study. Children of Indigenous mothers exhibited higher rates of stunting (26.74%) and underweight (5.90%). Wasting and thinness were more prevalent among children of Pardo, Asian, Black, and Indigenous mothers than those of White mothers. Regarding children's weight (kg) and length/height (cm), those of Indigenous, Pardo, Black, and Asian descent mothers were on average shorter and weighted less than White ones. Regarding WAZ and L/HAZ growth trajectories, a sharp decline in average z-scores was evidenced in the first weeks of life, followed by a period of recovery. Over time, z-scores for most of the subgroups analyzed trended below zero. Children of mother in greater social vulnerability showed less favorable growth. CONCLUSION: We observed racial disparities in nutritional status and childhood growth trajectories, with children of Indigenous mothers presenting less favorable outcomes compared to their White counterparts. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethnoracial health inequalities.

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Objetivo: analizar la asociación de características biológicas y sociales con la seguridad alimentaria y nutricional (san) de niños menores de 5 años con base en indicadores de percepción del hambre y antro-pométricos.Materiales y métodos: estudio transversal realizado en municipios brasileños que fueron priorizados para el desarrollo de acciones de prevención de la obesidad infantil en 2017/2018. La san se midió usando la Escala Brasileña de Inseguridad Alimentaria y se utilizaron los índices antropométricos Talla/Edad (T/E), Peso/Edad (P/E) y Peso/Talla (P/T). Las asociaciones se testaron por regresión de Poisson con varianza robusta.Resultados: de los 868 niños, el 24.3 % vivía en familias con inseguridad alimenta-ria y nutricional moderada-severa (ianm-s), el 7.0 % tenía T/E baja; el 7.8 % P/E alto, y el 14.4 %, P/T alto. Si bien la ianm-s se asoció con una amplia gama de factores negativos del contexto social, las prevalencias de las desviaciones antropométricas fueron mayores en menores de 2 años y cuando las madres tenían el mismo diagnóstico nutricional que el niño.Conclusión: a pesar de las prevalencias expresivas de ianm-sy desviaciones antropométricas, la ianm-s fue más pronunciada, especialmente en contextos sociales des-favorables. La san mostró un comportamiento diferente en sus dimensiones alimentaria y nutricional, tanto en términos de frecuencia como de determinación

Objective: To analyze the association between biological and social characteristics with the food and nutritional security (fns) of children aged <5 years based on hunger perception and anthropometric indicators. Materials and methods: This cross-sectional study was performed at Brazilian municipali-ties that have been prioritized for the development of actions aimed at preventing childhood obesity in 2017­2018. The fns aspect was analyzed with reference to the Brazilian Food Insecurity Scale and the anthropometric indices Height/Age (H/A), Weight/Age (P/A), and Weight/Height (P/H) were used. The associations were tested by the Poisson Regression with robust variance. Results: Of the 868 children, 24.3 % lived in families with moderate­severe food and nutritional insecurity, 7.0 % had low H/A, 7.8 % had high P/A, and 14.4% had high P/E. The moderate­severe food and nutritional insecurity was associ-ated with a wide range of negative factors in the social context, but the prevalence of anthropometric deviations was higher in children <2 years and when their mothers had the same nutritional diagno-sis. Conclusion: Despite the expressive prevalence of moderate­severe food and nutritional insecurity and anthropometric deviations, the former was more pronounced, especially under unfavorable social contexts. san displayed different behaviors in its food and nutritional dimensions, both in the terms of frequency and determination.

Objetivo: analisar a associação de características biológicas e sociais com a Segurança Alimentar e Nutricional (san) de crianças menores de 5 anos com base em indicadores de percepção da fome e antropométricos. Materiais e métodos: estudo transversal realizado em municípios brasileiros que foram priorizados para o desenvolvimento de ações de prevenção da obesidade infantil em 2017/2018. A san foi medida usando a Escala Brasileira de Insegurança Alimentar e utilizaram-se os índices antropométricos Estatura/Idade (E/I), Peso/Idade (P/I) e Peso/Estatura (P/E). As associações se testaram por Regressão de Poisson com variância robusta. Resultados: das 868 crianças, 24.3 % residiam em famílias com Insegurança Alimentar e Nutricional Moderada-Grave (ianm-g), 7.0 % tinham E/I baixa, 7.8 % P/I elevado e 14.4 % P/E elevado. Enquanto a ianm-gassociou-se a uma ampla gama de fatores negativos do contexto social, as prevalências dos desvios antropo-métricos foram maiores em menores de 2 anos e quando as mães tiveram o mesmo diagnóstico nutricional que a criança. Conclusão: apesar das prevalências expressivas de ianm-g e de desvios antropométricos, a ianm-gfoi mais acentuada, sobretudo em contextos sociais desfavoráveis. A san manifestou comportamento dife-rente nas suas dimensões alimentar e nutricional, tanto em termos de frequência quanto de determinação.

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BACKGROUND: Physical education classes are widely accepted as one of the most effective settings for promoting physical activity and health and have often been used to implement physical activity interventions. The aim of this pilot study was to test a physical education intervention program on physical activity levels and physical fitness in a sample of school-age children. METHODS: Participants were a convenience sample of 50 children (34 experimental group and 16 in the comparative group) aged between 6 and 11 years old (Mean = 8.28 years). A 21-week intervention was implemented, consisting of high-intensity and physical fitness-focused exercises, in addition to a once-a-month extra class nutritional education. The following variables were evaluated before and post-intervention: physical fitness, sedentary behavior (SB), light physical activity (LPA), moderate physical activity (MVA), and vigorous physical activity (VPA). Propensity score analyses calculated the average treatment effect on the treated (ATET) within a quasi-experimental framework. RESULTS: Physical fitness variables showed improvements after the intervention, specifically for agility (ATET = -0.67 s; p < 0.001), cardiorespiratory fitness (ATET = 89.27 m; p = 0.045), lower limbs power (ATET = 4.47 centimeters; p = 0.025), and speed (ATET = -1.06 s; p < 0.001). For physical activity and SB levels, there were no improvements after intervention implementation. CONCLUSION: The intervention program showed preliminary effectiveness to improve physical fitness of children, but not SB nor physical activity.

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Risk perception is socially constructed; psychological elements control people's reactions to a hazard, and even health professionals may have difficulty determining what healthy food is. This work aimed to measure food literacy and food risk perceptions among primary healthcare professionals in a Brazilian city. In the first phase, 280 health professionals working in primary care in Rio Claro, Brazil, were studied. The Short Food Literacy Questionnaire (SFLQ-Br) and scales of risk and benefit perception of 50 foods were used. In the second phase, 20 professionals were interviewed to investigate the responses to different foods observed in the first phase. In this second phase, 16 users of the health system were also enrolled to understand their perceptions and how the nutrition messages conveyed by the health team reached them. Professionals scored an average of 34.5 on food literacy (for which there is a maximum score of 52). They showed difficulty with dietary guidelines and their interpretation. Food's risk and benefit perception were generally consistent with the recommendations of the Food Guide for the Brazilian Population. However, some processed foods or those with no proven health benefits were considered healthy by the study participants, indicating a biased perception (e.g., gelatin, processed turkey breast, cream crackers, and cereal bars). Less misperception was observed when food literacy was higher, which positively predicted risk perception. The reasons for identifying benefits of these foods ranged from the false impression that they are natural and nutritious foods to the comparative claim that they are better for health than similar foods. The results indicate the need to educate health professionals based on current references to avoid bias in population counseling.

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RESUMO A garantia de uma alimentação adequada e saudável está no rol de direitos humanos necessários para promoção da saúde. As desigualdades na distribuição de recursos e dificuldades de acesso a políticas públicas resultam em piores condições de vida das populações do campo, onde a insegurança alimentar e nutricional está mais presente que nos centros urbanos. Assim, as equipes de saúde da família do campo enfrentam diferentes desafios no processo de trabalho, sendo os Agentes Comunitários de Saúde (ACS) profissionais-chave para a garantia do acesso ao serviço. Este trabalho apresenta o caminho teórico-metodológico dos Círculos de Cultura com quatro ACS do campo no Distrito Federal e as percepções desses profissionais sobre alimentação adequada e saudável pela lente da análise do discurso. Ao longo de dois encontros, foi possível refletir sobre todas as dimensões abordadas pelo referencial teórico, com exceção da etnia/raça, além da conscientização acerca das relações de poder no território. Por meio da educação popular, vislumbra-se a transformação da realidade com ações coletivas para melhoria do acesso a alimentos saudáveis no território. Os Círculos de Cultura se mostraram um caminho potente para construção do conhecimento aliada a um olhar crítico sobre a determinação social no território.

ABSTRACT Ensuring adequate and healthy food is one of the human rights necessary to promote health. Inequalities in the distribution of resources and difficulties in accessing public policies result in worse living conditions for rural populations, where food and nutritional insecurity is more prevalent than in urban centers. Thus, rural family health teams face different challenges in the work process, with Community Health Workers (CHWs) being key professionals in ensuring access to the service. This paper presents the theoretical-methodological path of Culture Circles with four CHWs from the countryside in the Federal District and the perceptions of these professionals about adequate and healthy eating through the lens of discourse analysis. Over the course of two meetings, it was possible to reflect on all dimensions covered by the theoretical framework, except ethnicity/race, in addition to raising awareness about power relations in the territory. Through popular education, the transformation of reality is envisioned with collective actions to improve access to healthy food in the territory. The Culture Circles proved to be a powerful way for building knowledge combined with a critical look at social determination in the territory.

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Resumo A alimentação, além de imperativo biológico para sobrevivência e saúde humana, é revestida de significados culturais que determinam suas múltiplas expressões na sociedade. Os campos da alimentação, da nutrição, da saúde e da antropologia se interseccionam na discussão sobre práticas alimentares. Este ensaio teórico do tipo reflexivo tem como objetivo refletir sobre a relevância das práticas alimentares das mulheres de camadas populares para possível superação da insegurança alimentar e nutricional, examinando as relações estabelecidas com a comida no contexto da cozinha, de seus corpos e do acesso aos alimentos. O percurso metodológico consiste no estudo reflexivo de caráter exploratório, que recorre a fontes bibliográficas e documentais para alicerçar as análises com base em uma leitura crítica da realidade. A herança patriarcal continua delegando à mulher o papel de cuidadora familiar, o que abarca a alimentação: desde a aquisição do alimento até o preparo e fornecimento das refeições. Propomos que as práticas alimentares dessas mulheres podem impulsionar potenciais mudanças, que serviriam como ferramentas para aplicação de políticas públicas. As reflexões oferecem subsídios para o planejamento de políticas que possam empoderá-las como sujeitos de ação e reflexão crítica, abrindo uma projeção de cenários possíveis para agenciar formas de superação das inseguranças alimentares.

Abstract Food, besides being a biological imperative for survival and human health, is coated with cultural meanings that determine its multiple expressions in society. The fields of food, nutrition, health, and anthropology intersect in the discussion about food practices. This theoretical and reflexive essay aims to reflect on the relevance of the food practices of low-income women for the possible overcoming of food and nutritional insecurity, examining the relationships established with food in the context of the kitchen, of their bodies, and of the access to food. The methodological path followed was the reflexive and exploratory study, which uses bibliographical and documental sources to support the analyses based on a critical reading of reality. The patriarchal heritage continues to assign women the role of family caretaker, which encompasses everything from acquiring food to its preparation and serving meals. We propose that the food practices of these women can drive potential changes, which would serve as tools for the application of public health policies. The reflections offer subsidies for planning of policies that can empower them as subjects of critical action and reflection, opening a projection of possible scenarios for the agency of ways to overcome food insecurity.

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Resumo: O artigo objetivou descrever a execução do Programa Nacional de Alimentação Escolar (PNAE) durante a pandemia da covid-19 com base em estudos publicados no período de 2020 a 2023 através de uma revisão integrativa. Naquele momento, a PNAE foi relevante, assumindo a garantia da Segurança Alimentar e Nutricional (SAN) dos alunos beneficiários e apontou para a necessidade de um maior investimento por parte do governo federal brasileiro.

Abstract: The article aimed to describe the execution of the National School Meal Program (PNAE) during the covid-19 pandemic based on studies published from 2020 to 2023 through an integrative review. During the pandemic, PNAE was relevant, guaranteeing the Food and Nutritional Security (SAN) of student beneficiaries and pointing to the need for greater investment by the Brazilian federal government.

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ABSTRACT OBJECTIVE To explore the internal structure and analyze evidence of measurement invariance of the Sisvan form of food intake markers of the Food and Nutrition Surveillance System (Sisvan) for children aged six to 23 months. METHODS Sisvan microdata from 2015 to 2019 were used. After analyzing sample adequacy, exploratory factor analysis was carried out considering factor loadings (≥ 0.30 and < 0.85), communality (> 0.20), model fit indices - Tucker-Lewis index (TLI) > 0.90, and root mean square error of approximation (RMSEA) < 0.08. A critical analysis of the form items was performed to adjust the parameters. Measurement stability was investigated between age groups, macro-regions and longitudinally by multi-group confirmatory factor analysis in configural, metric, and scalar invariance models. Configural invariance was accepted if RMSEA < 0.08 and TLI and comparative fit index (CFI) > 0.90. Metric and scalar invariances were accepted if ΔRMSEA < 0.015 and ΔCFI < 0.01, compared to the previous model. RESULTS After critical analysis, items were grouped (vegetables and leafy greens; meat or eggs and liver) and excluded (salty food; porridge with milk; rice, potatoes, yams, cassava, flour, or pasta). The exploratory model comprised three factors: healthy complementary feeding (fruit; vegetables; orange or dark green leafy vegetables or fruits; meat, offal, or egg; beans), ultra-processed (yogurt; hamburger and/or sausages; sweetened drinks; instant noodles, packet snacks, or salty cookies; sandwich cookies, sweets, or treats), and milk feeding (breast milk; other milk), with satisfactory factor loadings, communalities and fit (TLI: 0.918, RMSEA: 0.071). The reformulated instrument was stable in the invariance models tested. CONCLUSIONS With the incorporation of the modifications to the Sisvan form, the food intake markers subsidize a more adequate interpretation of the feeding situation of children aged six to 23 months.

RESUMO OBJETIVOS Explorar a estrutura interna e analisar evidências de invariância de mensuração do formulário de marcadores do consumo alimentar do Sistema de Vigilância Alimentar e Nutricional (Sisvan) para crianças de seis a 23 meses. MÉTODOS Utilizaram-se microdados do Sisvan de 2015 a 2019. Após análise de adequação da amostra, realizou-se análise fatorial (AF) exploratória considerando valores de cargas fatoriais (≥ 0,30 e < 0,85), comunalidade (> 0,20) e índices de ajuste do modelo - índice de Tucker-Lewis (TLI) > 0,90 e raiz do erro quadrático médio de aproximação (RMSEA) < 0,08. Empreendeu-se uma análise crítica aos itens do formulário para adequação dos parâmetros. A estabilidade de mensuração foi investigada entre grupos etários, macrorregiões e longitudinalmente por AF confirmatória multigrupo em modelos de invariância configural, métrica e escalar. A invariância configural foi aceita se RMSEA < 0,08 e TLI e índice de ajuste comparativo (CFI) > 0,90. Invariâncias métrica e escalar foram aceitas se ΔRMSEA < 0,015 e ΔCFI < 0,01, comparando-se ao modelo anterior. RESULTADOS Após análise crítica, itens do formulário foram agrupados (legumes e verduras; carnes ou ovos e fígado) e excluídos (comida de sal; mingau com leite; arroz, batata, inhame, mandioca, farinha ou macarrão). O modelo exploratório compreendeu três fatores: alimentação complementar saudável (frutas; hortaliças; vegetal ou fruta alaranjados ou folhas verdes escuras; carnes, vísceras ou ovo; feijão), ultraprocessada (iogurte; hambúrguer e/ou embutidos; bebidas adoçadas; macarrão instantâneo, salgadinhos de pacote ou biscoitos salgados; biscoito recheado, doces ou guloseimas), e láctea (leite do peito; outro leite), com cargas fatoriais, comunalidades e ajuste satisfatórios (TLI: 0,918, RMSEA: 0,071). O instrumento reformulado foi estável nos modelos de invariância testados. CONCLUSÕES Com a incorporação das modificações ao formulário do Sisvan, os marcadores subsidiam uma interpretação mais adequada da situação alimentar de crianças de seis a 23 meses.

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Abstract Objective To evaluate the impacts of a nutritional education intervention for patients with multiple chronic conditions during smoking cessation. Methods The non-probabilistic sample comprised 18 adults and seniors of both sexes recruited from a smoking cessation treatment group. At the beginning of treatment, smoking history, degree of dependence, and stage of motivation were assessed. Degree of craving was evaluated weekly for the 1st month. Anthropometric and biochemical assessments were conducted at baseline, at 1 month, and at 3 months. Dietary intake was assessed with the "How is your diet?" questionnaire. The nutritional intervention was delivered in three sessions. The themes covered were energy balance and physical activity, healthy eating, and the importance of fruit and vegetables in the diet. Statistical analysis was conducted with the Shapiro Wilk test of normality, the paired t test, and the Wilcoxon or Mann-Whitney U tests (significance ≤ 0.05). Results Most people (55.6%) in the intervention group had a high degree of smoking dependence, while the frequency in the control group was 22.2%. Degree of craving decreased significantly after 1 month of treatment (p = 0.017). After 3 months, both groups had a positive variation in mean body weight, although below 3%. In both groups, the average percentage of weight gain was less than 3%, suggesting that delivery of the nutritional education sessions and the nutritionist's use of the protocol proposed by the Instituto Nacional de Câncer (INCA) helped to control weight gain. Blood glucose and homeostasis model assessment-insulin resistance (HOMA-IR) both increased significantly in the intervention group (p = 0.15 and p = 0.50, respectively). Conclusion Greater proximity and more frequent intervention by a nutritionist assists and encourages healthy eating practices during the smoking cessation process, which can benefit individuals' control of chronic diseases over the long term.

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Os estudos sobre educação em saúde têm focado mais no que se ensina do que em quem aprende. Este artigo relata os resultados de uma metassíntese interpretativa qualitativa (QIMS) sobre experiências de pacientes que emergem durante a participação em intervenções educativas sobre alimentação e nutrição na América Latina. Foi realizada uma busca por estudos baseados no paradigma construtivista, hermenêutico ou interpretativo publicados entre 2006 e 2020 abrangendo nove bases de dados, identificando 1.676 registros. Foram contempladas três etapas: I) identificação da amostra por meio de fichas de caracterização e avaliação da qualidade, resultando em nove estudos; II) extração de temas abordados nos resultados da pesquisa para compreensão das experiências de participação, e III) tradução de dados e compreensão sinérgica por meio de integração de experiências, incluindo uma nova categorização de temas. O QIMS gerou sete temas: "conflito social", "insegurança", "sacrifício", "cuidado", "valorização da abordagem", "mudança na compreensão" e "aprendizado". Dado o nível de detalhamento da realidade social em que ocorre a participação, os temas destacam três dimensões cruciais na educação alimentar e nutricional na perspectiva dos pacientes: "história de vida", "configuração alimentar" e "apreciação educativa". A complexidade das experiências dos pacientes exige uma abordagem que reconheça melhor a configuração dentro das dimensões encontradas. Isto exige explorar como as experiências individuais dos pacientes se relacionam com o contexto mais amplo da nutrição e da educação alimentar na região latino-americana.

Studies about health education have focused more on what is taught than on who is learning. This article reports the findings of a qualitative interpretive meta-synthesis (QIMS) on patients' experiences which emerge during participation in educational interventions on food and nutrition in Latin America. A search for studies based on constructivist, hermeneutic or interpretive paradigm published between 2006 and 2020 encompassing nine databases was conducted, identifying 1,676 records. Three stages were contemplated: I) identification of the sample through characterization and quality assessment forms, resulting in nine studies; II) extraction of themes addressed in the research results to understand the participation experiences, and III) translation of data and synergistic comprehension through an integration of experiences, including a new categorization of themes. The QIMS generated seven themes: "social conflict", "insecurity", "sacrifice", "care", "valuing the approach", "change in understanding" and "learning". Given the level of detail regarding the social reality in which participation occurs, the themes highlight three dimensions that are crucial in food and nutrition education from the patients' perspective: "life history", "food configuration" and "educational appreciation". The complexity of patient experiences demands an approach that better acknowledges the configuration within the encountered dimensions. This necessitates exploring how individual patient experiences relate to the broader context of nutrition and food education in the Latin American region.