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Venezuela ha pasado a ser un país asimétrico, con grandes desigualdades y la inseguridad alimentaria familiar constituye quizás el problema nutricional más importante. En 1996, se comenzó a implementar la "Agenda Venezuela", la cual tiene un componente de protección social, que incluye 14 programas, para compensar a los grupos de población más desfavorecidos por las medidas económicas. Objetivo. Describir y analizar las fortalezas y debilidades de los programas de la Agenda, más vinculados con la situación nutricional. Materiales y métodos. Se basó en el análisis de informes presentados por los organismos ejecutores, de una encuesta de opinión realizada en Caracas, además de entrevistas a coordinadores de los programas. Se examinaron los programas: alimentos estratégicos, subsidio familiar, alimentación escolar, merienda y comedores escolares, hogares y multihogares de cuidado diario. Resultados. Las debilidades más comunes son: deficiente evaluación y apoyo educativo, escasa cobertura, solapamiento de beneficiarios, problemas de tipo logístico y presupuestario. A pesar de la fuerte inversión de recursos, el déficit nutricional en menores de seis años presenta una tendencia ascendente, lo cual reitera que los problemas nutricionales son multicausales y requieren de políticas sociales integrada, estables en el tiempo y focalizadas en los grupos más vulnerables. Conclusiones. Esta situación obliga a replantearse los programas en función a la pertinencia, factibilidad, costo-eficiencia e impacto y ha reiterado, la necesidad de un proceso de descentralización para otorgar más responsabilidad y poder de decisión a los gobiernos estatales, municipales y a la comunidad organizada y lograr un mayor impacto en la población objetivo y su contexto(AU)

Venezuela has become an asymmetric country, with great inequalities and family food insecurity is perhaps the most important nutritional problem. In 1996, the "Venezuela Agenda" began to be implemented, which has a social protection component, which includes 14 programs, to compensate the most disadvantaged population groups for economic measures. Objective. Describe and analyze the strengths and weaknesses of the Agenda programs, more linked to the nutritional situation. Materials and methods. It was based on the analysis of reports submitted by the executing agencies, an opinion poll conducted in Caracas, as well as interviews with program coordinators. The programs were examined: strategic food, family subsidy, school feeding, snack and school canteens, daily care homes and multi-homes. Results. The most common weaknesses are poor evaluation and educational support, poor coverage, overlapping beneficiaries, logistical and budgetary problems. Despite the strong investment of resources, the nutritional deficit in children under six years of age shows an upward trend, which reiterates that nutritional problems have multiple causes and require integrated social policies, stable over time and focused on the most vulnerable groups. Conclusions. This situation forces us to reconsider the programs based on their relevance, feasibility, cost-efficiency and impact and has reiterated the need for a decentralization process to grant more responsibility and decision-making power to state and municipal governments and to the organized community and achieve a greater impact on the target population and its context(AU)

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RESUMEN En este texto se analizan diversos elementos de la dinámica nutricional de un municipio predominantemente indígena de Guerrero, México, con el propósito de explorar la pertinencia del concepto de itinerarios de desatención nutricional para ampliar la comprensión del daño evitable a la salud. En el marco de un proceso de acompañamiento a la Comisión de Salud de la Coordinadora Regional de Autoridades Comunitarias - Policía Comunitaria, en el transcurso del año 2015, se aplicaron los siguientes recursos metodológicos: a) revisión de programas oficiales mediante consulta de documentos técnicos y entrevistas con personal sanitario; b) obtención de narrativas locales en familias de niños desnutridos, mediante entrevistas y observación participante; c) realización de somatometría en 151 menores en tres escuelas primarias de la región. Se resalta la inadecuación técnica y cultural de los programas oficiales de atención a la desnutrición y la existencia de distintas escalas (individual, familiar, comunitaria, estatal, estructural) y dimensiones (económica, ambiental, cultural, institucional, afectivo-emocional) de desatención, materializadas en altos índices de desnutrición crónica.

ABSTRACT Through the analysis of different elements of the nutritional dynamics in a predominantly indigenous municipality in Guerrero, Mexico, we explore the relevance of the concept of itineraries of nutritional neglect in order to broaden the understanding of avoidable health damage. In the framework of a process of accompaniment of the Health Commission of the Regional Coordination of Community Authorities - Community Police, the following methodological strategies were applied throughout the year 2015: a) a review of official programs by means of the analysis of technical documents and interviews with health personnel; b) the compilation of local narratives from families of undernourished children through interviews and participatory observation; c) the somatometric measurement of 151 children in three elementary schools. We highlight the technical and cultural inadequacy of official nutrition programs and the existence of different scales (individual, familial, community, state, structural) and dimensions (economic, environmental, cultural, institutional, affective-emotional) of neglect, materialized in high rates of chronic undernourishment.

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Introducción: Con el surgimiento de los programas sociales se creó también la necesidad de evaluar los recursos invertidos en ellos. Los métodos más utilizados para evaluar los programas y las políticas son los cuantitativos, sin embargo en los últimos años hemos visto el surgimiento de evaluaciones que combinan métodos, generando la necesidad de revalorizar a los actores. Objetivo: Conocer algunas de las percepciones sobre la evaluación que asumen los actores involucradas en los programas sociales. Materiales y métodos: Estudio cualitativo basado en entrevistas semiestructuradas y grupo focal. Siete participantes de los programas, cuatro líderes comunitarios y trece profesionales de nutrición y dietética fueron entrevistados en Medellín. En el grupo focal participaron profesionales de una corporación operadora de los programas sociales. Resultados: A partir de la información analizada en las entrevistas se identificaron las siguientes categorías relacionadas con la evaluación de programas sociales: la concepción sobre la evaluación, el objeto de la evaluación, los sujetos y actores de la evaluación y algunas estrategias de evaluación. Conclusiones: En general los actores no identifican la importancia de los procesos de evaluación de programas sociales, además tienen una visión asistencialista de dichas intervenciones, contraria a un enfoque universal y de derechos humanos.

Introduction: With the emergence of social programs, there was also a need to evaluate the resources invested in them. The most widely used methods for evaluating programs and policies are the quantitative, but in recent years the emergence of evaluations that combine methods was seen, which generates the need to revalue the actors. Objective: To know some of perceptions of assessment the actors involved in social programs assume. Materials and methods: A qualitative study based on semi-structured interviews and focal group was made. Seven participants of the programs, 4 community leaders and 13 nutrition and dietetics professionals were interviewed in Medellin. Professionals in a corporation which operates with the social programs participated in the focal group. Results: The following categories related to the evaluation of social programs was identified from the analyzed information in the interviews: the conception of evaluation, the object of the evaluation, subjects and actors in the evaluation and assessment strategies. Conclusions: In general, the actors do not identify the importance of the process of evaluation of social programs. Besides, they have a welfare vision of such interventions, contrary to a universal approach and human rights.

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Four Nutritional Programs (NP) used in the Brazilian poultry industry were tested in two broiler strains (Cobb 500 and Ross 308). NP varied in the concentrations of their main essential amino acids (AA) and were classified as Low, Regular, High and Mixed (high AA concentrations up to 21 days and regular concentrations after that). Minimum digestible Met+Cys/Lys, Thr/Lys, Arg/Lys, Ile/Lys, and Val/Lys ratios were 0.74, 0.64, 1.05, 0.65 and 0.75, respectively, in all NP, and no minimum amount of CP was fixed. There were no interactions between strain and NP for any of the evaluated responses. From 1 to 47 days of age, birds fed the Low NP presented lower average body weight and body weight gain (BWG). The high NP allowed for better feed conversion ratio (FCR), followed by the Regular and the Mixed NP. Ross 308 broilers were heavier, presenting worse FCR due to higher FI. Birds fed the High NP had lower carcass yield than those fed the Low NP. The Low and Regular NP had lower costs per WG when compared with the High NP. Low and Regular NP presented higher gross margin returns compared with the High NP. The Regular and Mixed NP are the most recommended, presenting intermediate performance and higher economic returns.(AU)

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Four Nutritional Programs (NP) used in the Brazilian poultry industry were tested in two broiler strains (Cobb 500 and Ross 308). NP varied in the concentrations of their main essential amino acids (AA) and were classified as Low, Regular, High and Mixed (high AA concentrations up to 21 days and regular concentrations after that). Minimum digestible Met+Cys/Lys, Thr/Lys, Arg/Lys, Ile/Lys, and Val/Lys ratios were 0.74, 0.64, 1.05, 0.65 and 0.75, respectively, in all NP, and no minimum amount of CP was fixed. There were no interactions between strain and NP for any of the evaluated responses. From 1 to 47 days of age, birds fed the Low NP presented lower average body weight and body weight gain (BWG). The high NP allowed for better feed conversion ratio (FCR), followed by the Regular and the Mixed NP. Ross 308 broilers were heavier, presenting worse FCR due to higher FI. Birds fed the High NP had lower carcass yield than those fed the Low NP. The Low and Regular NP had lower costs per WG when compared with the High NP. Low and Regular NP presented higher gross margin returns compared with the High NP. The Regular and Mixed NP are the most recommended, presenting intermediate performance and higher economic returns.

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Four Nutritional Programs (NP) used in the Brazilian poultry industry were tested in two broiler strains (Cobb 500 and Ross 308). NP varied in the concentrations of their main essential amino acids (AA) and were classified as Low, Regular, High and Mixed (high AA concentrations up to 21 days and regular concentrations after that). Minimum digestible Met+Cys/Lys, Thr/Lys, Arg/Lys, Ile/Lys, and Val/Lys ratios were 0.74, 0.64, 1.05, 0.65 and 0.75, respectively, in all NP, and no minimum amount of CP was fixed. There were no interactions between strain and NP for any of the evaluated responses. From 1 to 47 days of age, birds fed the Low NP presented lower average body weight and body weight gain (BWG). The high NP allowed for better feed conversion ratio (FCR), followed by the Regular and the Mixed NP. Ross 308 broilers were heavier, presenting worse FCR due to higher FI. Birds fed the High NP had lower carcass yield than those fed the Low NP. The Low and Regular NP had lower costs per WG when compared with the High NP. Low and Regular NP presented higher gross margin returns compared with the High NP. The Regular and Mixed NP are the most recommended, presenting intermediate performance and higher economic returns.

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The role of the family, media advertising and school influence on the eating habits of children was reviewed. The exposure of children to these behavioral factors has modified the consumption patterns in children, resulting in an increase in the prevalence of obesity. This underlines the importance of health education as a preventive and promotional tool in the change of behaviors related to the adoption of healthy eating habits, emphasizing the development of nutritional programs applied in schools with the cooperation of parents and teachers to modify unhealthy behaviors and to acquire healthy life styles.

Se realizó una revisión teórica acerca del papel de la familia, los anuncios publicitarios y la escuela, en la adopción, o bien modificación de los hábitos alimentarios de los niños. Debido a que las nuevas dinámicas familiares y la gran exposición de los niños a los comerciales alimentarios han modificado los patrones de consumo de los niños originando con ello el aumento de la obesidad infantil, motivo por el que se enfatiza la importancia de la educación para la salud como herramienta preventiva y promocional en el cambio de conductas relacionadas con la adopción de hábitos alimentarios saludables, destacando el desarrollo de programas nutricionales aplicados en escuelas con el objetivo de buscar el trabajo conjunto entre los padres de familia y los profesores, para lograr modificar conductas no saludables y lograr estilos de vida saludables.

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Introducción De acuerdo con los resultados de la última Encuesta Nacional de Nutrición y Salud del Ministerio de Salud en Argentina, el bajo peso y la desnutrición crónica (talla/edad) son las deficiencias nutricionales más significativas a nivel nacional. Además, la obesidad se presenta como un problema en ascenso que afecta en forma desigual a las regiones argentinas, y la anemia en menores de 2 años se encuentra todavía lejos de ser controlada. Objetivo Analizar la evolución de la estrategia pública en el diseño e implementación de los programas orientados a mejorar la situación nutricional de la población. Métodos Se realizó un repaso de los programas alimentarios nacionales implementados en las últimas dos décadas en la Argentina, analizando la focalización geográfica y poblacional, las prestaciones ofrecidas y la modalidad organizativa. Resultados Luego de 25 años de intervenciones en materia alimentaria, las deficiencias nutricionales son aún un problema a resolver. Uno de los desafíos más importantes fue identificar los mecanismos eficaces que permitan transferir capacidades a los beneficiarios más allá de la duración de los programas. Conclusiones La alimentación debe ser considerada por los tomadores de decisiones como uno de los principales indicadores sanitarios. Por ello, es importante fortalecer la presencia del área de Salud Pública en las intervenciones de política alimentaria para que ellas se orienten a evitar el deterioro de la salud y mejorar la calidad de vida de la población.

Introduction According to the last Argentinean National Survey of Nutrition and Health (2005) held by the Health Ministry, low weight and chronic undernourishment are the most important nutritional problems in the country. Besides, obesity emerges as a growing problem affecting the Argentinian regions whereas, anemia (iron deficit) in under 2-years-old children is still far from being considered under control. Objective To analyze the evolution of the public strategy for the design and implementation of nutritional programs aimed at improving the nutritional condition of population in Argentina. Methods The national nutritional programs implemented in the last two decades were reviewed, followed by the analysis of the geographic and population focalization, the goods and services offered, and organization modality. Results After 25 years of food interventions, the nutritional deficiencies are yet to be solved. One of the main challenges was to identify the effective mechanisms that allowed transferring capacities to the beneficiaries, regardless of the duration of the programs. Conclusions Feeding should be taken into account by the decision makers as one of the main health indicators. Therefore, it is important to strengthen the involvement of the public health area in the food policy interventions, so that these can be directed toward preventing health deterioration and improving the quality of life of the population.

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This work describes the trajectory of the National Program of School Meals ­ PNAE ­ implemented in Brazil for about 50 years. The main and decisive changes made by the Federal Government in the last two decades are examined. Among them, the decentralization of the program deserves a highlight, which affects the consumption of the meals distributed and the nutritional status of the beneficiaries. The analysis shows that during this period, the decentralization of the program was definitively implemented, with the Federal Government transferring the money to buy food directly to the school administrators. It was also verified that at the end of the eighties, the PNAE, benefited students with a greater per capita income and enrolled in the schools of the southern and southeastern region (more economicall y developed). In the nineties, there was a modification in this tendency and the PNAE reveals itself better focused in relation to the students in elementary education. Nourishment consumption analysis shows that the meal contribution to the group recommendation is low, mainly in energy, vitamins, and minerals, particularly calcium and iron. It shows also, low presence of fruits and vegetables in the school meals. With regard to the nutritional status, the coexistence of two problems ­ growth deficits and overweight ­reveals a complex nutritional situation of superposition that demands differentiated intervention to these very different realities

El objetivo de este trabajo fue describir la trayectoria del Programa Nacional de Merienda Escolar (PNAE) vigente en Brasil aproximada-mente 50 años. Se examinaron las principales modificaciones implementadas por el Gobierno Federal en las últimas décadas. Entre estas, hayque destacar la descentralización del programa y su repercusión en el consumo de las merendas distribuidas y en el estado nutricional de los beneficiarios del programa. El estudio revela que durante este período se consolidó definitivamente el proceso de descentralización, principalmente a mediados de la década del 90, cuando los recursos destinados a la compra de alimento comenzaran a ser repasados directamente a los administradores de las escuelas. Fue comprobado también que al final de la década del 80,el PNAE, beneficiaba indebidamente a alunos con mayor renta per cápita matriculados en las regiones Sur y Sudeste (que son economicamente más desarrolladas). En los años 90, esa tendencia fue modificada y el PNAE se mostró mejoren focado en relación a la población que frecuenta la enseñanza básica. El análisis del consumo alimenticio muestra que la contribución de la merienda no atiende las recomendaciones para ese grupo y es deficiente principalmente enenergía, vitaminas y minerales, principalmente calcio y hierro, siendo bastante escasa la presencia de frutas y hortalizas en la minuta de los escolares. Con relación al estado nutricional, la coexistencia de 2 problemas, el retardo del crecimiento y el sobrepeso, revela un panorama complejo que requiere intervención diferenciada para cada realidad

Este trabalho visa descrever a trajetória do Programa Nacional de Merenda Escolar (PNAE), que vigora no Brasil há cerca de 50 anos. São examinadas as principais e decisivas mudanças implementadas pelo governo federal, durante as últimas décadas. Entre essas, merece destaque a descentralização do Programa, as repercussões desta no consumo das refeições distribuídas e no estado nutricional dos beneficiários da merenda escolar. As análises revelam que durante o período concretizou-se, de forma definitiva, o processo de descentralização, coma inovação (especialmente em meados da década dos 90) do repasse das verbas federais, destinadas à compra de alimentos, diretamente para os administradores das escolas. Verificou-se, também, que no final da década dos 80, o PNAE, beneficiava, indevidamente, os alunos com maior renda per capita e matriculados nas escolas das regiões Sul e Sudeste (economicamente mais desenvolvidas). Nos anos 90, há modificação nessa tendência e o PNAE se revela melhor focalizado em relação à população que frequenta o ensino fundamental. Análises do consumo alimentar permitem inferir que a contribuição das refeições para o atendimento das recomendações do grupo é baixa, principalmente para a energia, vitaminas e minerais, com destaque para o cálcio e o ferro, sendo, bastante reduzida, também, a presença de frutas e hortaliças na pauta alimentar dos escolares. Quanto ao estado nutricional, a coexistência de duas problemáticas - déficits de crescimento e sobrepeso revela um quadro nutricional complexo de superposição, o que demanda intervenções diferenciadas para essas realidades muito distintas

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