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This study aimed to develop a specific instrument to evaluate food neophobia focused on Brazilian children and to perform the content validation and internal semantic consistency and reproducibility evaluation of the instrument. Three steps were necessary to conduct the study: (i) development of the instrument, (ii) internal validation (content validation and semantic evaluation) of the food neophobia instrument using 22 experts in the first round and 20 of them in the second round, (iii) evaluation of the internal consistency and reproducibility of the instrument with the children's caregivers, using the test-retest (where the same caregiver-n = 22-answered twice, with 24 h interval) and comparing responses between two caregivers (n = 44) of the same children (n = 22). We developed an instrument in Brazilian-Portuguese to evaluate children's food neophobia based on the caregivers' perceptions with 25 items divided into three domains (neophobia in general, neophobia for fruits and neophobia for vegetables). Our results indicated that the instrument has excellent internal consistency (>0.9) and reproducibility (>0.9) when answered by the caregiver who knows the child's eating habits, indicating reliability to be applied in Brazil. In addition, when the two caregivers answered the instrument, we found a good reproducibility (>0.6), confirming the possibility to be answered by one of the caregivers. Further studies are necessary to complete external validation with a representative sample of the target group in Brazil, showing nationwide the profile of the population. The potential of a neophobia study would contribute to the implementation of effective strategies and guidelines to support parents and health professionals, especially those involved in health and nutrition, to identify traces of food neophobia or neophobic behavior. By accurately measuring food neophobia in children, families can prevent nutritional deficiencies throughout adolescence and adulthood, improving eating habits. Children usually have neophobias similar to the ones presented by their parents-and when early detected, these neophobias can be addressed.

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OBJECTIVE: To assess characteristics and outcomes of young children receiving intensive multidisciplinary intervention for chronic food refusal and feeding tube dependence. STUDY DESIGN: We conducted a retrospective study of consecutive patients (birth to age 21 years) admitted to an intensive multidisciplinary intervention program over a 5-year period (June 2014-June 2019). Inclusion criteria required dependence on enteral feeding, inadequate oral intake, and medical stability to permit tube weaning. Treatment combined behavioral intervention and parent training with nutrition therapy, oral-motor therapy, and medical oversight. Data extraction followed a systematic protocol; outcomes included anthropometric measures, changes in oral intake, and percentage of patients fully weaned from tube feeding. RESULTS: Of 229 patients admitted during the 5-year period, 83 met the entry criteria; 81 completed intervention (98%) and provided outcome data (46 males, 35 females; age range, 10-230 months). All patients had complex medical, behavioral, and/or developmental histories with longstanding feeding problems (median duration, 33 months). At discharge, oral intake improved by 70.5%, and 27 patients (33%) completely weaned from tube feeding. Weight gain (mean, 0.39 ± 1 kg) was observed. Treatment gains continued following discharge, with 58 patients (72%) weaned from tube feeding at follow-up. CONCLUSIONS: Our findings support the effectiveness of our intensive multidisciplinary intervention model in promoting oral intake and reducing dependence on tube feeding in young children with chronic food refusal. Further research on the generalizability of this intensive multidisciplinary intervention approach to other specialized treatment settings and/or feeding/eating disorder subtypes is warranted.

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RESUMO Objetivo: Revisar evidências atuais da relação entre transtorno obsessivo compulsivo e dificuldades alimentares. Métodos: Revisão das bases Science Direct e PubMed no período entre 2007 e 2017 em inglês, português e espanhol, com os termos em associação "transtorno obsessivo compulsivo" e "picky eating/dificuldade alimentar". Foram selecionados apenas estudos de coorte, caso controle ou transversal, realizados em qualquer país, com crianças, adolescentes e/ou adultos e de qualquer tamanho amostral. Foram excluídos os artigos de opinião. Resultados: Cerca de 245 artigos foram selecionados e apenas 4 foram incluídos no estudo, segundo critérios de seleção. Os trabalhos descrevem essencialmente que há diferença no comportamento seletivo entre os sujeitos com e sem transtorno obsessivo compulsivo, com tendência para exacerbação de sintomas como nojo, ansiedade e escore de inflexibilidade de comportamento alimentar nos pacientes com esse transtorno. Conclusões: Existem sintomas compartilhados entre transtorno obsessivo compulsivo e dificuldade alimentar. O estudo alerta aos profissionais que acompanham pacientes com dificuldades alimentares para a importância da investigação de possíveis comorbidades psiquiátricas.

ABSTRACT Objective: To review current evidence on the relationship between obsessive-compulsive disorder and feeding difficulties. Methods: Review the Science Direct and PubMed databases between 2007 and 2017 in English, Portuguese and Spanish. The search terms, used in association, were "obsessive compulsive disorder" and "picky eating/feeding difficulty". Cohort, case control and cross sectional studies were included that analyzed children, adolescents and/or adults of any sample size from any country in the world. Opinion articles were excluded. Results: Around 245 articles were selected, and only 4 were included in this review, according to previous criteria. Results from the studies essentially described that there is indeed a difference in "picky" behaviors between subjects with and without obsessive-compulsive disorder. Patients with obsessive-compulsive disorder tend to have exacerbated symptoms of disgust, anxiety and a higher eating behavior inflexibility score. Conclusions: Obsessive-compulsive disorder and feeding difficulties patients share common symptoms. The present study alerts health professionals who follow patients with feeding difficulties as to the importance of investigating possible psychiatric comorbidities.

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OBJECTIVE: To review current evidence on the relationship between obsessive-compulsive disorder and feeding difficulties. METHODS: Review the Science Direct and PubMed databases between 2007 and 2017 in English, Portuguese and Spanish. The search terms, used in association, were "obsessive compulsive disorder" and "picky eating/feeding difficulty". Cohort, case control and cross sectional studies were included that analyzed children, adolescents and/or adults of any sample size from any country in the world. Opinion articles were excluded. RESULTS: Around 245 articles were selected, and only 4 were included in this review, according to previous criteria. Results from the studies essentially described that there is indeed a difference in "picky" behaviors between subjects with and without obsessive-compulsive disorder. Patients with obsessive-compulsive disorder tend to have exacerbated symptoms of disgust, anxiety and a higher eating behavior inflexibility score. CONCLUSIONS: Obsessive-compulsive disorder and feeding difficulties patients share common symptoms. The present study alerts health professionals who follow patients with feeding difficulties as to the importance of investigating possible psychiatric comorbidities.

OBJETIVO: Revisar evidências atuais da relação entre transtorno obsessivo compulsivo e dificuldades alimentares. MÉTODOS: Revisão das bases Science Direct e PubMed no período entre 2007 e 2017 em inglês, português e espanhol, com os termos em associação "transtorno obsessivo compulsivo" e "picky eating/dificuldade alimentar". Foram selecionados apenas estudos de coorte, caso controle ou transversal, realizados em qualquer país, com crianças, adolescentes e/ou adultos e de qualquer tamanho amostral. Foram excluídos os artigos de opinião. RESULTADOS: Cerca de 245 artigos foram selecionados e apenas 4 foram incluídos no estudo, segundo critérios de seleção. Os trabalhos descrevem essencialmente que há diferença no comportamento seletivo entre os sujeitos com e sem transtorno obsessivo compulsivo, com tendência para exacerbação de sintomas como nojo, ansiedade e escore de inflexibilidade de comportamento alimentar nos pacientes com esse transtorno. CONCLUSÕES: Existem sintomas compartilhados entre transtorno obsessivo compulsivo e dificuldade alimentar. O estudo alerta aos profissionais que acompanham pacientes com dificuldades alimentares para a importância da investigação de possíveis comorbidades psiquiátricas.

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La anorexia nerviosa es la tercera enfermedad crónica en la adolescencia. La autopercepción del cuerpo no sólo tiene influencia en el aspecto físico, sino en el subjetivo, asociándose con las áreas psicológica y social de la persona. La aparición de enfermedades como los trastornos de la conducta alimentaria (TCA) pueden afectar la calidad de vida relacionada con la salud (CVRS) de la población que las padece. El objetivo general fue estudiar la CVRS en adolescentes con TCA asistentes al programa “Trastornos Alimentarios” del Hospital Nacional de Clínicas durante el año 2013. Se realizó un estudio cuantitativo, descriptivo y transversal Se tomó la totalidad de las pacientes que asistieron al programa “Trastornos Alimentarios”: 29 mujeres de 12 a 22 años. A las mismas se les aplicó el Cuestionario KIDSCREEN-52, junto a una planilla de recolección de datos personales. A los padres, madres o tutores se les aplicó el mismo cuestionario en la versión específica para informadores indirectos

ABSTRACT: Anorexia nervosa is the third chronic disease in adolescence. The self - perception of the body not only has influence on the physical aspect, but in the subjective, associated with psychological and social areas of the person. The emergence of diseases such as Eating Disorder (ED) can affect the Health-Related Quality Of Life (HRQOL) of the population that suffers. The overall objective was to study HRQOL in adolescents with eating disorders attending the "Eating Disorders" program of the National Clinical Hospital in 2013. A quantitative, descriptive and cross-sectional study was done. All the patients who attended the "Eating Disorders" program were taken: 29 women from 12 to 22 years. At the same applies to the Questionnaire KIDSCREEN-52, along with a form of personal data collection. To the parents or guardians they were applied the same questionnaire in the specific version for indirect informers. The patients had scores below the average of reference in the self-perception of HRQOL. The dimensions of HRQOL with the highest score were Friends And Social Support (ẋ46,70) and Economic Resources (ẋ46,16), followed by The School Environment (ẋ42,35) dimension

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Objective:To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).Methods:We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors “rumination” and “bipolar disorder” and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review.Results:Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD.Conclusions:Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.

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OBJECTIVE: To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD). METHODS: We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors "rumination" and "bipolar disorder" and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review. RESULTS: Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD. CONCLUSIONS: Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.

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La obesidad y sus consecuencias, son motivo de preocupación constante en el ámbito asistencial. Los intrincados mecanismos de control del apetito, han sido extensamente debatidos y estudiados y aunque aún no están del todo dilucidados, se han logrado grandes avances en lo que respecta a su comprensión. A pesar de este conocimiento, con frecuencia los tratamientos farmacológicos y dietéticos fracasan y la tasa de recaídas son muy elevadas. La obesidad, comparte muchos puntos en común con otras adicciones y si lo observamos desde este punto de vista, podemos identificar sustancias con alto poder adictivo que se encuentran en muchos alimentos hipercalóricos, pudiendo ser esta la causa por la cual, los tratamientos pierden efectividad y los pacientes recaen víctimas de un craving, de manera similar a como lo hacen con otras drogas.

Obesity and its consequences are cause for concern incessant in the field of care setting. The intricate appetite control mechanisms, have been extensively studied and debated, and although they are not yet fully understood, there has been great strides in regards to their understanding. Despite this knowledge, often pharmacological and dietary treatments fail and relapse rates are very high. Obesity share mach in common with other addictions and if you look at it from this point of view, we can identify with highly addictive substances that are found in many high calorie foods, this may be the reason why, treatments lose effectiveness and patients fall victim to a craving, similarly as with other drugs do so.

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OBJECTIVES: the aim is to assess caregivers' perceptions about the influence of television on the eating habits of children from the socially vulnerable Northeast region of Brazil. METHODS: a total of 14 semi-structured interviews were conducted with caregivers. The participants included parents and grandmothers of 29 schoolchildren from a public school on the outskirts of a town in the Agreste Meridional in Northeast Brazil. The interviews were transcribed and analysed in the light of socio-historical theory based on the work of Vygotsky (1984) and Bakhtin (2001). RESULTS: the caregivers explained the influence of televised food advertisements on children's requests for food and the criteria children use to choose foods. The caregivers also observed that the family's buying decisions were governed by the children's requests, which are driven by television advertisements. Furthermore, the children's food preferences (i.e., the structure and rhythm of children's meals) have changed because of the influence of the media. CONCLUSIONS: although caregivers are able to describe the influence of television on the eating habits of children, the magnitude of this influence on children's lives is still unclear. Understanding the magnitude of the this influence is the challenge posed by this study to professionals, experts in the field, and the Brazilian health system.(AU)

OBJETIVO: o objetivo deste estudo é aprofundar a compreensão sobre a influência da televisão nos hábitos de alimentares de crianças a partir da análise da percepção dos cuidadores - mãe, pai e avó. MÉTODO: 14 entrevistas semi-estruturadas foram aplicadas em cuidadores - mãe, pai e avó, de 29 crianças escolares com idade entre 7 e 9 anos, matriculadas na 2ª Série do Ensino Fundamental de uma Escola Pública da periferia urbana de um município do Nordeste Brasileiro.As entrevistas foram gravadas e transcritos os discursos. Os resultados foram apresentados em quadros temáticos de análises e analisados à luz da teoria sócio-histórica, com base nas contribuições de Vygotsky (1984) e Bakhtin (2001). RESULTADOS: cuidadores frequentemente identificaram a influencia das propagandas de alimentos veiculadas pela televisão nas demandas e nos critérios de escolha dos alimentos e dos brinquedos das crianças. Também perceberam que as decisões de compra da família passam a ser reguladas pelas solicitações das crianças motivadas pelas propagandas televisivas. E que as preferências alimentares - a estrutura e o ritmo das refeições das crianças sofreram modificações devido à influência deste veículo midiático. CONCLUSÃO: os cuidadores identificam a influência da televisão nos hábitos de consumo alimentar das crianças, mas não conseguem entender a magnitude dessa influência na vida das crianças por eles cuidadas. Entender essa magnitude é um desafio que nos é colocado a partir deste estudo.(AU)

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Este artigo apresenta uma revisão sobre a história da alimentação e sua influência no desenvolvimento da obesidade infantil. Percorre diferentes momentos históricos, acompanhando as principais transformações ocorridas na sociedade e, como consequência, na alimentação das famílias. Fundamenta-se teoricamente no pensamento sistêmico por entender que, através dessa visão, se tem uma melhor compreensão do processo em que essas mudanças ocorreram. Conclui-se que as modificações no modo de vida das famílias, no contexto sociocultural, progresso de urbanização e industrialização, sedentarismo, influência da mídia e aumento da ingestão calórica contribuem para a incidência do excesso de peso nas crianças.

This article presents an overview of the history of feeding and its influence on the development of childhood obesity. We analyze different historical moments, following the major transformations insociety and, as a consequence, in the household diet. The article is theoretically based on systems theory, because the authors propose that through this vision one has a better understanding of the process in which these changes occurred. We conclude that changes in the modes of family life, in the sociocultural context, progress of urbanization and industrialization, sedentary lifestyle, media influence and increased caloric intake contributes to the incidence of overweight in children.

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Este artigo apresenta uma revisão sobre a história da alimentação e sua influência no desenvolvimento da obesidade infantil. Percorre diferentes momentos históricos, acompanhando as principais transformações ocorridas na sociedade e, como consequência, na alimentação das famílias. Fundamenta-se teoricamente no pensamento sistêmico por entender que, através dessa visão, se tem uma melhor compreensão do processo em que essas mudanças ocorreram. Conclui-se que as modificações no modo de vida das famílias, no contexto sociocultural, progresso de urbanização e industrialização, sedentarismo, influência da mídia e aumento da ingestão calórica contribuem para a incidência do excesso de peso nas crianças (AU)

This article presents an overview of the history of feeding and its influence on the development of childhood obesity. We analyze different historical moments, following the major transformations insociety and, as a consequence, in the household diet. The article is theoretically based on systems theory, because the authors propose that through this vision one has a better understanding of the process in which these changes occurred. We conclude that changes in the modes of family life, in the sociocultural context, progress of urbanization and industrialization, sedentary lifestyle, media influence and increased caloric intake contributes to the incidence of overweight in children (AU)

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Obesity is a complex disease with not only physical consequences but also psychological. The aim of the present work was to analyze differences between community children with normal weight versus community overweight children versus children with overweight in clinical setting, at the level of quality of life, psychological morbidity and self-concept . The study sample has 267 children represented in three groups: group of community children with normal weight (N = 147), group of community overweight children (N = 89) and a group of overweight children in treatment (N = 31). The results from this study showed differences on quality of life, for the total scale and on the dimension of physical health and school health, in which overweight children in the clinical sample are the ones who presented more negative perception of physical health and school health, when compared with community children with normal weight vs community overweight children. For the rest of the dimensions of quality of life, no significant differences were found between the three groups. Regarding the self-concept on the group of children with a clinical diagnosis of obesity they perceived themselves as less competent relative to school competency, athletic competency, physical appearance, social acceptance, behavior and self-esteem. Regarding the variable depression this study suggests that community overweight children present more depressive symptomatology when compared with the other groups. No significant differences were found regarding anxiety symptomatology. To summarize, results from this empirical study demonstrated the importance of psychological variables when in the presence of obesity.(AU)

A obesidade acarreta consequências para além das meramente relacionadas com a saúde física, sendo também de salientar os aspetos psicossociais. Com o objetivo de avaliar as diferenças ao nível da qualidade de vida, morbilidade psicológica e imagem pessoal (autoconceito) foram avaliadas 267 crianças divididas em três grupos: um grupo de crianças da comunidade com peso normal (N = 147), um grupo de crianças da comunidade com excesso de peso/obesidade (N = 89) e um grupo de crianças com excesso de peso/obesidade em tratamento (grupo clínico) (N = 31). Os resultados mostraram que as crianças com excesso de peso/obesidade em tratamento são as que têm uma percepção mais negativa da sua saúde física e da saúde escolar, quando comparadas com as restantes crianças. Relativamente ao auto-conceito o grupo de crianças com excesso de peso/obesidade do grupo clínico perceciona-se como menos competente no domínio escolar, atlético, aparência física, aceitação social, comportamento e auto-estima. As crianças do grupo clínico com excesso de peso/obesidade apresentam ainda mais sintomatologia depressiva quando comparadas com as crianças da comunidade com peso normal e com as crianças do grupo clínico. Não foram encontradas diferenças significativas ao nível da sintomatologia ansiosa nas três amostras estudadas. Em suma, as diferenças entre os grupos avaliados podem refletir diferentes características das crianças com excesso de peso/obesidade que procuram tratamento.(AU)

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This study aimed to identify the differences in body self-esteem, general self-esteem and eating attitudes in a representative sample of children, aged 9-12 years, attending school in México DF. The logistic regression model incorporated the variables of sex, general self-esteem, BMI, age and discrepancy between the perceived image and the ideal image. Participants with an increased risk of eating disorders were girls: a) with less general self-esteem; b) BMI at the upper range of normal weight; c) greater negative discrepancy between perceived and ideal image; d) aged 11-12 years. Higher general self-esteem would act as a protector for eating disorders, while the desire for a thinner ideal body would be a risk factor.

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Procura discutir os distúrbios alimentares em bebês, em especial a doença do refluxo gastroesofágico, articulando a noçäo de sujeito para a psicanálise e a importäncia da oralidade no estabelecimento do laço mäe e bebê, principalmente no que se refere à experiência de frustraçäo

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A five-month-old female infant was admitted to the Tropical Metabolism Research Unit with a weight for age of 49% and no evidence of oedema giving rise to a diagnosis of marasmus (Wellcome Classification). The underlying reason for her malnutrition was the Infant Rumination syndrome. This is an uncommon disorder which is thought to have a psychological component. A lack of awareness of the syndrome often leads to delay in diagnosis.

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A five-month-old female infant was admitted to the Tropical Metabolism Research Unit with a weight for age of 49 percent and no evidence of oedema giving rise to a diagnosis of marasmus (Wellcome Classification). The underlying reason for her malnutrition was the Infant Rumination syndrome. This is an uncommon disorder which is thought to have a psychological component. A lack of awareness of the syndrome often leads to delay in diagnosis. (AU)

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A five-month-old female infant was admitted to the Tropical Metabolism Research Unit with a weight for age of 49 percent and no evidence of oedema giving rise to a diagnosis of marasmus (Wellcome Classification). The underlying reason for her malnutrition was the Infant Rumination syndrome. This is an uncommon disorder which is thought to have a psychological component. A lack of awareness of the syndrome often leads to delay in diagnosis.

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