RESUMO
Globally, increasing number of fruits and vegetables are being consumed to maintain healthy eating habits. Family farming plays a crucial role in fruits and vegetables production; products are marketed in supply chains, which are increasingly demanding, diversified, and complex. Participation of the family farms in each of these supply chains is subject to their ability to meet the increasingly strict participation criteria. In this context, this study identified the main factors that affect the participation of the family farmers in the supermarket supply chains for fresh fruits and vegetables. A systematic literature review was conducted, covering the period from 2005 to 2019. Results indicated eleven variables that affect the participation of the fruits and vegetables family farms in the supermarket supply chains. These variables were grouped in an analytical framework, which comprised four factors: characteristics of the producer, characteristics of the farm, institutional aspects, and available infrastructure. This framework is useful for the development and implementation of the public and private policies for successful participation of fruits and vegetables family farmers in supermarket supply chains.(AU)
Preocupações ambientais e a busca por uma alimentação saudável têm levado ao aumento mundial de consumo de frutas, legumes e verduras. A agricultura familiar é um segmento muito importante na produção de frutas, legumes e verduras, sendo os seus produtos comercializados em cadeias de suprimentos crescentemente mais exigentes, complexas e diversificadas. A participação de produtores familiares em cada uma destas cadeias de suprimentos está submetida a capacidade deles atenderem critérios de inserção cada vez mais estritos.As cadeias de suprimentos de frutas,legumes e verduras que abastecem os supermercados não fogem a esta situação.Neste contexto, este artigo identificou os principais fatores que condicionam a inserção dos agricultores familiares nas cadeias de suprimentos de frutas, legumes e verduras dos supermercados.Para tanto, foi realizada uma revisão sistemática da literatura num período compreendido entre 2005 e 2019. Os resultados encontrados mostraram que existem onze variáveis que condicionam a inserção da agricultura familiar em cadeias supermercadistas de frutas, legumes e verduras. Estas variáveis foram agrupadas em um framework analítico composto por quatro fatores: características do produtor e da propriedade, aspectos institucionais e infraestrutura. Este framework é útil ao desenvolvimento e implementação de políticas públicas e privadas voltadas à inserção exitosa da produção de frutas, legumes e verduras de agricultores familiares nas cadeias de suprimentos de supermercados.(AU)
Assuntos
Agricultura/economia , Agricultura/organização & administração , Frutas/provisão & distribuição , Verduras/provisão & distribuição , FabaceaeRESUMO
OBJECTIVE: To evaluate the feeding practices for infants under one year of age, according to food and nutrition policies. METHODS: This is a descriptive cross-sectional study based on secondary data from the Chamada Neonatal project (research on prenatal, childbirth, and infant care) in the state of Rio Grande do Norte. The sample analyzed comprised 837 mother/child (under one year of age) pairs. We found a prevalence of data on exclusive breastfeeding (EBF) in the first hour of life - partial and total -, as well as on food consumed by children 24 hours prior to the interview. We estimated the probability of consumption according to the child's age in days using the probit analysis. RESULTS: Among the interviewed mothers, 64.8% (95%CI 62.4-70.8) declared breastfeeding in the first hour of life, and 60% (95%CI 56.41-63.07) of the children were still breastfed at the end of their first year of life. The median duration of EBF was 63 days (95%CI 60-67). Water or tea, dairy products, fruits, and vegetables were introduced early, with medians lower than 180 days. The probit analysis revealed that the consumption of breast milk tended to decrease and food intake to increase as the child gets older, with exponential growth in the "unhealthy food" group. CONCLUSIONS: Although most children were breastfed up to one year of life, few did so exclusively. Foods were introduced early, with increased consumption of unhealthy ones, resulting in inadequate dietary quality according to recommendations from food and nutrition public policies.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar/fisiologia , Mães/estatística & dados numéricos , Política Nutricional/legislação & jurisprudência , Adulto , Brasil/epidemiologia , Aleitamento Materno/tendências , Estudos Transversais , Laticínios/provisão & distribuição , Alimentos, Dieta e Nutrição , Feminino , Frutas/provisão & distribuição , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Masculino , Prevalência , Verduras/provisão & distribuição , Adulto JovemRESUMO
OBJECTIVE: The aim of this study was to examine the association of county-level food access, recreational opportunities, and natural amenities with participant engagement in a weight management program. METHODS: In this cohort study, participants in the Veterans Health Administration MOVE! weight management program between October 1, 2007, and September 30, 2013, were observed for 12 months after enrollment. Engagement was measured as the number of program visits per year at 12 months. Cross-sectional analysis and spatial regression were used to examine county characteristics associated with greater participant engagement at 12 months. RESULTS: A total of 321,624 participants in 2,708 counties were included. Greater engagement was associated with older age, female sex, white race, being married, and being retired. After accounting for similarities between nearby communities, engagement at 12 months was 3.1 visits higher for each additional farmers' market per 1,000 population (P = 0.01). Engagement was highest for participants living in counties with the most natural amenities (P < 0.001). Recreational opportunities had only a small effect on engagement in the program (ß = 0.02 visits at 12 months; P = 0.002). CONCLUSIONS: Consideration of a participant's county characteristics in addition to other known demographics and program factors may help to explain variation in engagement in weight management programs.
Assuntos
Planejamento Ambiental/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Parques Recreativos/provisão & distribuição , Recreação/fisiologia , Veteranos/estatística & dados numéricos , Programas de Redução de Peso , Adulto , Idoso , Alaska/epidemiologia , Estudos de Coortes , Estudos Transversais , Feminino , Frutas/provisão & distribuição , Havaí/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Parques Recreativos/estatística & dados numéricos , Filipinas/epidemiologia , Porto Rico/epidemiologia , Características de Residência/estatística & dados numéricos , Verduras/provisão & distribuição , Programas de Redução de Peso/estatística & dados numéricosRESUMO
ABSTRACT Objective: To evaluate the feeding practices for infants under one year of age, according to food and nutrition policies. Methods: This is a descriptive cross-sectional study based on secondary data from the Chamada Neonatal project (research on prenatal, childbirth, and infant care) in the state of Rio Grande do Norte. The sample analyzed comprised 837 mother/child (under one year of age) pairs. We found a prevalence of data on exclusive breastfeeding (EBF) in the first hour of life - partial and total -, as well as on food consumed by children 24 hours prior to the interview. We estimated the probability of consumption according to the child's age in days using the probit analysis. Results: Among the interviewed mothers, 64.8% (95%CI 62.4-70.8) declared breastfeeding in the first hour of life, and 60% (95%CI 56.41-63.07) of the children were still breastfed at the end of their first year of life. The median duration of EBF was 63 days (95%CI 60-67). Water or tea, dairy products, fruits, and vegetables were introduced early, with medians lower than 180 days. The probit analysis revealed that the consumption of breast milk tended to decrease and food intake to increase as the child gets older, with exponential growth in the "unhealthy food" group. Conclusions: Although most children were breastfed up to one year of life, few did so exclusively. Foods were introduced early, with increased consumption of unhealthy ones, resulting in inadequate dietary quality according to recommendations from food and nutrition public policies.
RESUMO Objetivo: Avaliar as práticas alimentares em menores de um ano de idade, de acordo com as políticas de alimentação e nutrição. Métodos: Estudo transversal descritivo, com dados secundários da Chamada Neonatal no Estado do Rio Grande do Norte. A amostra analisada foi de 837 pares mãe/filho menor de um ano de idade, e observou-se a prevalência de dados do Aleitamento Materno Exclusivo (AME), na primeira hora de vida, parcial e total, assim como dos alimentos ingeridos pelas crianças nas últimas 24 horas anteriores à entrevista. Por meio da análise de probitos, estimaram-se as probabilidades de consumo dos alimentos por idade da criança, em dias. Resultados: A prática de aleitamento na primeira hora de vida foi relatada por 64,8% (IC95% 62,4-70,8) das mães entrevistadas e, ao final do primeiro ano de vida, 60% (IC95% 56,41-63,07) das crianças ainda estavam sendo amamentadas. A mediana de aleitamento exclusivo foi de 63 dias (IC95% 60-67). Água ou chá, alimentos lácteos, frutas, legumes e verduras foram introduzidos precocemente, com medianas menores que 180 dias. Observou-se por análise de probitos que o consumo de leite materno tendeu a diminuir e o de alimentos a aumentar, de acordo com a idade da criança, com aumento exponencial do grupo "alimentos não saudáveis". Conclusões: Apesar de a maioria das crianças ser amamentada até um ano de vida, poucas estavam em aleitamento exclusivo. Alimentos foram introduzidos precocemente, com aumento do consumo dos não saudáveis, resultando em inadequação da qualidade alimentar frente ao preconizado pelas políticas públicas de alimentação e nutrição.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Adulto , Adulto Jovem , Epidemiologia/estatística & dados numéricos , Política Nutricional/legislação & jurisprudência , Comportamento Alimentar/psicologia , Mães/estatística & dados numéricos , Verduras/provisão & distribuição , Brasil/epidemiologia , Aleitamento Materno/tendências , Prevalência , Estudos Transversais , Entrevistas como Assunto , Laticínios/provisão & distribuição , Alimentos, Dieta e Nutrição , Frutas/provisão & distribuiçãoRESUMO
OBJECTIVE: We analysed the impact of the national general truck drivers' strike on the availability, variety and price of foods sold by a food supply centre. DESIGN: Descriptive study using secondary data to examine the percentage change in the mean price of fruits, vegetables and eggs before, during and after the strike. The strike in Brazil lasted 10 d from 21 to 30 May 2018. The drivers were on strike in order to make diesel oil tax-free and to obtain better working conditions. SETTING: The food supply centre, named CEASA-Minas Grande BH, was located in the metropolitan area of a Brazilian city. PARTICIPANTS: We examined twenty types of foods. RESULTS: After 10 d, there was a ~30 % reduction in the availability of all types of foods and prices increased. Foods with the highest price increases included cabbage (233·3 %), potatoes (220·0 %), papaya (160·0 %) and oranges (78·6 %). At the end of the strike, we observed reductions in the price of eggs, fruits, vegetables, roots and tubers; however, some foods remained more expensive than before the strike, including chayote (203·2 % higher), cucumber (66·7 % higher) and potatoes (60·0 % higher). CONCLUSIONS: The general truck drivers' strike was correlated with a reduction in the availability of food and, consequently, increases in price and possibly restrictions on access. The strike demonstrated the dependence of metropolises on road transportation and the conventional market. We speculate that initiatives aiming to shorten the food supply chain and promote food sovereignty and resilience of the supply circuits could be important.
Assuntos
Abastecimento de Alimentos/economia , Abastecimento de Alimentos/estatística & dados numéricos , Veículos Automotores , Greve , Brasil , Comércio , Ovos/economia , Ovos/provisão & distribuição , Frutas/economia , Frutas/provisão & distribuição , Humanos , Meios de Transporte , Verduras/economia , Verduras/provisão & distribuiçãoRESUMO
ANTECEDENTES Y OBJETIVOS El sobrepeso comprende un problema de salud a nivel global. Al mirar las tendencias en la población infantil, el último reporte de salud pública de la Organización para la Cooperación y el Desarrollo Económicos sobre el país, estima que casi un 45% de los niños y niñas chilenos tienen obesidad o sobrepeso, lo que supera al 25% promedio que presentan los países miembros. El presente informe tiene como objetivo evaluar los cupones o vouchers para la compra de frutas y verduras en función de reducir la obesidad, y de esta manera informar a las autoridades sobre las distintas estrategias efectivas que abordan la obesidad infantil. METODOLOGÍA Se buscaron revisiones sistemáticas en las bases de datos Medline y Embase, utilizando Ovid, en marzo de 2019. Además, se construyó una matriz de evidencia en Epistemonikos con el objetivo de encontrar literatura adicional. Se utiliza la metodología de certeza de la evidencia GRADE. Se incluyen evaluaciones de cupones, vouchers, tarjetas de descuento para la compra de F&V, estudios que evalúan el efecto en cualquier tipo de población y contexto. Se excluyen artículos que utilizaran un diseño observacional, intervenciones que contemplaran reembolsos, transferencias o entregas directas de dinero a los usuarios, reducciones de precios al oferente o proveedor y la entrega gratuita de alimentos RESULTADOS -Se recuperaron 9 revisiones sistemáticas, de las cuales se obtienen los siguientes resultados -Es incierto si la entrega de vouchers aumentaría el consumo diario de frutas. La certeza en la evidencia es muy baja. -La entrega de vouchers podría aumentar el porcentaje de personas que compran frutas y verduras en el mercado. La certeza en la evidencia es baja.
Assuntos
Verduras/provisão & distribuição , Assistência Alimentar , Dieta Saudável , Frutas/provisão & distribuição , Acesso a Alimentos Saudáveis , Chile , Financiamento GovernamentalRESUMO
The study aimed to verify the validity of secondary data in the investigation of the food environment and to analyze the characteristics of the community environment and consumers in territories covered by a health promotion service. This was an ecological study in 18 units of the Health Academy Program in Belo Horizonte, Minas Gerais, Brazil, selected by simple cluster sampling. Validation of the establishments marketing fruits and vegetables, obtained from public databases, was done via telephone contact, Google Street View, and on-site audit. The following variables were investigated in the community food environment: type and location of the establishment; consumer's environment: availability, variety, price, and advertising of fruits and vegetables; availability and variety of ultra-processed foods; and hygienic and sanitary conditions. The access to healthy foods index was used to measure access to these foods. The on-site audit revealed weak concordance (45.7%) with the secondary databases. Of the 298 establishments, the majority were bulk grocery stores and open-air markets (61.3%), which showed the highest availability of healthy foods, but also marketed large amounts of ultra-processed foods (60.7%). One-third of the establishments showed substandard hygienic and sanitary conditions. The secondary databases showed low validity, emphasizing the need to audit the establishments. The establishments also showed a striking presence of ultra-processed foods and poor hygiene and sanitation.
O objetivo foi verificar a validade de dados secundários na investigação do ambiente alimentar e analisar as características do ambiente da comunidade e do consumidor em territórios de serviço de promoção da saúde. Estudo ecológico desenvolvido em 18 unidades do Programa Academia da Saúde de Belo Horizonte, Minas Gerais, Brasil, selecionadas por amostragem de conglomerado simples. A validação dos estabelecimentos que comercializam frutas e hortaliças, obtidos valendo-se de bases de dados públicas, foi realizada por contato telefônico, uso da ferramenta Google Street View e auditoria. As variáveis do ambiente alimentar da comunidade investigadas foram: tipo de estabelecimento e localização; e do ambiente do consumidor: disponibilidade, variedade, preço e propaganda de frutas e hortaliças, e disponibilidade e variedade de alimentos ultraprocessados; e aspectos higiênico-sanitários. Para mensurar o acesso a alimentos saudáveis, utilizou-se o índice de acesso a estes alimentos. A auditoria revelou concordância fraca (45,7%) das bases secundárias de dados. Dos 298 estabelecimentos auditados, a maioria era sacolões e feiras-livres (61,3%), que apresentavam maior disponibilidade de alimentos saudáveis, mas também comercializavam de forma expressiva alimentos ultraprocessados (60,7%). Quanto às condições sanitárias, 1/3 dos estabelecimentos foi reprovado. Foi baixa a validade das bases secundárias, reforçando a necessidade de realizar auditoria nos estabelecimentos. Ademais, os estabelecimentos investigados apresentaram presença marcante de alimentos ultraprocessados e inadequadas condições higiênico-sanitárias.
El objetivo fue verificar la validez de los datos secundarios en la investigación sobre el ambiente alimentario, así como analizar las características del ambiente de la comunidad y del consumidor, en territorios con servicios de promoción de la salud. Estudio ecológico, desarrollado en 18 unidades del Programa Academia de la Salud de Belo Horizonte, Minas Gerais, Brasil, seleccionadas por muestreo de conglomerado simple. La validación de los establecimientos que comercializan frutas y hortalizas, se obtuvo valiéndose de bases de datos públicas, se realizó por contacto telefónico, además del uso de la herramienta Google Street View y auditorías. Las variables del ambiente alimentario de la comunidad investigadas fueron: tipo de establecimiento y localización; ambiente del consumidor: disponibilidad, variedad, precio y propaganda de frutas y hortalizas, disponibilidad y variedad de alimentos ultraprocesados, además de aspectos higiénico-sanitarios. Para medir el acceso a alimentos saludables, se utilizó el índice de acceso a estos alimentos. La auditoría reveló una concordancia débil (45,7%) de las bases secundarias de datos. De los 298 establecimientos auditados, la mayoría era tiendas de comestibles y mercados al aire libre (61,3%), que presentaban una mayor disponibilidad de alimentos saludables, pero también comercializaban de forma expresiva alimentos ultraprocesados (60,7%). En cuanto a las condiciones sanitarias, 1/3 de los establecimientos suspendió. La validez de las bases secundarias fue baja, reforzando la necesidad de realizar auditorías en los establecimientos. Además, los establecimientos investigados presentaron una presencia expresiva de alimentos ultraprocesados e inadecuadas condiciones higiénico-sanitarias.
Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Promoção da Saúde/métodos , Brasil , Comércio , Comportamento Alimentar , Qualidade dos Alimentos , Frutas/provisão & distribuição , Humanos , Valores de Referência , Reprodutibilidade dos Testes , Características de Residência , Estatísticas não Paramétricas , Verduras/provisão & distribuiçãoRESUMO
OBJECTIVE: Identify the effects of food environment and self-efficacy perceptions on fruit and vegetable (FV) consumption. METHODS: A cross-sectional study with a representative sample population from a public health service in a Brazilian city. Participants (3414) aged ≥20 years were recruited from 18 Health Academy Program centres via stratified cluster sampling. Perceptions of the food environment were measured by survey; participants indicated how confident they were about FV availability in their food environment. Statements about self-efficacy assessed three domains regarding perceived affordability, time, and cooking skills. In order to assess the combined effects of both perceptions of food environment and self-efficacy on FV consumption, a combined variable was created. RESULTS: Both perceptions of food environment and self-efficacy in addition to FV consumption were higher in older participants and those with higher incomes and educational levels. Analyses of the combined variables showed that the highest FV intake was found among individuals with better food environment perceptions and greater self-efficacy. After adjustments, the association of food environment perceptions with FV consumption was marginally significant (pâ¯=â¯0.062), while self-efficacy was more strongly associated (pâ¯<â¯0.001); a one standard deviation higher confidence score was associated with a 35.10â¯g higher FV intake. CONCLUSIONS: Among participants of low socioeconomic position, individuals' self-efficacy for promoting FV intake were more important to greater consumption than perceptions of food environments. In addition to public policies for tackling socioeconomic inequalities in restricted environments, it is possible that building capabilities among vulnerable individuals are fruitful pathways for enabling them to partially overcome the challenges of poor food environments.
Assuntos
Dieta , Meio Ambiente , Frutas , Verduras , Adulto , Idoso , Brasil , Custos e Análise de Custo , Estudos Transversais , Escolaridade , Feminino , Alimentos/economia , Preferências Alimentares , Frutas/economia , Frutas/provisão & distribuição , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Política Nutricional , Percepção , Autoeficácia , Fatores Socioeconômicos , Estados Unidos , United States Public Health Service , Verduras/economia , Verduras/provisão & distribuiçãoRESUMO
O objetivo foi verificar a validade de dados secundários na investigação do ambiente alimentar e analisar as características do ambiente da comunidade e do consumidor em territórios de serviço de promoção da saúde. Estudo ecológico desenvolvido em 18 unidades do Programa Academia da Saúde de Belo Horizonte, Minas Gerais, Brasil, selecionadas por amostragem de conglomerado simples. A validação dos estabelecimentos que comercializam frutas e hortaliças, obtidos valendo-se de bases de dados públicas, foi realizada por contato telefônico, uso da ferramenta Google Street View e auditoria. As variáveis do ambiente alimentar da comunidade investigadas foram: tipo de estabelecimento e localização; e do ambiente do consumidor: disponibilidade, variedade, preço e propaganda de frutas e hortaliças, e disponibilidade e variedade de alimentos ultraprocessados; e aspectos higiênico-sanitários. Para mensurar o acesso a alimentos saudáveis, utilizou-se o índice de acesso a estes alimentos. A auditoria revelou concordância fraca (45,7%) das bases secundárias de dados. Dos 298 estabelecimentos auditados, a maioria era sacolões e feiras-livres (61,3%), que apresentavam maior disponibilidade de alimentos saudáveis, mas também comercializavam de forma expressiva alimentos ultraprocessados (60,7%). Quanto às condições sanitárias, 1/3 dos estabelecimentos foi reprovado. Foi baixa a validade das bases secundárias, reforçando a necessidade de realizar auditoria nos estabelecimentos. Ademais, os estabelecimentos investigados apresentaram presença marcante de alimentos ultraprocessados e inadequadas condições higiênico-sanitárias.
The study aimed to verify the validity of secondary data in the investigation of the food environment and to analyze the characteristics of the community environment and consumers in territories covered by a health promotion service. This was an ecological study in 18 units of the Health Academy Program in Belo Horizonte, Minas Gerais, Brazil, selected by simple cluster sampling. Validation of the establishments marketing fruits and vegetables, obtained from public databases, was done via telephone contact, Google Street View, and on-site audit. The following variables were investigated in the community food environment: type and location of the establishment; consumer's environment: availability, variety, price, and advertising of fruits and vegetables; availability and variety of ultra-processed foods; and hygienic and sanitary conditions. The access to healthy foods index was used to measure access to these foods. The on-site audit revealed weak concordance (45.7%) with the secondary databases. Of the 298 establishments, the majority were bulk grocery stores and open-air markets (61.3%), which showed the highest availability of healthy foods, but also marketed large amounts of ultra-processed foods (60.7%). One-third of the establishments showed substandard hygienic and sanitary conditions. The secondary databases showed low validity, emphasizing the need to audit the establishments. The establishments also showed a striking presence of ultra-processed foods and poor hygiene and sanitation.
El objetivo fue verificar la validez de los datos secundarios en la investigación sobre el ambiente alimentario, así como analizar las características del ambiente de la comunidad y del consumidor, en territorios con servicios de promoción de la salud. Estudio ecológico, desarrollado en 18 unidades del Programa Academia de la Salud de Belo Horizonte, Minas Gerais, Brasil, seleccionadas por muestreo de conglomerado simple. La validación de los establecimientos que comercializan frutas y hortalizas, se obtuvo valiéndose de bases de datos públicas, se realizó por contacto telefónico, además del uso de la herramienta Google Street View y auditorías. Las variables del ambiente alimentario de la comunidad investigadas fueron: tipo de establecimiento y localización; ambiente del consumidor: disponibilidad, variedad, precio y propaganda de frutas y hortalizas, disponibilidad y variedad de alimentos ultraprocesados, además de aspectos higiénico-sanitarios. Para medir el acceso a alimentos saludables, se utilizó el índice de acceso a estos alimentos. La auditoría reveló una concordancia débil (45,7%) de las bases secundarias de datos. De los 298 establecimientos auditados, la mayoría era tiendas de comestibles y mercados al aire libre (61,3%), que presentaban una mayor disponibilidad de alimentos saludables, pero también comercializaban de forma expresiva alimentos ultraprocesados (60,7%). En cuanto a las condiciones sanitarias, 1/3 de los establecimientos suspendió. La validez de las bases secundarias fue baja, reforzando la necesidad de realizar auditorías en los establecimientos. Además, los establecimientos investigados presentaron una presencia expresiva de alimentos ultraprocesados e inadecuadas condiciones higiénico-sanitarias.
Assuntos
Humanos , Abastecimento de Alimentos/estatística & dados numéricos , Promoção da Saúde/métodos , Valores de Referência , Verduras/provisão & distribuição , Brasil , Qualidade dos Alimentos , Características de Residência , Reprodutibilidade dos Testes , Comércio , Estatísticas não Paramétricas , Comportamento Alimentar , Frutas/provisão & distribuiçãoRESUMO
Hunger may play a role in noncommunicable disease (NCD) risk. This study used the 2012 Global School-based Student Health Survey from Bolivia to determine the association between hunger and risk factors for NCDs among adolescents. Hunger was associated with increased odds of nondaily fruit and vegetable consumption (adjusted odds ratio [AOR] = 1.21; P < .001), inadequate physical activity (AOR = 1.21; P = .001), and current tobacco use (hunger sometimes [AOR = 1.83; P < .001] or most of the time/always [AOR = 2.12; P < .001]). Interventions to reduce the burden of NCDs in Bolivia should address hunger, in addition to traditional behavioral risk factors.
Assuntos
Exercício Físico , Fome , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Bolívia , Feminino , Frutas/provisão & distribuição , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Razão de Chances , Fatores de Risco , Serviços de Saúde Escolar , Instituições Acadêmicas , Verduras/provisão & distribuiçãoRESUMO
This study provides a spatial analysis of distribution and access to commercial fruit and vegetable establishments within the territory of a representative sample of public fitness facilities known as the Health Academy Program (HAP) in Belo Horizonte, Minas Gerais State, Brazil. The study evaluated commercial food establishments within a buffer area based on a radius of 1,600 meters around each of 18 randomly selected fitness facilities. Quality of access to fruits and vegetables was assessed by the Healthy Food Store Index (HFSI), consisting of the variables availability, variety, and advertising of fruits, vegetables and ultra-processed foods. The analysis was based on calculation of the Kernel intensity estimator, nearest neighbor method, and Ripley K-function. Of the 336 food establishments, 61.3% were green grocers and open-air markets, with a median HFSI of 11 (5 to 16). In only 17% of the territories, the majority of the "hot area" establishments displayed better access to healthy foods, and only three areas showed a clustering pattern. The study showed limited access to commercial establishments supplying healthy fruits and vegetables within the territory of the public fitness program.
Assuntos
Comércio , Abastecimento de Alimentos , Frutas/provisão & distribuição , Características de Residência , Verduras/provisão & distribuição , Brasil , Humanos , Programas Nacionais de SaúdeRESUMO
Abstract This study provides a spatial analysis of distribution and access to commercial fruit and vegetable establishments within the territory of a representative sample of public fitness facilities known as the Health Academy Program (HAP) in Belo Horizonte, Minas Gerais State, Brazil. The study evaluated commercial food establishments within a buffer area based on a radius of 1,600 meters around each of 18 randomly selected fitness facilities. Quality of access to fruits and vegetables was assessed by the Healthy Food Store Index (HFSI), consisting of the variables availability, variety, and advertising of fruits, vegetables and ultra-processed foods. The analysis was based on calculation of the Kernel intensity estimator, nearest neighbor method, and Ripley K-function. Of the 336 food establishments, 61.3% were green grocers and open-air markets, with a median HFSI of 11 (5 to 16). In only 17% of the territories, the majority of the “hot area” establishments displayed better access to healthy foods, and only three areas showed a clustering pattern. The study showed limited access to commercial establishments supplying healthy fruits and vegetables within the territory of the public fitness program.
Resumen Analizamos espacialmente la distribución y el acceso a tiendas de frutas y verduras en el territorio de una muestra representativa de lugares donde se realiza el Programa Academia de la Salud (PAS por sus siglas en portugués) de Belo Horizonte, Minas Gerais, Brasil. Evaluamos los establecimientos que aparecen en zonas acotadas con un radio de 1.600 metros, con respecto a 18 zonas procedentes de muestras al azar. La calidad de acceso a frutas y hortalizas se evaluó mediante el Índice de Acceso a los Establecimientos de Alimentación (IAA), integrado por variables de disponibilidad, variedad, anuncios de frutas y hortalizas, así como alimentos ultraprocesados. Se usó en este análisis el estimador de intensidad Kernel, el barrio más cercano y la función K de Ripley. De los 336 establecimientos encuestados, un 61,3% eran tiendas y mercados al aire libre, con una media de 11 IAA (5-16). Tan sólo en un 17% del territorio analizado la mayoría de los establecimientos estaban situados en la zona más significativa, donde había un mejor acceso a alimentos sanos, e incluso tres áreas mostraron un patrón de aglomeración. Verificamos, asimismo, un acceso limitado a los establecimientos comerciales que ofrecen frutas y verduras en otras áreas del HAP, sobre todo en cuanto a la calidad.
Resumo Analisar espacialmente a distribuição e o acesso a estabelecimentos comerciais de frutas e hortaliças no território de uma amostra representativa de polos do Programa Academia da Saúde (PAS) de Belo Horizonte, Minas Gerais, Brasil. Avaliaram-se estabelecimentos contidos dentro de buffers com raios de 1.600 metros a partir de 18 polos amostrados aleatoriamente. A qualidade do acesso às frutas e hortaliças foi avaliada pelo Índice de Acesso a Alimentos em Estabelecimentos (HFSI), composto por variáveis de disponibilidade, variedade e propaganda de frutas e hortaliças e alimentos ultraprocessados. A análise constou do cálculo do estimador de intensidade kernel, método do vizinho mais próximo e função K de Ripley. Dos 336 estabelecimentos, 61,3% eram sacolões e feiras-livres, com mediana de HFSI 11 (5 a 16). Em apenas 17% dos territórios analisados, a maioria dos estabelecimentos da área quente apresentava melhor acesso a alimentos saudáveis, sendo que apenas três áreas apresentaram padrão de aglomeração. Verificou-se acesso limitado a estabelecimentos comerciais que ofertam frutas e hortaliças com qualidade no território do PAS.
Assuntos
Humanos , Comércio , Abastecimento de Alimentos , Frutas/provisão & distribuição , Características de Residência , Verduras/provisão & distribuição , Brasil , Programas Nacionais de SaúdeRESUMO
Differential access to healthy foods has been hypothesized to contribute to health disparities, but evidence from low and middle-income countries is still scarce. This study examines whether the access of healthy foods varies across store types and neighborhoods of different socioeconomic statuses (SES) in a large Brazilian city. A cross-sectional study was conducted in 2010-2011 across 52 census tracts. Healthy food access was measured by a comprehensive in-store data collection, summarized into two indexes developed for retail food stores (HFSI) and restaurants (HMRI). Descriptive analyses and multilevel models were used to examine associations of store type and neighborhood SES with healthy food access. Fast food restaurants were more likely to be located in low SES neighborhoods whereas supermarkets and full service restaurants were more likely to be found in higher SES neighborhoods. Multilevel analyses showed that both store type and neighborhood SES were independently associated with in-store food measures. We found differences in the availability of healthy food stores and restaurants in Sao Paulo city favoring middle and high SES neighborhoods.
Assuntos
Comportamento Alimentar , Alimentos Orgânicos/provisão & distribuição , Características de Residência , Restaurantes , Classe Social , Brasil , Comércio/estatística & dados numéricos , Estudos Transversais , Feminino , Frutas/provisão & distribuição , Humanos , Masculino , Verduras/provisão & distribuiçãoRESUMO
OBJECTIVE: To evaluate the impact of activities promoting the consumption of fruit and vegetables (FV) in the workplace. METHODS: Intervention study with historical control group conducted in a public company in Rio de Janeiro, Southeastern Brazil, between 2007 and 2009. It consisted of three stages: (a) baseline, which included the characterization of both the company studied and the one responsible for providing meals to the employees, assessment of FV intake by the staff and forming a focus group to identify the determinants of FV consumption and to inform the planning of the intervention; (b) intervention, comprised of an environmental component (company's restaurant) and an educational component (directed at individuals); and (c) post-intervention assessment, which included impressions about changes in the company's restaurant in terms of FV supply, exposure of individuals to the intervention and FV consumption by the employees. The analysis of the association between exposure and outcome indicators was conducted using multiple regression models. RESULTS: On average, the coverage of educational activities and materials was 63.5%. Most employees perceived positive changes in at least one of the five environmental aspects examined. There was an increase (38%) in FV consumption by employees, which corresponds to 0.66 servings in the meal evaluated (lunch). Significant association between indicators of exposure, (both environmental and educational components) and outcome indicators was observed. CONCLUSIONS: FV consumption increased among employees exposed to an intervention focused on the promotion of these foods in the workplace. The multi-component design of the intervention seems to have contributed to these findings.
Assuntos
Comportamento Alimentar , Frutas , Promoção da Saúde/métodos , Verduras , Local de Trabalho , Adulto , Brasil , Serviços de Dietética , Feminino , Frutas/provisão & distribuição , Humanos , Masculino , Saúde Ocupacional , Verduras/provisão & distribuiçãoRESUMO
OBJETIVO: Avaliar o impacto de ações para promoção do consumo de frutas e hortaliças em ambiente de trabalho. MÉTODOS: Estudo de intervenção com grupo controle histórico conduzido com 61 funcionários de uma empresa pública, no Rio de Janeiro, RJ, de 2007 a 2009. O estudo foi realizado em três etapas: (a) diagnóstico pré-intervenção, que abrangeu caracterização da empresa estudada e da fornecedora de refeições, avaliação do consumo de frutas e hortaliças pelos funcionários e a inclusão de grupo focal para conhecer os determinantes do consumo de frutas e hortaliças e subsidiar o planejamento da intervenção; (b) intervenção, composta por uma vertente ambiental (refeitório da empresa) e outra educativa (dirigida aos indivíduos); e (c) diagnóstico pós-intervenção, que incluiu impressões sobre modificações no restaurante no tocante à oferta de frutas e hortaliças, exposição dos indivíduos à intervenção e respectivo consumo. A associação entre indicadores de exposição e desfecho foi analisada por meio de modelos de regressão múltipla. RESULTADOS: A média de cobertura das atividades e materiais educativos foi de 63,5%. A maioria dos funcionários percebeu mudanças positivas em pelo menos um dos cinco aspectos examinados referentes ao ambiente. O consumo de frutas e hortaliças aumentou 38,0% (0,66 porção na refeição avaliada). Indicadores de exposição da vertente ambiental e da vertente educativa associaram-se a indicadores de desfecho. CONCLUSÕES: O consumo de frutas e hortaliças aumentou entre trabalhadores expostos à intervenção de promoção desses alimentos no ambiente de trabalho. O desenho multicomponente da intervenção parece ter contribuído para esses achados.
OBJECTIVE: To evaluate the impact of activities promoting the consumption of fruit and vegetables (FV) in the workplace. METHODS: Intervention study with historical control group conducted in a public company in Rio de Janeiro, Southeastern Brazil, between 2007 and 2009. It consisted of three stages: (a) baseline, which included the characterization of both the company studied and the one responsible for providing meals to the employees, assessment of FV intake by the staff and forming a focus group to identify the determinants of FV consumption and to inform the planning of the intervention; (b) intervention, comprised of an environmental component (company's restaurant) and an educational component (directed at individuals); and (c) post-intervention assessment, which included impressions about changes in the company's restaurant in terms of FV supply, exposure of individuals to the intervention and FV consumption by the employees. The analysis of the association between exposure and outcome indicators was conducted using multiple regression models. RESULTS: On average, the coverage of educational activities and materials was 63.5%. Most employees perceived positive changes in at least one of the five environmental aspects examined. There was an increase (38%) in FV consumption by employees, which corresponds to 0.66 servings in the meal evaluated (lunch). Significant association between indicators of exposure, (both environmental and educational components) and outcome indicators was observed. CONCLUSIONS: FV consumption increased among employees exposed to an intervention focused on the promotion of these foods in the workplace. The multi-component design of the intervention seems to have contributed to these findings.
OBJETIVO: evaluar el impacto de acciones para la promoción del consumo de frutas y hortalizas en ambiente de trabajo MÉTODOS: Estudio de intervención con grupo control histórico conducido con 61 funcionarios de una empresa pública, en Rio de Janeiro, RJ de 2007 a 2009. El estudio fue realizado en tres etapas: a) diagnóstico pre-intervención, que abarcó la caracterización de la empresa estudiada y de la proveedora de las comidas, evaluación del consumo de frutas y hortalizas por los funcionarios y la inclusión de grupo de estudio para conocer los determinantes del consumo de frutas y hortalizas y subsidiar la planificación de la intervención; b) intervención, compuesta por una vertiente ambiental (comedor de la empresa) y otra educativa (dirigida a los individuos); y c) diagnóstico post-intervención, que incluyó impresiones sobre modificaciones en el restaurante con relación a la oferta de frutas y hortalizas, exposición de los individuos a la intervención y respectivo consumo. La asociación entre indicadores de exposición y resultado fue analizada por medio de modelos de regresión múltiple. RESULTADOS: El promedio de cobertura de las actividades y materiales educativos fue de 63,5%. La mayoría de los funcionarios percibió cambios positivos en al menos uno de los cinco aspectos examinados con relación al ambiente. El consumo de frutas y hortalizas aumentó 38,0% (0,66 porciones en la comida evaluada). Indicadores de exposición de la vertiente ambiental y de la vertiente educativa se asociaron a indicadores de resultado. CONCLUSIONES: el consumo de frutas y hortalizas aumentó entre trabajadores expuestos a la intervención de promoción de dichos alimentos en el ambiente de trabajo. El diseño multicomponente de la intervención parece haber contribuido en los resultados.
Assuntos
Adulto , Feminino , Humanos , Masculino , Alimentação Coletiva , Comportamento Alimentar , Promoção da Saúde Alimentar e Nutricional , Frutas , Promoção da Saúde/métodos , Verduras , Local de Trabalho , Brasil , Serviços de Dietética , Comportamento Alimentar , Frutas/provisão & distribuição , Saúde Ocupacional , Verduras/provisão & distribuiçãoRESUMO
BACKGROUND: During recent decades household incomes have increased steadily, leading to changes in dietary habits and food expenditure. AIM: To report changes in household food expenditure focusing on trends in processed food across income quintiles in Metropolitan Santiago. MATERIAL AND METHODS: Information obtained from the Fourth (1986-1987), Fifth (1996-1997) and Sixth National Institute of Statistics (INE) Surveys (2006-2007) were used. Food expenditure data over the study periods was extracted from household expenditure surveys (HES) after verifying and adjusting food prices registered by the INE to current 2007 prices. RESULTS: Absolute food expenditure over the study period increased for all groups; the largest increase was found in lowest income quintiles; however, the proportion of total family budget spent on food decreased in all groups. The largest increases in food expenditure corresponded to sweetened beverages, processed fruit juices, alcoholic drinks, ready meals and "eating out". Expenditure on fish rose slightly whereas the absolute spending on legumes, eggs and oils decreased. Expenditure in processed food as percentage of total food expenditure increased from 42% to 57% of total for mean household. For the 2nd quintile it rose from 31% to 48% and for the lowest quintile increased from 53% to 68% over the three decades (1987-2007). Changes were greatest in energy rich processed foods such as bread, pastries, confectioneries and granulated sugar. These particular foods are of high energy density and contain high amounts of saturated fat, sodium and added sugars. CONCLUSIONS: These results confirm that food consumption patterns over the past decades have progressively departed from the recommended dietary guidelines given by national and international health organizations.
Assuntos
Inquéritos sobre Dietas , Alimentos/economia , Bebidas/economia , Chile , Ingestão de Energia , Fast Foods/economia , Comportamento Alimentar , Alimentos/estatística & dados numéricos , Análise de Alimentos , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/estatística & dados numéricos , Frutas/provisão & distribuição , Humanos , População Urbana , Verduras/provisão & distribuiçãoRESUMO
Background: During recent decades household incomes have increased steadily, leading to changes in dietary habits and food expenditure. Aim: To report changes in household food expenditure focusing on trends in processed food across income quintiles in Metropolitan Santiago. Material and Methods: Information obtained from the Fourth (1986-1987), Fifth (1996-1997) and Sixth National Institute of Statistics (INE) Surveys (2006-2007) were used. Food expenditure data over the study periods was extracted from household expenditure surveys (HES) after verifying and adjusting food prices registered by the INE to current 2007prices. Results: Absolute food expenditure over the study period increased for all groups; the largest increase was found in lowest income quintiles; however, the proportion of total family budget spent on food decreased in all groups. The largest increases in food expenditure corresponded to sweetened beverages, processed fruit juices, alcoholic drinks, ready meals and "eating out". Expenditure on fish rose slightly whereas the absolute spending on legumes, eggs and oils decreased. Expenditure in processed food as percentage of total food expenditure increased from 42% to 57% of total for mean household. For the 2nd quintile it rose from 31% to 48% and for the lowest quintile increased from 53% to 68% over the three decades (1987-2007). Changes were greatest in energy rich processed foods such as bread, pastries, confectioneries and granulated sugar. These particular foods are of high energy density and contain high amounts of saturated fat, sodium and added sugars. Conclusions: These results confirm that food consumption patterns over the past decades have progressively departed from the recommended dietary guidelines given by national and international health organizations.