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      Promotion of healthy eating at schools in the Federal District of Brazil Translated title: Promoção da alimentação saudável: cenário das escolas da capital do Brasil

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          Abstract

          OBJECTIVE: The aim of the present study was to describe strategies for the Promotion of Healthy Eating at Public and Private Schools in the Federal District of Brazil. METHODS: A descriptive, analytical, cross-sectional study was carried out involving 122 Private Schools and 173 Public Schools. The components of health promotion in the school setting were adapted to the context of the promotion of healthy eating, with interviews conducted for the administration of a semi-structured questionnaire. The Student's t test, Spearman's correlation coefficients and likelihood ratios were used for the statistical analysis (5% level of significance; p<0.05). RESULTS: Only one private elementary school fulfilled the criteria for 20 of the 24 items studied. At the other extreme, two public high schools only fulfilled the criteria for three items. A positive correlation was found between number of meetings held with the school community to address healthy eating and presence of healthy environments as well as between presence of healthy environments and monitoring of nutritional status of schoolchildren (p<0.01). Schools that held an above-average number of meetings to address healthy eating had a smaller proportion of street vendors and local stores in the surrounding area (p=0.01). The majority of schools that had a partnership with healthcare professionals included the topic of healthy eating in the curriculum (p=0.04). CONCLUSION: The different associations found demonstrate the importance and interdependence of the components of the promotion of healthy eating. Preschools have developed more strategies for the Promotion of Healthy Eating and health in general in comparison to other teaching modalities. Schools in the Federal District of Brazil need support and training to be developed as a "Health Promoting School", specifically with regard to actions directed toward healthy eating.

          Translated abstract

          OBJETIVO: Caracterizar as estratégias de Promoção da Alimentação Saudável em escolas públicas e privadas do Distrito Federal. MÉTODOS: Estudo transversal descritivo-analítico realizado com 122 escolas particulares e 173 públicas. Adaptaram-se os componentes de promoção da saúde no ambiente escolar para o contexto da Promoção da Alimentação Saudável, sendo realizadas entrevistas para a aplicação do instrumento. Os testes utilizados foram: t de Student, coeficiente de correlação de Spearman e teste da razão de verossimilhança (nível de significância p<0,05). RESULTADOS: Apenas uma escola privada de ensino infantil contemplava positivamente 20 dos 24 itens pesquisados. No outro extremo, duas escolas públicas de ensino médio contemplavam apenas três itens. Observou-se correlação positiva entre o número de reuniões com a comunidade escolar para abordar a temática alimentação saudável e a presença de ambientes saudáveis e; entre a presença de ambientes saudáveis e o monitoramento do estado nutricional dos escolares (p<0,01). As escolas que realizavam reuniões acima da média para abordar alimentação saudável possuíam em menor proporção ambulantes e/ou comércios locais próximos (p=0,01). A maioria das escolas que possuíam parceria com profissional de saúde incluía a temática Alimentação Saudável no currículo (p=0,04). CONCLUSÃO: As diversas associações encontradas demonstram a importância e a interdependência dos componentes de Promoção da Alimentação Saudável estudados. As escolas de educação infantil desenvolveram mais estratégias de Promoção da Alimentação Saudável e da saúde em relação às demais modalidades. A maioria das escolas do Distrito Federal precisa de apoio e capacitação para desenvolver-se como Escola Promotora da Saúde, no recorte específico de ações voltadas para a alimentação saudável.

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          Impact of the Bienestar school-based diabetes mellitus prevention program on fasting capillary glucose levels: a randomized controlled trial.

          To evaluate the impact of a school-based diabetes mellitus prevention program on low-income fourth-grade Mexican American children. A randomized controlled trial with 13 intervention and 14 control schools. Elementary schools in inner-city neighborhoods in San Antonio, Tex. Eighty percent of participants were Mexican American and 94% were from economically disadvantaged households. Baseline and follow-up measures were collected from 1419 (713 intervention and 706 control) and 1221 (619 intervention and 602 control) fourth-grade children, respectively. The Bienestar Health Program consists of a health class and physical education curriculum, a family program, a school cafeteria program, and an after-school health club. The objectives are to decrease dietary saturated fat intake, increase dietary fiber intake, and increase physical activity. The primary end point was fasting capillary glucose level, and the secondary end points were percentage of body fat, physical fitness level, dietary fiber intake, and dietary saturated fat intake. Fasting capillary glucose level, bioelectric impedance, modified Harvard step test, three 24-hour dietary recalls, weight, and height were collected at baseline and 8 months later. Children in the intervention arm attended an average of 32 Bienestar sessions. Mean fasting capillary glucose levels decreased in intervention schools and increased in control schools after adjusting for covariates (-2.24 mg/dL [0.12 mmol/L]; 95% confidence interval, -6.53 to 2.05 [-0.36 to 0.11 mmol/L]; P =.03). Fitness scores (P =.04) and dietary fiber intake (P =.009) significantly increased in intervention children and decreased in control children. Percentage of body fat (P =.56) and dietary saturated fat intake (P =.52) did not differ significantly between intervention and control children. This intervention showed some positive results, but additional research is needed to examine long-term benefits, translation, and cost-effectiveness.
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            Health and nutrition education in primary schools of Crete: changes in chronic disease risk factors following a 6-year intervention programme.

            The effectiveness of a health and nutrition education programme, in changing certain chronic disease risk factors, was assessed after the 6 years intervention period was completed. The school-based intervention programme was applied to all children registered in the first grade (age 5.5-6.5 years) in 1992 in two counties of Crete, while the children from a third county served as a control group. In order to assess the effectiveness of the intervention, a variety of biological and behavioural parameters were measured before and following completion of the intervention in a randomly selected school-based sample of 602 intervention group (IG) and 444 control group (CG) pupils. At the end of the 6-year period, it was found that biochemical indices generally improved significantly more in the IG compared with the CG (mean change for IG v. CG was -0.27 v. -0.12 mmol/l for total cholesterol (TC); -0.07 v. +0.24 for TC:HDL and -0.13 v. +0.14 for LDL:HDL). Similarly, the changes observed in the anthropometric variables in the two groups were in favour of the IG (+3.68 v. +4.28 kg/m2 for BMI; +2.97 v. +4.47 mm for biceps skinfold). Total energy intake and consumption of total fat and saturated fat increased significantly less in the IG compared with the CG (+747.7 v. 1534.7 kJ (+178.7 v. +366.8 kcal); +5.9 v. +18.8 g and +0.8 v. +5.1 g respectively), while time devoted to leisure time physical activity and cardiovascular run test performance increased significantly more in the IG (+281 v. +174 min/week and +2.5 v. +1.2 stages respectively). The findings of the present study underline the importance of such programmes in health promotion and disease prevention. Although the long-term effects of these programmes can only be assessed by tracking this population through to adolescence and adulthood, these programmes seem to have the potential to lead to a healthier lifestyle and thus a reduction in risk factor levels.
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              O programa nacional de alimentação escolar e a gestão municipal: eficiência administrativa, controle social e desenvolvimento local

              OBJETIVO: Avaliar o perfil da gestão pública municipal do Programa Nacional de Alimentação Escolar de 670 prefeituras inscritas no Prêmio Gestor Eficiente da Merenda Escolar, entre os anos de 2004 e 2005. MÉTODOS: Este estudo foi realizado a partir da inscrição de municípios de todo o Brasil no Prêmio Gestor Eficiente da Merenda Escolar, organizado pela Organização Não Governamental Ação Fome Zero. A inscrição é feita de forma voluntária e os municípios fornecem informações em relação a aspectos financeiros, formas de administração do Programa, compra de produtores rurais, atuação do Conselho de Alimentação Escolar e outras ações relacionadas à execução do Programa Nacional de Alimentação Escolar. Em seguida, a Organização Não Governamental confere os dados comparando-os com relatórios oficiais, a partir da realização de visitas. RESULTADOS: Verificou-se que a principal forma de administração do Programa Nacional de Alimentação Escolar é a centralizada (citada por mais de 80% das prefeituras inscritas nos dois anos). A grande maioria dos municípios inscritos em 2004 (90,1%) e em 2005 (84,0%) complementou o repasse de recursos do Governo Federal. O custo médio da refeição foi de R$0,31 (para as inscritas em 2004) e de R$0,34 para as inscritas em 2005. Em relação à compra de gêneros alimentícios, 26,1% das prefeituras inscritas em 2004 e 30,4% das inscritas em 2005 declararam comprar diretamente de produtores rurais. CONCLUSÃO: A execução do Programa Nacional de Alimentação Escolar assume características próprias em cada município brasileiro. Identificar o perfil da administração pública, assim como as características das prefeituras que se destacaram no Prêmio, permite a implantação de ações que melhorem a execução do Programa.
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                Author and article information

                Journal
                rn
                Revista de Nutrição
                Rev. Nutr.
                Pontifícia Universidade Católica de Campinas (Campinas, SP, Brazil )
                1415-5273
                1678-9865
                April 2013
                : 26
                : 2
                : 145-158
                Affiliations
                [01] Brasília DF orgnameUniversidade de Brasília orgdiv1Faculdade de Ciências da Saúde Brasil
                [02] Brasília DF orgnameUniversidade de Brasília orgdiv1Núcleo de Pesquisa em Políticas Públicas orgdiv2Observatório de Políticas de Segurança Alimentar e Nutricional Brasil
                [03] Florianópolis SC orgnameUniversidade Federal de Santa Catarina orgdiv1Centro de Ciências da Saúde orgdiv2Departamento de Saúde Pública Brasil
                Article
                S1415-52732013000200003 S1415-5273(13)02600200003
                e2858b26-0a0f-4531-b121-6fdc9c292e73

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 24 February 2012
                : 12 November 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 14
                Product

                SciELO Brazil

                Categories
                Original Articles

                School feeding,Schools,Health promotion,Instituições acadêmicas,Alimentação escolar,Promoção da saúde

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