The COVID-19 pandemic has not affected the general population equally, especially the group of university students, reflecting disproportionately on some aspects, such as those related to remote study conditions and food (in)security, which had already been reaching worrying levels since 2014. The combination of these two factors can intensify contexts of vulnerability that are not easily repaired and this was the background to this dissertation. Thus, the aim of this work was to analyze the relationships established between Food Security and the Study Conditions of university students during the first wave of the COVID-19 pandemic in Brazil. Using a theoretical model based on the social determinants of health (SDH) and a study by Mercuri (1992), relationships were established between the outcome (remote study conditions) and exposure ((in)food security). Methodologically, this is a cross-sectional study nested in the research project entitled "Influence of the COVID-19 pandemic on the mental health and eating behavior of students and teachers at public and private higher education institutions: a cohort study" - CoCASa, which used an online questionnaire (and based on the non-inclusion criteria of the cohort and this study) to obtain data from 2,361 undergraduate students from 26 Brazilian states and the Federal District. Material (technology, connectivity, furniture), temporal (course period), spatial (home) and personal (hours of sleep) factors, inspired by Mercuri, were used to identify the remote study conditions construct, using latent class analysis (LCA) - the dependent variable. The condition of food security, obtained through the EBIA, with three categories (food security, mild food insecurity and moderate/severe food insecurity) characterized the main exposure. Sociodemographic, economic, health and lifestyle characteristics, and those related to higher education institutions (HEIs) made up the co-variables. The data was analyzed descriptively using Pearson's Chi-square, LCA and multinomial logistic regression. The results of the study indicate that the average age was 25 years (SD: 7.5), there was a higher prevalence of students from the Northeast region (43%), the population was mostly female (79%), unmarried (82%), with an income < R$3,000.00 and 44% reported being of black/brown/indigenous race/skin color. They belonged to public HEIs (59%), did not work (63%) and were more than halfway through the course at the time of the baseline (57%). It was also found that 59% of the students had a laptop/personal computer, 74% had access to a smartphone/tablet and a good internet connection (63%). As for adequate space for remote study, 71% reported not having access or a suitable table and chair (71% and 60% respectively). Food insecurity was identified in 44.4% of households. A model with 4 latent classes (LC) was used to identify the construct. The remote study conditions were characterized as Vulnerable (CL1), Adequate (CL2), At Risk (CL3) and Imbalanced (CL4), with the highest proportion in CL1 (33.3%), followed by CL3 (28.1%). In CL1, the majority of the population was characterized by lower family income and food insecurity (mild and moderate/severe) in the household, of black/brown/indigenous race/skin color, with a reduction in family income during the pandemic and coming from a private HEI. CL2 had a population of other races, with income in the highest stratum, from a public HEI and in food security. CL3 had the highest percentage of women (83%), lower income (63%) and a medical diagnosis of anxiety (56%) when compared to the other classes. The majority of CL4 members had no paid work, were in the lowest family income stratum and had a reduced income, came from a public HEI, had a medical diagnosis of anxiety, but were food insecure. The association between food insecurity and the construct showed that students exposed to food insecurity were more likely to belong to the most underprivileged classes (CL1 and CL3) of the remote study conditions and the chances increased significantly according to the severity of exposure, even after adjusting for the co-variables gender, race/skin color, income, education of the head of the family and type of HEI. The chance of adhering to CL1 remained positive and significant at 62% and 183% for the categories of mild (OR: 1.62; 95%CI: 1.16-2.29) and moderate (OR: 2.83; 95%CI: 1.74-4.94) food insecurity, respectively. The chance of adhering to CL3 (Risk) also remained the same for individuals with moderate/severe food insecurity when compared to those who were food secure (OR: 2.08; 95%CI: 1.28-3.38). The scenario experienced by university students in 2020 raises important questions that are potentially associated with food insecurity. The results of this dissertation can contribute to future actions within HEIs and public policies aimed at this audience.

The implementation of the purchase of food from family farming (AF) for school meals was regulated for the first time in Article 14 of Law No. 11,947/2009, aiming at two central objectives: promoting access to healthy food in schools and guaranteeing a market and income for small farmers. With complications in some periods, these objectives remain and are reiterated in the government taking office in 2023. However, several studies showed that this purchasing process had not been occurring homogeneously throughout the national territory, with the operationalization, although subject to national standards, facing several challenges, especially when considering the institutional capacity of states and municipalities to implement legal parameters. In this way, it is argued that the implementation of the purchase of AF food for school meals is the result of different local institutional arrangements, which are constituted from the interaction between the local actors involved in its execution, the sociopolitical context and institutional rules established. From this perspective, the study proposed to analyze the characteristics of the local institutional arrangements that influenced the acquisition of AF food by the management of the National School Meal Program (PNAE). The research was carried out within the scope of the larger project entitled “Implementation of the National School Food Program: Analysis of the Institutional Arrangements of the Program with the Economic Organizations of Family Agriculture in the Recôncavo da Bahia”. Thus, the data analyzed were obtained in case studies, for which the Bahian municipalities of Muritiba and Santo Amaro were selected. The collection took place between October 2019 and March 2020, using semistructured interviews with the institutional actors involved in the purchase and field diaries as a technique. Added to this, documents and information relating to the processes of implementing the purchase of AF in each municipality were analyzed, as well as the legislation that regulates the program. To analyze the information collected, a matrix was constructed that included the central categories, definitions, operational categories and variables identified as most important to address the study problem, and the analytical focus was directed to the central categories defined based on the conception of institutional arrangement. location adopted in the study. Thus, it was possible to identify that in the local context, the socio-political scenario can play a favorable role in the purchase of food from family farming, even if the technicaladministrative aspects are not fully adequate for the execution of the Program. Furthermore, it was verified that the interaction between actors management and the definition of local rules have an influence on the purchasing process, since in some situations the rules adopted by the municipalities analyzed constrained or allowed to circumvent the challenges posed locally to the commercialization of AF. In this way, it is understood that institutional purchasing is shaped by the interactions of the different social actors involved and the rules adopted, which took on different contours in each sociopolitical context. In this scenario in which the strategy is resumed, with the potential for expansion and diversification of the actors involved on the production side, the results presented indicate possible ways to improve implementation in different local realities

Introduction: Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by avoidance or restriction of food intake, with persistent failure to meet appropriate nutritional and/or energy needs, resulting in weight loss and/or nutritional deficiencies requiring nutritional supplementation. ARFID is identified in different age groups, but it is more common in children and adolescents. Objective: This dissertation aimed to explore current evidence on nutritional deficiencies in children and adolescents with ARFID. Method: Data from non-empirical studies were used, consisting of a scoping review conducted according to the Joanna Briggs Institute methodology, aimed at investigating nutritional deficiencies in children and adolescents with Avoidant/Restrictive Food Intake Disorder (ARFID). The acronym PCC guided the main research question. The research was conducted in three stages: 1) initial search in Medline/PubMed to identify possible descriptors; 2) search using the terms "Feeding and Eating Disorders", "Avoidant Restrictive Food Intake Disorder", "malnutrition", in the following databases: Medline (PubMed), Embase (Elsevier), the Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, PsycINFO and Google Scholar (gray literature); 3) checking the reference lists of identified studies. EndNote was used to remove duplicates, and two independent reviewers conducted a full reading of the articles. Data extraction was performed by two independent reviewers, and a third reviewer checked the extraction. Results: Of the 3273 records retrieved, 24 were included in the review, comprising 13 descriptive studies, eight observational studies, and three narrative reviews. Laboratory and anthropometric assessments were most commonly used for nutritional deficiency screening. The main findings included malnutrition, deficiencies in fat-soluble vitamins (A, D, E, and K), B-complex vitamins, vitamin C, iron, zinc, electrolytes, and compromised bone health. Aggravation of nutritional deficiencies resulted in diagnoses of anemia, Wernicke's encephalopathy, retinopathy, scurvy, osteoporosis, and myelodysplasia. Malnutrition was more common in male children and in school-age, and the severity of malnutrition decreased with advancing age. Despite the high prevalence of malnutrition and limited food repertoire, a preference for high-calorie and ultra-processed foods may favor the development of overweight and obesity. No relationship was observed between nutritional deficiencies and ethnic origin, family income, or maternal education level. Conclusions: School-age children and male children with ARFID appear to be more nutritionally vulnerable and even with nutritional supplementation, they presented nutrient deficiencies. There is a significant risk of developing severe diseases due to nutrient deficiencies caused by ARFID. Children and adolescents with symptoms of ARFID may benefit from early and frequent examinations to guide the adequacy of micronutrient intake.

Considering various aspects that influence food choices, availability in the food environment can be defined according to the physical, socioeconomic, political and cultural context in which individuals are inserted and are led to make food choices. This is known as behavioral ecology in health, which is influenced by the population's age group and ability to choose food. Since adolescents remain in schools for long periods, it is understood that the school food environment plays an important role in the quality of their diet. Deserts, swamps and food oases terms have been used to characterize the food environment ac-cording to the identified food availability. In this context, this work aimed to map deserts, swamps and food oases around federal schools in Bahia/Brazil, emphasizing the importance of implementing the Brazilian National School Feeding Program (PNAE) in these schools, to guarantee food security and nutrition. An ecological study was carried out in all 35 federal schools in Bahia/Brazil, using an 800-meter buffer analysis, with the school as the centroid. The geographic coordinates of schools and food establishments were initially obtained using Google Maps and later confirmed on site. Data were collected in WGS 84 and converted to Universal Transverse Mercator System (UTM) zone 23S SIRGAS 2000. To map the consumer environment, establishments found in the 250-meter buffer and also can-teens within schools were audited, using the ESAO-r instrument that considers the availability and prices of healthy and unhealthy foods; availability of nutritional information near the point of purchase or on the menu; and presence of internal marketing of healthy and unhealthy foods. The establishments were grouped into four categories (healthy, unhealthy, mixed and super-markets). To evaluate food deserts and swamps, the methodology proposed by the CDC was used and the Modified Retail Food Environment Index (mRFEI) was calculated; when the result was equal to zero, the surrounding area was considered a food desert and values between 0.01 and 20 determined food swamps; for values above 20, the neighborhood was classified as mixed. Food oases were considered regions containing at least one supermarket within the analyzed buffer. Descriptive analyses were carried out with frequency measurements, measures of central tendency (mean and median) and dispersion (standard deviation). The food environment of schools was compared about the number of students impacted, the area where the school was located (urban or rural) and the size of the municipalities. Around the analyzed schools, 732 food establishments were identified, 73.8% (n = 540) formal and 26.2% (n = 192) informal. Considering the characteristics of existing commerce, there was a predominance of snack bars (45%), grocery stores (23%) and bars (7.8%), with a smaller number of supermarkets identified (4.1%). School canteens were found in 20 schools analyzed and only 15% had a variety of healthy foods. When evaluating the availability of healthy foods, a median HMRI of 3 (1 – 7) was observed. When analyzing this index according to the type of establishment, it was found that fruit and vegetables presented higher values (HMRI = 7; P25-P75: 4-8) compared to large chain supermarkets (HMRI = 5; P25-P75: 2-6; p < 0.001) and local markets (HMRI = 4; P25-P75: 2-5; p < 0.001). The average number of establishments was 22.39 (± 13.03), including snack bars (7.33 ± 4.43), grocery stores (5.83 ± 4.09) and restaurants (2.94 ± 2. 19) being the categories that presented the highest averages. Food deserts and mixed environments were identified in 40% of the sample, while swamps represented 20% and oases 65%. From the analysis of the food and consumer environments, it was possible to make inferences about the quality of the food offered to students in these locations, as well as the possible health outcomes arising from this exposure and the need to carry out food education and nutritional activities. An association was observed between food deserts and social vulnerability, making it necessary to emphasize the importance of adequate implementation of the PNAE in these schools, to reduce food and nutritional insecurity, guaranteeing the human right to adequate and healthy food and providing better nutrition and health perspectives within the school environment and impact on students' lives through food and nutrition education actions, which are also part of the context of PNAE activities.

The Cactaceae family, commonly found in arid and semi-arid regions, does not have use of its nutritional and technological potential for human food, being considered an Unconventional Food Plant (UFP). Therefore, the consumption of cacti in the Northeast region of Brazil, which has high levels of Food and Nutrition Insecurity, is stigmatized and associated with poverty. On the other hand, the fruits of these plants have distinct sensory characteristics and are highly nutritious, being consumed in several countries. Thus, this research aimed to analyze the potential use of the fruits of five cacti widespread in the Brazilian Caatinga biome (Opuntia ficus-indica, Cereus jamacaru, Pilosocereus pachycladus, Pilosocereus gounellei, and Melocactus zehntneri) for human consumption and new products development. A scientific prospection was then carried out to analyze what has been studied about cacti in human food worldwide, and the nutritional characteristics, bioactive compounds, and antioxidant activity of the fruits of the five cacti studied were systematized. The perceptions and interests of the Brazilian population regarding the consumption of cactus fruits and the patent documents that use these plants in food production were also analyzed. It was found that many studies have shown the antioxidant properties, bioactive compounds, and high levels of micro and macronutrients in several species of cacti. These plants have characteristics that allow a wide variety of uses. They can be consumed fresh or processed, in addition to being used by industry to extract compounds of interest, such as coloring substances and antioxidants, in developing additives and nutraceuticals. As for consumption, it was observed that the Brazilian population is willing to use cacti as food due to their functional properties, representing a promising market niche. Thus, exploring the diversity of uses of these fruits can provide significant benefits from a scientific, economic, and social point of view, impacting the Sovereignty and Food and Nutrition Security of families residing in the Brazilian Northeast.

The COVID-19 pandemic launched urgencies and resignifications in the ways of being, being and acting in the world. Recommendations and decrees were issued from the perspective of health care and have been impacting daily practices, including body care and food care practices. The phenomenon of the pandemic, however, affects people in different ways, in view of the great diversity of economic, political, cultural and identity crossings present in society. In this scenario, then, black women, fat and from the periphery, combine experiences marked both by the overlapping and re-elaboration of vulnerabilities, as well as by the construction of movements of resistance and identity. Six narrative interviews were carried out with women who declared themselves to be black, fat and from the outskirts, in the city of Salvador, with the aim of understanding how black, fat and from the outskirts women experienced their corporalities and managed eating practices during the COVID-19 pandemic. 19. The material was subsequently analyzed, resulting in the final product of two articles, the first centered on experiences about corporality and the second guided by experiences about care and food during the COVID-19 pandemic. The results found transit through the intersectional look of oppressions, the imminence of death by COVID-19 as an important agent of bodily and food experiences; The dimension of fatphobia as a protagonist in the perception of one's own identity and on the particularities of female burdens during the pandemic. The conclusions of this work discuss the transversal and multidirectional presence of structural oppression in the experiences of fat black women from the periphery, as a sum of tributaries, converging in a torrential current towards exhaustion and physical and mental illness. The existence of black women, fat and from the periphery is from beginning to end, swimming against the current and living is based on developing survival strategies and confrontations. Empowerments emerge, especially in the collective spheres of activism as a relevant agent of resistance and promoter of health care.

INTRODUCTION: In patients with hematologic malignancies, impaired nutritional status has a negative impact on disease prognosis, treatment tolerance, survival, and especially quality of life. However, there are few studies that investigate the relationship between nutritional status and quality of life in adult and elderly patients with hematologic malignancies. OBJECTIVE: To investigate a possible relationship between nutritional status and quality of life in hospitalized patients with hematologic malignancies. METHOD: Cross-sectional and observational study in patients with hematologic malignancies aged ≥ 18 years, both sexes, admitted for treatment in the oncohematology wards of a University Hospital, from July 2021 to July 2022. Sociodemographic, nutritional, clinical, lifestyle and quality of life data were evaluated. Nutritional assessment was assessed using objective (anthropometry and dynamometry) and subjective (Patient-Generated Subjective Global Assessment) methods. Quality of life was assessed using the FACT-G instrument. RESULTS: A total of 100 patients were evaluated, with a mean age of 49.2 ± 16.1 years. Most were adults (70%), female (59%), with education ≤ high school (85%) and income less than two minimum wages (75%). Multiple myeloma was the most prevalent neoplasm (39%), followed by leukemia (35%) and then lymphoma (25%). A high prevalence of patients at risk of malnutrition or presence of malnutrition was found by the PG-SGA, despite having a high percentage of overweight patients evaluated by BMI. When assessing absolute handgrip strength, 25.3% of patients had reduced strength. Relative strengths by weight and BMI were also evaluated, with a mean of 0.44 and 1.14, respectively. Patients diagnosed with hematologic malignancies in general showed a negative correlation between nutritional status by PG-SGA and FACT-G scores (r= -0.45; p<0.01) and physical subdomains (r= -0.49; p<0.01 ), emotional (r= -0.29; p<0.01) and functional (r= -0.23; p<0.05). A positive correlation was observed between the HGS value and the FACT-G score (r= 0.25; p<0.05) and the physical subdomain (r= 0.29; p<0.01). Regarding relative handgrip strengths, positive correlations were found between HGS relative to weight and the physical subdomain (r= 0.25; p<0.05) and between HGS relative to BMI and the FACT-G score (r= 0.22 ; p< 0.05) and the physical subdomain (r= 0.30; p<0.01). An increase of one unit on the PG-SGA scale is significantly associated with a reduction of 0.45 points on the FACT-G scale (β = -0.45; 95%CI: -0.63; -0.27); each unit that increases in absolute HGS interferes with an increase of 0.25 points on the FACT-G scale (β = 0.25; 95%CI: 0.05; 0.45). CONCLUSION: Patients with hematological malignancies who have better nutritional status and greater muscle strength have better general, physical, emotional, social and functional quality of life scores, with emphasis on PG-SGA and handgrip strength in influencing quality of life scores. The product of this dissertation contributes to the broadening of the debate on nutritional aspects, especially with regard to handgrip strength, as an indicator of relevance for the approach to patients with hematological neoplasia, especially in the hospital environment.

Introduction: Excess adipose tissue causes metabolic disorders. Phenolic compounds, such as onion skin powder, can alleviate adipose tissue dysfunction. Objective: To investigate the effects of supplementation with onion skin powder (Allium Cepa L) on murinometric parameters and adipose tissue histomorphometry in rats submitted to a high-fat diet during pregnancy, lactation and post-weaning. In addition, to study in the literature the effects of quercetin on adipose tissue. Methodology: The study was divided into two stages. In the first one, a systematic review was carried out in the databases: Embase, Pubmed, Web of Science, Scopus and Science Direct. In the second stage, an experimental study was carried out in rats. The animals were divided into three groups: Control/Control (CC, n=8), Hyperlipidic/Hyperlipidic (HH, n=7) and Hyperlipidic/ Hyperlipidic + onion peel powder (HHOP, n=8). body weight gain, Lee index, waist circumference and caloric intake, adipose tissue weights (brown, inguinal and epididymal), adipocytes per field and adipocyte size. Statistical analysis for parametric data was used Anova One Way followed by Tuckey's test and for non-parametric data Kruskal-Wallis followed by Dunn's test. Results: The HH group showed a greater body weight gain than the CC after weaning. Lee index showed no differences between groups. There was a reduction in abdominal circumference in the HHOP group compared to the CC and HH. Calorie intake was higher in the HH group compared to the CC group. In brown adipose tissue, there was no difference between groups in tissue weight and adipocytes per field, but adipocyte size was larger in the HH and HHOP groups compared to the control. In the inguinal adipose tissue, the tissue weight of the HHOP was smaller in relation to the HH and this greater than the CC. There was a greater number of adipocytes per field in the HHOP group compared to the HH and smaller adipocytes size in the HHOP compared to the HH. In the epididymal adipose tissue, the weight of the tissue was greater in the HH compared to the CC, the number and size of adipocytes did not differ. Conclusion: The consumption of onion peel powder contributed to the reduction of white adipose tissue mass, greater control of adipocyte hypertrophy in the inguinal white adipose tissue, greater size of brown adipose tissue, in addition to contributing to the reduction of abdominal circumference in exposed rats. A high-fat diet, which may help to achieve greater homeostasis of adipose tissue. Likewise, quercetin supplementation seems to attenuate the deleterious effects of high-fat diet consumption on adipose tissue metabolism in rats.

In an attempt to address issues that the hegemonic model of care in Nutrition has not achieved, there is a movement towards the reconfiguration of nutritional care, which takes place through the use of non-prescriptive approaches by nutritionists. Such approaches are presented as an alternative capable of building comprehensive care, promoting concrete changes in the long term, self-acceptance, autonomy, and a balanced relationship with the body and food. Although studies point to the use of these practices by nutritionists, the process that leads these professionals to use such approaches in association with a nutritional prescription or even as a substitute for it is still unclear. Since professional practice is built through mediations between the professional and society, the present work proposes to understand this process from the perspective of subjectivity, by investigating the senses and meanings that mediate this use. Aiming to carry out an analysis that was not limited to description only, the starting point was the theoretical-methodological framework of socio-historical psychology. Therefore, an interface was established between the field of Food and Nutrition and the Human and Social Sciences, to denaturalize the phenomenon observed here without isolating it from reality, apprehending its subjective and social dimensions without dichotomizing them. This is a qualitative, descriptive study to be carried out with male and female nutritionists. The investigation took place in two stages: in the first, information on training, professional performance, and use of non-prescriptive approaches by nutritionists was obtained. In the second stage, participants were interviewed using a semi-structured script with questions related to the thinking, feeling, and acting of these professionals about non-prescriptive approaches. The results obtained are presented in the articles “Understanding of Nutritionists on non-prescriptive approaches in nutritional care” and “Professional Practice of Nutritionists – meanings of care based on non-prescriptive approaches”. The nutritionists' speeches evidenced the use of non-prescriptive approaches by nutritionists from different areas of activity, in an attempt to counterpoint the idea of prescription associated with hegemonic nutrition and to build a care practice that is expanded, promoting autonomy and empowerment, and that has long-lasting results. In this process, the role of education, identity, and professional practice as mediators are highlighted, articulating the search of nutritionists for an approach that corresponds to their vision of ideal care. It is also noteworthy that, although progress can be observed in recovering the human aspect in the practice of care, these professionals do not necessarily approach approaches with the necessary theoretical depth, which can lead to the reproduction of weaknesses that nutritionists have associated with prescriptive care. Thus, it cannot be said that the use of non-prescriptive approaches by nutritionists directly indicates the construction of a transforming praxis.

Introduction: During the COVID-19 pandemic, social distancing, together with the suspension of face-to-face classes with remote teaching, favored the occurrence of psychological distress among university students. In addition, symptoms of depression, anxiety, and stress have been associated with weight change during the pandemic. Objective: To evaluate the association between symptoms of depression, anxiety, and stress with the perception of weight change in university students during the COVID-19 pandemic. Methods: Cross-sectional study based on baseline data from the Online Cohort on Eating Behavior and Health (COCASa). The information was collected through an online questionnaire applied to Brazilian university students between July and August 2020. The questionnaire included demographic and socioeconomic information, isolation time, educational institution, undergraduate course, perception of weight variation, and psychological suffering. For the assessment of psychological distress, the Depression, Anxiety, and Stress Scale (DASS-21) was adopted. Descriptive analyses and Pearson's chi-square test were performed. Associations were tested using Poisson regression to estimate the Prevalence Ratio (PR). Statistical analysis was performed using the R software. Results: A total of 2875 university students participated in the study, of which 76.1% were female and 55.4% reported a perception of weight gain. After adjustment for age, gender, race/skin color, income, isolation time, symptoms of depression [moderate (PR=1.16; 95%CI 1.06; 1.26) and severe (PR=1.20; 95%CI 1.12; 2.29)]; anxiety [moderate (PR= 1.12; 95%CI 1.02; 1.22) and severe (PR= 1.18; 95%CI 1.09; 1.27)]; stress [moderate (PR= 1.13; 95%CI 1.03;1.24) and severe (PR= 1.21; 95%CI 1.12; 1.29)] were positively associated with the perception of weight loss. With regard to weight gain, a positive association was observed only for severe anxiety symptoms (PR= 1.24; 95%CI: 1.04 - 1.48). Conclusion: During the pandemic, psychological distress was associated with the perception of weight change among college students. It should be noted that these results are essential to contribute to public policy strategies that help promote mental health and body weight perception among university students.

Primary Health Care (PHC) is one of the main gateways to the health network's services and is the organizing center of services by level of care.  In PHC, the most trivial problems of the community are addressed, and health prevention, promotion and recovery services are offered. Food and Nutrition (F&N) actions have faced great challenges in recent decades when it comes to the contradictions that exist in postmodern society such as social inequalities, differences at the global and local levels. In view of this, it is necessary to look at the actions of F&N in the scope of PHC. F&N are basic conditions for the promotion and protection of health, enabling the full affirmation of the potential for human growth and development, with quality of life and citizenship, also emphasizing the active contribution to coping with the current epidemiological conditions. That said, this study aims to evaluate the supply of F&N actions in PHC based on data and information obtained in external evaluation cycles of the Program for the Improvement of Access and Quality of Primary Care (PMAQ-AB) in Brazil and regions and social and anthropometric variables. This is an ecological study with a quantitative approach. To this end, the secondary database referring to the results of the external evaluation of the PMAQ-AB of the 2nd and 3rd cycle (2012-2017) was adopted, available in the public domain. To evaluate F&N actions in PHC in the period 2014 to 2017, the instrument developed by Silva et al. (2019) was adopted, consisting of five isolated and composite indicators that include variables of interest to the field of F&N in PHC. The results are presented in two manuscripts, the first entitled Evaluation of food and nutrition actions in the SUS: An analysis of the Program for improving access and quality of primary care - PMAQ-AB, in which results are presented on the reduction of 11.4% in the number of nutrition professionals who were part of the team, in relation to the F&N actions carried out in primary care, the results reveal great inequalities in the process between the Brazilian regions, with a positive highlight for the South, Southeast and Midwest regions allowing us to conclude that studies on the supply of F&N actions are necessary to evaluate and monitor the historical context of the insertion of actions in PHC. The second manuscript, entitled Expanded Nucleus of Family Health and Primary Care and Food and Nutrition Actions: An evaluation based on the PMAQ-AB focuses on the actions linked to the NASF team and concludes that through this evaluation it was possible to identify a small cut of the offer of A&N actions carried out by the ESF and the NASF team. In the final considerations, it is argued that even though it is not specific to the A&N component, the results of the PMAQ, which was extinguished in 2018, generated some data that reveal permanent weaknesses for the organization of nutritional care in an equitable way in the country and meeting the principles of the SUS and the demands of the epidemiological challenge in the country.

In the Recôncavo of Bahia, among the traditional foods, there is Copioba flour: an artisanal product of indigenous origin, obtained in flour mills, from unfermented cassava, and with records dating back to the 16th centuries, whose notoriety is given for its crunchiness, texture and flavor characteristics. Although an essential part of regional food culture, this flour has been little valued from a social and economic perspective, especially in the rural tourist market. In addition, its processing has undergone changes, with movements that highlight the need to protect this flour and its production system. Thus, this study sought to analyze the food heritage of the Copioba flour mill production complex in Recôncavo Baiano and its production process, from the perspective of Ecogastronomy and rural tourism practices in family farming. An exploratory research was carried out, conducted in three stages: literature review, comparative study of multiple cases and ecogastronomic diagnosis study. The literature review covered the conceptual foundations, characterizations and interrelations for building the theoretical framework. The comparative study of multiple cases, in turn, addressed the production techniques and operational modifications related to the flour roasting process, considering the maintenance of the older manual method, in a clay bowl, and the more recent one, in a system electric semi-mechanized with stainless steel oven. To this end, semi-structured interviews and on-site observations were carried out in Copioba flour mills in the territory, chosen by rational selection, to survey the socioeconomic and labor characteristics, similarities and differentiations of their production systems. As for the eco-gastronomic tourist diagnostic study, the same previous traditional productions were analyzed, with semi-structured interviews with rural producers, 2 technicians from the municipal management of Nazaré, 2 specialists in Ecogastronomy and Tourism from Slow Food Brasil and 1 technician from rural technical assistance from territory. The analysis of the marketing environment of these rural establishments was carried out using the SWOT Matrix. The results demonstrated that the use of the food heritage of the flour houses of Copioba in Recôncavo Bahia, in the context of eco-gastronomic tourism and rural tourism in family farming, can be considered both viable and possible. Furthermore, its notoriety characteristics as a traditional food, its specific production systems and heritage knowledge and practices are unique. Both manual and semi-mechanized production produce traditional Copioba flour, with its distinctive characteristics of crunchiness, texture and flavor, from the farmers' perspective, with the master flour maker's know-how being the key element in safeguarding these. Regarding the eco-gastronomic tourist diagnostic study, the viability of this food heritage is satisfactory: despite the weaknesses regarding accessibility and accommodation in rural establishments, its notoriety, scenic beauty and the historical architectural heritage of this territory stand out and it is possible to carry out tourist activities in this territory. quality rural environment, even without accommodation. Therefore, the food heritage of these Copioba flour houses and their production process can be a satisfactory basis for the socioeconomic development of Recôncavo Baiano, from the perspective of Ecogastronomy and rural tourism practices in family farming.

Objective: This study aimed to understand how Integrative and Complementary Health Practices act in the production of care for people with obesity in a Specialized Ambulatory Care service, in which there are different spaces of care, with different medical rationales and therapeutic practices. Methodology: This is ethnographic research carried out between January and July 2019, carried out at the Obesity Outpatient Clinic, in the Obesity Outpatient Clinic of the Medical Residency in Endocrinology and in the Outpatient Clinic for Integrative and Complementary Practices (ICP), belonging to a service of Specialized Ambulatory Care (AAE) for people with obesity, located in the city of Salvador, Bahia. The present work was configured, primarily, in an ethnographic investigation that interfaces with the Social Sciences in Health. The perspective of Bruno Latour's Actor-Network Theory (ANT) (2012), considering the agency of actors (human and non-human) and spaces, as well as the (inter)actions between them, supported the theoretical- methodological aspect of the research by favoring the observation, description, and microanalyses of the textures of care processes. Results and Discussion: For the purposes of this thesis, the results will be presented in the form of an article and book chapters, except for Chapter 1, which describes the study locus, its structures, clinics and teams. The first article, which explores the experience of ethnography about caring for people with obesity in an SEA service, observed that at the moment when my skinny body met obese bodies, there was a (between) body, and it was this body that came into contact. scene and presents itself as a challenge of the process, given that the understanding of one's own body, and consequently of obesity, is also built in the relationship with the other. My presence, not just my body, but who I was and the insignia it carried, would affect what I observed; I would be affected by the agency of actors present in the SEA service; and my results would be outcomes of these two facts. The second article sought to understand how the different modes of collective embracement are coordinated in the production of care for people with obesity based on the experience of the ICP Outpatient Clinic and the experience of the Obesity Outpatient Clinics. It was observed that user embracement still preserves a technical and instrumental dimension aimed at user embracement of new users and providing information. However, in the IPC Outpatient Clinic, the use of other devices was also observed, such as, for example, the inclusion of veteran users in the collective reception as protagonists of the reception, thus producing a space for valuing unique experiences and the knowledge of users who can collaborate with the feeling of belonging to the space and the collective construction of user embracement. It was noted that there was production of interpersonal bonds as a therapeutic action and the appreciation of the family-user-team bond as a strengthening of the interrelationship of horizontal knowledge and of different agencies in the production of care. In the third article, it was proposed to reflect on the place of body weight in the production of care, with a view to seeking new care strategies for people with obesity, confronting experiences in the different outpatient clinics studied. The proposal to create versions and ways of providing care for people with obesity emerges from the understanding that it is not just weight that matters. In this sense, the allusion to the “middle way” seemed to be an unveiled strategy when it comes to provoking shifts in the modes of care in search of strategies that do not consider the reduction of body weight as the only way to achieve health, which does not that stigmatize bodies and that do not promote inquisitive eyes on them. Following this reflective line, the measurement of body weight by health professionals must prioritize the singularities, contextualities and intersectional markers that delineate the living beings. Complementarily, there is also a fourth article, a systematic review and meta-analysis, which was driven to scrutinize the “state of the art” of studies on ICP, obesity, and quality of life, which showed that the overall mean differences of the studies that evaluated the effect of acupuncture in the physical, social and environmental dimensions of quality of life did not identify a statistically 9 significant association. Final considerations: It is noteworthy that the redistribution of forces, by enabling veteran users to share their experiences with the ICP, present in the collective user embracement promoted by the ICP outpatient clinic, makes the act a powerful space for dialogue and for the collective construction of affections. Collective embracement is considered a powerful claim that can collaborate in facing the difficulties in dealing with the fat body and act in opposition to the prejudice and stigma of the fat body in the medical and family context. About approaches to caring for people with obesity, regardless of medical rationales and therapeutic practices, the middle path seems to be a promising perspective when it comes to provoking shifts in care modes. Finally, when trying to understand how the ICP act in the production of care, it was possible to perceive that, although in a secondary way, the ICP proved to be a power in the expansion of care practices for people with obesity, as they propose to understand and consider that subjectivities are part of reality and that, therefore, the singular experiences and the understanding of the plurality of actions of people with obesity in the world, are important in the construction of joint strategies that seek the power of the existence of the other and that, even considering body weight, it proposes to go beyond it, mobilizing the search for comprehensive health care.

Introduction: Overweight/obesity is caused by a combination of several factors including exposure to an environment that promotes weight gain, inadequate behavioral and biological responses to this exposure, and sociocultural and economic factors. Objective: To evaluate the association between dietary patterns, disordered eating behaviors, body image, food security, and overweight/obesity in adolescents. Methods: This thesis is structured in a multipaper format. This was a cross-sectional study carried out with adolescents of both sexes, aged between 11 and 17 years, and enrolled in the state public school system in the city of Salvador/BA, Brazil. A probabilistic sampling process was used, and the selection of schools was carried out using a cluster sampling procedure in two stages: schools and classrooms. The sample size was 1,215 participants. Nutritional status was determined using the body mass index. A semi-quantitative food frequency questionnaire was used to identify dietary pattern, and latent class analysis was subsequently performed. To verify the presence of bulimia behaviors, the Bulimic Investigation Test of Edinburgh and Body Shape Questionnaire were used to identify body dissatisfaction. Household food security was verified using the Brazilian Food Insecurity Scale. Multinomial logistic regression and 95% confidence intervals were used to evaluate the association between sociodemographic characteristics, food security, and dietary patterns. The association between dietary patterns and overweight/obesity was assessed using Poisson multiple regression analysis with robust variance. We also evaluated the association between disordered eating behaviors, body dissatisfaction, and overweight/obesity in adolescents according to the household food security situation. Results: Three manuscripts were developed. The first identified four dietary patterns called “Mixed,” “Low consumption,” “Prudent” and “Diverse.” The “Diverse” dietary pattern was associated with the lowest economic stratum (OR:2.02; CI:1.26 – 3.24). There was no association between food insecurity and identified dietary patterns. The results of the second manuscript indicated that the prevalence of overweight/obesity was 15.4%. The greatest adherence was to the “Low consumption” and “Prudent” dietary patterns, both in the general sample and among the overweight/obese adolescents. A positive association was found between the “Low consumption” pattern (PR:1.53; CI:1.01–2.32), when compared to the “Mixed” pattern and overweight/obesity among adolescents. The third manuscript pointed out that, in households with food security, associations were identified between negative eating attitudes (PR:1.83; CI:1.06 – 3.15), body dissatisfaction (PR:4.81; CI:3.09–7.47), and overweight/obesity. Among adolescents with household food insecurity, bulimia behaviors (PR:3.46; CI:2.24 – 5.34) and body dissatisfaction (PR:3.81; CI:2.53–5.75) were associated with a more significant occurrence of overweight/obesity. Conclusions: Understanding the relationships involved in the development of overweight/obesity and the role that food (in)security plays is fundamental to providing comprehensive health care and assisting in developing public policies for adolescents. Thus, it is expected to contribute to the promotion of healthy eating for this age group at all socioeconomic levels, especially the lowest.

Introduction: University students often experience greater uncertainty about the future and poorer mental health because of academic demands. And this can be exacerbated during the COVID-19 pandemic as the world population was exposed to various stressors and abrupt changes in lifestyle, with longer screen time, sedentarism, changes in food intake, with exacerbation of emotional eating and consumption of ultra-processed foods, which can lead to weight gain and the adoption of unhealthy weight control behaviors (UWCB). Objective: To identify the prevalence and factors associated with UWCB in university students during the first wave of the COVID-19 pandemic. Methods: This is a cross-sectional study performed using baseline data from the Online Cohort on Eating Behavior and Health (COCASa). The information used was collected between July and August 2020, through an online questionnaire self-administered by Brazilian university students. The questionnaire includes data on weight, height, sex, age, race, area of knowledge, frequency of breakfast, the search of diet content on social media, weight concern, weight perception, COVID-19 concern. The Depression, Anxiety and Stress Scale (DASS-21) was also applied. Additionally, students indicated the frequency of UWCB using the scale adapted from Hay, 1998, which accesses the adoption of food restriction/fasting, purging, and a question on excessive exercise was added. Statistical analysis was performed using the R software, version 4.1.0, and included frequency analysis, Cramer's V test to analyze the effect size between the independent variables, followed by bivariate logistic regression to select the variables with p<0.2 to compose the final model, which was
tested by generalized logistic regression. Furthermore, the final model estimated by the prevalence ratio and 95% confidence interval was defined by the permanence of the variables with a value of p<0.05 and the best fit of the model by the lowest value of the Akaike Information Criterion (AIC). Results: The effect size between variables indicates a very strong relationship between nutritional status, weight concern and weight perception, between symptoms of depression, anxiety, and stress, and between UWCB, search of diet content on social media, weight concern, and weight perception. It was found a prevalence of 32,7% (n=848) for UWCB, with 24,1% for restriction/fasting, 17,0% for excessive exercise and 5.4% for purging. Search for diet content on social media and concern about weight gain were positively associated with all outcomes. Furthermore, severe symptoms of depression, self-perceived overweight, and skipping breakfast increased the prevalence of restriction/fasting. Intermediate income and greater concern about COVID-19 were negatively associated, and
severe anxiety symptoms positively with excessive exercise. Positive associations were also observed between severe anxiety symptoms, skipping breakfast, and purging. Conclusion: This study showed that during the first wave of COVID-19 there was a high prevalence of UWCB among Brazilian university students. In addition, social media use, weight concerns, poorer mental health, behavioral factors, and intermediate income were positively or negatively associated with one or more UWCB in college students. It signals the need to develop health
measures aimed at promoting healthy habits on eating behavior and weight control.

The risk of malnutrition in patients with the new coronavirus disease has been associated with worse outcomes, including mortality. Impaired nutritional status can impair the effectiveness of treatments, which may be related to increased morbidity and mortality. The aim of the study is to evaluate the association between the risk of malnutrition and the clinical evolution of hospitalized patients with COVID-19. Methods: This is a multicentric cohort, carried out in the Northeast of Brazil. Sociodemographic, clinical, and nutritional data were collected on hospitalized patients diagnosed with COVID-19. The risk of malnutrition will be assessed using the Malnutrition Universal Screening Tool (MUST). Clinical outcomes included admission to the intensive care unit or medical clinic, type of ventilation (spontaneous ventilation or mechanical ventilation), discharge and death. Results: 459 patients were included, most of them adults (64.5%), male. According to the MUST tool, 84.5% of patients were at moderate or high nutritional risk, such patients had a higher prevalence of involuntary weight loss and loss of appetite, compared to the group of patients with low risk of malnutrition (47.2 % vs 14.1%) and (71.9% vs 1.4%), (p<0.05), respectively. In addition, the presence of high nutritional risk was associated with worse clinical outcomes, such as admission to the intensive care unit, use of mechanical ventilation and mortality (49.7% vs 0.0%), (39.7% vs. 0.0%) and (25.5% vs 4.2%), (p<0.05), respectively. Conclusion: The nutritional status of patients with COVID-19 is closely related to clinical outcomes. The use of nutritional screening tools is the first step in the nutritional care of hospitalized patients, which can lead to better results, especially in patients at high nutritional risk

Introduction: Recent studies suggest that consumption of diets high in fat promotes metabolic changes, and these impacts also affect the bone structure, however little is said about the relationship from consumption in the gestation and lactation phases. Objective: To evaluate the effects of high-fat diet consumption during pregnancy, lactation and post-weaning periods on the bone structure of adult rats. Methodology: The study was divided into two stages. In the first, a systematic literature review was developed by searching the PubMed/Medline, Embase, Scopus and Web of Science databases. The inclusion criteria of the review were: use of hyperlipidic diets, adult Wistar rats, and bone structure analysis. In the second stage of the study, an experimental study was conducted in rats. The animals were divided into four subgroups: Control/Control (CC, n=6) – the mother consumed a control diet and the offspring maintained consumption after weaning; Control/Hyperlipid (CH, n=5) – the mother consumed the control diet and the offspring consumed the hyperlipidic diet after weaning; High Fat/Control (HC, n=9) – the mother consumed the high fat diet and the offspring the control after weaning; Hyperlipidic/Hyperlipidic (HH, n=8) – the mother consumed the high-fat diet and the offspring maintained consumption after weaning. Upon completing 90 days of life, the animals were euthanized and desiccated for organ collection. The weight and length of the animals were analyzed, and later the Lee index was calculated. The amount of retroperitoneal adipose tissue and the dimensions of the femur (weight, distance between the epiphyses, distance between the trochanters and width of the midpoint of the diaphysis) and of the 4th lumbar vertebra (weight and length) were analyzed. Statistical analysis was performed using the GraphPadPrism 5.0 program, and the Kolmogorov-Smirnov normality test was used. For the parametric data, ANOVA one way, followed by Tukey or Bonferroni was used. For non-parametric data, the Mann-Whitney U test was used, followed by Kruskal-Wallis or Dunns. The study was approved by the Ethics Committee on Animal Experimentation of the Faculty of Veterinary Medicine and Animal Science at UFBA under protocol 04/2019. Results: The Lee index showed no statistical difference in the mean values between the groups. The amount of absolute and relative retroperitoneal adipose tissue was statistically higher in the HH and CH groups compared to the CC group. Femur weight was statistically lower in the HH and CH groups when compared to the CC group. The 4th lumbar vertebra had a statistically lower weight in the HH group compared to the CC group. The distance between the epiphyses and the width of the midpoint of the diaphysis were statistically smaller in the HH and CH groups compared to the CC group. The distance between the trochanters was statistically smaller in the HH group when compared to the CC group. The length of the 4th lumbar vertebra showed no statistical difference between the groups. Conclusion: The results of this study suggest that the high-fat diet when consumed during pregnancy, lactation and postweaning can harm the bone structure of offspring

New therapeutic approaches emerge aiming not only at obesity management, but also, and
fundamentally, at the expansion of integral care to people with obesity, such as Integrative
and Complementary Health Practices (IPCPs). This dissertation aimed to understand how
Integrative and Complementary Practices produce senses and meanings attributed to the body
and health in people with obesity in the context of the Health Care Network. This study used a
qualitative exploratory-descriptive methodology and was developed in the PICS Outpatient
Clinic of a State Reference Unit of SUS. The empirical universe of the research was made up
of males and females, aged between 18 and 60 years, with a medical diagnosis of obesity,
referred to the practices offered at the unit: Podal Reflexology, Reiki, Chromotherapy,
Auriculotherapy and Meditation. The research, carried out from January to August 2020, used
semi-structured interviews and participant observation as data production techniques, and
field diary writing as a data recording technique. Comprehensive analysis was used as the
mechanism for data analysis and interpretation. The design process of this study resulted in
the construction of two articles. The first article sought to understand the effects produced by
the use of Integrative and Complementary Practices in the care of people with obesity treated
at a state referral center of the Brazilian Unified Health System, from the users' narrative. As a
result of the results of the first article, the second article referred to an integrative review,
which aimed to assess the state of the art on the possible associations between anxiety
symptoms and obesity in adults, from the literature relevant to the topic. Through the analysis
of the interviews it was possible to understand that “feeling well” appears as an articulating
element of a reorganization of the subject's life, of caring for oneself and for the other. It was
possible to observe that the organic presence of the PICS assumes a hybrid and dynamic place
in the flow of care, although a perspective that still links the PICS to obesity through the
control of anxiety, the body, and food stood out. With the integrative review, it was possible 

to observe that, in general, the evidence for the association between anxiety symptoms and
obesity in adults is not conclusive, although the justifications for the findings and the
discussions presented direct towards a confirmation of the association between obesity and
anxiety symptoms, understanding that the latter is mitigated when there is a reduction in body
weight. In this sense, it is essential that further studies be developed aiming not only to
understand the possible associations between anxiety symptoms and obesity, as well as in
other health conditions, but especially to understand the processes involved when there is
coexistence of these. Given the above, it is important to develop new research with theoretical
and methodological contributions similar to those used in this study, so they can contribute to
strengthening health systems that consider not only the various dimensions related to the
phenomenon of obesity, but also the therapeutic strategies to be used in the process of selfcare
and health. It is hoped, then, that the design and reading of this study, and of the
bibliographic productions arising from it, may broaden the debate about obesity, considering
the complex, plural and multidimensional perspective of this phenomenon.

The Coronavirus 2 pandemic in Brazil spread quickly across the country, changing the routine of the population, and causing thousands of deaths. To contain and combat this pandemic, many health professionals began to perform some activities remotely, leading to incomplete or deficient assessments, such as nutritional diagnosis at hospital admission. This study aimed to describe nutritional care, clinical and nutritional characteristic of patients with COVID-19 admitted to intensive care units (ICU), as well as to verify whether there is an association between visually diagnosed obesity and the outcome of these patients. Retrospective cohort study with critically ill patients with COVID-19 who received nutritional therapy for at least 48 hours. The exposure variable was the nutritional diagnosis obtained by visual examination at the time of admission to the ICU and the main outcome was the patient's evolution (discharge or death). Descriptive statistics were performed and Pearson Qui-square, Mann-Whitney and Student's t tests were used to compare the groups. P values <0.05 were considered significant. We studied 643 patients with a mean (standard deviation) of 63 (16) years, 58.2% of whom were male. The most frequent complaints were respiratory difficulty (79.8%) and fever (48.7%) and comorbidities, arterial hypertension (61.1%) and diabetes mellitus (41.4%). Only 300 (46.7%) of these patients had nutritional diagnosis and 145 (48.3%) had a diagnosis of obesity. When compared according to the presence or absence of obesity, it was found that the former was younger [59 (16) x 62 (17) years; p=0.046], had a shorter median length of stay [11 (6 – 18) x 13 (8 – 23) days; p=0.025], but the same percentage of death (89.0% x 87.7%; p=0.741). In conclusion, more than half of the patients did not have a nutritional diagnosis on admission and the obese patients died earlier.

Introduction: The infectious disease coronavirus-19 (COVID-19) has a broad clinical spectrum, ranging from asymptomatic infection to severe clinical conditions. Among the risk factors for COVID-19 associated with a worse prognosis are advanced age, obesity, presence of comorbidities, as well as factors related to lifestyle and diet. Objective:To assess the influence of dietary patterns and lifestyle prior to SARS-CoV-2 infection on the clinical outcomes of the disease in adults and the elderly. Method: a cross-sectional study was carried out and additionally a dynamic and multicentric cohort study in northeastern Brazil. Male and female, adult, and elderly, with a positive laboratory result for COVID-19 were included. Data were collected by telephone call. To characterize the sample, measures of central tendency and dispersion were calculated for continuous variables and the frequencies for categorical variables were verified. To assess differences between outcomes, the Chi-square test or Fisher's exact test were used. A Factor Analysis (FA) was carried out by principal components, with the aim of identifying food consumption patterns. To evaluate the association between the variables of interest, logistic regression and bivariate Poisson regression analyzes were performed. These variables, together with those that showed potential for confounding, were included in the model as adjustment covariates. Results: The research sample with data from the state of Bahia was 125 individuals. The mean age was 44.8 years (SD: 17.62). Three patterns that explained 53.76% of the variability in food consumption were extracted. Considering the distribution of food groups, the patterns were labeled and characterized as follows: Pattern 1 as Western Pattern, Pattern 2 as Healthy Pattern and Pattern 3 as Regional Pattern. After adjustments for potentially confounding variables in the final model, only alcoholism remained associated with a reduction in the probability of the hospitalization outcome (OR: 0.216, 95% CI: 0.770-0.609). When assessing the relationship between dietary patterns and hospitalization, ICU stay and death from COVID-19, 347 individuals were included, with a mean age of 43.19 years (SD: 16.50). Of these, 68% were hospitalized, 34% required ICU admission and 20.7% died. A total of four dietary patterns were extracted and explained 54.01% of the sample's dietary intake variability. After adjusting for potentially confounding variables, lower adherence to fiber source pattern was associated with ICU stay (PR: 1.097, 95% CI: 1.006-1.197). Conclusion: Practice of physical activity was not associated with hospitalization for COVID-19, while drinking alcohol was negatively associated in the state of Bahia, Brazil. Lower adherence to a healthy dietary pattern, consisting of vegetables, slightly increased the prevalence of ICU admission due to COVID-19 in a study in Northeast Brazil. Such findings reinforce the importance of understanding the risk factors related to the worst prognosis in individuals affected by COVID-19, especially the modifiable risk factors, in order to favor the identification of vulnerable populations and the development of related public policies.

Introduction: The acute phase of critical illness is characterized by intense protein catabolism and consequent loss of muscle mass, which is associated with worse clinical outcomes. Minimizing protein catabolism in the acute critical illness phase is the challenge of nutritional therapy. However, the ideal protein offer, as well as the best moment for this therapy to provide a better clinical response to patients, is still controversial. Objective: To evaluate the association between protein intake in the acute phase of critical illness and morbidity and mortality in intensive care patients. Method: This is a retrospective cohort study of patients admitted to a medical-surgical Intensive Care Unit (ICU), aged over 18 years, of both sexes, from January 2018 to June 2020. Demographic data were collected , clinical and nutritional supply until the seventh day of hospitalization, using the electronic medical records and nutritional monitoring software used in the Hospital. A protein target of 1.2g/KgWeight and a caloric target of 20-25Kcal/KgWeight were considered adequate. Six-month mortality data were collected from the Bahia Court of Justice website. Descriptive analysis of the variables was performed using measures of central tendency, frequency and prevalence and compared using the t-Studet, Mann Whitney and Pearson Chi Square tests. The association between protein intake and six-month ICU and hospital mortality was assessed by Cox multivariate regression, and the association between protein intake and length of stay in the ICU and hospital by negative binomial regression. Results: Of the 197 patients included in the study, 52.8% (n=104) died within 6 months. Patients who died had higher APACHE and SOFA scores (17 versus 15, p=0.028 and 6 versus 4, p=0.004, respectively), developed more sepsis during the ICU stay (81.7% versus 40 .9%, p < 0.001) and remained hospitalized longer (41 days versus 30.5 days, p=0.004) than survivors. Patients who died also had a higher frequency of nutritional risk (51.9% versus 34.4%, p=0.013). The 1g/KgWeight increase in mean protein intake on the seventh day reduced 6-month mortality by 65.0% (HR: 0.346, 95% CI: 0.133-0.903), ICU mortality by 64.4% (HR: 0.356 , 95% CI: 0.142-0.895) and 61.9% in-hospital mortality (HR: 0.381, 95% CI: 0.164-0.883). Considering nutritional risk, the reduction in mortality was even greater and only among patients at high nutritional risk: 81.5% 6-month mortality (HR: 0.185, 95% CI: 0.046-0.732), 78.5% ICU mortality (HR: 0.215, 95% CI: 0.061-0.75) and 82.7% hospital mortality (HR: 0.173, 95% CI: 0.051-0.587). For the length of stay in the ICU, the increase of 1g/KgWeight in mean protein intake on days 3 and 7 reduced by 32.0% (RR: 0.680, 95% CI: 0.498-0.928) and 28.4% (RR: 0.716, CI 95%: 0.533-0.961) respectively, the length of stay in the ICU. For patients at high nutritional risk, the reduction in ICU length of stay was 41.0% (RR: 0.590, 95% CI: 0.374-0.928) and 34.5% (RR: 0.655, 95% CI: 0.450- 0.954) respectively. Conclusion: Increasing mean protein intake on day 7 reduced 6-month mortality, ICU and hospital mortality, and length of ICU stay in critically ill patients. These results were even more evident in patients at high nutritional risk. Such findings reveal the importance of optimizing protein supply for patients with critical illness, particularly for patients at high nutritional risk, emphasizing the importance of nutritional screening for taking a more assertive nutritional approach.

The analysis of the exposure to occupational risks of food handlers in School Food Services (SFS), managed by the School Food Program (PNAE), is essential for elaborating public policies for health promotion. Thus, the objective of this study was to analyze factors associated with exposure to occupational risks in SFS in a county in the state of Bahia. This cross-sectional, exploratory study consisted of nine stages: 1. elaboration of instruments following the literature review and regulatory standards of the Ministry of Labor; 2. evaluation of the instruments by the specialists using the Delphi Technique; 3. a semantic analysis by focus group composed of food handlers; 4. evaluation of SFS good practices using a checklist of good practices in school feeding (GPSFS); 5. identification of SFS's physical areas; 6. identification of sociodemographic and work characteristics, attitudes, and level of knowledge in food hygiene of food handlers; 7. food handlers’ perception of exposure to occupational risk; 8. anthropometric assessment and presence of comorbidities in food handlers; 9. exposure of food handlers to occupational hazards and environmental comfort measures at SFS. The analysis of variance, Student's T-Test, and Pearson's Chi-square were used for statistical analysis. The tests were performed using the Statistical Package for Science - SPSS version 26.0®. Four instruments were developed with the participation of experts (CVC ≥0.80), and of these, two were submitted to semantic analysis in a focus group, obtaining 80% agreement for each item. 159 SFS and 142 food handlers participated in the study. The classification of the sanitary situation of the SFS was of Regular Health Risk in 74.8% (n=119) and 25.2% (n=40) in High Health Risk. At least 98% of the SFS did not have areas for receiving food, pre-preparing meat, and storing waste. Most handlers were female (98.6%). Regarding attitudes, 1.4% (n=2) of the food handlers were classified as Unsatisfactory, 8.5% (n=12) Satisfactory with Restriction and 90.1% (n=128) Satisfactory. The knowledge level of 6.3% (n=9) of the food handlers was Unsatisfactory, 27.5% (n=39) Satisfactory with Restriction and 66.2% (n=94) Satisfactory. Regarding the Perception of Exposure to Occupational Risk: 0.7% (n=1) had a Very Low Perception (0 to 1.5); 20.4% (n=29) had Low Perception (1.51 to 2.5); 41.5% (59) had Fair Perception (2.51 to 3.5) and 37.3% (n=53) had Good Perception (3.51 to 4.5). There was a statistically significant association between the Perceived Occupational Risk Exposure score with work characteristics: type of employment contract (0.004) and time working in school meals (p=0.029). Also, there was a statistically significant association with comorbidities/symptoms: musculoskeletal problems (0.001), presence of edema (p<0.001) and headaches (p<0.001). The anthropometric assessment identified an average of 30.2 kg/m2 for BMI. Regarding the classification of SFS to occupational risks, 22.6% (36) presented High Occupational Risk, 76.1% (122) Very High Occupational Risk, and 1.3% (2) Regular Occupational Risk. In order to fulfill the objective of the SFS and to prevent exposure to occupational risk, it is necessary to adapt the physical structure for the adoption of good manufacturing practices, distribution of Personal Protective Equipment (PPE), training on food hygiene, and exposure to occupational risks with the use of active methodologies.

Introduction: Neonatal outcomes vary depending on the time of delivery, and adverse birth consequences can be seen in the short and long term among preterm (PTB) and early-term births. PTB a complex syndrome resulting from factors that, including sociodemographic, psychosocial, nutritional, behavioral, and biological factors. However, a previous PTB is considered the most important predictor for a subsequent PTB. Studies have shown that risk factors for early-term birth are similar to those for PTB, with emphasis on cesarean section (CS). Although several studies have examined the risk factors associated with recurrent PN, few studies assess, at the same time, the factors associated with incident and recurrent PN. Studies evaluating the association between CS and early-term birth are also limited, especially in low- and middle-income countries. General objective: To assess the factors associated with incident and recurrent PTB and early-term birth among live births in Brazil. Specific objectives: 1) Develop a hierarchical theoretical model of PTB determinants; 2) Estimate the associations between the previous PTB and the recurrence of the PTB; 2) Investigate the recurrence of preterm birth in the CIDACS birth cohort; 3) Explore risk factors for preterm birth according to the gestational age of the previous birth (term or preterm); 4) Investigate the association between CS and early-term birth according to the Robson Classification. Methods: The thesis was presented in four articles according to each specific objective. To carry out the first article, a hierarchical theoretical model of the PTB determinants was proposed, which describes the interrelationships between the variables in each level of its determination (distal, intermediate, and proximal). The second and third articles were developed with data from the Center for Data and Knowledge Integration for Health (CIDACS) Birth Cohort, based on the theoretical model developed on the previous objective. This cohort was created by linking data from the National System of Live Births in Brazil (SINASC) and the 100 Million Brazilians Cohort baseline for the period from January 1, 2001, to December 31, 2015. In article 2, PTB was defined as birth with less than 37 weeks of gestation. Multivariate logistic regression was used to estimate the association between PTB in the first pregnancy and the subsequent PTB. In article 3, incident PTB was defined as a live birth with a gestational age less than 37 weeks and preceded by a previous full-term birth; and recurrent PTB was defined as live birth with a gestational age less than 37 weeks preceded by a previous PTB. Longitudinal transition model with logistic regression was used to investigate the factors associated with incident and recurrent PTB. For the development of the 4th article, a population-based cross-sectional study was conducted with routine data from SINASC, from 2012 to 2019. Women of reproductive age were classified into one of the ten Robson groups based on characteristics of pregnancy and delivery. Propensity scores were used to match women who had cesarean sections with women who had vaginal deliveries (1: 1). Logistic regression was used to assess the association between cesarean section and early-term. Results: In the second article, 3,528,050 live births were evaluated. The adjusted odds for the recurrence of a PTB was 2.58 (95% confidence interval [CI] 2.53–2.62). Lower gestational ages in a previous pregnancy increased the odds of a subsequent PTB (<28 weeks: adjusted OR [aOR] 3.61, 95% CI 3.41–3.83; 28–31 weeks: aOR 3.34, 95% CI 3.19–3.49; and 32–36 weeks: aOR 2.42, 95% CI 2.38–2.47). Women who had two previous PTBs were at high risk of having a third (aOR 4.98, 95% CI 4.70–5.27). Recurrence of PTB was more likely when the interbirth interval was less than 12 months. In the second article, different risk factors for incident and recurrent PTB were identified. The following factors were associated with an increased chance for PTB incidence, but not recurrence: household overcrowding (aOR 1.09; 95% CI 1,07-1,10), maternal race/ethnicity [(black/mixed: aOR 1.04; 95% CI 1.03-1.06) and (indigenous: aOR 1.34; 95% CI 1.24-1.44)], young maternal age (14–19 years: aOR 1.16; 95% CI 1.14-1.18), and cesarean delivery (aOR 1.09; 95% CI 1.08-1.11).  The following factors were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85; 95% CI 0.84-0.86  vs 0.90; 95% CI 0.87-0.93), reduced number of prenatal visits [(No visit: aOR 2.56; 95% CI 2.47-2.66  vs aOR 2.16; 95% CI 1.98-2.36) and (1–3 visits: aOR 2.44; 95% CI 2.40-2.49 vs OR 2.24; 95% CI 2.14-2.33)], short interbirth intervals [(12–23 months: aOR 1.04; 95% CI 1.02-1.06  vs aOR 1.22; 95% CI 1.17-1.26), and (<12 months: aOR 1.89; 95% CI 1.80-1.98 vs aOR 2.58; 95% CI 2.38-2.79)], and advanced maternal age (35–49 years: aOR 1.42; 95% CI 1.38-1.47  vs aOR 1.45; 95% CI 1.33-1.58). For most risk factors, the point estimates were higher for PTB incidence than recurrence.  In the fourth article, 17,081,685 live births were included. Births by CS had higher odds of early-term birth (aOR 1.32; 95% CI 1.32-1.32) compared with vaginal deliveries. Births by CS to women in groups with low clinical need and expected rate of CS showed the highest odds of early term compared with vaginal deliveries: group 2 (aOR 1.50; 95% CI 1.49–1.51) and group 4 (aOR 1.57; 95% CI 1.56-1.58). Increased odds of early-term births were also observed among births of women in group 3 (aOR 1.30; 95% CI 1.29–1.31). Also, births from women with a previous CS (Group 5: aOR 1.36; 95% CI 1.35–1.37), single breech pregnancy [(Group 6: aOR 1.16; 95% CI 1.11-1.21) and (Group 7: aOR 1.19; 95% CI 1.16-1.23)], and multiple pregnancies (Group 8: aOR 1.46, 95% CI 1.40–1.52) had high odds of an early-term birth. Conclusion: These articles present important information regarding the factors associated with incident and recurrent preterm birth and early-term birth in Brazil. The results can contribute to the development of intervention strategies and implementation of public policies aimed at reducing PTB in a subsequent pregnancy and reducing the excessive number of clinically unnecessary cesarean sections which will allow the reduction in the number of early-term births.

The objective of this work was to develop and characterize ice cream cone using cowpea flour (Vigna unguiculata (l.) walp), rice flour (Oryza sativa) and crude palm oil (Elaeis guineensis), in order to obtain a product with high nutritional value, able to contribute reasonably with daily vitamin A intake and recommended iron and meet the demand for gluten-free products. To this end, the methodology adopted consisted of an experimental study of a quantitative and qualitative nature, through which different formulations were obtained through a Design of experiments (DOE) 2³ statistically designed using Response Surface Methodology (RSM) to optimize the formulation. Adopted as independent variables the rice flour (RF; 15-20g), Cowpea flour (BF; 15-20g) and water (WT; 10-15g). BRS Guariba cowpea flour (CF) was prepared to produce the product. The following were determined in the ice cream cone formulations (ICC): centesimal composition (%), total carotenoids (μg / g); color (CIELab), minerals (Ca, Fe and Zn (mg. 100g ^-1)), fractions of phytic acid (InsP3, InsP4, InsP5, InsP6; (µmol g^-1), condensed tannins (mg eq. CE / g), polyphenols (mg / g), instrumental texture (N) and sensory analysis. The characterization of crude palm oil (CPO) applied in the preparation of the product was carried out in terms of color (CIELab), free fatty acid (FFA%), peroxide index (meq O2 / kg) and total carotenoids (μg / g). For the selection of the formulation applied in the sensory analysis with the optimized values of the investigated parameters, the desirability profile function was used. Choosing the formulation 20 g of CF and rice flour, and 15 g of water for the sensory analysis. The developed ICC consisted of 6.4-10 % moisture, 1.2-1.5 % for ashes, 10.1-11.9 % protein, 65.2–70.0 % carbohydrates, 2.3-5.9 % neutral dietary fiber, 4.1-4.6 % acid dietary fiber, 2.5-3.7 % lipids. The energy content to 335.2-350.9 kcal and Aw to 0.308-0.475. The ICC showed a bronze-orange color resulting from the presence of carotenoids (4.9-9.3 mg/g W) from the crude palm oil used. Texture and sensory analysis of the ice cream cones revealed a crispy and hard nature. The formulation applied in the sensory analysis showed excellent acceptability - acceptabilities (≥4). Evaluation of the factorial design demonstrates that CF concentration was significant for polyphenols, tannins, IP₆ and IP₅ (+14.89 ± 0.00; 21.22 ± 0.0; +7.88 ± 0.02 and (+7.22 ± 0.01, p<0.00), respectively. Similar to the IP₆, IP₅ and IP₄ also increased with increasing percentages of RF in the formulations (+10.71 ± 0.02, +5.38 ± 0.01; +5.89 ± 0.01, p <0.03, respectively).  Fe and Ca bioavailability might be negatively affected. The  20 g portion of this formulation according to the daily dietary reference intake (DRIs) for minerals (boy and girl) represent represents 0.29%; 2.78%; and 5.33 to 3.33% for calcium, zinc and iron.  The results were presented in the form of articles titled ARTICLE 1: Development of a gluten-free ice cream cone alternative using cowpea flour (Vigna unguiculata (l.) walp), rice flour (Oryza sativa) and crude palm oil (Elaeis guineensis). ARTICLE 2: Minerals and nutritional factors of ice cream cones made with a mixture of cowpea and rice flours. Thus it is concluded that the developed gluten-free ICCs present an excellent alternative to wheat-based ones, indicating a clear potential for alternative production for the demand for gluten-free products.

INTRODUCTION: Sarcopenia is a muscle disease characterized by decreased strength, muscle mass and potency and is related to health complications. Elderly people are institutionalized when compared to the elderly in the community, and generally presenting worse health conditions, increased risk for falls, malnutrition, weight loss, recurrent hospitalizations, and have a higher prevalence of sarcopenia compared to the elderly in the community. This study aims to identify the prevalence of sarcopenia according to EWGSOP2 and associated factors in elderly residents in Long-Term Care Facilities. METHODS: This is a cross-sectional study with 58 60-year-old seniors or older of both sexes living in three Long-Term Care Facilities, located in two Brazilian cities. The diagnosis of sarcopenia was based on the criteria proposed by the Revised European Working Group on Sarcopenia in Older People, with the evaluation of strength by hand grip test, muscle mass by calf circumference and muscle performance by gait speed. The factors evaluated in relation to sarcopenia were sociodemographic, clinical and anthropometric data. RESULTS: The prevalence of sarcopenia was 29.3%, increasing with age in both sexes and more markedly in males (p=0.02). There was a moderate negative correlation between age and calf circumference (p<0.01; r= -0.42), indicating that the higher the age the lower the calf circumference and a moderate positive correlation between calf circumference and BMI (p<0.01; r=0.51), showing that the higher the BMI the higher the calf circumference. Dependent elderly had 2.38 more chances of presenting sarcopenia in relation to independent elderly (95%CI=1.07 - 5.30). CONCLUSION: The prevalence of sarcopenia was high among institutionalized elderly people in all age and sex groups. Elderly people with dependence according to functional capacity had a higher chance of presenting sarcopenia when compared to independent elderly people. Sarcopenia can be diagnosed with low cost and easy reproducibility techniques, facilitating the investigation and diagnosis of sarcopenia in Long-Term Care Facilities.

Brazil was the first country to investigate the relationship between congenital Zika virus (ZIKV) infection and microcephaly. The potential risk of ZIKV infection during pregnancy to cause microcephaly is poorly understood. Genetic predisposition and environmental factors are possible cofactors that can increase susceptibility to ZIKV infection and lead to phenotypic changes in the brain. Several factors have been proposed to influence the fetal outcome during maternal ZIKV infection; however, the effect of maternal anthropometric nutritional status has not been investigated. Maternal anthropometric nutritional status, estimated by pre-gestational maternal body mass index (BMI) and gestational weight gain, has been widely studied as a predictor of adverse pregnancy outcomes, including spontaneous abortion, premature birth, low birth weight and congenital anomalies. Objective: To investigate possible associations between maternal anthropometric nutritional status before and during pregnancy and the occurrence of microcephaly due to ZIKV infection. Methodology: This is a cross-sectional study, with a sample consisting of 121 mothers with exposure to ZIKV during pregnancy confirmed by the Neutralization Test by Plaque Reduction (PRNT). The mothers were divided into two groups: with and without microcephaly in newborns. Results: Most women with microcephalic children (n = 35) were young <30 years of age (82.4%), black (93.9%), with unsatisfactory self-reported family income (70%), primiparous (57.1%), with cesarean delivery (55.9%) and inadequate weight gain (60%). Family income was associated with microcephaly (p = 0.035). And mothers with low weight at the beginning of pregnancy were more likely to have children with microcephaly (adjusted OR = 11.72; 95% CI: 1.15 - 119.11). Conclusion: Maternal anthropometric nutritional status may have an influence on the occurrence of microcephaly due to congenital ZIKV infection. Low pre-pregnancy weight was associated with cases of microcephaly. And a higher prevalence of microcephaly found among mothers with insufficient weight gain during pregnancy.

The prevalence of prematurity is increasing worldwide. Premature birth exposes the mother-child binomial to a series of potentially fatal complications, including low birth weight. This investigation is a retrospective cohort study of secondary database that evaluated the influence of birth weight on the growth of preterm children in the first year of life and involved 130 pairs of mothers and children born with GA < 37 weeks, accompanied at the Early Stimulation Clinic. The study protocol was developed according to STROBE guidelines. Exposure variables were birth weight < 2500 grams and Small for Gestational Age. The sample calculation considered a power of 80% and a significance level of 5%, with two-tailed tests. Anthropometric measurements (weight, length, head circumference) from birth to 64 weeks were entered into the INTERGROWTH-21st software and measures at nine and twelve months were entered into AnthroR to determine the Z-score values of the weight-for-age indicators (P /I), height for age (A/A) and head circumference for age (HC/A), for the construction of growth curves and definition of the anthropometric diagnosis. Data were entered using the Epidata Software and the analysis was performed using the statistical package STATA for Mac, version 16.0. To describe the sample, prevalences and frequencies were calculated, for categorical data, and mean for continuous data, and to assess the influence of birth weight on the growth of premature children, the Generalized Estimating Equation modeling was performed. Potential confounding variables were those that were associated with both exposure and outcome, expressed as a variation of 10% or more in the measure of association, compared to the measure of the reduced model. In the final model, the variables that presented significance lower than 5% remained. Statistical analyzes showed that children born weighing < 2500 grams or small for gestational age have a growth in weight and height and head circumference in the first year of life, which is lower than children born weighing ≥ 2500 grams and adequate for gestational age . This difference in growth can be observed considering the indicators P/I, A/I, PC/I. 

Food security has been studied under a multidimensional approach, which reflects the complexity of this concept, considering different realities. However, there are only a few that, when noted that the Black population and women are more susceptible to food insecurity, take into consideration the influence of systemic determinants such as racism and sexism. One of the ways to progress in this direction is to use the intersectionality approach in the analysis of food insecurity in a way to better understand the reality faced by these groups. The aim of this research isto analyse food (in)security in the household, from the perspective of race and gender intersectionalities, in the city of Salvador, Bahia, Brazil. This is an analysis using the data from a cross-sectional and population-based study entitled Qualidade do Ambiente Urbano de Salvador, carried out between 2018 and 2020. The sample was defined using systematic random sampling without return of households in 160 neighbourhoods, based on the information available on Salvador’s system of basic sanitation, which covers 98% of the capital and contains a georeferenced registry of active and inactive water connection. For the present analysis, 14,713 households were considered. The outcome was food (in)security situation, classified as mild and moderate or severe, collected from the Brazilian Food Insecurity Scale, which was applied along the larger survey questionnaire that contained 62 questions. The main exposure was the crossing of race and sex variables: white man, white woman, black man and black woman. Multinomial logistic regression models were used to estimate the association between main exposure and outcome, adjusted for socioeconomic variables and stratified according to education and per capita family income. In most households black women (50.1%) were the main or even solo breadwinners for their families. In second place, black men (35.4%), then white women (8.3%) and lastly white men (6.2%). The prevalence of food security was higher in households headed by a white man (74.5%), followed by a white woman (69.5%), a black man (62.2%) and a black woman (53.2%). Households headed by black women had higher chances of mild food insecurity (OR=1.39; 95%CI 1.15-1.68; p=0.001) and moderate or severe (OR= 1.94; 95%CI1.49- 2.52; p<0.001) in comparison to households headed by white men. These households were more likely to have moderate or severe food insecurity at all levels of education and in the ranges up to ½ minimum wage and >1 minimum wage. When the main breadwinner was a black man, the highest chances for this condition were in the households with earnings around the range of > 1 minimum wage. Households held by a black woman were the ones with the highest chances of being food insecure, even in socioeconomically favourable conditions. Due to social disadvantages and discriminatory practices experienced by the Black population, the progress related to education and income issues are not universal. The situation of black women is even more concerning and food insecurity in the households headed by this group reveals itself as one of the consequences of the structural interaction of racism and sexism.

Breast cancer is the most common cancer in women. The associated presence of dynapenia, sarcopenia and obesity increases the possibility of adverse effects that can affect the tolerability of the treatment and possibly the quality of life. Aims: to assess whether there is an association between dynapenia, sarcopenia and sociodemographic, clinical and quality of life characteristics in hospitalized women with excess weight and breast cancer. Method: This is a cross-sectional study, carried out at a Philanthropic Reference Hospital in the city of Salvador. Socioeconomic and demographic data were evaluated; clinicians; Lifestyle; nutritional data; assessment of physical performance and quality of life. The assessment of dynapenia was performed using absolute and relative handgrip strength. For the diagnosis of sarcopenia, the assessment of dynapenia, muscle mass reserve and physical performance was used. Quality of life was assessed using the Functional Assessment of Cancer Therapy - Breast (FACT-B) instrument. Results: 97 women participated in the study with a mean age of 52.2 years (SD=11.2), 55% had a diagnosis of obesity, 58.8% time since diagnosis was less than 6 months and 56.7% had not been previously submitted to antineoplastic treatments. Assessing absolute handgrip strength, 72.2% had dynapenia, 11.3% had low muscle mass reserve and 32% had low physical performance. 66% had probable sarcopenia, 3.1% sarcopenia and 2.1% severe sarcopenia. The mean quality of life score, according to FACT-B, was significantly higher among African descendent women (111.7 vs. 99.5, p=0.04). Women diagnosed with probable sarcopenia/sarcopenia scored 6.54 (CI: -11.79; -1.29) points lower on the FACT-B when compared to those without sarcopenia. When adjusting the model, it was observed that the mean quality of life score in women with probable sarcopenia/sarcopenia was even lower (-7.41; CI:-12.97; -1.85). Patients diagnosed with dynapenic obesity had a mean quality of life score of 8.47 points lower (CI: -13.12; -3.82) when compared to those without dynapenic obesity and in the adjusted model, the mean quality of life score was even lower ( -8.89). There was an agreement between FPPA and FPPR of 0.779 (p=0.000). In the evaluation of FPPR, women with dynapenia had higher BMI values (34.0, SD=6.2 vs. 30.8, SD=3.6, p=0.002) and WC (103.4, SD=12.7 vs. 95.9, SD=9.3, p= 0.003). There was a moderate inverse correlation between FPPR and BMI (-0.42, p=0.000), WC (-0.48, p=0.000) and a positive correlation with physical performance (0.29, p=0.003). There was a correlation between FPPR and physical well-being (0.27, p=0.007), emotional well-being (0.21, p=0.035), functional well-being (0.29, p=0.004); between the breast cancer subscale (0.32, p=0.001) and FACT-B (0.36, p=0.000). Conclusion: In this study, women with higher BMI, abdominal fat deposition and dynapenia had lower quality of life scores. Relative strength by weight was able to identify greater associations with nutritional variables and quality of life. Thus, FPPR can be used as an adjuvant method for early nutritional assessment, and must be accompanied by every antineoplastic treatment.

The phenomenon of hunger is characterised as one of the most expressive manifestations of social inequalities, projecting to us the idea that its symbolism and materiality are revealing of the way in which society manifests itself. The pandemic of COVID-19 shows the results of a health and political crisis arising from the unequal structures of the capitalist system, which generates and reproduces a constant precarization of life. In Brazil, the governmental management allied to the country's structural challenges increasingly aggravates the pandemic, having as a consequence an expressive number of people in a situation of hunger. In this context, the present study of a socio-anthropological nature aimed to understand the intermingling and intersections between the phenomenon of hunger and the pandemic of COVID-19 in Brazil. For this, it is affiliated to the studies of the Actor-Network Theory in the development of an ethnography in digital contexts. In order to deal with the heterogeneity of conflicts, spaces and narratives of hunger, it takes as a principle the use of multiple theoretical and methodological strategies to produce the empirical material that sustains this research. The results start from following the flows of events that emerged from the hunger in the midst of the COVID-19 pandemic, for this purpose, the analyses are divided between three manuscripts based on distinct contexts. In a first moment, the analysis of the media discourses demonstrates the intentional reproduction of stigmas that continuously increase the vulnerability and invisibility of people in situations of hunger. Subsequently, the results show that the reality of hunger is segmented, tensioned and spectacularized from the projection of polyphonic media narratives. On the other hand, the ethnography developed in a peripheral community in the city of Salvador, Bahia demonstrates that vulnerable people build counter-hegemonic movements from the production in networks of a horizontal and daily solidarity, which escapes through dissident ways to the structures that imprison them. Finally, it is hoped that this study may contribute to the production of critical thinking in relation to the phenomenon of hunger, as well as influence the construction and implementation of public policies to alleviate poverty and promote Food and Nutrition Security, based on the promotion of the right to existence of all lives that persist despite the crisis and beyond hunger. 

ABSTRACT

The research, of the exploratory type, aims to analyze the contributions generated by the National Food and Nutrition Security Conference (NFNSC) for the elaboration of public policies, particularly in relation to programs of interest for the promotion of Food and Nutrition Security (FNS). This is a qualitative-quantitative research, whose qualitative part was developed through semi-structured interviews with seven members and former members of the National Food and Nutrition Security Council. Data analysis was based on thematic content analysis. For the quantitative part, documentary analysis was used, whose sources of information were the final reports and normative acts (convocations acts and regulations) of the five NFNSC held in Brazil in the period from 1994 to 2015. The research was divided into three phases: the first analyzed the data from the normative acts and reports, categorizing them into five groups: G1- Characterization of conferences; G2- Form of organization; G3- Rules for deliberation; G4- Inclusive potential; and G5- Outputs of the conference process. For the second, the recommendations for FNS public policies contemplated in the reports were analyzed. The third phase was carried out in two stages: the first consisted in the identification of recommendations directed to PNAE and the second consisted in the search for legislative projects that had thematic pertinence with the demands of the NFNSC to the mentioned Program in the 24 months after each event. Main results: most of the NFNSC aimed at proposing public policies, with the III NFNSC being the most propositional; a quota system was established as of the III NFNSC, expanding the participation of traditional peoples and communities; the NFNSC mobilized a large number of participants and municipalities; regarding the nature of the recommendations, 22% met the criterion of being propositional; all the classic dimensions of FNS, were object of recommendations in the whole of the NFNSC; food availability was the dimension with most recommendations, supported by the thematic categories of agrarian reform, strengthening family of agriculture and rural Credit Stimulus; in the last NFNSC the food consumption dimension stood out; a set of NFNSC recommendations for PNAE focused on transforming it into a public policy that contributes to guaranteeing the rights of school children; legislative bills were found relevant to 41.7% of the NFNSC recommendations for PNAE, indicating that there is convergence between the NFNSC and the Brazilian legislative agenda; two laws were approved during the studied period. The results reveal that although the NFNSC declare themselves as propositional, the analysis showed a low number of recommendations for public policies. However, it is important to point out that it was possible to identify the contributions of the NFNSC for the FNS agenda in Brazil, as well as the main recommendations for the PNAE. From all the results, it can be concluded that the CNSANs that took place constituted a social and political space of relevance for SAN in the country.

Malnutrition in patients with advanced chronic liver disease (ACLD) is multifactorial and is associated with a higher incidence of complications and mortality. Thus, early detection of nutritional disorders in these patients is necessary, in order to favor nutritional interventions that minimize the impact of these changes on the clinical course of the disease. However, the available screening and nutritional assessment tools have low sensitivity, since they underestimate the presence of malnutrition and detect it late. Objectives: Develop and validate the Specific Nutritional Evaluation – Advanced Chronic Liver Disease (SNE-ACLD); compare two nutritional screening tools – Nutritional Risk Screening (NRS-2002) and the Royal Free Hospital Nutritional Prioritization Tool (RFH-NPT) with the Global Leadership Initiative on Malnutrition (GLIM) malnutrition diagnostic criteria; to verify the predictive capacity of mortality of different methods of screening and nutritional diagnosis in patients with ACLD. Method: The Delphi methodology was used to validate the content of the SNEACLD, based on the consensus of experts in the field of nutrition and hepatology. Adult and elderly patients with ACLD, hospitalized and outpatient, had their nutritional status assessed using the following methods: NRS-2002, RFH-NPT, Subjective Global Assessment (SGA), Arm Muscle Circumference (AMC), Skinfold triciptal (TSF) and SNE-ACLD. Results: The final version of the SNEACLD consists of 5 domains, 10 items, with scores ranging from 0 to 40. The new instrument showed good accuracy in identifying malnutrition. RFH-NPT showed better agreement with diagnosis according to GLIM criteria (k=0.64; 95%CI 0.52- 0.75), higher sensitivity (80%), higher negative predictive value (79%) and higher AUC ( 82.3%) compared to NRS-2002. In the sub-sample of hospitalized patients, malnutrition, diagnosed by the SGA, and high nutritional risk, identified by the RFH-NPT, were associated with longer hospital stays, in-hospital and 12-month mortality. Conclusion: The RFH-NPT is the nutritional screening method that has shown the best validity for identifying nutritional risk in patients with ACLD. SNEACLD can be used to assess the nutritional status of patients with ACLD, but other validation steps are needed to improve its performance in clinical practice.

Introduction: The occurrence of Non-Alcoholic Fatty Liver Disease (NAFLD) is generally associated with components of metabolic syndrome, such as abdominal obesity and type 2 diabetes mellitus. Thus, individuals with NAFLD are also at a higher risk of complications if affected by the SARS-CoV-2 virus, whose resulting disease is known as COVID-19. Home confinement incurred during the current pandemic period has caused changes in eating behavior and made it more difficult to maintain healthy eating habits. Objective: Evaluate the implications of eating habits on clinical and anthropometric conditions of NAFLD patients, develop a Food Frequency Questionnaire (FFQ) for this population and investigate the relationship between changes in food intake and sociodemographic factors related to weight variation during the COVID-19 pandemic. Methods: A systematic review with meta-analysis was adopted to assess the effect of dietary interventions with different macronutrient compositions on attenuation of clinical and anthropometric parameters of individuals with NAFLD. Additionally, a longitudinal study evaluating 81 adults with NAFLD was carried out. Sociodemographic, anthropometric, physical exercise and food intake information was collected, using 24-hour recalls, during two periods: before and during the COVID-19 pandemic. Diet composition was analyzed for the development of the FFQ, and foods that contributed up to 95% of energy, macronutrients and micronutrients of interest were selected from the information in the 24-hour recalls applied in the baseline. Mann-Whitney test was used to verify differences between medians, Spearman's correlation coefficient was used to calculate correlations and Fisher's exact test was used to assess associations. The significance level adopted in the tests was 5%. Results: The results of the systematic review and meta-analysis indicate that positive effects observed in the hepatic steatosis, clinical and anthropometric variables are more related to the use of low-calorie diets than to the use of dietary interventions reduced in lipids and/or carbohydrates. In the original study, baseline data revealed that the habitual food consumption of NAFLD patients is similar to the basic pattern of the Brazilian population, with a predominance of natural and minimally processed foods. A quantitative FFQ was created from the selection of 96 foods. In a later evaluation, during the COVID-19 pandemic, increased consumption of processed and ultra-processed foods was observed, along with a reduction in the consumption of natural and minimally processed foods, especially among patients with greater weight gain in the period. There was a high percentage of individuals who did not practice physical exercise before the pandemic, and this number was exacerbated during home confinement. Conclusion: More studies are needed with larger sample sizes and adequate methodological designs to more accurately identify the possible metabolic benefits of using dietary interventions, such as reduced lipids and/or carbohydrates, for patients with NAFLD; we expect that the proposed FFQ will become a useful tool in monitoring the dietary practices of this population. Finally, it is noteworthy that NAFLD patients had difficulty maintaining a healthy lifestyle, and this worsened during the pandemic period, as reflected by weight gain. This fact reinforces the importance of attention to individuals with liver disease, especially given the current circulation of the SARS-CoV-2 virus and the low vaccination coverage in Brazil.

Beef is one of the most consumed foods and its quality is an important public health issue in informal markets. This study aimed to analyze the trade of fresh beef at the street market in Santo Antônio de Jesus, state of Bahia. This is an exploratory study carried out in three stages. In the first stage, using six electronic databases, a scientific literature review was carried out on the quality and safety of beef sold in the retail trade, methods used for quality evaluation and proposed interventions. In the second stage, seeking to characterize the issue of trade, food safety and quality of raw beef, a questionnaire was administered and meat samples were collected, which were submitted to a physical-chemical and microbiological evaluation, including: total coliform, Escherichia coli, and Salmonella spp counts. The third stage aimed to identify factors associated with consumer confidence. A quantitative study was conducted with consumers, using a questionnaire. Data were treated by descriptive statistics, Latent Class Analysis, regarding the outcome “trust” and/or “distrust” and application of a binary logistic regression model. Considering the first stage, thirty-three articles were included in the review. The methodological strategies used revealed inadequate conditions, neglects in several stages of processing and operations to maintain of quality. In the second stage, meat sellers were between 20 and 64 years of age, predominantly males (82.4%), with limited education and without professional training (64.7%). Medians for temperature and pH in the small butcher shops samples were 18.10°C and 5.75 respectively, and 21.80°C and 5.50, in supermarkets samples. The difference in pH was significant (p<0.05). The filtration test suggested quality changes in 17.65% of the samples. Total coliform counts medians were 4.90 and 4.78 log CFU/g, for the samples taken from butcher shops and supermarkets, respectively. E. coli was identified in approximately 40.0% of the samples, with medians for counts of 4.30 and 3.84 log CFU/g, for butcher shops and supermarkets, respectively. Salmonella spp. were confirmed in two samples. There was a significant association between inadequate storage conditions and microorganism counts (p<0.02). In the results of the third stage, meat purchase at the street market, increased by 3.25 times the chance (CI 1.05 - 10.04) of confidence in purchased meat, while not always buying at the same sales point reduced the chances of consumer confidence (OR 0.32; CI 0.14 - 0.71). In opinion questions, considering the meat to be unsafe and with unmet needs increased by 11.05 times (CI 3.45 - 35.37) the chance of dissatisfaction and mistrust, while unsafe feeling and family members’ health concerns reduced the chances (OR 0.07; CI 0.02 - 0.20). Furthermore, satisfaction and confidence chances increased 1.58 times (CI 1.01 – 2.49) among those who did not recognize the need for strategies to improve commerce. The results confirm a worrying scenario, a meat supply with preservation failures and non-compliance with hygienic requirements and the definition of a logistic model based mainly on loyalty practices and the establishment of trust in places and sales agents – a trust more likely built by cultural aspects rather than by specific product criteria.

Introduction: Anorexia nervosa (AN) and risk behavior for eating disorders are considered important health problems in adolescents due to their emotional, psychosocial and physical consequences, which can be perpetuated until adulthood. Objective: To evaluate the relationship between food consumption, anorexia nervosa and risky behavior for eating disorders, as well as to describe the factors associated with this risky behavior in adolescents. Methodological considerations: This thesis comprises studies obtained from secondary and primary data. The secondary study is a scope review reported in accordance with the recommendations of the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and evaluated the association between anorexia nervosa, restrictive eating behavior (REB) and food consumption in children and adolescents. For the primary studies, a cross-sectional design carried out in Salvador-Bahia was adopted. The primary study sample was obtained using the simple random sampling without replacement (AASs) selection technique. The selection of schools was carried out using the conglomerate sampling procedure in two stages (1) schools and (2) classrooms. The sample size was 1,494 students, of both sexes, from the state public education system in Salvador. Data were collected in the school environment from July to December 2009. The Eating Attitudes Test-26 (EAT-26) was used to investigate risk behavior for eating disorders. The Body Image Questionnaire (BSQ) assessed satisfaction with body image. Dietary data were obtained using the Food Frequency Questionnaire (FFQ). Demographic, socioeconomic, anthropometric status, omission of breakfast, adoption of fasting, and extreme weight control behavior (self-induced vomiting, use of laxatives, diuretics, and weight loss medications) were collected. Descriptive data analysis was performed to characterize the study population and structural equation analysis was adopted to assess factors associated with risk behavior for eating disorders. For analysis of food consumption, dietary data were submitted to the principal components method and subsequently performed generalized linear Poisson model adjusted for covariates (gender, anthropometric status, body image and sexual maturation) to analyze the association between dietary pattern and risk behavior for eating disorders. Analyzes were conducted using Mplus 8.5 and R version 4.1.1 software. Results: Three manuscripts were developed. The first article refers to the scope review that included 24 studies. Similarities in food consumption in children and adolescents with AN/ REB were identified: lower intake of calories and macronutrients, especially fats and certain micronutrients, as well as lower intake of low-quality snacks, fast food, sweets and foods with high carbohydrate and fat content. Greater intake of caffeine, fiber, vegetables and fruits was also recorded. Also, the intake of meat, poultry, fish and eggs groups was related to adolescents with REB. When evaluating the healthy eating index, it was detected the need to improve the quality of the diet among the participants. The results of the second manuscript recorded a prevalence of 15.2% of risk behavior for eating disorders and a direct association between anthropometry, extreme weight control behavior, adoption of fasting, skipping breakfast and sex, and risk behavior for eating disorders. No association was identified between age, body image, economic status and EAT-26. The third manuscript retained three western food patterns (sweets, carbonated drinks, soft drinks, fast food, other dairy products, cheeses, typical dishes and bakery); traditional (noodles, vegetables/vegetables, cereals, roots, fruits, meat/eggs and beans) and mixed
(oils/fats, sugar, milk, rice and bread) which together explained 48.06% of the total variance in food consumption. Adherence to the highest tertiles of these patterns was associated with an increase in the final risk behavior score for eating disorders, while adherence to the moderate tertile of the traditional pattern was inversely associated with the EAT-26 score. Conclusion: Children and adolescents with AN/REB reduce the intake of calories, nutrients and foods that are sources of fat and carbohydrates, in addition to increasing the intake of fruits, vegetables/vegetables, fiber and caffeine. Also, a relationship between intake of protein-rich food groups and REB was identified. The analysis of the a priori dietary pattern found an intermediate score of diet quality among adolescents. Still, an important prevalence of risk behavior for eating disorders was recorded and sex, anthropometry and behavioral factors are directly associated with the EAT-26, but no relationship was detected between age, body image and economic status and dysfunctional behaviors. Furthermore, adolescents who adhere to Western, traditional and mixed eating patterns in the highest tertiles increase the final score of risk behavior for eating disorders, except for adherence to the moderate tertile of the traditional pattern. Thus, it is expected to contribute to the development of prevention strategies for risky behaviors for eating disorders and promote the adoption of healthier eating practices in adolescence.

Sarcopenia is a progressive and generalized muscle disorder with the reduction of muscle strength as the main diagnostic parameter. However, there are a few studies that assess the prevalence of sarcopenia with the new European consensus (EWGSOP2) as well as the investigation of indicators that identify it more quickly, simply and at low cost. Thus, the aim of this study was to determine the prevalence of sarcopenia and associated factors and to evaluate the phase angle as a diagnostic method for sarcopenia. This is a cross-sectional study carried out with elderly women in the community. Sarcopenia was defined according to the EWGSOP2 algorithm, muscle strength was assessed by handgrip strength, muscle mass by bioimpedance and performance by walking speed. Sociodemographic characteristics, lifestyle, health and nutritional status were considered independent variables to determine the factors associated with sarcopenia. The phase angle was obtained by tetrapolar electrical bioimpedance. It was observed that the prevalence of sarcopenia was 12.3%, probable sarcopenia of 13.5% and severe sarcopenia of 6.4%. Most elderly women with sarcopenia were older than 70 years, had an inadequate BMI (underweight, overweight or obesity) and adequate waist and calf circumferences. Sarcopenia was associated with age (OR: 12.80; 95% CI: 3.56 - 46.09), physical activity (OR: 3.45; 95% CI: 1.23 - 9.63), circumference calf (OR: 5.15; 95% CI: 1.56 - 14.32) and waist circumference (OR: 0.20; 95% CI: 0.06 - 0.62). It was found that the cutoff point of the phase angle to identify sarcopenia was ≤ 5.15 °, with an area under the ROC curve of 0.685 (95% CI: 0.571-0.800) sensitivity of 81.0%, specificity of 60.8% and accuracy of 63.31%. Elderly women with reduced phase angle were more likely to have reduced muscle mass (OR: 2.53; 95% CI: 1.18 - 5.50) and sarcopenia (OR: 4.69; 95% CI: 1.44 - 15.25). Thus, it was found that the prevalence of sarcopenia in elderly women in the community using the EWGSOP2 consensus definition was significant, and associated with age, physical activity and waist and calf circumferences. In addition to the phase angle, it can be used as an indicator for screening elderly women with sarcopenia. 

Introduction: The evaluation of effectiveness in social programs is of fundamental importance to assess the appropriate use of public resources. It is directly related to the concern with the accountability of these strategies. Effectiveness, in particular, concerns the relationship between the results and the objective, by measuring the impact or the degree of achievement of the proposed objectives. Objective: To evaluate the effectiveness of popular restaurants administered by the Government of the State of Bahia, for the dimension of access to food. Methods: cross-sectional, descriptive study, using secondary data from the public opinion survey “Profile of users of popular restaurants” with users of popular restaurants (≥18 years old). Results: the popular restaurants evaluated are effective in serving 53.1% of the target population of the policy in their total service capacity. Among the 1464 respondents, 778 (53.1%) were target audience. The percentage of coverage of these instruments in serving the socially vulnerable population was estimated at 1.4%, without considering the other municipalities in Bahia. The average energy value of the meal served by the researched PR units was 853.05 kcal / meal, with low energy density (1.15 kcal / g). The difficulty of access to food in RPs was 45.5% among the target audience. The main reasons for not having access to food was that it exceeded the number of meals provided for in the distribution (49.3%), the PR was closed (30.1%), inadequate planning of the number of meals (12.5%) and others (8.1%). The utilization profile, 46.6% attended the RPs 5 times / week, 96.0% did not have difficulties to pay, 56.2% did not consider any day difficult to eat and 69.0% traveled with motorized transport. The largest proportion of these respondents were male, were 40 and 54 years old, declared race / skin color not white, had up to 9 years of formal education, and marital status without a partner. Most of the interviewees declared to reside in the municipality of salvador. Conclusion: the evaluation of the effectiveness of the popular restaurants evaluated showed that these instruments were minimally effective in promoting access to food for the population with the highest levels of social vulnerability, within their total capacity for daily service and the current quantity of this equipment was presented insufficient and the number of meals served was insufficient to guarantee users continuous access to food. In addition, it is necessary to create new strategies to reach the low-income population, including them continuously and effectively in the social protection network of the State, substantially reducing the difficulties of access to food that the equipment itself may be creating.

Moin-moi is a traditional African street food obtained by steaming a homogeneous paste containing cowpea (Vigna unguiculata), added with crude palm oil, dried shrimp, peanuts, ginger and cashew nuts, wrapped in banana leaf and sold in the streets of Salvador-Bahia, by baianas de acarajé. In this research, a historical retrospective and studies focused on the dynamics of production, commercialization, physical-chemical characteristics and anti-nutritional factors of abarás commercialized in the city of Salvador-Bahia were studied. For the study of production and commercialization of abarás, a semi-structured questionnaire was applied to 30 baianas of acarajé, at the time of collection of product samples. Four moin-moin samples were collected from each of the thirty sales points included in the study and analyzed for weight (g), internal temperature (°C), color (CIELab), texture (N), proximate composition (%), total carotenoids (g/g). The anti-nutritional factors analyzed were: phytic acid fractions (InsP₃, InsP₄, InsP₅, InsP₆; µmol/g), condensed tannins (mg eq. CE / g), polyphenols (mg/g), trypsin inhibitor activity (TIU / mg), hemagglutinin activity (HU / Kg). The historical retrospective was carried out by consulting literature available on the internet, national libraries and public archives. The moin-moin has its origin in the southeastern region of Nigeria, known as ole-le, alele, tabani, moin-moin, moinmoin, moyi-moyi or bean pudding. The general formulation of moin moin consists of cowpea, water, oil and salt, with optional ingredients: egg, chopped seafood, peppers, tomato puree, onions and green pepper. In Bahia, as baianas de acarajé interviewed, predominantly use fradinho (53.3%) and macaçar (40.0%), for the preparation of moin-moin, with maceration time of 2 to 3 hours (76.7%). The removal of the integuments step subsequent to the soaking is performed by 83.3% of the Bahian women. A striking feature of the moin-moin sold on the streets of Salvador is the packaging in the banana leaf (Musa sp.). To use the leaf, baianas burn it over a fire (46.7%), submerge it in boiling water (23.3%) and / or sanitize it only with water, water with sodium hypochlorite or “just pass a damp cloth ”, letting it dry or even placing it in the freezer to“ harden ”.The following ingredients were used by the baianas de acarajé for the preparation of moin-moin: grated dry shrimp heads (100.0%), grated onions (96.7%), salt (73.3%), CPO (53.3%) or CPOL (46.7%) and garlic (16.7%). Peanut, codfish, cashew nuts, wheat flour, ginger and tomatoes are further ingredients frequently used. Texture analysis revealed that moin-moin is a soft, fragile and brittle food product. The content of total carotenoids ranged from 22.68 to 164.09 ppm with an average value of 79.96 ± 39.08 ppm, giving the product an ocher-orange/yellow-orange color. An average sized moin-moin ball (186.6 g) contains 14.09% protein, 13.08% lipids, 34.80% carbohydrates, 11.46% fiber and 313.2 kcal, corresponding to 18.78%, 23.78%, 11.60% and 15.66% of the daily requirements of an adult for protein, lipids, carbohydrates and energy, respectively. Minerals and antinutritional factors (AF) of moin-moin commercialized in Salvador (Brazil) as a street food by typically clothed women called baianas de acarajé were studied. Four MM samples were collected from each of the thirty sales points included in the study. The mineral contents of MM showed a wide variation: K: 917.4 ± 166.2 mg 100 g^-1 DM, P: 400.0 ± 59.8 mg 100g^-1 DM, Mg: 97.9 ± 16.4 mg 100 g^-1 DM, Ca: 94.0 ± 70.4 mg 100 g^-1 DM, Fe: 57.3 ± 16.9 µg g^-1 DM, Zn: 22.4 ± 4.2 µg g^-1 DM, Cu: 6.3 ± 3.3 µg g^-1 DM, Mn: 6.0 ± 2.8 µg g^-1 DM and V: 4.3 ± 2.0 µg g^-1 DM. AF in MM were: 0.60 ± 0.77 µmol g^-1 DM (InsP₄); 1.34 ± 1.07 µmol g^-1 DM (InsP₅); 4.77 ± 3.53 µmol g^-1 DM (InsP₆); 1.69 ± 0.03 mg eq. CE g^-1 DM (tannins); 6.37 ± 0.12 mg g^-1 DM (polyphenols). Zn and Fe bioavailability might be negatively affected. Information on cowpea cultivars used for MM preparation were obtained from a structured questionnaire. ‘Olho de Pombo’ showed the highest concentrations for AF and minerals. MM was identified as a good source of minerals.

Nutrition during the period of development can have lasting repercussions for the health of the being in training. In this way, a nutritional manipulation of periods is a relevant study model for understanding the modulation of phenotypic plasticity and its repercussions. Among the repercussions are molecular changes, more specifically in gene expression. The present study aimed to investigate the effect of exposure to a high-fat diet during intrauterine life and lactation associated or not with the maintenance of food intake of high-fat diet after weaning on the genes expression related to the control of food intake and inflammation in rats adults. This study was approved by the Animal Use Ethics Committee of the Faculty of Dentistry of the Federal University of Bahia (nº 02/13). Animal handling and care followed the recommendations of the Brazilian Society of Laboratory Animal Science (SBCAL) and ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments). The animals were kept in the Experimental Nutrition Laboratory of UFBA (LABNEX), under a temperature of 23 ± 2 ° C and a light / dark cycle of 12 hours. Wistar rats were divided into four subgroups: Control / Control (CC, n = 5) - descendants of rats fed the control diet and fed the same diet after weaning; Control / High-fat diet (CH, n = 5) - offspring of rats fed a control diet and fed a high-fat diet after weaning; High-fat diet / Control (HC, n = 5) - offspring of rats fed a high-fat diet in the perinatal period and fed a control diet in the post-weaning period; High-fat diet / High-fat diet (HH, n = 5) - offspring fed a high-fat diet in the perinatal period and after weaning. After euthanasia and dissection of the white adipose tissue, hypothalamus and nucleus accumbens, analyzes of the drd1, drd2, pomc, npy, tnf-α and nf-kb genes expression using the real-time PCR technique. The CH group showed greater expression of drd1 and drd2, the HC group showed greater expression of drd2 and the HH group showed greater expression of drd1. The HC group showed greater pomc expression and the HH group showed greater pomc and npy expression. The CH and HH groups showed higher expression of nf-kb and tnf - α in omental and retroperitoneal white adipose tissue and the HC and HH groups showed higher nf-kb expression in hypothalamus. Thus, the high-fat diet altered the genes expression related to hedonic and homeostatic control of food intake and the expression of inflammatory genes, more intensely in animals exposed to a high-fat diet in the critical stages of development and who continued to intake same diet after weaning.

Introduction: Overweight, chronic non-communicable diseases (NCDs) and food insecurity have been presented as serious public health problems worldwide, over the years. Whose picture is getting worse and reaching more and more the world's populations. With regard to collective food workers, few studies have been carried out that have assessed their health, work and, especially, food insecurity conditions. And yet, nationwide. Objective: To assess the health condition and food (in) security among food handlers in popular restaurants in Brazil. Methodology: The thesis was structured through three articles that addressed aspects related to the health of these workers, developed through a cross-sectional study in 36 popular restaurants in Brazil, which is anchored in a larger study. 559 workers participated in the study and the socioeconomic, demographic, work and health conditions aspects were evaluated, as well as data that characterize food insecurity using the Brazilian Food Insecurity Scale. The statistical analysis of the 03 articles involved descriptive, bivariate analysis and application of Pearson's chi-square test. To confirm the associations, according to each article, Poisson Regression (article 1) and Multinomial Logistic Regression (articles 2 and 3) models were used with a 5% significance, and considering the objectives and characteristics of the outcomes of each study: Noncommunicable Conical Diseases (NCDs), Overweight and (In) Food Security. Results. The majority of the study population was female (63.1%), married (51.7%), overweight (59.9%) and among those who presented NCDs (17.2%), the majority reported the presence of arterial hypertension (45.8%), in addition, the perception of food insecurity was 44.4%. There was a caloric intake with distribution of adequate macronutrients, however, the sodium intake showed higher values than recommended. It was found that obese workers were twice as likely to have chronic diseases; those who worked in restaurants for more than three years also presented more risks for the development of excess weight; and socioeconomic conditions were associated with food insecurity with workers with less education being twice as likely to be in the most severe range of food insecurity. Conclusion: This was the first nationwide study to assess the health and food (in) security situation among collective food workers (food handlers). High prevalences of overweight and food insecurity were found. Longer working hours in restaurants proved to be a possible risk factor for the development of overweight, however more studies need to be carried out to better clarify this association.

Overweight has shown an increase in global prevalence, including in adolescents, becoming a global concern due to its relation with adverse health conditions and negative effects on quality of life. The present study is a cross-sectional study with repeated data that used information from three cross-sectional studies conducted in different periods and evaluated variations in the prevalence of overweight and abdominal obesity in adolescents. The sample consisted of 2,496 adolescents of both sexes. The presence of overweight was characterized by BMI / I ≥ Percentile 85, and abdominal obesity was characterized by values of ≥ 0.5 TSC and for CC the Taylor p80 was used. The level of statistical significance was adopted at 5%. In the statistical analysis, the Pooled OLS regression was used since the data were independent. It was decided to present the results in the form of an article. In the results of the article "Temporal variation of overweight and abdominal obesity in adolescents", it is possible to observe that the excess weight rates increased 104% and the indicators of abdominal obesity, WC and WHR, presented growth of 153% and 142 %, respectively. The results were controlled by sex and age of the adolescent.

Objective: To assess the sociodemographic factors associated with the double burden of malnutrition (DBM) among Brazilian adolescents. Methods: This was a descriptive study based on data from 59,637 and 10,770 students who participated in the National Adolescent School-Based Health Survey (Pesquisa Nacional de Saúde do Escolar – PeNSE), 2009 and 2015 editions, respectively. Weight and height measurements were obtained to evaluate nutritional status. DBM was classified as follows: category 0 (reference): adolescents with normal body mass index (BMI) and height-for-age (BMI/A: Z-score ≤ +1 and H/A: Z-score ³ -2); category 1: adolescents with normal BMI-for-age and low height-for-age (BMI/A: Z-score ≤ +1 and H/A: Z-score < -2); category 2: adolescents with high BMI-for-age and normal height-for-age (BMI/A: Z-score > +1 and H/A: Z-score ³ -2); and category 3 (double burden): adolescents with high BMI-for-age and low height-for-age (BMI/A: Z-score > +1 and H/A: Z-score < -2). Sociodemographic data on the participants were also collected. A multinomial logistic regression analysis was usedto detect associations of interest. Results: The prevalence of DBM in the 2009 and 2015 editions of the PeNSE was 0.4% and 0.3%, respectively. In the 2009 edition, the chance of DBM was lower among boys (OR=0.60; 95% CI=0.45-0.81) and higher among those over 14 years old (OR=2.40; 95% CI=1.80-3.20),  living in the country’s north and northeast regions (OR=2.01; 95% CI=1.49-2.84), and  from families with a low maternal education level (OR=1.48; 95% CI=1.07-2.04). In the 2015 edition, no significant associations were found regarding the DBM outcome. Conclusion: The results indicate the presence of socioeconomic inequalities in the occurrence of DBM. Simultaneous interventions in the area of equity are necessary to prevent the advancement of nutrition-related problems

Food trucks (FT) are an innovation in the segment of street food. In Brazil, this sector began its activities in 2013, arriving in Salvador-Bahia in 2015. In this city, FT are present, specially, in gastronomic events, attracting many people. Given this phenomenon, this work aimed to characterize FT consumers, considering their profile, practices and perceptions, in Salvador-BA. A cross-sectional, quantitative, study was carried out with the application of a semi-structured questionnaire, alonh with FT consumers. The sample consisted of 128 consumers, with a balanced distribution between men (50.78%) and women (49.22%), predominantly young adults (80.47%), unmarried (76.56%), with full or incomplete university degree (58.89%), and average family income corresponds to classes C and D (77.34%). The most cited reasons for consumption in FT were: convenience (54.69%), taste and / or pleasure (43.75%) and price (10.94%). Many consumers (54.69%) had been attending the FT for more than a year, but infrequently (44.53%). FT hygiene was considered good (82.03%) and food quality was reliable (74.22%). The most cited selection criteria of the points of sale were: the appearance of preparations (68.75%) and seller (64.84%), site cleaning (50.78%), product packaging (35.59%) and the price (32.81%). Most consumers (95.31%) believed in the continuity of FT, highlighting the practicality, the affordability, and the diversity of the menus. The study demonstrates that consumers are the support link of this new street food sector, therefore, it is essential to carry out more studies to better know their profiles, habits and food preferences.

Background: Bulimia nervosa is a serious health problem due to its magnitude in adolescents and young adults, besides the presence of associated emotional, psychosocial and physical comorbidities. Concerns about body weight and shape, the influence of cultural ideals of thinness, body dissatisfaction, obesity, low self-esteem, and depression have been recognized as important factors which may enhance the presence of abnormal eating behaviors and predispose to the development of the eating disorders in adolescents. Objective: To evaluate the factors associated with the occurrence of bulimic behaviors in adolescents and to analyze the Bayesian network framework of bulimic behaviors. The second aim is to accomplish a Bayesian network analysis of bulimia nervosa symptoms and to estimate the relationship of the structure between bulimic behaviors, body dissatisfaction and depressive symptoms. Methods: This is a cross-sectional study nested in a cohort entitled “School and family environment and cardiovascular risk: a prospective approach”. The sample of the first manuscript was made by 487 adolescents. To identify bulimic behaviors, it was used the Bulimic Investigatory Test of Edinburgh. The anthropometric status, psychological aspects, body dissatisfaction, lifestyle, social, economic and demographic factors were also evaluated. The descriptive data analysis was performed to characterize the study participants. The Poisson Regression model was adopted for evaluation as associations of interest between the exposure variables and the outcome, with a significance level of p <0.05. In the second manuscript, 413 adolescents were assessed using the Bulimic Investigatory Test of Edinburgh, Body Image Questionnaire and Child Depression Inventory. A network analysis was performed for the Bayesian network, using the bnlearn R package, and the HC - Hill Climbing algorithm. Results: In the first manuscript, 34.9% of the adolescents had bulimic behavior and in 2.9% of these, the symptoms were of high severity. Body dissatisfaction (RP = 2.23, 95% CI = 1.35 - 3.70), depressive symptoms (RP = 1.70, 95% CI = 1.15 - 2.51) and family weight-teasing (RP = 85, 95% CI = 1.35 - 2.54) significantly increased the prevalence of bulimic behavior. The results of the second manuscript showed that the items "pattern of eating severely disturb my life, "worry about not have control over how much eat" "consider myself to be a compulsive eater" are central symptoms in the psychopathology of bulimia nervosa. The attitude “worry about your flesh been dimply” had a high predictive capacity in bulimic behaviors, assuring that body dissatisfaction has a great influence on the development of bulimic symptoms. The depressive symptoms "sadness" and "crying spells" showed high potential for intermediating bulimic symptoms in the network. Conclusion: The high prevalence of bulimic behaviors shows a reality that needs effective interventions, with attention to the factors that can increase the occurrence of those behaviors.

Introduction: Complications observed in the cardiovascular system with consequent cardiac remodeling associated with inflammatory conditions and changes in lipid profile became an important contributor to early CVD mortality. In this context, the identification of risk factors associated with cardiovascular diseases (CVD) favors the improvement of strategies for the prevention and reduction of complications caused by CVD. Therefore, the objective of this study was to evaluate the effects of exposure to a hyperlipidic diet during the perinatal period and after weaning on indicators of cardiometabolic risk and aortic histomorphometry in descending rats.

Methods: Female Wistar rats were separated into two groups and fed a standard diet (4% lipid) or a hyperlipid diet (23% lipid) during gestation and lactation. The offspring were divided into four groups: CC group (n = 6), CH group (n = 6), HH (n = 6) and HC group (n = 6). At 60 days of age, the biochemical and histomorfometric analyzes of the aortic artery were performed. Two-way ANOVA was used in the statistical analysis, followed by the Turkey’s test. The significance level adopted was 5%, in all cases.

Results: In the analysis of the cardiometabolic risk indicators, the CH group (2.27 ± 0.35mg/dl) showed a significant difference for the Castelli I index compared to the CC (1.02 ± 0.19 mg/dl), HC (1, 76 ± 0.88 mg/dl) and HH (1.76 ± 0.88 mg/dl) p < 0.01. In the evaluation of the other indicators there was no difference between the groups. The thickness of the intima and middle layers of the aortic artery of the CH groups (43.47 ± 8.33 µm) and HH (43.94 ± 7.30 µm) had higher values compared to the CC group (30.40 ± 5.40 µm ). The HH group also presented a higher thickness compared to the HC group (33, 73 ± 5.68 µm) p < 0.01. The thickness of the elastic lamellae of the aorta of the HH group (3.08 ± 0.98 µm) presented a larger diameter when compared to the groups HC (2.00 ± 0.29 µm) and CC (1.84 ± 0.23 µm) p < 0.001 . In the elastic lamellar count, the CH (6.09 ± 1.22 µm) and HH (5.73 ± 0.64 µm) groups had a higher number compared to the CC (4.24 ± .50 µm) and HC ( 4.18 ± 0.69 µm) p < 0.01.

Conclusion: Exposure to a hyperlipidic diet increased the risk for developing cardiometabolic complications in addition to altering the histomorphometry of the aortic artery of young rats.

Food has been studied for the bias of cultural studies of the social and human sciences for some time, since we already know that the act of eating is loaded with symbolic meanings that affect our taste and identify us. The kitchen as an empirical universe is placed as a setting for the culinary language, which consists of several specific genera, among them that of seasonings. The seasoning is for food just as the adjective is for grammar, which places it as an essential factor in the qualification of a culinary speech.

The present research has as general objective to understand which symbolic values are associated to the consumption and culinary use of the coriander, being divided, for this, in two moments: to review the trajectory of the coriander in antiquity until the contemporaneity in a general setting in the gastronomy, entering the second moment for the Brazilian territory with a clipping in the city of Salvador, Bahia. Bibliographical and documentary researches were carried out with a qualitative and exploratory approach, as well as a field work with interviews application in the chosen cut. Despite having entered European territory quite early in the interchange with the Arab world, European kitchens would estimate coriander, along with other herbs as a seasoning and as a medicinal plant.By starting the process of designing a gastronomy from a certain period, France establishes a hierarchy of tastes while consolidating a cultural hierarchy between European and non-European cuisine. At the same time, the coriander carries identity and affective values within the Bahian food culture, since it connects all the varied aspects of food found in this place: the homemade seasoning, linked to affective memories and the typical food seasoning, linked to the baiana cuisine identity of extensive and definitive way.

This study aimed to understand how the school cook lunch mean their work in school kitchens, considering gender as a constituent element of their cooking experiences. This study is the product of semi-structured interviews conducted with nine school cook lunch of public schools of the municipal school system of Salvador / Ba. From the consent of the participants, the interviews were recorded, transcribed and analyzed through the Meaning Nuclei, an analysis instrument based on Socio-Historical Psychology. They seek to apprehend, analyze and interpret the statements from the social, cultural and historical context in which they are produced. Through the analyzes, the results were organized into three articles. The first discusses theoretically, through bibliographies, the relationship between female work and food care, highlighting its relationship with social reproduction. The second, based on empirical data, discusses the meanings attributed to culinary work based on culinary learning, the naturalization of the woman - kitchen relationship and the feelings related to cooking. The third seeks to discuss how the work of school cook lunch acquires meanings of care in the school context. We highlight how the relationship between women and food care extends to the public sphere through ideological discourses that naturalize female culinary work, and how society appropriates it to make them responsible for social reproduction. The need to cook to serve the family was the starting point for the culinary learning process of the school cook lunch, making them believe that cooking is a natural feminine assignment that should be developed at home and at school, even if it is accepted. burden of work. From this, we observe how the work of school cook lunch can be understood as a form of care, considering that in the search to meet the needs of students through food, relationships of trust, attention and affection are also built in the daily work

Artisanal or small-scale fishing plays an important role for coastal populations, as it assists in local social and economic development. In this segment, shellfish is one of the most common forms of fishing and subsistence activities. Despite its relevance, this work is still invisible economically and socially. Given this, education in this group is fundamental to develop real capacity for intervention and transformation of its reality. Thus, training in Good Production Practices can contribute to the improvement of their production practices, valorization of fish and, consequently, of the important work of shellfish farmers. Moreover, it is assumed that these educational activities can reach the formation of multiplier agents, people who participate in the formation process and present the challenge of passing on what they have learned to others. Given the above, the objective of this work was to demonstrate the contribution of a training experience conducted by shellfish farmers, as multipliers of food safety, to the improvement of shellfish processing practices and improvement of the quality of artisanal fish. This is a descriptive intervention study of a qualitative and quantitative nature, which was carried out with shellfish farmers from São Francisco do Conde, Bahia, Brazil. For this, an educational intervention work was conducted that included the formation of multipliers agents of Good Fish Production Practices and, later, the training of new community seafood restaurants by these knowledge diffusers. To obtain the information, we used assessment tools of shellfish knowledge (structured questionnaire) and processing practices (checklist), as well as a conversation wheel developed with the help of script questions. Quantitative data were tabulated and processed in a database using the Statistical Package for the Social Sciences - SPSS, v 21. The results of the structured questionnaires and checklists were analyzed, respectively, using the Wilcoxon and Pearson's chi-square test. . The qualitative data from the Conversation Wheel were transcribed and treated by content analysis, with definition of categories / subcategories. There was a statistically significant difference in shellfish knowledge (Z = -3.350; p = 0.001 <0.05) and practices (X2 (2) = 98; p-value <0.001) after the training performed by the multipliers. There was a significant improvement in the work, regarding the cleaning of facilities, equipment, furniture and utensils, personal hygiene, vector control and urban pests, water supply, waste management and shellfish preparation. Still, it was verified that the instructors presented characteristics that helped in learning, effective communication and the feeling of appreciation of shellfish and their work. In view of this, the formation of multiplier agents was an effective instrument for improving artisanal fishing and promoting food safety in fishing communities, and it is recommended that this strategy be disseminated to other coastal and riverine communities.

Background: There has been an increase in overweight prevalence, which constitutes an important public health problem in adolescents. In this sense, prevention interventions focused on the promotion of healthy habits may lead to better health behaviors, with more significant use of multimedia tools and other innovative technological resources, highlighting the Internet. Thus, cultural adaptation of interventions based on international technologies aimed at the prevention of overweight is placed as a feasible alternative considering the scarcity of national production for this type of intervention. Objectives: To evaluate the effects of an intervention using a computer program, via the web, adapted to the Brazilian reality (StayingFit Brasil), in the health parameters of adolescents enrolled in elementary schools of the public school of the city of Salvador, Bahia. Methods: A systematic review was carried out in accordance with the recommendations proposed by the Guide Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA), registry (# CRD42018089340). Relevant scientific articles were searched in MEDLINE / PubMed, Embase, Scopus, Lilacs, PsycINFO, Cochrane and MEDLINE / Ovid. Randomized clinical trials and quasi-experimental studies examining the effect of an intervention - using computerized feedback (website or CD-ROM) - on food consumption and anthropometric parameters in adolescents in the school environment were included. In addition, a cultural adaptation study was conducted following four of the five steps of Barrera et al (2013): (1) information gathering; (2) preliminary adaptation design, which included the participation of topical experts for preliminary evaluation of the original content of the intervention; (3) preliminary adaptation tests; (4) adaptation refinement. A web school-based 12-month trial examining 7th to 9th grade students was conducted under registration number RBR-7qgnbn. The students were from twelve schools belonging to the comprehensive public education system of Salvador, Bahia, Brazil. The schools’ students were randomly distributed into the intervention and control groups. The adolescents in the intervention group participated in StayingFit, an online programme designed to encourage and guide healthy eating habits and control body weight. Data on food consumption, anthropometry, physical activity level, and sedentarism were collected from all of the students at the beginning of and after the 12-month study. Sociodemographic and socioeconomic data were collected at baseline. Generalised estimating equations (GEEs) were used to evaluate the effect of the intervention. The analyzes were performed in the statistical package Stata, version 14.0. Results: After the analysis of the original and the translated versions by the topical experts, modifications were suggested in order to provide a better understanding of the phrases translated into Portuguese and also into the reality of the adolescents, in order to guarantee the semantic, idiomatic and experimental equivalence of the adapted program. Participants demonstrated to understand the content of the sessions, navigating easily and approving the layout of the virtual environment. The baseline data showed a high prevalence of overweight (14.4% overweight, 8.5% obesity), physical inactivity (87.6%) and sedentary lifestyle (59.1%). In addition, low prevalence of adolescents with regular consumption of fruits (18.8%) and vegetables / legumes (16.3%). At the end of the follow-up period, students in the intervention group had a 43% increased chance of regularly consuming beans (OR=1.43, 95% CIs=1.10-1.86) and a 35% decreased chance of regularly consuming soft drinks (OR=0.65, 95% CIs=0.50-0.84). No differences were found between the groups studied with regard to the anthropometric parameters. Conclusion: The process of cultural adaptation of the StayingFit program to Brazil was successful in developing an engaging and interactive intervention for adolescents of full-time public schools in Salvador/BA/Brazil. Despite these modest results, the implementation of a web intervention can be beneficial and help promote positive changes in adolescent eating habits.

Yogurt derives from the fermentation of pasteurized or sterilized milk, using protosymbiotic cultures of Streptococcus salivarius subsp. thermophilus and Lactobacillus delbrueckii subsp. bulgaricus with addition or not of other lactic acid bacteria, which determine the characteristic of the product. Chemical additives are used to increase yogurt shelf life and some of them may be harmful to health. Consumers have been more demanding for natural foods without chemical preservatives. In this context, propolis is an attractive ingredient to produce natural and healthy foods, due to its antimicrobial, anti-inflammatory, healing and anesthetic properties, as well as the immunomodulatory effect, among others. This study aimed to evaluate the addition of red propolis on conservation of the stirred yogurt (YRP), strawberry flavor, replacing the potassium sorbate commonly used in conventional yogurt (CY). The yogurts obtained were submitted to stability tests under refrigeration through the determination of bio-indicators, such as Salmonella spp., coliforms at 37°C and Escherichia coli, molds and yeasts, as well as lactic acid bacteria. In addition, were evaluated the physical-chemical properties, presence of bioactive compounds, antioxidant activity, and fatty acids profile. The physical-chemical properties were evaluated using traditional methods, antioxidant activity by FRAP and DPPH methods and the presence of bioactive compounds through the content on phenols and flavonoids. In the second part of the study, YRP samples were evaluated for rheologic properties, sensory analysis and purchase intent. The sensory analysis and purchase intent of YRP and commercial yogurt (obtained at retail), strawberry flavor, was conducted with 90 untrained consumers. The results of the physical-chemical properties, fatty acids, texture and sensory analysis, and purchase intent were submitted to statistical treatments, and the means were compared the Tukey test. The results for microbiological stability showed that yogurt incorporated with red propolis (0.046%) (YRP) and conventional yogurt (CY) samples have shelf life of 28 days, which is desirable for product marketing. However, there was a decrease in lactic acid bacteria count in CY, which does not comply with the Brazilian legislation. The values for pH of YRP and CY samples ranged from 4.35 to 4.03 and 4.30 to 4.00 (0 to 28 days), and titratable acidity 1.28 to 0.85 and 1.27 to 0.83 (0 to 28 days), respectively. Related to protein content, the YRP presented a mean value of 3.16 and CY of 3.20, ashes YRP 0.70 and CY 0.71, moisture, YRP 87.44% and CY 87.56%, lipids, YRP 3.28% and CY 3.10%, and carbohydrates, YRP 23.56% and CY 22.70%.  There were no significant differences in the physical-chemical properties of samples when compared to control. The main fatty acids detected in YRP and CY samples were palmitic, oleic + elaidic, myristic and stearic acids, with a statistically significant difference in the content of caprylic acid. In the samples of YRP, the DPPH value ranged from 0.93 to 1.09 Trolox/g at time zero and from 0.66 to 0.85/g Trolox/g at 28 days. FRAP values ranged from 12.10 to 13.81 mg Fe (II)/g at time zero and from 8.33 to 10.93 mg Fe (II)/g at 28 days. The values of phenols were between 5.49 and 5.73 mg eq. AG/g at time zero and from 5.38 to 3.65 mg eq. AG/g at 28 days. Flavonoids ranged from 0.11 to 0.28 mg AG/g at time zero and from 0.09 to 0.21 mg eq. AG/g at 28 days. These results showed the antioxidant activity and the presence of bioactive compounds in propolis. The average value found for apparent viscosity in YRP was 307.27 mPa, demonstrating a pseudo-plastic fluid not Newtonian behavior, as expected for stirred yogurt. Texture properties, such as cohesiveness, firmness, adhesion, elasticity and gum were similar to those of commercial yogurt. The sensory evaluation of the YRP samples presented an average score equal of 9.0, similar to that achieved in the evaluation of commercial yogurt, on a scale of 10 points, which means “liked a lot”. Regarding purchase intent, YRP samples showed a score of 64.45% of positive intention, while the commercial yogurt sample had 96,67%. According to the results can be concluded that the crude extract of red propolis is an excellent additive for conservation of natural yogurt and can replace chemical additives commonly used in the product, without changing viability of lactic acid bacteria.

Conceptually, Food and Nutritional Security (FNS) is the right of every human being to have permanent physical and economic access to quality food in sufficient quantities without compromising other essential needs from healthy food practices, sustainable food practices and respect for the cultural diversities. In this context of food as a right, this study provides considerations regarding the triad: religiosity, vulnerability and commensality in the religious universe of the Candomble grounds, raising discussions in the light of the FNS. For that, an exploratory case study of a qualitative nature was carried out in a candomble ground defined by the criterion of antiquity, located in the city of Salvador-Ba. Data collection was done
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through the participant observation technique with field diary registration. It was evidenced in the fieldwork that the people of the Candomble ground live under the constant threat of the non-guarantee of FNS, constituting a socially vulnerable group and that, even so, indirectly promote the FNS of the community through food distribution practices. Being that the care in food is something that stands out in this space.

The palm fruit, Elaeis guineensis Jacquin, originating in Africa, came to Brazil during the 16th Century, along with the slave ships. It adapted well to the country’s weather and soil characteristics. The crude palm oil (CPO), made from the fruit, became a culinary icon in the state of Bahia and celebrated in Candomble religious ceremonies. The city of Valença, in the region of the Lower South of Bahia, is one of the biggest producers of the palm oil in the territory, even though it still uses very rudimentary extraction methods.
OBJECTIVE: To evaluate the technical and political aspects involved in the production process of the crude palm oil in Valença, and its impact on the final product quality.
METHODS: The study was developed with 27 palm oil producers: 7 of them uses palm pestles (PP), 12 of them uses a little mechanized wheel (LMW), and 8 with a mechanized wheel (MW). Overall, the research involved 71 people, being them 44 collaborators and 27 owners. The data were acquired through interviews with crude palm oil producers, through the application of semi structured questionnaires, divided in parts, containing: identification and sociodemographic characteristics od the participants; extraction and fabrication process of the palm oil; trajectory and tradition; sanitary issues and good practices on the fabrication process of the palm oil. The infrastructure conditions were described through a checklist that was applied during the visitations, period when it was collected samples of the crude palm oil, with less than 30 days of fabrication.The samples were collected in three different moments, and submitted to physicochemical analysis of total polar compounds (%), acidity level (IA; % oleic), peroxide level (IP; meq O2/kg), collor (CIELab), total carotenoids (CT; μg/g), Deterioration of Bleachability Index(DOBI), p-anisidine, total oxidation (TOTOX) and oxidative stability evaluation . All of the analysis, except the oxidative stability evaluation, were made in triplicate.
RESULTS: ARTICLE 1: Diagnostic study of technical, social and political aspects involved in the crude palm oil production in Valença, Bahia. ARTICLE 2: Physicochemical description of the crude palm oil extracted using pestles, little mechanized wheel and mechanized wheel in Valença, in Bahia (In process).

Introduction: Studies have highlighted the importance of assessing dietary patterns during life cycles and their complex relationship with health outcomes. Adolescence is characterized by an increase in nutritional needs which is not always accompanied by adequate and balanced dietary intake. And, adolescents dissatisfied with the body tend to adopt inadequate dietary patterns. In this direction, the adolescent may be at risk of developing many diseases, especially eating disorders. Objectives: To identify dietary patterns and evaluate the association between body image and these dietary patterns in schoolchildren. Methods: This is a cross-sectional study held in Salvador, Bahia. The sample consisted of 385 adolescents of both sexes, aged between 10 and 17 years, enrolled in four state schools of Salvador. Data were collected in the school environment between 2016 and 2017. For the identification of dietary patterns, two 24-hour dietary recalls (R24h) were collected on non-consecutive days. The list of foods of R24h and energy content were obtained by Virtual Nutri Plus software. The brazilian Silhouettes Scale evaluated the body image. Demographic, socioeconomic, lifestyle and anthropometric informations were collected. The Multiple Source Method removed intrapersonal variability from food group intake. Then, dietary data were submitted to the Exploratory Factor Analysis by Principal Component Analysis. We performed data descriptive analysis to characterize the sample and multinomial logistic regression adjusted by covariates evaluated associations between body image and dietary patterns quintiles of adherence. Odds ratio and its respective 95% confidence interval were used to assess, respectively, association and strength of association between variables. Analyzes were performed in Stata software version 14.0. Results: The prevalence of body dissatisfaction was 77.9%, with a prevalence of 50,4% of desire to decrease weight and 27.5% to increase weight. Three major dietary patterns were retained: Pattern 1 (chocolates, biscuits/ sweetened cereals, milks, breads, yoghurts/ cheeses, sausages, pastas/ baked salted, sauces), Pattern 2 (white meats, oils/ fats, cereals, red meats, vegetables, fruit/ fruit juices and pulp, beans, sugar) and Pattern 3 (dairy desserts, snacks/fried snacks, typical dishes, sweetmeats, sweetened drinks). The first and third patterns were characterized by higher concentration of high calorie, fat and sugar foods and the second pattern was composed of traditional meal’s foods. Adolescents with desire to decrease weight had lower (1st, 3rd and 4th quintiles) adherence to Dietary Pattern 1 in relation to that satisfied with its body. Conclusions: Adolescents who wish to lose weight tend to adhere less to unhealthy dietary patterns, which is not necessarily related to a healthy lifestyle. Further longitudinal studies are needed to address the various body image dimensions and the adolescent’s food consumption complexity. Thus, it is expected to contribute to the elaboration of strategies for the prevention of body image disorders in order to promote the adoption of healthier eating practices inadolescence.

This study proposed to understand how the alimentary taste is established on formative path nutrition students of a public University, in Salvador, Bahia. The work is situated at the interface between the Health and Nutrition Sciences and the Social Sciences and Humanities in order to broaden the understandings on the phenomena in the field of food and nutrition. For the study, was used to combine the understanding interview and the narrative interview as empirical production techniques. Was chosen as a locus of this study a public University of Salvador, Bahia, and the empirical universe was composed of 10 students of both sexes. In data analysis, was used the comprehensive approach. As search results, was developed a original article where the study found that changes in the feeding practices that are engineered from the formation of the nutritionist, are in many ways bringing nuance to possibilities of constitution of new tastes over time and, often, retracting tastes who had before joining the nutrition course. The field revealed how food practices and taste feed back, triggering phenomena, such as the emergence of the range of possibilities, including as aversions and the list of alimentary taste, using strategies of education of new tastes and practices, not just the scientific field this education, but also the social relations did not via formative way, inferring that the construction of the taste is also social. Thus, even observing in narratives and protocols of conduct, the valuation of the eating habits and tastes of individuals, in practice, is still far from articulating this plan. Reformulations of tastes are still based on dietary restrictions, justified by healthy discourse and quality of life.

Food practices and identity processes are interwoven phenomena, producing mutual effects, which in the case of students of Brazilian public schools, School Feeding has been mediating and constitutive of these phenomena, permeated by the advances in the achievement of the right to adequate and healthy food, yet also because of stigma and welfare practices. This study sought to understand the interactions between feeding practices around school feeding and student identity processes, seeking to elucidate what underlies these phenomena. The ethnography was configured as a theoretical-methodological approach to study the problem, taking as a scenario a public elementary school in the city of Santo Antônio de Jesus, Bahia, focusing on the series from the sixth to the ninth – children in the age group from eleven to fourteen . Fieldwork lasted seven months, constituting an observation of the school routine and twenty-three semi-structured interviews with students and key actors of the school. The process of analysis was constituted in a hermeneutical exercise, seeking to elucidate the meanings and interactions of the school triad, subjects and school feeding. The results were organized based on a description of daily school life, which point out the agency of the school in the processes of pupils' identity construction mediated by eating practices. Then it was done an deepening of categories such as: "the school is ours" that revealed processes of resignification of the identity of the public school resulting from the inventiveness and activeness of both students and the institution itself; the commensality resulting from this scenario that makes it possible to conceive school feeding as food, contributing to the promotion of healthy food practices and processes of resistance to the affirmation of regional food identities; "Food is what unites" that translates as the sharing of school feeding, in its material and symbolic dimensions, converged to a shared identity among all school subjects. It is concluded that the uncontested experiences of the studied reality invite us to ask for what identities the alimentary practices in the context of the PNAE should contribute, considering the potential of both to serve reproduction and social transformation. The school also becomes evidence of how much dialogue between the field of education and the field of food and nutrition can contribute to school nutrition being integrated into school practices, not as a mere nutritional support, but as a political-pedagogical element and cultural, translated into food and identity of a school community.

Introduction: The relationship between dietary intake of children and adolescents and the development of cardiometabolic alterations have epidemiological importance considering that this exposition is characterized as protection or risk factor for non-communicable chronic diseases in adulthood. However, the knowledge of this relationship is still scarce, and the amount of study should be expanded in order to make information consistent and contribute to the improvement of evidence-based clinical and nutritional care. Aim: To evaluate the influence of dietary patterns on cardiometabolic risk factors among children and adolescents. Methodology: systematic review and meta-analysis of six databases was used to evaluate the influence of healthy and unhealthy dietary patterns on markers of cardiometabolic risk among adolescents. In addition, data on the dietary intake of a cohort study conducted in 2006-2007 with 492 children and adolescents from Mutuípe-BA were evaluated to extract dietary patterns using two techniques of data reduction: Principal Components Analysis (PCA) and Exploratory Structural Equation Modeling (ESEM). Dietary patterns extracted by the methods were compared, and associations of these patterns with longitudinally changes on anthropometric indicators of adiposity (BMI, z-score of BMI/Age, waist circumference (WC) and height to waist circumference ratio) were evaluated through Generalized Estimating Equations (GEE). In addition, structural equation models (SEM) were proposed to evaluate the association between dietary pattern and cardiometabolic risk factors, with the latent variable ‘Abdominal adiposity' (created from the junction between BMI and WC) acting as mediator of the association. Results: The systematic review identified 19 articles that met the eligibility criteria, and seven of them were included in the meta-analysis. The results indicated that high intakes of foods present in unhealthy and healthy dietary patterns were associated with higher mean BMI and waist circumference in adolescents. The analysis of the cohort dietary data with PCA and ESEM, extracted three dietary patterns. It was observed that both methods were associated with the variations of adiposity anthropometric
indicators over time, however the patterns obtained with ESEM were associated more significantly. When the relationship between dietary pattern and cardiometabolic risk factors was evaluated, the dietary patterns had direct effects on ‘Abdominal adiposity’ and it acted as a mediator by indirect effects on serum triglyceride levels. Conclusion: dietary patterns of children and adolescents were associated with excess of weight and waist circumference in meta-analysis and longitudinal studies. Together these anthropometric indicators also acted as mediators in the relationship between dietary intake and serum triglyceride levels. These findings reinforce the importance of using robust techniques to carry out studies in this area, producing valid results that improves public prevention strategies capable of reducing the occurrence of cardiometabolic alterations in these age groups and in adult life.

The term "street food" means food and beverages ready for consumption, or prepared and marketed on public roads. Despite the sector's contribution to the generation of jobs and income and to the provision of fast and accessible meals, can pose a danger to consumer health, due to risks associated with the sanitary quality of foods marketed. According to the literature, most of the vendors do not have technical preparation for handling, the infrastructure of the commercialization sites is precarious and there is insufficient regulation aimed at the sector. In Brazil, there are a set of standards regarding food safety, but these are not specific to the sector.In Salvador-Bahia, research has reported the inexistence or failure of regulations that specifically cover this sector. Thus, this study aimed to understand the evolution of the regulation of the street food sector, in Salvador-BA, from the perspective of the legal framework and its implementation. For that, two works were conducted: one aimed at analyzing the legal framework and another focused on the implementation of regulatory actions, based on the perception of social actors involved. In the first, a documentary research on the regulation of street food in Salvador-BA was carried out for the acts published between 1999 and 2015. The analysis of the documents revealed different categories and perspectives of action, or even of inaction, of the public authority, before the segment. It was observed a predominance of the municipal legislation, without having a federal guideline. Most of the standards have been published since 2013, mainly by acts of public authorities of space planning and health surveillance. In the elaboration of the norms, there was a marked social participation in the federal scope, with little reflection of this practice in the municipality. There was fragmentation in the content presented among the norms, as well as little articulation between the organs and spheres of government, making it difficult to decentralize and harmonize actions and their implementation at the municipal level. Considering the control of health risks, there was an evolution of the legislation, especially with regard to food, registering gaps for environmental risks and worker health. Throughout the period, there were common requirements for cleaning and ordering of the premises, as well as for the aesthetics of the worker, without there being a counterpart of the municipality to the improvement of the conditions of accomplishment of the work. For the second study interviews were conducted, following set of questions aimed at two groups: 1- employees of two levels of the Health Surveillance System - municipal and state, and the Municipal Public Order, municipal organ, and 2 - representatives of organizations of segment of sellers. Despite the unanimous perception by the interviewees of the importance of street food, the omission and distancing of public bodies from the reality of the segment in the implementation of regulatory actions was verified.There was insufficient intersectoral articulation and between levels of government, as well as little social participation of the segment in the establishment of specific norms. In addition, representative organizations have shown fragmentation, resulting in limitations for more effective action. The study evidenced the need for the segment's political insertion in the public agenda in order to allow a more interested, articulated and coherent action to the reality, as well as new studies, that can describe, advise and evaluate regulatory processes, in order to subsidize future planning for the segment.

The Brazilian primary health care, aims to solve the health problems of population through health promotion, prevention and treatment of diseases and rehabilitation. In their organization process, Family Health Strategy was created to reorder the health care model in Brazil. This works as the system's preferred gateway. In order to guarantee resolving, regionalization, territorializing, system hierarchy, integrality and continuity of primary health care, the Family Health Support Nucleus (Núcleo de Apoio à Saúde da Família – NASF) was established in 2008 by the Brazilian Health Ministry. The Family Health Support Nucleus actuation is divided into nine strategic areas. Among these, the food and nutrition field stands out, due to the growing demands associated with food and nutritional problems and their implications on the health of the population. The aim of this study was to characterize the food and nutrition actions incorporated into the Family Health Support Nucleus in the city of Salvador, Bahia, Brazil. This study is an exploratory qualitative research with professionals from the Family Health Support Nucleus teams of modality 1. The semi-structured interview was used as a data production technique. Were identified food and nutrition actions developed and their obstacles and opportunities. The content analysis was used as analysis method. The results were presented in three stages: "Characterization of study subjects", "Food and Nutrition actions in the Family Health Support Nucleus context", which was organized from the levels of care and "Scope and Limits in Food and Nutrition Actions". Actions such as anthropometry, diagnosis of chronic diseases, identification of individual and collective demands, nutritional orientations, alimentary and nutritional education, strategies for eating practices changes, food labeling, cooking workshop, gardening, breastfeeding and complementary feeding, actions to guarantee food and nutrition security, intra and intersectoral articulations were developed. Actions focused on all life cycles, especially those in care lines in primary health care. They are included in individual, shared, collective actions such as scholar health, groups, workshops, talk wheels and waiting rooms. We have identified that food and nutrition field shares appear to occupy a place in the primary health care in Salvador, just as there was a tendency for Family Health Support Nucleus to build a place in primary health care. The biomedical model, centered on the disease, is still hegemonic in food and nutrition practices, however, professionals reported that they are deconstructing the modus operandi based on this model. Prevention actions are also developed. The promotion actions were strengthened in collective actions. Teams face different limits such as difficulty in understanding the role of the Family Health Support Nucleus, planning, case discussion, and co-responsibility. However, the way to do health in the logic of the NASF goes through the deconstruction of the limits between the core knowledge of each professional. Once in the role of supporters, NASF professionals share knowledge in the matriciation process that also enables them to carry out planning, case discussion and co-responsibilities actions. The knowledge, shared among professionals from different areas, then integrates the process of care to the health system users. There was recognition of the need to take action in food and nutrition. The establishment of food and nutrition as a Family Health Support Nucleus strategic area of action has contributed to the implementation of Brazilian policy of food and nutrition and to advances in food and nutrition security. Food and nutrition actions are part of Family Health Support Nucleus work as part of the integral health care process. Therefore, the actions directed at the subjects tend to be carried out according to the demands of these and of teams of family health.