Eduardo Yoshio Nakano

Background/Objectives: This prospective, longitudinal, quasi-experimental study evaluated changes in eating competence (EatC) and its association with nutritional risk, dietary markers, and clinical outcomes, including body mass index (BMI), body fat percentage, and glycated hemoglobin (HbA1c), in Brazilian older adults with type 2 diabetes (T2DM) or prediabetes. Methods: Thirty-three older adults (87.9% female, predominantly inactive, regarding occupational status, and with low educational level) participated in a 12-month food and nutrition education (FNE) program at a public Primary Health Care unit in Ceilândia, Distrito Federal, Brazil. EatC was assessed using the validated ecSI2.0™BR; nutritional risk was measured by the Determine Your Nutritional Health (DNH) Checklist; and dietary intake was characterized using VIGITEL markers. Body composition was measured by bioelectrical impedance and HbA1c using standardized methods. Results: At baseline, regarding occupational status, active participants had significantly higher total EatC scores than inactive participants (p = 0.021). After 12 months, body fat percentage decreased significantly (p = 0.011), whereas BMI and HbA1c remained stable. Total EatC scores and its domains did not change significantly and most participants were already competent eaters at baseline (84.8%). However, variation in specific EatC domains was associated with important outcomes. Variation in food acceptance was negatively correlated with DNH variation (r = −0.417, p = 0.016), indicating an association between increased food acceptance and reduced nutritional risk. Variation in internal regulation was positively correlated with DNH variation (r = 0.492, p = 0.004). Variation in contextual skills was negatively associated with variation in body fat percentage (r = −0.412, p = 0.019). Additionally, variation in soda or artificial juice consumption was positively associated with variation in nutritional risk (r = 0.503, p = 0.003). Conclusions: Improvements in contextual skills and food acceptance were associated with better clinical and nutritional outcomes in older adults with T2DM or prediabetes. Public health interventions should prioritize meal planning, food preparation, and contextual skills as factors potentially associated with nutritional risk.

Objective: This study aimed to assess food literacy (FL) among early childhood education teachers in the Federal District/Brazil. Methods: This cross-sectional study used the Short Food Literacy Questionnaire (SFLQ-Br) and sociodemographic and professional questions administered to 203 teachers via online dissemination. Results: Participants were predominantly women (98%), aged 40–49 years (39.4%), with higher education in Pedagogy (76.4%) and postgraduate qualifications (67.5%). Over half (53.2%) had not attended courses in Food and Nutrition (F&N), although 75.9% reported familiarity with the Brazilian Dietary Guidelines. The mean FL score was 36.46 ± 7.74. Higher FL was associated with employment by Civil Society Organisations rather than by government, higher academic qualifications, and participation in more than 6 health or F&N courses ( p < 0.001). Conclusion: These variables associated with food literacy scores indicate stronger functional and relational FL dimensions, while revealing gaps in initial and continuing teacher education.

Background/Objectives: School feeding is a fundamental component of public policies aimed at promoting health, improving educational outcomes, reducing inequalities, and guaranteeing the human right to adequate food. This study aimed to evaluate the nutritional quality of school meals offered to public school students in a federal unit of Brazil, quantify the environmental impacts using carbon and water footprints, and simulate potential reductions through a strict vegetarian menu. Methods: This cross-sectional, descriptive study analyzed 130 daily menus (390 meals) from full-time public schools in the Federal District of Brazil in 2024. Nutritional quality was assessed based on energy, nutrients, food groups, degree of processing, and food origin. Carbon and water footprints were estimated using literature-based indicators. A nutritionally adequate strict vegetarian menu was then developed and compared with the observed menus. Results: The current menus presented good overall nutritional quality, with high food diversity and predominance of fresh or minimally processed foods. Most nutritional parameters met the recommended levels; however, protein and saturated fat exceeded the recommended limits. Animal-based foods accounted for most of the carbon and water footprints. The simulated strict vegetarian menu demonstrated significantly lower environmental impacts while maintaining nutritional adequacy. Conclusions: These findings highlight the importance of integrating nutritional and environmental strategies, such as a weekly “Meatless Monday” initiative alongside food and nutrition education, to improve student health outcomes and reduce the environmental burden of public school meals. Incorporating environmental sustainability criteria into school meal planning and public food procurement may advance nutritional quality, resource efficiency, and climate goals, positioning school feeding programs as strategic instruments for sustainable development.

Background: The decline in traditional cooking practices and the increased consumption of ready-to-eat meals have raised concerns about dietary quality and health, especially among university students. Nutrition students, despite their academic training, often struggle to translate theoretical knowledge into healthy eating practices. Culinary classes in academic settings have emerged as promising strategies to enhance both cooking skills (CS) and eating competence (EC). Objectives: This study aimed to evaluate the impact of a 12-month cooking class program on the development of culinary skills and eating competence among nutrition students at a public university in Brazil. Methods: A longitudinal study was conducted with 42 nutrition students who completed a structured questionnaire at three time points: baseline, after 6 months, and after 1 year of participation in sequential cooking-related subjects. Data were collected using the Brazilian Cooking Skills and Healthy Eating Questionnaire (QBHC) and the Brazilian version of the Satter Eating Competence Inventory (ecSI2.0™BR). Statistical analyses included a repeated-measures ANOVA and a Pearson correlation. Bonferroni post hoc comparisons were conducted following the repeated-measures ANOVA to identify the time points at which significant differences occurred. Results: Participants, predominantly young females (78.6%, mean age 21.07 ± 2.71 years), demonstrated high CS at baseline and showed significant improvements over time (p < 0.05). At baseline, 59.5% of participants (n = 25) were considered competent eaters (EC ≥ 32). Knowledge in cooking terms and techniques increased after one year (p = 0.023). EC mean scores classified participants as competent eaters at the beginning and after one year, with an increase in the internal regulation domain. Improvements in technical culinary knowledge were associated with gains in contextual skills. Conclusions: Participation in structured cooking classes positively influenced the development of CS and EC internal regulation among nutrition students.

Background: Coeliac disease (CD) is an autoimmune chronic condition that requires a strict diet without gluten as a single effective treatment. However, adherence to a life-long gluten-free diet (GFD) may promote psychological suffering and disordered eating. The Coeliac Disease Food Attitudes and Behaviours Scale (CD-FAB) is the only instrument specifically designed to evaluate these aspects in individuals with CD. Objective: This study aimed to translate the CD-FAB and test its reliability in the Brazilian population. Methods: The research was conducted in three stages: (i) translation and cultural adaptation of CD-FAB into Brazilian Portuguese; (ii) pretesting with Brazilian individuals diagnosed with CD to assess item understanding; and (iii) psychometric evaluation through reproducibility (test–retest reliability) via intraclass correlation coefficient (ICC) and internal consistency via Cronbach’s alpha. Results: The CD-FAB was successfully adapted to the Brazilian CD population (Child CD-FAB-BR) and demonstrated strong internal consistency (α = 0.807) and an intraclass correlation coefficient (ICC = 0.928). Conclusions: The Brazilian version of CD-FAB proved to be reliable for assessing food attitudes and behaviours in people with CD, potentially allowing for the identification of factors to guide research and clinical practice by driving behaviour-based strategies to improve nutritional education and strategic policies for coeliac patients. Studies with larger and more diverse samples are recommended to provide external validation of the instrument.

One of the most popular cure rate models in the literature is the Berkson and Gage mixture model. A characteristic of this model is that it considers the cure to be a latent event. However, there are situations in which the cure is well known, and this information must be considered in the analysis. In this context, this paper proposes a mixture model that accommodates both latent and non-latent cure fractions. More specifically, the proposal is to extend the Berkson and Gage mixture model to include the knowledge of the cure. A simulation study was conducted to investigate the asymptotic properties of maximum likelihood estimators. Finally, the proposed model is illustrated through an application to credit risk modeling.

Background/Objectives: This study aimed to translate the Child Coeliac Disease Food Attitudes and Behaviours Scale (Child CD-FAB) into Brazilian Portuguese and to evaluate its reproducibility and internal consistency. Methods: Three steps were carried out: (i) translation and cultural adaptation of the Child CD-FAB into Brazilian Portuguese; (ii) pre-test; and (iii) psychometric evaluation of the Child CD-FAB-BR. The Child CD-FAB was translated and back-translated, and then discussed with and approved by the author of the original instrument. The translated version was tested on five children and adolescents (aged 8 to 16 years) with coeliac disease to assess comprehension. Subsequently, psychometric evaluation used responses from 20 participants with the same characteristics, assessing reproducibility (test–retest reliability) via intraclass correlation coefficient (ICC) and internal consistency via Cronbach’s alpha. Results: The Child CD-FAB was successfully translated to Brazilian Portuguese (Child CD-FAB-BR), and it presented good internal consistency (α = 0.892) and an excellent intraclass correlation coefficient (ICC = 0.923). Conclusions: The Child CD-FAB-BR is the first instrument to evaluate food attitudes and behaviours in Brazilian children and adolescents with CD, showing good psychometric properties. This instrument will support future research and clinical practice by guiding behaviour-based strategies to enhance nutritional education and public policies for this group.