Alanderson Alves Ramalho

This study aimed to test the factorial structure of the Eating Motivation Survey (TEMS) using Confirmatory Factor Analysis (CFA) in a sample of 632 university students from the Western Brazilian Amazon. A cross-sectional study was conducted between December 2022 and April 2023 with participants of both sexes, aged 18 or older. In addition to CFA, psychometric analyses were performed, and a Structural Equation Model was developed to examine the relationships between individual characteristics (age, sex, and Body Mass Index (BMI)) and the TEMS constructs. The results showed that 58.3% of participants were female, with a mean age of 25.29 years. The CFA supported an eight-factor model (health, natural concerns, socialization, price, visual appeal, weight control, emotional control, and social image) with 24 items, presenting good validity and reliability indices. Older individuals and those with lower BMIs prioritized health, natural concerns, and weight control, while younger participants, women, and those with higher BMIs were more influenced by emotional control. The findings contribute to understanding eating motivations in culturally diverse contexts and may support strategies aimed at promoting healthier dietary behaviors and preventing diet-related chronic diseases.

Objective This study aimed to analyze the association between socioeconomic conditions and food insecurity (FI) in the perception of quality of life (QoL) of older adults living in a capital of the Northeast of Brazil. Method This cross-sectional study included 190 older adults selected through probabilistic sampling. FI was evaluated by the Brazilian Food Insecurity Scale (EBIA) and QoL by the WHOQOL-BREF and WHOQOL-OLD questionnaires. Socioeconomic information was collected through in-person interviews, with responses recorded using an electronic questionnaire developed on the EpiCollect5 digital platform (available for smartphones, tablets, and web). Statistical analyses included absolute and percentage frequencies and Poisson regression with robust variance. Result The main results showed that, in the WHOQOL-BREF questionnaire, being in FI increased the probability of having a worse perception of QoL in the psychological (PR=1.47; 95%CI 1.10-1.66) and environmental (PR=1.70; 95%CI 1.21-2.41) domains. Considering the WHOQoL-OLD questionnaire, FI was associated with a worse perception of QoL in the domains of sense functioning (PR=1.46; 95% CI 1.06-2.00), autonomy (PR=1.57; 95% CI 1.13-2.18), present, past and future activities (PR=1.75; 95% CI 1.23-2.49), social participation (PR=1.34; 95% CI 1.01-1.79), death, dying (PR=1.90; 95% CI 1.34-2.68) and in the total score (PR=2.28; 95% CI 1.62-3.20). Conclusion The results show that the household’s FI condition can have a negative impact on older adults' perception of QoL.

Objective: This study aimed to evaluate food insecurity and associated factors during and after remote learning among undergraduates at Brazilian public universities. Methods: This is a comparative study of two cross-sectional studies; the first had its data collection from August 2020 to February 2021, and the second from May 2023 to December 2023. The questionnaire contained socio-economic variables, the Brazilian Food Insecurity Scale, the Diet Quality Scale, and the Perceived Stress Scale. Results: In total, 4799 undergraduates of Brazilian public universities responded in the first study, and 2897 responded in the second. Food insecurity was present in 36.5% of the students in 2020/2021 and 35.9% of the students in 2023. In the correspondence analysis, low income, poor health, stress and poor diet were associated with food insecurity in 2020/2021. Low income, reduced income, poor health, stress and diet quality were associated with food insecurity in 2023. Logistic regressions demonstrated that the year of collection, whether during or after remote learning, did not significantly contribute to food insecurity. However, students from low-income families had the highest AOR for food insecurity; no change in income or weight and lower perceptions of stress were associated with a lower AOR for food insecurity.

Introdução: A Resolução CD/FNDE nº 06/2020 define que a aplicação dos recursos no âmbito do Programa Nacional de Alimentação Escolar (PNAE) deve ser composta por no mínimo 75% de alimentos in natura ou minimamente processados; e que até 20% dos recursos utilizados poderão ser investidos na compra de alimentos processados e ultraprocessados, e no máximo, 5% para aquisição de ingredientes culinários. Objetivo: Avaliar a aplicação dos recursos financeiros do PNAE segundo a diversidade e o nível de processamento dos alimentos na Regional Juruá, extremo oeste brasileiro. Métodos: Trata-se de um estudo observacional seccional que utilizou dados do Sistema de Gestão de Prestação de Contas (SiGPC) dos municípios da Regional Juruá no estado do Acre, referentes ao ano de 2022. Os alimentos foram categorizados segundo nível de processamento. Resultados: No ano de 2022, o PNAE da Regional Juruá informou no SiGPC uma aquisição média de 56,2 gêneros alimentícios. A proporção de alimentos in natura ou minimamente processados variou de 47,37% a 79,03% nos municípios da Regional Juruá, e apenas um município apresentou diversidade mínima de 50 alimentos deste grupo. A proporção de recursos financeiros para aquisição de alimentos in natura ou minimamente processados variou de 57,34% a 85,39%; para alimentos processados e ultraprocessados, de 10,80% a 36,74%; e para ingredientes culinários, de 3,50% a 7,70%. Conclusão: Os municípios da Regional Juruá ainda enfrentam dificuldades para cumprimento da obrigatoriedade proporcional de destinação de recursos financeiros segundo nível de processamento e diversidade mínima de 50 alimentos in natura ou minimamente processados.

A Educação Alimentar e Nutricional (EAN) é uma estratégia essencial para a promoção de hábitos alimentares saudáveis na infância. A escola se destaca como um espaço estratégico para a implementação de intervenções em EAN, exigindo metodologias estruturadas que garantam abordagens eficazes e engajadoras. Este estudo tem como objetivo desenvolver um método sistemático para a seleção de temáticas em ações de EAN voltadas a crianças dos anos iniciais do ensino fundamental. O método proposto é composto por cinco etapas sequenciais: (1) Análise do Contexto e Necessidades Locais, (2) Avaliação do Desenvolvimento Cognitivo e Sensorial, (3) Definição de Objetivos Educacionais e Alinhamento Curricular, (4) Consulta a Stakeholders e (5) Priorização e Seleção Final das Temáticas. Para demonstrar sua aplicabilidade, o método foi utilizado na criação de um recurso educativo musical intitulado "Experimentar é Legal!", que incentiva as crianças a explorarem novos alimentos por meio da música. O processo estruturado de seleção garantiu que a temática escolhida fosse relevante, pedagogicamente adequada e alinhada às diretrizes nacionais de alimentação saudável. O estudo destaca o potencial da música como ferramenta pedagógica na EAN, favorecendo a retenção do conhecimento e promovendo mudanças comportamentais positivas. Apesar das contribuições, limitações incluem a necessidade de validação em diferentes contextos e a ampliação da participação de crianças e famílias na seleção das temáticas. Pesquisas futuras devem explorar outras estratégias interativas e avaliar o impacto de longo prazo das intervenções musicais nos hábitos alimentares infantis.

Malnutrition and overweight are significant public health challenges, especially in low- and middle-income countries. In the Amazon, high rates of malnutrition and the alarming rise of obesity highlight persistent regional inequalities. Therefore, the aim of this study was to analyze spatial distributions and temporal trends of malnutrition among children under five, adults, and elderly individuals in primary healthcare services across municipalities in the Legal Amazon from 2013 to 2023. Methods: This ecological study used data from the Food and Nutritional Surveillance System (SISVAN). The analysis included the prevalences of underweight, overweight, and obesity, stratified by year, sex, and federative unit. Spatial distributions were analyzed using QGIS version 3.22, and temporal trends were assessed with Joinpoint version 4.6 and expressed as annual percentage changes (APCs) and 95% confidence intervals (95% CIs). Results: Between 2013 and 2023, SISVAN monitored 10,451,758 children under five years, 30,831,720 adults, and 4,456,650 elderly individuals in the Legal Amazon. Stunting in children under five years decreased from 20.45% to 15.30%, with a significant downward trend (APC: −2.7; 95% CI: −3.7; −1.6). Childhood overweight exhibited a general downward trend but with notable fluctuations. Overweight in adults increased from 48.85% to 64.64%, and obesity from 17.10% to 28.49%, both showing significant upward trends. For the elderly, underweight decreased from 17.47% to 13.04%, with a downward trend until 2018, while overweight increased from 42.35% to 48.22%, with a significant upward trend until 2017. Conclusions: Despite progress in reducing childhood underweight, its prevalence in the Legal Amazon remains high compared to national averages. Significant regional disparities and rising overweight rates among adults and elderly individuals indicate a need for targeted public health strategies to address these nutritional issues.

The study aimed to analyze the health profile of women undergoing Roux-en-Y gastric bypass according to the time elapsed since surgery. Ninety-three women who underwent this procedure at the Clinics Hospital in Acre, Brazil, from 2008-2017, were divided into three groups according to the post-surgery period: G1 (n = 37) up to two years; G2 (n = 20) from two to four years; G3 over four years (n = 36) after surgery. Pre-surgery and post-surgery clinical, anthropomet-ric, and dietary variables were analyzed through a 24-hour recall. The postoperative time was 16.9±7.9 months (G1); 33.9±9.2 months (G2) and 75.3±19.1 months (G3). In the postoperative period, there was a decrease in the number of patients who practiced physical activity (35.5-33.3%). The mean percentage of excess weight loss was 66.1±15.4%. Satisfactory results were achieved by 88.17% (% PEP ≥50%). 67% of the patients presented weight reacquisition, proportional to the postopera-tive time (p˂0.001). The dietary survey indicated a daily energy consumption of 1262.75±424.11 kcal. The macronutrient distribution showed 59.25±8.33% for carbohydrates, 24.26±6, 90% for lipids and 17.12±6.68% for proteins. The mean protein intake was lower in group G1 (16.09±6.23), and lipid intake slightly in-creased over time. Bariatric surgery had a significant impact on the reduction of comorbidities, medication use, and the loss of excess weight. However, the nutrient adequacy and the increasing incidence of weight regain in the post-surgery period demonstrated that bariatric surgery does not end the obesity treatment, but it is only a step that requires periodic monitoring.

Background: Continued breastfeeding reduces infant mortality and provides nutritional, immunological, and developmental benefits for the child. Objectives: A prospective cohort study conducted in 2015 followed 608 children who were breastfed between 6 and 24 months. The study assessed the risk of breastfeeding interruption at 12, 18, and 24 months, as well as the factors associated with this outcome, in a cohort of newborns in Rio Branco, using the life table method. Methods: The factors associated with breastfeeding cessation and their 95% confidence intervals (CI95%) were analyzed using both crude and adjusted Cox proportional hazards regression in a hierarchical model. The risks of breastfeeding cessation at 12, 18, and 24 months were 19%, 65%, and 71%, respectively. Results: Factors positively associated with the risk of breastfeeding cessation include the use of a pacifier before 6 weeks of age (HR = 1.62; CI: 95% 1.24–2.11) and the use of a bottle during the first year of life (HR = 1.41; CI: 95% 1.11–1.78). Maternal return to work after the birth of the baby (HR = 0.78; CI: 95% 0.62–0.97) was found to be negatively associated with the risk of breastfeeding interruption. Conclusions: Early pacifier use before 6 weeks and the introduction of a bottle in the first year affect continued breastfeeding. Maternal employment was associated with reduced risk of breastfeeding cessation, contrary to most studies.