Identificar os fatores associados à introdução de alimentos não recomendados no primeiro ano de vida, entre crianças residentes em municípios de baixo nível socioeconômico. Estudo multicêntrico transversal com 1.567 crianças de 12 a 59 meses de idade residentes em 48 municípios participantes do plano Brasil Sem Miséria da Região Sul do Brasil. Aplicou-se questionário estruturado aos responsáveis pelas crianças para a obtenção das informações sociodemográficas e idade na qual alimentos não recomendados foram introduzidos pela primeira vez na alimentação complementar. A prevalência de introdução de açúcar antes dos quatro meses de idade da criança foi de 35,5% (n = 497; IC95%: 33,1-38,0). As prevalências de introdução de biscoito doce/salgado, queijo petit suisse e gelatina antes do sexto mês de vida da criança foram de 20,4% (n = 287; IC95%: 18,3-22,3), 24,8% (n = 349; IC95%: 22,4-27,1) e 13,8% (n = 192; IC95%: 12,0-15,7), respectivamente. Identificou-se associação entre a menor escolaridade materna (RP = 1,25; IC95%: 1,03-1,51) e a menor renda mensal familiar (RP = 1,22; IC95%: 1,01-1,48) com a introdução de alimentos não recomendados. Verificou-se a introdução de alimentos não recomendados no primeiro ano de vida entre crianças residentes em municípios de alta vulnerabilidade socioeconômica da Região Sul do Brasil, e esta prática associou-se à menor escolaridade materna e menor renda familiar mensal.

Purpose: – Qualitatively ascertain perceptions of parents regarding their children's influence on family food purchases. The paper aims to discuss these issues. Design/methodology/approach: – Content analysis of the transcripts of 31 semi-structured interviews conducted with parents of students from public and private institutions in Brazil. The public school provided meals supplied by the National School Feeding Program, and discouraged the consumption of foods brought from home. The private school did not receive any governmental subsidies for school feeding, and students were responsible for bringing their own school snacks. Findings: – Parents perceived children's influence especially of energy-dense nutrient-poor food purchases. Parents from the public school students, with lower income and educational levels, showed greater concern with quality and frequency with which requested foods were made available to the child. Only the parents from the private school students mentioned perceiving peer influence over their children's requests. Research limitations/implications: – Results enabled an overview of the main factors that influence children's purchase requests as perceived by parents. School environment seemed to influence requests, reinforcing the need for strategies similar to those present in the public school to be employed in private schools, where government programs that encourage healthy eating are not in place. Originality/value: – Qualitative study conducted with parents of Brazilian school children found that those with lower income and educational level were actually more concerned about their children's eating habits and perceived less peer influence over their children's requests for foods. Initiatives in the public school environment that effectively reduced access to certain kinds of foods in favor of healthier food choices reinforced the school's role as a health promoter for students and also their families.

Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children’s hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals’ data were collected using a structured questionnaire, and secondary and ecological data of children’s municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.

Objective: To estimate the prevalence of vitamin A deficiency (VAD) in children and associated risk factors. Design: Analysis of data from a cross-sectional multicenter study performed in the primary care units of the municipalities from January to June 2015. The children’s legal guardians answered a socioeconomic questionnaire and the children’s blood samples were obtained by venipuncture. Plasma retinol was determined by high performance liquid chromatography (HPLC). Plasma retinol values of <0.70 μmol/L were considered VDA. Poisson multiple regression with robust variance was used. Values of p <0.05 were considered significant. The data were analyzed in the SPSS software, 21.0. Setting: Forty-eight poorest municipalities in the South Region of Brazil. Subjects: Children (n = 1503) aged 12-59 months. Results: The prevalence of VAD in the sample was 1.9% (95%CI 0.5-6.8). The following risk factors were associated with the outcome in the final explanatory model: family received Bolsa Familia program benefits (PR = 3.19; 95%CI 1.69-6.02), child was not being breastfed (PR = 5.22; 95%CI, 1.68-16.18) and stunting (PR = 4.75; 95%CI 2.10-10.73). Conclusions: VAD did not represent a public health problem for children living in socioeconomically vulnerable municipalities in the South Region of Brazil, suggesting a new panorama of this nutritional deficiency even in regions of low socioeconomic conditions in these three states. Thus, in view of the current nutritional transition scenario, it is necessary to continuously monitor and improve public policies related to vitamin A supplementation in the country.

Revisão sistemática e metanálise de estudos que avaliaram a efetividade da suplementação de sulfato ferroso na prevenção da anemia em crianças menores de cinco anos de idade. Foram pesquisadas as bases PubMed, Scopus, SciELO e LILACS e incluídos artigos publicados entre 1980-2011 em espanhol, inglês ou português, utilizando os unitermos: criança, pré-escolar, lactente, anemia, prevenção, suplementação e ferro. Foram selecionados 13 estudos, que mostraram que independentemente da dose e do tempo de suplementação, o esquema diário foi mais consistente na melhoria dos níveis de hemoglobina (efeito combinado 0,56mg/dL, IC95%: 0,31; 0,81, p < 0,001) do que o semanal (efeito combinado 0,28mg/dL, IC95%: -0,22; 0,78, p = 0,273). Não houve efeito da suplementação na redução da prevalência de anemia, mesmo com doses diárias, e a administração conjunta com outros micronutrientes não trouxe benefícios adicionais em comparação com a administração exclusiva do suplemento. A suplementação diária de sulfato ferroso mostrou-se mais efetiva do que doses semanais na melhoria dos níveis de hemoglobina.

Resumo O estudo objetivou avaliar a prevalência da vacinação contra a influenza antes e durante a pandemia e seus fatores associados na população adulta e idosa de um município do Sul do Brasil. Trata-se de um estudo transversal com dados de duas pesquisas de base populacional realizadas em Criciúma-SC. A amostragem foi realizada em duas etapas: seleção aleatória dos setores censitários e dos domicílios. Foram avaliadas as prevalências de vacinação contra influenza antes e durante a pandemia de COVID-19, além de variáveis sociodemográficas, de saúde e comportamentais. Foram estudados 820 indivíduos antes da pandemia e 863 durante a pandemia. A maioria era do sexo feminino, de cor da pele branca e sem plano de saúde. A prevalência de vacinação contra influenza reduziu 18% na pandemia. Antes da pandemia, maior percentual de vacinação foi observado nos idosos. Durante a pandemia, além dos indivíduos idosos, naqueles que apresentavam multimorbidade e que tinham plano de saúde, a prevalência também foi maior. Observou-se queda importante na prevalência de vacinação contra influenza durante a pandemia de COVID-19. Os achados reforçam a necessidade de desenvolver estratégias de saúde pública como forma de aumentar as coberturas vacinais contra a influenza.