Resumo O objetivo deste estudo foi analisar criticamente a aplicação do Índice de Qualidade da Dieta – Revisado (IQD-R), explicitar facilidades e dificuldades em seu cálculo, sugerir adaptações e comparar sua distribuição segundo variáveis sociodemográficas entre os 15.105 servidores públicos participantes do Estudo Longitudinal de Saúde do Adulto, no período de 2008 a 2010. O consumo alimentar foi aferido com base em Questionário de Frequência Alimentar e o IQD-R foi estimado de quatro maneiras: original; ponderado para frequência de consumo de frutas e hortaliças; modificado considerando leguminosas separado dos demais vegetais e adaptado abrangendo as duas alterações anteriores. Os resultados indicaram que independentemente da adaptação realizada, as mulheres, os indivíduos com mais de 65 anos e os indivíduos de menor escolaridade apresentaram escores médios mais altos indicando dieta de melhor qualidade. Acredita-se que as adaptações propostas podem ser úteis para estudos futuros que apliquem o IQD-R.

The COVID-19 pandemic exacerbated various determinants of mental disorders. Several behavioral changes were observed given this increase, including harmful health consequences, such as excessive consumption of ultra-processed foods (UPFs). To assess this relationship, we investigated the meditational role of symptoms of mental disorders (anxiety and depression) in the association between stress resulting from social distancing during the COVID-19 pandemic and the consumption of UPFs in 3884 Brazilian public employees in a supplementary study of the ELSA-Brasil study. Structural equation models (SEMs) were estimated to assess the direct and indirect effects mediated by symptoms of mental disorders. The results suggested a significant and positive mediational effect of the symptoms of mental disorders on the association between the stress resulting from social distancing and the consumption of UPFs. These findings contribute to informing the need for policies and early interventions in potentially stressful situations, with a focus on the promotion of mental health, and may thus help prevent or reduce the consumption of unhealthy foods.

Este artigo descreve aspectos metodológicos e caracteriza a participação no primeiro ano do estudo Impacto da Regulamentação do Ambiente Alimentar Escolar. O estudo visa monitorar a comercialização de alimentos nas cantinas e no entorno de escolas privadas de três cidades brasileiras com distintos contextos regulatórios, bem como investigar a percepção dos escolares sobre a cantina. Trata-se de um estudo transversal repetido (2023/2024 e 2025), com amostras independentes, em Recife (Pernambuco), Niterói (Rio de Janeiro) e Porto Alegre (Rio Grande do Sul). Para o Módulo Cantina, planejou-se uma amostragem de escolas privadas de ensinos Fundamental e Médio, estratificada pelo porte escolar e com reposição inversa. Para o Módulo Ambulante, uma amostra de conveniência. E para o Módulo Aluno, uma amostra por conglomerados em três estágios. Os dois primeiros módulos replicam a metodologia do estudo Comercialização de Alimentos em Escolas Brasileiras. A primeira coleta de dados ocorreu entre setembro de 2023 e maio de 2024. Participaram 202 escolas e 532 alunos. Apenas três vendedores ambulantes foram localizados. As taxas de participação escolar foram de 47,8% em Porto Alegre, 53,9% em Niterói e 69,9% em Recife. Houve resistência das escolas em receber a pesquisa, o que prolongou a coleta de dados e exigiu adaptações metodológicas. O artigo discute os desafios enfrentados no trabalho de campo e os ajustes metodológicos para o segundo ano de acompanhamento, trazendo recomendações para futuros estudos no ambiente escolar. Este projeto é fruto da colaboração entre academia e sociedade civil organizada, que demandou informações para apoiar ações de advocacy pela alimentação saudável na escola. As evidências geradas poderão subsidiar a formulação e o aprimoramento de políticas de proteção do ambiente alimentar escolar em outras cidades e níveis governamentais.

This article describes the methodological aspects and characterizes participation in the first year of the Impact of School Food Environment Regulation study. The study aims to monitor the commercialization of foods in canteens and the surrounding areas of private schools in three Brazilian cities with distinct regulatory contexts, as well as to investigate students' perceptions of the school canteen. It is a repeated cross-sectional study (2023/24 and 2025) with independent samples, conducted in Recife (PE), Niterói (RJ), and Porto Alegre (RS). For the Canteen Module, a stratified sampling of private elementary and high schools was planned, considering school size and using inverse replacement. The Street Vendor Module used a convenience sample, while the Student Module employed a three-stage cluster sampling. The first two modules replicate the methodology of the Commercialization of Food in Brazilian Schools (Caeb) study. The first data collection occurred between September 2023 and May 2024, involving 202 schools and 532 students. Only three street vendors were found. School participation rates were 47.8% in Porto Alegre, 53.9% in Niterói, and 69.9% in Recife. Schools' reluctance to participate in the study prolonged the data collection period and required methodological adaptations. This article discusses the challenges in fieldwork and the methodological adjustments planned for the second year of follow-up, offering recommendations for future studies in the school environment. This project results from a collaboration between academia and organized civil society, which sought information to support advocacy efforts for healthy eating in schools. The evidence generated may contribute to the development and improvement of policies aimed at protecting the school food environment in other cities and at different government levels.

In Brazil, there is no federal law regulating the school food environment against the commercialization of unhealthy foods, only municipal and state initiatives. This study describes the changes in the healthiness of school canteens in three Brazilian cities with different regulatory contexts. A repeated cross-sectional study was conducted in 2022 and 2023, with probabilistic samples of private schools in Recife, Niterói, and Porto Alegre. The Healthiness Index (HI) was calculated, scoring positively for the availability of fresh, minimally processed, and processed foods, and negatively for the presence of ultra-processed foods. Differences between years and cities were assessed using statistical tests, and the relative change in HI was analyzed using negative binomial regression. In 2022 and 2023, a total of 240 and 203 canteens were assessed, respectively. In 2022, the HI in Porto Alegre was higher than in Recife (70 vs. 54, p<0.00) and Niterói (44, p<0.00). In 2023, the healthiness of Recife’s canteens worsened (50, p<0.00). Compared to Recife, the HI increased by 24% in Niterói (RT = 1.24; 95%CI: 1.17-1.32), possibly due to a law prohibiting the sale and advertising of ultra-processed foods in schools. Porto Alegre, which has had specific legislation since 2018, maintained a more favorable scenario, but the HI decreased by 6% (RT = 0.94; 95%CI: 0.90-0.97). Despite this, Porto Alegre’s HI remained higher than in Recife (vs. 50, p<0.00) and Niterói (vs. 46, p<0.00). The establishment of national regulations on food sales in schools, alongside actions to promote the transition to healthy canteens and foster sustained policy adherence, would be beneficial.