Background: Given the current worldwide epidemic of obesity, there is a demand for interventions with higher impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of intervention performed according to the stages of change of the transtheoretical model (TTM) for weight management. Methods: This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education. The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The intervention group (IG, n = 51) received the same orientation as the comparison group (CG, n = 35) plus individual health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance (ANCOVA) used to assess intervention effectiveness. Results: There was a difference between groups of − 1.4 kg (CI95%: − 2.5; − 0.3) in body weight after the intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood glucose results compared to the CG during follow-up. Conclusion: The individualized TTM-based intervention, combined with usual care, was an effective strategy in PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify additional strategies is needed to address barriers to weight maintenance among obese low-income women. Trial registration: The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv, Registration date: 12/12/2017 (retrospectively registered).

The evaluation of food consumption in childhood is essential to help understand the effect of food choices on health. The objective of this study was to conduct a systematic review of studies that identified the dietary patterns in schoolchildren (7–10 years old) and their associated factors. Observational studies published in the last ten years were searched in the databases BVS (Virtual Health Library), Embase, PubMed, Scopus, and Web of Science. The Newcastle Ottawa Scale was adopted to evaluate the articles’ quality. The studies covered schoolchildren, children, and adolescents as part of the sample. We selected 16 studies, 75% of which were considered good/very good and seven mentioned three food patterns. A dietary pattern considered unhealthy was identified in 93.75% of the studies, having as associated factors to its consumption: higher screen time, low bone mass, gain of weight and fat in children, and meal skipping. The children who usually had breakfast showed greater adherence to the dietary pattern consisting of healthier foods. The children’s dietary patterns were related to their behavior, nutritional status, and family environment habits. Food and nutrition education’s effective actions, as well as the regularization of the marketing of ultra-processed foods, must be stimulated and inserted in public policies as a way to promote and protect children’s health.

This study aimed to investigate the association between child development, daily habits, and ultra-processed food consumption with screen exposure in 4-year-old children. A cross-sectional study was conducted using a questionnaire that included sociodemographic data, the child’s daily habits, and screenings for child development and eating habits. The daily screen exposure time (cell phone, computer, television, and/or tablet) was measured in minutes and classified as inadequate if >60 min. We conducted bivariate analyses and a generalized linear model. Overall, 362 caregivers–children pairs were investigated. The average screen time per child was 120 min (IQR: 120), and most of the children (71%) showed inadequate screen time for the age group. The longest screen time was associated with the lowest score in child development (β = −0.03; p = 0.01), an increased habit of eating in front of screens (β = 0.34; p < 0.001), and the highest score of ultra-processed foods (UPFs) (β = 0.05; p = 0.001). The sample showed a high prevalence of inadequate screen time, and this has been associated with the lowest score in child development, an increased habit of eating in front of screens, and the highest score of UPFs.

Objective: Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city.Design: Cross-sectional study.Setting: Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil.Participants: Totally, 3372 participants.Results: UPF were found to contribute to 27·7 % of the diet’s total energy. The highest consumption was associated with higher values for energy intake (1561·8v. 1331·8 kcal/d;P< 0·01), energy density (1·7v. 1·4 kcal/g;P< 0·01), total (32·5v. 27·3 %;P< 0·01) and trans-fats (2·1v. 1·2 %;P< 0·01) and Na (1001·6v. 758·9 mg/1000 kcal;P< 0·01) and with lower values for proteins (14·9v. 19·6 %;P< 0·01), mono-unsaturated fats (16·1v. 20·1 %;P= 0·02),n-3 (0·9v. 1·1 %;P< 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P< 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population.Conclusions: Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.

OBJETIVO: Avaliar o uso de chupeta e mamadeira e sua influência na prevalência do aleitamento materno exclusivo entre lactentes de mães atendidas em um Banco de Leite Humano. MÉTODOS: Estudo transversal com mães atendidas em um Banco de Leite Humano entre 2009 e 2011 a partir de informações (sociodemográficas, antecedentes obstétricos, dados sobre aleitamento materno exclusivo, mamadeira e chupeta) obtidas por meio de questionário estruturado. Realizaram-se análise descritiva, teste de Qui-quadrado e regressão de Poisson. RESULTADOS: Avaliaram-se 9 474 mães, 65,2% com escolaridade até o ensino médio e 60,6% referiram aleitamento materno exclusivo. A prevalência de uso de mamadeira e chupeta foi de 22,9 e 25,0%, respectivamente. A amamentação exclusiva foi menor entre os lactentes que usavam chupeta (38,4 versus 43,2%; p<0,001) e mamadeira (13,5 versus 46,6%; p<0,001). O uso de mamadeira se associou à menor prevalência de aleitamento exclusivo (RP=0,43; IC95%=0,35-0,53), em contraste com a amamentação sob livre demanda (RP=5,5; IC95%=4,17-7,3), maior nível de escolaridade materna (RP=1,2; IC95%=1,08-1,35), pré-natal (RP=1,25; IC95%=1,13-1,38) e a mãe orientada sobre amamentação (RP=1,10; IC95%=1,02-1,18), que favoreceram esta prática. O uso de chupeta não se associou à prevalência de aleitamento materno exclusivo (RP=1,10; IC95%=1,00-1,21). CONCLUSÃO: O uso de mamadeira exerceu influência negativa na prevalência do aleitamento materno exclusivo e deve ser considerado alvo de estratégias para incremento dessa prática.

To evaluate the effectiveness of a collective intervention to encourage the consumption of fruits and vegetables on the nutrients intake for the prevention of chronic non-communicable diseases (NCDs), a randomized controlled community trial was conducted with a representative sample from the Health Academy Program. While the individuals in the control group (CG) participated in regular physical exercise, those in the intervention group (IG) also participated in a collective intervention. After 12 months, IG and CG showed a reduction in energy, omega 3 and sodium intake and an increase in the consumption of carbohydrates, fiber, vitamins, and minerals. Individuals from the CG showed an increase in phosphorus consumption and, in the IG, a reduction in the consumption of total, saturated, and polyunsaturated fats as well as an increase in the consumption of monounsaturated fats was seen. In both groups, there was an increase in the prevalence of adequate nutrients. Participation in the nutritional intervention was associated with lower consumption of energy and protein in the diet. The results pointed to the importance of individuals’ participation in the program, which, associated with nutritional intervention, promoted an improvement in the nutrient profile of the diet and the prevention and control of NCDs.