Background: Delays in gross motor development, sensory processing issues, organic and behavioral problems are known to interfere in the development of feeding skills (FS); and – therefore - in the success of the process of feeding a child. Children with feeding difficulties (FD) commonly present inadequacy of FS. Objectives: Assessment of five FS in Brazilian children with FD, and search of associations with types of FD. Methods: Cross-sectional study with 70 children below 10 years old. Data was obtained from medical records: age, gender, age at texture transitions, feeding phase (breastfeeding, weaning to solids or full solids) at first complaint; characteristics of the meal (duration, environment and shared meals with adults), self-feeding practices, use of feeding equipment and bottle, mouthing, feeding position and FD diagnosis. Skills were categorized according to standards for age. Chi-Square, Anova Test (or non-parametric equivalent) and Multinomial logistic regression tests were used, with a significance level of 5%. Results: There was no difference in FS (p>0,05) or in the number of FS inadequateness (p=0,84) according to FD diagnosis. The majority (94%) of children presented at least one delayed development of FS; 1/3 presented delays in more than half of the FS. The most prevalent inadequacies in FS were inadequate feeding position (73,5%), prolonged bottle feeding (56,9%) and inadequate self-feeding practices (37,9%). Feeding complaints first appeared at 10,9m ± 11,4, and picky eating was the most prevalent type of FD (37,1%). Most children were fed in inadequate environments (55,2%), without the company of adults (78%). Transition to solid foods occurred at 16m ± 5,6. Multinomial logistic regression showed no difference in likelihood of presenting any type of FD compared to picky eating, according to FS. Age at texture transition both from breastfeeding to complementary feeding (p=0,95), and from complementary feeding to solid foods (p=0,43) did not vary according to FD diagnosis. Conclusions: FS development or number of FS inadequateness did not vary according to FD diagnosis. Identification of these inadequacies could help the discussion for multi-professional treatment of patients with FD.

Objectives: to review the prevalence of family meals and its impact on BMI and eating habits during childhood and adolescence. Methods: reviews are from Bireme / Lilacs / Scielo / Cochrane and Pubmed, between 2000-2016 with descriptors "family meal or mealtime", "behavior", "nutrition or diet or consumption or eating", and "child or children or adolescence"; performed by two independent examiners, according to the systematic steps in English and Portuguese. The articles were selected based on prevalence and/ or discussion between nutritional variables. 2,319 articles were found, which 15 were selected all in English: systematic reviews (n=2), cross-sectional studies (n=8), longitudinal studies (n=8); all related to children (n=5), adolescents (n=6) and both (n=5). Results: the mean of shared meals was 1x/day, with a prevalence of 27 to 81%. Most studies (n=13) reported the beneficial impact on BMI, higher consumption of fruit and vegetables, protein, calcium and a lower consumption of sweets and sugar sweetened beverages, family union and self-regulation of appetite. Conclusions: having daily family mealtime has beneficial effect on the nutritional status and children and adolescents' eating behavior.

Introduction: With the increase of childhood obesity, early intervention in nutrition education becomes necessary. Therefore, during the school period, the school becomes the best place for implementation of a nutritional education program. Objective: The current study was carried out in a public and in a private school, with the objective of evaluating and comparing the results of the "Nutriamigos®" Program on food and nutrition knowledge of children with different socioeconomic levels, sex, age and Body Mass Index (BMI). Method: Comparative longitudinal study, before and after educational intervention. To evaluate the intervention, a public (school 1) and a private school (school 2) were selected. This was a random, convenience sample comparing students from different social and economic levels, consisting of 242 (school 1) and 99 children (school 2), respectively, totaling 341 children, from 6 to 10 years of age. The Body Mass Index was used to measure nutritional status. Knowledge about food and nutrition was evaluated through a questionnaire, applied before and after intervention. The nutritional intervention consisted of 12 classes of 50 minutes each. Results: The improvement in knowledge on food and nutrition between the pre and post intervention stages was statistically significant. Conclusion: The "Nutriamigos®" Program reached its goal, demonstrating that it is effective in public and private schools and should not be differentiated for boys or girls, or for children with normal or excessive weight.

Background: Given the positive influence of responsive caregiving on dietary habits in childhood, to raise awareness of caregivers regarding their behavior is crucial in multidisciplinary care on infant feeding. Objectives: To identify the most common responsive and non-responsive feeding practices in mothers of children with feeding complaints, as well as to seek associations between practices and caregivers’ profile. Methods: Cross-sectional study with 77 children under 18 years old, with complaints of feeding difficulties. Data were collected during interviews with mothers: child age, gender, duration of exclusive breastfeeding, presence of organic disease, dynamics of bottle use, self-feeding practices and posture at meals, use of appropriate feeding equipment; basic information about the mothers (parity and level of education), caregiver feeding style, presence of coercive feeding, frequency and characteristics of family meals. Statistical analysis considered significance level at 5%. Results: The non-responsive profile predominated among mothers (76.2%, with the Authoritarian style being the most prevalent—39.7%). The responsive profile was characterized by absence of coercive feeding, stimulation of self-feeding practices, use of appropriate feeding equipment and meal environment, with interaction at meals. Non-responsive profile consisted of both inadequate environment and posture at meals, use of distraction and coercive feeding, lack of shared meals, and disregard for children’s hunger signals. Only the habit of sharing meals with children was associated with mothers’ profile, and considered a protection factor against non-responsive care (OR 0.23; 95% CI 0.06–0.88). Both Authoritarian (p = 0.000) and indulgent mothers (p = 0.007) breastfed exclusively for longer time than negligent ones. There was a higher level of interaction with children in “responsive” parental style (OR 0.056; p = 0.01) compared to other feeding styles. Conclusion: Results highlight the need for educational interventions focused on caregivers’ behaviors.

Background/Objectives: The optimal dietary approach for managing glycemic and metabolic control in type 2 diabetes (T2D) is still uncertain, though it should be tailored for clinical settings. Therefore, we sought to assess the impact of a multicomponent nutritional strategy on glycemic control in T2D patients within a public health system. Methods: NUGLIC was an open-label, parallel-group, superiority, multicenter randomized controlled trial. Participants aged 30 and older with poorly controlled T2D were randomly assigned to either (1) a personalized dietary prescription (control group, n = 185) or (2) a strategy involving targeted nutritional advising, mindfulness techniques, and short message services (NUGLIC [intervention] group, n = 186). The primary outcomes were glycated hemoglobin (HbA1c, %) measured after 24 weeks and glycemic control, defined as having an HbA1c > 7% at baseline and achieving ≤7% after follow-up, or having HbA1c ≤ 7% at baseline and reducing the use of glucose-lowering medications post-follow-up. The secondary outcomes included cardiometabolic features, self-care practices, diet quality, and quality of life. Results: A total of 371 participants were included in an intention-to-treat analysis for the primary outcomes. At six months, both groups exhibited a reduction in HbA1c levels compared to the baseline (NUGLIC group: −0.6% [95% confidence interval (CI) −0.9; −0.3], p < 0.001; control group: −0.5% [95% CI −0.7; −0.3], p < 0.001). However, no significant differences were observed between the groups in terms of HbA1c after follow-up (intervention group: 8.1%; control group: 8.3%; difference: −0.2% [95% CI −0.5; 0.1], p = 0.30) or glycemic control (NUGLIC group: 19.9%; control group: 18.9%; odds ratio 0.96 [95% CI 0.56; 1.67], p = 0.89). While the control group showed an improvement in overall diet quality, no significant differences emerged between the groups by the end of this study (p = 0.13). There were also no significant differences in other secondary outcomes nor in the use of glucose-lowering medications and adverse events after follow-up. Conclusions: The multicomponent nutritional strategy did not demonstrate superiority over personalized dietary prescriptions in achieving glycemic control for participants with poorly managed T2D. In this sense, both nutritional interventions could be used in clinical practice to improve HbA1c levels, considering the profile and preferences of individuals.