Promoção da alimentação saudável no âmbito do Programa Escola Integrada: influência no perfil nutricional de crianças e adolescentes

Abstract

Introduction: The effectiveness in promoting healthy eating in childhood and adolescence depends on appropriate strategies to this stage of life such as play food and nutrition education activities and cooking classes. Objective: Evaluate the influence of healthy eating interventions in the nutritional profile of students included in the Integrated School Program (EI), compared to the Traditional School students (ET). Materials and methods: The study was conducted as a non-randomizedcontrolled intervention with children and adolescents (6-14 years) of the EI and ET of a municipal school of Belo Horizonte/ Minas Gerais. The nutritional intervention was conducted with EI students. Socioeconomic and demographic information of all students were collected at baseline, while anthropometric data (weight and height) and food consumption (Illustrated qualitative questionnaire - ASSIS et al., 2007 forchildren, and 24 hours Recall and Food Frequency Questionnaire for teenagers) were assessed before and after the intervention. The intervention was conducted during seven months and covered the food groups through 14 education workshops and cooking classes. The acceptance of each workshop was verified by hedonic scale applied at the end of the activities. Statistical analysis consisted of descriptiveanalysis and application of the simple and paired Student t, Mann-Whitney, Wilcoxon, Chi-Square, McNemar and regression analysis tests. Results: We evaluated 294 studentes, 51.1% male and 53.0% of EI. Identified high occurrence of overweight: 14.5% and 17.6% of students in EI and ET, respectively, p=0.781, with no differences after intervention. At baseline EI children showed greater adequacy to the fruit foodgroup (81.8% vs 18.2% ET, respectively, p = 0.004) and number of meals per day (67.6 ET% vs 32.4%, p=0.002). Additionally, cholesterol intake was higher among adolescents from EI [231.7 (150.9 to 328.8) vs 172.8 (107.4 to 303.8) mg from ET, p = 0.030]. After intervention, the probability of having an EI child with adequate intake of fruits and grain legumes decreased (0.099 and 0.67 times respectively) and sweetgroups increased (2.35 times). In addition, more children from EI presented adequate intake for milk and dairy products in relation to the ET (74.1% vs 25.9%, p = 0.024). Adolescents of ET showed an increase in the median intake of sodium [383.1 (-92.9 - 1032.8) mg, p = 0.001] and a greater number of students from EI had consumption within the recommended parameters of zinc (EAR-UL: 68.1% vs 57.7% in ET;p=0.036). Moreover, a significant decrease was found in daily consumption of juice/bottle (7.8 days of the month), eggs (5.5 days of the month) and chicken (3.98 days of the month) in the EI group, after the nutritional intervention. In all workshops the option "I really enjoyed" was the most given answer by the students (78.9% to 92.7%), without differences between the type of strategy (education or cooking).Conclusion: The dietary intervention did not alter anthropometric measurements, but allowed some positive dietary changes and other actions to be developed in the future. Moreover, the Integrated School Program had an important role in the feeding of students, being a probable enhancer of the intervention performed.