Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ
NESA Publicação oficial
ISSN: 2177-5281 (Online)
Páginas 98 a 103
Autores: Rozilaine Redi Lago1; Thalita Hanna Teixeira Ribeiro2; Marcos Nicodemos Costa de Souza3
1. Doctoral student in Public Health, College of Public Health, São Paulo University (USP). São Paulo, São Paulo State. Master's Degree in Collective Health - Lecturer, Acre Federal University (UFAC), Assistant Professor, Health and Mental Health Promotion and Oversight Areas. Rio Branco, Acre State, Brazil
Thalita Hanna Teixeira Ribeiro
How to cite this article
Keywords: Food habits, adolescent, food and nutrition education.
In order to achieve quality of life, healthy habits are needed, including an adequate and well-balanced diet, with a wide variety of foods that are evenly dimensioned in terms of nutrient quantities, including vitamins, minerals, proteins, carbohydrates and lipids, among others (Silva et al. 2012)1.
A steady shift in eating habits of peoples all over the world is also under way in Brazil, with the introduction of new technologies and lifestyle changes in societies: migration from rural zones to urban areas, letters replaced by e-mails, from walking to driving automobiles, from eating at home to eating in the street, and many other behavioral alterations that have taken place over the years, driven mainly by demographic and economic factors (Bezerra et al. 2013)2.
These minor shifts in behavior influence people´s health both directly and indirectly. Fox example, walking less means that younger generations are more likely to suffer from overweight, heart problems, neurological and muscular disorders, osteoporosis and other problems. City life is stressful, with long working hours, and eating away from home means that people start to choose foods that can undermine their health, when eaten on a large scale. The ingestion of large amounts of salt, carbohydrates, fats and sugars in processed foods has become a constant presence in Brazilian meals (Silva et al. 2012)3.
Among so many changes, concerns over the health of the Brazilian population have been targeted by government assessments and addressed through public policies, trying to persuade people to stay healthier throughout their lives. Many non-communicable diseases (such as diabetes, high blood pressure, osteoporosis and others) are associated with poor diets and sedentary lifestyles. Better education, encouragement to engage in more physical activities and more appropriate food choices may also help lessen these problems (Cardoso et al. 2011)4.
According to research projects, teenagers fall within the highest risk group for dietary factors. They spend more time in front of television screens and they eat more meals away from home, almost always opting for fast foods, soda pop, cookies and chips (Camelo et al. 2012)5.
Dos Santos et al. (2012)6 and Petroski et al.20 reached the conclusion that there is a teen dilemma between "eating foods that identify them as someone who is modern, cool and aligned with the standards showcased in the media and admired by most other adolescents, or adopting healthy habits".
Moreover, adolescents form a group that tends to switch eating habits more easily due to today´s fast-food culture, high in salt, sugar and fats. This preference generally continues for several years, often extending through into subsequent phases of their lives (Madruga et al. 2012)7.
Due to rising importance of assigning high priority to adolescent health on the agenda of the healthcare authorities and other sectors as well, in parallel to the need to achieve a better understanding of aspects related to the eating habits of this public, conducting this study is justified in order to provide synthesized information about the knowledge produced on the eating habits of these adolescents, in order to provide input for the activities of educators and healthcare practitioners, in addition to other stakeholders reaching out to this group8-20.
This is an exploratory, systematic review of the literature conducted through the Virtual Health Library (BVS), from which complete papers were selected, based on the following descriptors: eating habits; adolescents; dietary re-education. As screening criteria, the full texts had to be available free of charge for download in 2011, 2012 and 2013, published in Portuguese.
During this search, 67 papers were found, of which thirty were included in this research project. Two independent evaluators then analyzed the material, setting aside for review papers addressing the proposed objective of this project. On a supplementary basis, documents available on the Ministry of Health website on this matter were also consulted.
RESULTS and DISCUSSION
Adolescence is a time of transition, with physical, emotional, psychological and even social transformations taking place, making this a complex time of life (BRASIL 2009)8.
The word adolescence comes from the Latin word for youth: adolescentia, which means the time of life between childhood and adulthood. According to the Children's and Adolescents' Statute (ECA), promulgated through Law Nº 8,069 on July 13, 199015, an adolescent is a person between 12 and 18 years old. Meanwhile, the World Health Organization (WHO) defines adolescence is the period between 10 and 19 years of age, when many changes begin. Standardized chronological boundaries do not necessarily reflect this phase of life accurately, merely indicating the duration of this period, which depends on many different contextual elements that may be experienced in full.
Affected by hormone swings during this phase, teen sensitivity means that these youngsters are more likely to opt for high-calorie diets rich in sugar, fat and salt. Studies indicate that these nutrients act directly on what is known as the hedonic brain circuit. This brain center controls three separate types of behavior - liking, wanting and learning - through conscious and unconscious neural responses (Sawaya and Filgueiras 2013)9.
According to researchers, the food and beverages industry has developed products that stimulate the hedonic system, triggering overconsumption of high-calorie foods; this trigger involves specific hormones such as dopamine and insulin, together with leptin and acetylcholine inhibition. Furthermore, lengthy exposure to sugar, fat and salt steps up the functioning of the central nervous system and the gastro-intestinal tract, modifying genetic codes and resulting in weight gains during this stage of life (Sawaya and Filgueiras 2013)9.
Together with other factors shaped by contemporary social contexts, adolescent eating habits have spurred a real pandemic of obesity, with many related problems (Cardoso et al. 2011)4.
In this field, it is well known that the Brazilian population has shifted to a high-calorie diet, frequently eating processed foods that are high in fats, sugars and salts, while neglecting wholesome foods such as fruit, vegetables and greens that are high in fibers and vitamins. In the view of the population in general, particularly adolescents and young people, industrialized foods taste better and fit seamlessly into their adopted lifestyles compared to more natural diets (Estima 2012)10. Ferreira et al. (2012)11 go even further, saying that: "for Brazilians, salads and vegetables are tasteless, they have no flavor, they do not sate hunger and merely decorate the dish."
However, several factors tend to influence teen eating habits, either directly or indirectly, including social, cultural and even economic aspects. In this context, we cannot forget the massive influence of the media, wielded by major fast food corporations through television and radio advertisements, billboards, movies, electronic marketing and many other communications media, being extremely persuasive. Surveys have proven that the more hours people spend in front of television screens, the more their dietary choices will tend towards high-calorie items, with adolescents accounting for the largest segment of this population (Camelo et al. 2012)5.
For people whose food choices are steered by their financial status, belonging to the less prosperous segments of society, there is an ample supply of foods with low nutritional quality that are often cheaper, more affordable and easier to access. On the other hand, the consumption of some processed foods buoyed by marketing efforts - such as those sold through restaurant chains and snack bar franchises - have become hugely popular in society, linking consumption to social status and identity (Camelo et al. 2012)5.
In the midst of this complex food choice process, it becomes clear that teenagers are strongly encouraged to pick foods with poor nutritional quality that may adversely affect their health and quality of life during adulthood and the closing decades of their lives (dos Santos et al. 2012)6. These choices are steered by the factors listed above, as well as unfamiliarity with nutritional values, making them a high-risk group when food choices shift towards high-fat options as economic conditions improve (Silva et al. 2012)3.
During the teen years, dietary decisions become more autonomous, with parents and guardians no longer intervening to any great extent. This is a matter of concern for the public health authorities, as this is a vital stage in terms of quality of life. According to Madruga et al. (2012)7, "childhood eating habits are viewed as stable, as well as from childhood to adolescence. However, eating standards seem to vary more during adolescence". This is why these youngsters must be prepared to deal with this autonomy in their dietary decisions, compared to childhood, when they are still very open to guidance from parents and teachers. Ribeiro et al. (2012)12 highlighted the importance of some players, stating that: "school is a major stage where these prevention efforts can be implemented, jointly with families".
The upsurge in obesity among children and adolescents is a matter of much concern. Although this is a multi-factor disease, eating badly is closely linked to its causes. With the appearance of massive food conglomerates, people´s diets are steadily growing worse, with almost two million people in the Brazilian population estimated as overweight (Sawaya and Filgueiras 2013)9.
Concern over the need that the Brazilian population is able to take decisions and chose healthy dishes prompted the Ministry of Health to promulgate Interministerial Edict Nº 1010 on May 8, 200616, establishing the Brazilian Guidelines for ensuring healthy meals in government and private kindergartens, primary and secondary schools. This strategy is largely underpinned by the objective of curtailing the spread of Non-Communicable Chronic Diseases (NCCD) among the Brazilian population. These diseases are associated with many different factors, including sedentary lifestyles, poor diet, smoking, lack of physical activity, drinking alcohol, unhealthy working conditions and others.
Through the General Nutrition and Diet Policy Coordination Office, the Ministry of Health prepared a leaflet8 listing some of the steps leading to a healthy diet for adolescents:
"To maintain, lose or gain weight, contact a healthcare practitioner.
The influence of diet on individual health and the resulting harm affects large segments of the global population. The most frequently mentioned Non-Communicable Chronic Diseases (NCCD) are diabetes, high blood pressure and heart disease, caused by factors such as poor diet and the lack of physical activities. We stress the importance of eating properly, as food quality, social customs and dietary decisions acquired by people during their lives will either encourage the appearance of diseases or help avoid them.
During this stage of life, teenagers are the most likely to change their eating habits, far more than children whose meals are prepared by their parents, and also more than adults whose habits firmed up many years before, mainly during their youth. From this standpoint, it is clear how the teen years may directly influence the health of future adults, with processed foods resulting in the consumption of high-calorie, high-fat and high-salt meals to which youngsters become accustomed, with this continuing into their future eating habits. We are well aware of the importance of families in for providing their offspring with dietary guidance from the earliest phases of life, as people tend to select foods with which they are familiar.
It is thus necessary that some values in modern society be modified, in order to avoid future generations being victimized by bad habits firmed up in the course of a lifetime, as eating habits are shaped by factors ranging from social and cultural to economic and physiological, among others. Current eating patterns spotlight certain foods that tend to have adverse effects on societies as a whole, with the communications media, conglomerates and even society itself tending to over-appreciate the consumption of processed foods.
It is important to stress that no papers were found mentioning oversight activities by government watchdog entities that would initially be the most appropriate organizations for monitoring the quality of the food offered to the population. However, this topic is so complex that monitoring is only a single step towards improving the eating habits of the population, with such modifications involving psychological, social, economic and demographic aspects that encompass other areas such as communications and psychology, in addition to pursuing the interests of a massive organized market where huge conglomerates have many ways of leading people into dietary consumerism.
Studies of social behaviors in terms of food intake, in addition to research projects exploring other habits such as physical activities, hours worked, recreation quality and many other factors, are vital for learning how the population behaves and what interventions could be planned that would usher in better eating habits with fewer health problems in the future.
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