Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ
NESA Publicação oficial
ISSN: 2177-5281 (Online)
|Case Report|| Imprimir
Páginas 118 a 123
Autores: Flávia Vasconcelos Teixeira1; Lumma Rodrigues Olavo2; Neirice Rodrigues Alves de Vasconcelos3; Silvana Frota Vasconcelos4; Antônia Gabriela Aragão de Oliveira Macêdo5; Denise Tomaz Aguiar6; Eroteíde Leite de Pinho7
1. Bachelor's Degree in Nursing, Vale do Acaraú State University (GRAPE). Former Monitor, PET Redes de Atenção / Rede Cegonha Networks. Sobral, Ceará State, Brazil
Flávia Vasconcelos Teixeira
How to cite this article
Keywords: Health promotion, nutritional status, adolescent health.
Adolescence encompasses the period between 10 and 19 years of age, accounting for 25% of the Brazilian population1. During this transition phase between childhood and adulthood, biological alterations are triggered by puberty, with physical, emotional, social and psychological changes that are specific to adolescence2.
Food consumption is influenced by living conditions, such as income, urbanization and access to a variety of foods, as well as individual characteristics such as education, age and family eating habits3. A healthy diet during adolescence fosters proper growth and development, while also lessening the risks of diseases related to poor diet4.
Implemented in 1955, Brazil´s National School Meals Program (PNAE) fosters the growth, development, learning and classroom performances of schoolchildren, in addition to establishing healthy eating habits through providing school meals, together with diet and nutrition education actions5.
Children spend more than four hours a day in their schools, which influences their food choices. Attempts to improve nutrition quality wilt under the onslaught of time spent with friends in school canteens (selling soda pop, savory snacks, candies and chocolates) and items brought from home, all competing with the menus offered in schools by this Program.
In many countries all over the world - including Brazil - obesity rates are on the rise among children and adolescents, closely linked to changes in lifestyles and eating habits, including easy access to cheap options that are high in fats and sugares6.
Pressure from peers and the media in general, among other factors (including biological and psychological aspects, families, body dissatisfaction and longing for a perfect body) also discourage teenagers from eating correctly, stepping up the risk of disorders such as anorexia and bulimia. Girls account for 90% of the affected population; in the more industrialized countries, where slimness is highly appreciated, this problem is more prevalent7.
Dietary changes ushered in by easier access to foods and sedentary lifestyles also lead to an uneven balance between calorie intake and energy output. Overweight also results from consuming too many calories, together with malnutrition caused by insufficient intakes of proteins and micronutrients8.
Due to the prevalence of poor eating habits among adolescents, it is vital to implement new nutrition education programs in schools, thus introducing a health-friendly context promoting good eating practices and healthy lifestyles. Strategies must also be drawn up for dealing with nutritional problems and eating disorders, together with the appearance of chronic diseases among these youngsters, such as obesity and diabetes, with massive impacts on public health9,10.
Consequently, in view of the importance of healthy eating habits as a strategy for promoting adolescent health, the objective of this study is to examine the implementation of health promotion actions in order to upgrade nutrition quality for these youngsters.
This study addresses an action-research project in which the engagement of the people affected by the problems was of the utmost importance. The idea of working from this methodological standpoint arose from the wish to help solve the problem rated as a key factor in this research project, examining proposed actions and solutions in order to highlight the type and complexity of the problems to stakeholders involved in this issue. Using a qualitative approach, this study focuses on obtaining descriptive data through direct contact between the researcher and the situation explored by the study.
This survey was conducted in a government school in Sobral, Ceará State, among 26 adolescents (22 boys and four girls between 13 and 15 years old in the 9th grade of Basic Education II, properly enrolled and attending school regularly. The data were collected through a questionnaire completed by this public, together with interventions analyzing the eating habits of these schoolchildren. This research project received prior approval from the Research Ethics Committee at Vale do Acaraú State University (GRAPE), on June 4, 2014, under Opinion Nº 674.824.
RESULTS AND DISCUSSION
Initially, the actions were conducted in order to educate youngsters on the importance of adding healthy foods to their daily meals, helping them understand the countless benefits of proper nutrition for a better quality of life. They then completed a guide questionnaire exploring their eating habits, followed by a lecture through which teachers cleared up some doubts about healthy eating, in addition to Body Mass Index (BMI) measurements. The questions addressed the following topics: number of meals each day; amount of fruit eaten each day; how they rate their diets and bodies.
In terms of the number of meals eaten each day, sixteen of the respondents ate less than four, and only three of them ate six times or more. When asked why they ate this number of meals, most stated that they lacked the social and economic conditions to eat more, while others stated that they felt no need to increase the number of meals.
In terms of daily fruit intake, this was very poor, with three of them stating that they did not consume any fruit at all, and only three confirming that they ate fruit three times a day. However, a significant number (21) of youngsters mentioned that they ate fruit between 1 and 3 times a day. When asked why they eat this amount of fruit, most of them replied that they prefer high-fat, high-calorie foods, rather than fruit and vegetables.
In terms of how these youngsters viewed their own eating habits, sixteen said that they felt they were adequate, although a significant number (10) of them did not agree with this statement. Teens who did not feel that they were eating properly were divided up as follows: those choosing foods high in sugars and fats, despite their awareness of potential harm and knowing the importance of eating healthy foods; and those who stated that they did not really know which foods should be included in their diets, nor the kinds of foods rated as healthy.
In terms of how they viewed their bodies, more than half (14) of the respondents said they were quite normal, while six believed they were thin; five felt fat and only one believed he was obese. Initially, it was planned to assess obesity rates and the quality of life of the target public, but the results did not lead in this direction, due the alarming presence of overweight adolescents. Six of the respondents were underweight, but most of the youngsters who did not allow their BMI measurements to be taken seemed to weigh more than average. Most (58%) of the others fitted into the normal standards, other than 17% with BMI measurements of more than 25 (overweight). It is stressed that only twelve of the 26 respondents agreed to BMI testing.
It was noted that the large number of pupils rated as underweight might be associated with the number of meals eaten each day, metabolic disorders and poor quality foods, resulting in a significant number of lean youngsters. However, it is believed that education on this topic is poor, in terms of ways of pursuing a wholesome quality of life, in addition to limited awareness among those with some knowledge.
The school plays an important function here, as it can adapt its menus, in terms of nutrition, as well as banning sales of high-sugar and high-fat items. Furthermore, this study focused only on food intake, although well aware that there are many other ways of pursuing a positive quality of life, with respondents stating that their sleeping patterns were good, as well as engaging frequently in physical activities. Consequently, after analyzing the results, Table 1 was drawn up, reflecting the questionnaire:
The findings of this study show that more than half the respondents eat less than four meals a day, with only a few eating six times a day or more. In terms of fruit consumption, most of them mentioned eating between one and three fruits each day. Among these youngsters, there is a clear preference for high-calorie, high-fat foods. Their explanations for this underscore their social and economic status and the lack of information on the problems resulting from eating certain foods. This highlights the importance of nutritional oversight for teenage pupils, serving as a tool for assessing and preparing intervention measures, such as school meals. The main conditioning factor that shapes adolescent eating habits and consequently underpins their nutritional status is the social and economic class of their families.
1. Organização Mundial de Saúde (OMS). Estratégia global sobre dieta, atividade física e saúde. [accessed on: October 10, 2013]. Available at: http://www.who.int/hpr/qs.consultation.document.shtml.
2. Penteado CPG, Oliveira JS, Teixeira MT, Chaves R, Costa CL. Avaliação do perfil nutricional de adolescentes com risco para transtornos alimentares. Adolesc Saude [período na Internet]. 2012; 9(3): 12-20. [accessed on: March 14, 2015] Available at: http://www.adolescenciaesaude.com/audiencia_pdf.asp?aid2=326&nomeArquivo=v9n3a03.pdf.
3. Maciel ES, Sonati JG, Modeneze DM, Vasconcelos JS, Vilarta R. Consumo alimentar, estado nutricional e nível de atividade física em comunidade universitária brasileira. Rev. Nutr [período na Internet]. 2012; 25(6): 707-718. [accessed on: March 14, 2015] Available at: http://www.scielo.br/pdf/rn/v25n6/03.pdf.
4. Leme ACB, Philippi ST, Toassa EC. O que os adolescentes preferem: os alimentos da escola ou os alimentos competitivos? Saúde Soc [período na Internet]. 2013; 22(2): 456-67. [accessed on: March 14, 2015] Available at: http://www.scielo.br/pdf/sausoc/v22n2/v22n2a16.pdf.
5. BRASIL. Fundação Nacional de Desenvolvimento da Educação. Ações Educativas [Internet]. [accessed on: April 10, 2015]. Available at: http://www.fnde.gov.br/index.php/programas/alimentacao-escolar/alimentacao-escolar-apresentacao.
6. Wang Y, Monteiro C, Popkin BM. Trends of obesity and underweight in older children and adolescents in the United States. Am J Clin Nutr 2002. 75: 971-7.
7. Silva GR, Cruz NR, Coelho EJB. Perfil nutricional, consumo alimentar e prevalência de sintomas de anorexia e bulimia nervosa em adolescentes de uma escola da rede pública no município de Ipatinga, MG. Revista Digital de Nutrição [período na Internet]. 2008; 2(3). [accessed on: March 14, 2015] Available at: http://www.unilestemg.br/nutrirgerais/downloads/artigos/volume3/artigo_4_rng_perfil nutricional.pdf.
8. Gliglioni EH, Ferreira TV, Bannemman RM. Estado nutricional dos alunos das escolas da rede de ensino municipal de Maringá, Estado do Paraná, Brasil. Acta Scientiarum. Health Sciences [período na Internet].; 33(1):83-88. 2011 [accessed on: March 14, 2015] Available at: http://periodicos.uem.br/ojs/index.php/ActaSciHealthSci/article/view/6349/6349.
9. Buss PM. Promoção e educação em saúde no âmbito da Escola de Governo em Saúde da Escola Nacional de Saúde Pública. Cad Saúde Pública 1999;15 (Supl 2): 177-85.
10. Toral N, Conti MA, Staler B. A alimentação saudável na ótica dos adolescentes: percepções e barreiras à sua implementação e características esperadas em materiais educativos. Cad Saúde Pública [período na Internet]. 2009; 25(11): 2386-94. [accessed on: March 14, 2015] Available at: http://www.scielo.br/pdf/csp/v25n11/09.pdf.