Adesão à alimentação escolar e consumo alimentar segundo o grau de processamento, em Sumidouro – RJ

Abstract

The National School Feeding Program (PNAE) aims to promote healthy and adequate nutrition, contributing to growth, learning, and the development of healthy eating habits among students in Brazil’s public education system. Among the healthy dietary practices encouraged by the program are the limitation of ultraprocessed foods and the promotion of in natura/minimally processed foods. Therefore, school menus in Brazilian public schools are designed based on this principle, alongside the development of Food and Nutrition Education activities. However, few studies have investigated the relationship between adherence to school feeding (AE) and the consumption of in natura/minimally processed and ultraprocessed foods. Thus, the objective of the present study was to examine the association between adherence to school feeding and the consumption of these different types of food. This study has a cross-sectional design, with data collected from the baseline of a quasi-experimental study conducted in 2019 at three public schools in the municipality of Sumidouro, in the State of Rio de Janeiro. The study aimed to evaluate the effectiveness of a multicomponent intervention on school feeding adherence and acceptability. The baseline sample included 518 students from grades 4 to 9 of elementary school. Sociodemographic data were collected, and a Food Frequency Questionnaire (FFQ) was administered. Adherence to AE was categorized into three levels: non-adherence, partial adherence (1-3 times per week), and effective adherence to school feeding (4-5 times per week). The primary relationship of interest was assessed using linear regression, adjusted for sex, age, skin color, socioeconomic status, breakfast consumption with parents, nutritional status, and physical activity level. The results indicated no relationship between AE adherence and the consumption of in natura/minimally processed foods, and a negative association between AE adherence and the consumption of ultraprocessed foods, both in grams (β = -56.549, p-value < 0.001) and in Kcal (β = -89.423, p-value < 0.002). A dose-response effect was also observed between the level of adherence and the average consumption of ultraprocessed foods (Non-adherence = 554.44g (SD = 341.99); Partial Adherence = 476.23g (SD = 242.62); Effective Adherence = 429.36g (SD = 259.40)). Students' adherence to PNAE was associated with lower consumption of ultraprocessed foods, emphasizing the importance of public policies that promote healthy eating habits for children and adolescents.