OBJECTIVE: To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages. METHODS: We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE – National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother's educational level, score of goods and services. We performed multivariate analyses using Poisson regression. RESULTS: The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66). CONCLUSION: Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.
ABSTRACT OBJECTIVE To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages. METHODS We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE – National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother's educational level, score of goods and services. We performed multivariate analyses using Poisson regression. RESULTS The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66). CONCLUSION Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.
OBJETIVO: Avaliar a efetividade de esquemas, diário e semanal, de suplementação profilática de ferro medicamentoso na prevenção da anemia ferropriva em lactentes não anêmicos. MÉTODOS: Estudo populacional, prospectivo, de abordagem quantitativa com intervenção profilática, realizado no município de Viçosa, MG, em 2007/8. Foram selecionadas 103 crianças não anêmicas, entre seis e 18 meses de idade, correspondendo a 20,2% das crianças cadastradas e atendidas pelas Equipes de Saúde da Família. As crianças foram divididas em dois grupos de suplementação: dosagem diária recomendada pela Sociedade Brasileira de Pediatria (grupo 1, n=34) e dosagem semanal preconizada pelo Ministério da Saúde (grupo 2, n=69). As avaliações ocorreram no início do estudo e após seis meses, sendo realizadas dosagem de hemoglobina (ß-hemoglobinômetro portátil), avaliação antropométrica e dietética, e aplicação de questionário socioeconômico. Os indicadores de impacto utilizados foram a prevalência de anemia, variação de hemoglobina, adesão e efeitos adversos aos suplementos. RESULTADOS: Os grupos se mostraram homogêneos quanto às variáveis socioeconômicas, biológicas e de saúde anteriores à intervenção. Após seis meses de suplementação, observaram-se maiores médias de hemoglobina no grupo 1 em relação ao grupo 2, (11,66; DP=1,25 e 10,95; DP=1,41, respectivamente, p=0,015); além de menores prevalências de anemia (20,6% e 43,5%, respectivamente, p=0,04). Apenas o tempo de suplementação influenciou na anemia grave (p=0,009). Não foram encontradas diferenças estatisticamente significantes para as variáveis adesão ao suplemento e efeitos adversos. CONCLUSÕES: A dosagem diária recomendada pela Sociedade Brasileira de Pediatria mostrou-se mais efetiva na prevenção da anemia em lactentes, quando comparada à dosagem utilizada pelo Ministério da Saúde. A dosagem semanal recomendada pelo programa do governo brasileiro precisa ser reavaliada para aumentar sua efetividade na prevenção de anemia em crianças atendidas em serviços públicos de saúde. ; OBJETIVO: Evaluar la efectividad de esquemas, diario y semanal, de suplementación profiláctica de hierro medicamentoso en la prevención de anemia ferropriva en lactantes no anémicos. MÉTODOS: Estudio poblacional, prospectivo, de abordaje cuantitativo con intervención profiláctica, realizado en el municipio de Vinosa, Sureste de Brasil, en 2007/8. Fueron seleccionados 103 niños no anémicos, entre seis y 18 meses de edad, correspondiendo a 20,2% de los niños catastrados y atendidos por los Equipos de Salud de la Familia. Los niños fueron divididos en dos grupos de suplementación: dosificación diaria recomendada por la Sociedad Brasilera de Pediatría (grupo 1, n=34) y dosificación semanal establecida por el Ministerio de la Salud (grupo 2, n=69). Las evaluaciones ocurrieron en el inicio del estudio y posterior a seis meses, siendo realizadas dosificación de hemoglobina (b-homoglobinómetro portátil), evaluación antropométrica y dietética, y aplicación de cuestionario socioeconómico. Los indicadores de impacto utilizados fueron la prevalencia de anemia, variación de hemoglobina, adhesión y efectos adversos a los suplementos. RESULTADOS: Los grupos se mostraron homogéneos con relación a las variables socioeconómicas, biológicas y de salud anteriores a la intervención. Posterior a seis meses de suplementación, se observaron mayores promedios de hemoglobina en el grupo 1 con relación al grupo 2, (11,66; DP=1,25 e 10,95; DP=1,41, respectivamente, p=0,015); así como menores prevalencias de anemia (20,6% y 43,5%, respectivamente, p=0,04). Sólo el tiempo de suplementación influyó en la anemia grave (p=0,009). No fueron encontradas diferencias estadísticamente significativas para las variables adhesión al suplemento y efectos adversos. CONCLUSIONES: La dosificación diaria recomendada por la Sociedad Brasilera de Pediatría se mostró más efectiva en la prevención de la anemia en lactantes, al compararla con la dosificación utilizada por el Ministerio de la Salud. La dosificación semanal recomendada por el programa de gobierno brasilero precisa ser reevaluada para aumentar su efectividad en la prevención de anemia en niños atendidos en servicios públicos de salud. ; OBJECTIVE: To assess the effectiveness of weekly and daily schemes of preventive supplementation with supplementary iron to prevent iron deficiency anemia in non-anemic infants. METHODS: A prospective population study with a quantitative approach and preventive intervention was performed in the city of Viçosa, Southeastern Brazil, in 2007-8. A total of 103 non-anemic children, aged between six and 18 months of age, were selected, corresponding to 20.2% of the children registered with and cared for by Equipes de Saúde da Família (Family Health Teams). Children were divided into two supplementation groups: daily dosage recommended by the Sociedade Brasileira de Pediatria (Brazilian Society of Pediatrics) (group 1, n=34) and weekly dosage recommended by the Brazilian Ministry of Health (group 2, n=69). Assessments were made in the beginning of the study and after six months, with hemoglobin dosage (portable ß-Hemoglobin-meter) and anthropometric and dietary assessments being performed and socioeconomic questionnaire applied. Impact indicators used were prevalence of anemia, hemoglobin variation, adherence to and side effects of supplements. RESULTS: Groups were homogeneous in terms of socioeconomic, biological and before-intervention health variables. After six months of supplementation, higher means of hemoglobin were found in group 1 than in group 2 (11.66; SD=1.25 and 10.95; SD=1.41, respectively, p=0.015); in addition to lower prevalences of anemia (20.6% and 43.5%, respectively, p=0.04). Only "supplementation time" influenced severe anemia (p=0.009). Statistically significant differences were not found for the "adherence to supplementation" and "side effects" variables. CONCLUSIONS: The daily dosage recommended by the Sociedade Brasileira de Pediatria was found to be more effective to prevent anemia in infants, when compared to the dosage used by the Ministry of Health. The weekly dosage recommended by the Brazilian government program needs to be reviewed to increase the effectiveness of prevention of anemia in infants cared for in public health services.
