Fernanda Scagliusi

Prior studies suggest that one anticipated benefit of bariatric surgery is the achievement of a thinner body, one that is less subject to perceived negative judgment and condemnation by others. However, additional analyses also indicate that stigma may persist even with significant post-surgery weight loss. To investigate the stigma-related perceptions and experiences of women who have undergone bariatric surgery and the resulting body
transformations, we conducted individual, semi-structured interviews with thirty Brazilian women (15 aged 33–59 and 15 aged 63–72). The resulting text was then analyzed using thematic analysis. We found that some form of weight stigma persisted for our participants, regardless of weight loss. Ongoing experiences of stigma were also evidenced by the constant internal and external vigilance reported by the women, as well as their articulated efforts to distance themselves from their previous bodies. Additionally, participants reported being judged for choosing an “easy way out” to lose weight. Those in the older group reported that weight stigma was entangled with ageism: older participants received mixed messages underscoring the ways that weight and age may interact in doubly stigmatizing ways. Family and close peers were especially powerful sources of stigma experiences. Collectively, these results show that weight stigma persists even when people undergo a procedure to lose substantive weight and that the degree and types of stigma experiences are influenced by gender and age. Our study suggest future research should explore whether a targeted approach might be more effective, for example, an approach that would emphasize the importance of developing coping strategies with respect to experiences of stigma and discrimination after surgery.

Most contemporary Western cultures are characterized by fatphobia. The fat body is seen as morally incorrect, a sign of disease, loss of control and weakness. People with obesity and overweight, especially women, are discriminated against and stigmatized for their body size, including by health professionals like dietitians. This study sought to understand and compare social representations of obesity and overweight among dietitians and laywomen from three nationalities: Brazilian, French and Spanish. A qualitative and comparative methodology was established based on 131 semi-structured individual interviews. The analysis revealed that the categories of overweight and obesity were negatively perceived by laywomen and dietitians from all three nationalities. Moral discourses linking these conditions with lack of discipline and a lack of emotional control were frequently used. Fatness was associated with irrationality, putting individuals who were overweight and obese in a position of social and moral inferiority. In the case of obesity, these ideas were more discriminatory and stigmatizing. Although environmental, genetic, hereditary or metabolic causes were mentioned as factors causing obesity, behavioural aspects occupied a central place in the discourses. Differences were also observed among the three nationalities. Cultural factors related to the relationship with body and food seemed to influence the interviewees' social representations. Brazilian laywomen and dietitians put more emphasis on moral and individual aspects. Spanish, French and informants who were overweight were more likely to cite physiological and environmental determinants. French informants also mentioned the role of food education given by parents. In conclusion, the discourses of professionals and laywomen had more similarities than differences, were based on moral and normative judgements and influenced by sociocultural norms. Fatphobic attitudes may impact dietitians' perception of patients with obesity and the eating education process.

We examined whether weight loss following HAES ®-based interventions associates with changes in cardiometabolic risk factors and quality of life of women with obesity. This was an exploratory, ancillary analysis of a 7-month, mixed-method, randomized controlled trial. Fifty-five women (age: 33.0 ± 7.2; BMI: 30-39.9 kg/m 2) were included in this study. Body weight, cardiovascular risk factors, clustered cardiometabolic risk, and quality of life were assessed before (Pre) and after HAES ®-based interventions (Post). Delta scores (Post-Pre) were calculated for each outcome and used in linear regression models. After adjusting by potential confounders, weight loss was associated with improvements in waist circumference (β = 0.83, p < 0.001), fasting glycemia (β = 0.45, p = 0.036), total cholesterol (β = 1.48, p = 0.024), LDL (β = 1.33, p = 0.012), clustered cardiometabolic risk (β = 0.18, p = 0.006), and quality of life (β = −1.05, p = 0.007). All participants but one who reduced body weight (n = 11) improved clustered cardiometabolic risk and quality of life. Of relevance, 34% and 73% of the participants who maintained or gained weight improved clustered cardiometabolic risk and quality of life, respectively, although the magnitude of improvements was lower than that among those who lose weight. Improvements in cardiovascular risk factors and quality of life following HAES ®-based interventions associated with weight loss as expected. However, most of the participants who maintained or even gained weight experienced benefits to some extent. This suggests that weight-neutral, lifestyle-modification interventions may improve wellness and health-related outcomes, even in the absence of weight loss.

Purpose-The authors aimed to triangulate food intake data obtained by two qualitative methods (in-depth interviews and participant observations) and one quantitative method (food-frequency questionnaire (FFQ)). The purpose of this paper was to analyze the kind of data each method produced and how these different pieces of information are methodologically related to the characteristics and limitations of different methods used and theoretically connected to participants' identities and masculinities. Design/methodology/approach-The analysis was based on data from an ethnographic study; whose participants were 35 men who self-identified as gay bears. The participants' food intake was investigated through participant observations, in-depth interviews and an FFQ. Findings-The qualitative methods indicated an overconsumption of meat and beer and a rejection of fresh foods, especially fruits and vegetables, as diacritical signs of the bears' identity. The FFQ showed a major consumption of minimally processed food, with fruits and vegetables being eaten more than meat. The authors proposed that the participants have compartmentalized their many habitual intakes and assessed one of them, separately, according to the method used (what was being asked and the context of that moment). Additionally, the authors connected these two patterns of habitual intake to the participants' identities and masculinities, questioning the existence of a constant hegemonic masculinity among this group. Originality/value-The triangulation of methods employed in the present study is seldom addressed in the literature. This approximation provided a rich discussion regarding the connections between eating, sexuality, gender and identity, through a novel methodological and theoretical lens.

This article examines constitutive elements of contemporary domestic cooking practices among women who live in the urban area of Cruzeiro do Sul, Acre, Brazil. We conducted semi-structured interviews with 16 self-identified women and mothers, who cook at home at least once a day. Here, we offer an in-depth analysis of our qualitative data, having coded our interviews with attention to the elements of cooking practices (i.e., understandings, procedures, engagements, materials, competencies, and meanings). Our findings reveal that cooking practices are not only gendered but also play a vital part in the construction and affirmation of these Brazilian women's identity, as indicated by how they negotiate elements of their domestic culinary practices regarding financial availability (materials), time availability (procedures), sociocultural gender norms (competences), and aspirations and personal desires (understandings). Read from a feminist perspective, we conclude that tensions surrounding the performance of femininity occurred when buying food at the supermarket or participating in the practice of "comprar fiado" in small neighborhood markets; preparing menus to meet familial preferences; preparing meals quickly and with little effort; offering the best foods to her children and husband; and showing affection and appreciation to those they feed.

Objective: To assess how mothers classify foods and how their eating practices interact with these classifications, with special attention to meanings and uses given to ultra-processed foods. Design: Qualitative research with in-depth interviews and pile sorts. Setting: Urban Brazilian Amazon. Participants: A sample of 34 mothers were selected through theoretical sampling. Analysis: Content analysis for in-depth interviews and multidimensional scaling and cluster analysis for pile sorts. Phenomenon of Interest: Food classification. Results: Classifications were based on context (ie, a time or a situation in which the food is eaten) and foods' healthiness. Five food groupings based on mothers' classifications were defined: (1) main meal foods, (2) fruits and fruit juices, (3) convenient foods, (4) leisure foods, and (5) canned sardines. Ultra-processed foods were classified differently from non-ultra-processed foods and considered unhealthy, consumed on special occasions or when there was no time or desire to cook. Conclusions and Implications: Results highlight the potential of incorporating context-based categories and personal experiences to guide nutrition interventions and the potential of pile sorts to tailor messages to target populations.

Weight stigma is reportedly globalizing, but there is limited evidence of how concerns around weight change are impacting those in many places. Additionally, few studies to date have considered how weight stigma operates in the context of interventions that purposefully eschew from a focus on weight itself. We have used qualitative analysis to examine body acceptance and responses to weight stigma among urban Brazilian gorda women participating in two forms of Health at Every Size ® (HAES ®) interventions: an intensive HAES ® program (I-HAES ® , n=26), which directly addressed weight stigma and a traditional, lessintensive HAES ® program (CTRL, n=13). Individual, semi-structured interviews regarding how participants felt about their bodies were conducted post-intervention. Exploratory content analysis followed an inductive approach. The I-HAES ®-group was more prone to accept their bodies, to feel well-being, to do new things, and to give proactive responses to weight stigma, while the CTRL-group internalized and accepted stigma, reported a lack of body acceptance, and indicated they were less able to challenge stigma in their lives. Interdisciplinary, intensive HAES ® interventions appear able to meaningfully tackle responses to weight stigma and promote body acceptance, important in contexts where stigma is a major component of how women experience their weight.

Although food insecurity configures a public health issue in developing countries going through nutrition transition, there is still lack of evidence on how it is affected by social determinants and its relationship with ultra-processed food (UPF) consumption. Using qualitative methods, we investigated the experience of food (in)security among mothers living in the Brazilian Amazon area, identifying aspects of food insecurity promoting UPF consumption. In-depth interviews were performed with 40 women and inductive content analysis was used. Signs of food insecurity included difficulties in food affordability and irregular access to food. Strategies to deal with lack of food quantity took place during food production (growing foods and raising animals), acquisition (gaining food, shopping incentives and food substitutions) and preparation (creativity in cooking). Not being able to afford staple foods was the main aspect of food insecurity promoting UPF consumption, as fresh foods were substituted by UFP options. Our study contributes to the current literature by presenting explanatory insights about the inconclusive quantitative results on the relationship between food insecurity and UPF consumption. Additionally, it supports the need of policies and interventions focused on promoting sustainable food systems and the regional food culture, which may approach food insecurity through an intersectional perspective.

To investigate the association between food consumption stratified by processing level and cardiovascular risk factors in rheumatoid arthritis. In this cross-sectional study, 56 patients (age: 62.5 ± 7.9 years, BMI: 28.4 ± 5.1 kg/m 2) had food consumption evaluated according to the processing level (e.g., unprocessed or minimally processed foods, processed foods, and ultraprocessed foods) and associated with cardiovascular risk factors. The most prevalent food processing level was unprocessed or minimally processed foods (42.6 ± 12.6% of total energy intake [TEI]), followed by processed (24.2 ± 11.9%TEI), ultraprocessed (18.1 ± 11.8%TEI), and culinary ingredients (15.1 ± 6.4%TEI). Adjusted regression models showed that higher consumption of ultra-processed foods was positively associated with Framingham risk score (β = 0.06, CI: 95% 0.001, 0.11, p = 0.045) and glycated hemoglobin (β = 0.04, CI: 95% 0.01, 0.08, p = 0.021). In contrast, higher consumption of unprocessed or minimally processed foods was associated with lower 10-year risk of developing cardiovascular diseases (β = −0.05, CI: 95% − 0.09, −0.003, p = 0.021) and LDL (β = −1.09, CI: 95% − 1.94, −0.24, p = 0.013). Patients with rheumatoid arthritis consuming more ultra-processed foods showed worse metabolic profile, whereas those consuming more unprocessed or minimally processed foods had lower cardiovascular risks. A food pattern characterized by a high ultra-processed food consumption appears to emerge as a novel, modifiable risk factor for cardiovascular diseases in rheumatoid arthritis. Key-Points • Higher ultra-processed food consumption was associated with worse metabolic profile and increased cardiovascular risk, whereas higher unprocessed or minimally processed food consumption was associated with lower 10-year risk of developing cardiovascular diseases. • A food pattern characterized by a high ultra-processed food consumption appears to emerge as a novel, modifiable risk factor for cardiovascular diseases in rheumatoid arthritis.

Objective: To identify and monitor food industry use of political practices during the adoption of nutrition warning labels (WL) in Colombia. Design: Document analysis of publicly available information triangulated with interviews. Setting: Colombia. Participants: Eighteen key informants from the government (n 2), academia (n 1), civil society (n 12), the media (n 2) and a former food industry employee (n 1). Results: In Colombia, the food industry used experts and groups funded by large transnationals to promote its preferred front-of-pack nutrition labelling (FOPL) and discredit the proposed warning models. The industry criticised the proposed WL, discussing the negative impacts they would have on trade, the excessive costs required to implement them and the fact that consumers were responsible for making the right choices about what to eat. Food industry actors also interacted with the government and former members of large trade associations now in decision-making positions in the public sector. The Codex Alimentarius was also a platform through which the industry got access to decision-making and could influence the FOPL policy. Conclusions: In Colombia, the food industry used a broad range of political strategies that could have negatively influenced the FOPL policy process. Despite this influence, the mandatory use of WL was announced in February 2020. There is an urgent need to condemn such political practices as they still could prevent the implementation of other internationally recommended measures to improve population health in the country and abroad, nutrition WL being only of them.

It is over there, next to that fat lady": a qualitative study of fat women's own body perceptions and weight-related discriminations 1 "É lá, perto da moça gorda": estudo qualitativo sobre as percepções de mulheres gordas acerca de seus corpos e discriminações relacionadas ao peso corporal

Background: In the business literature, the term "corporate political activity" (CPA) refers to the political strategies undertaken by corporations to protect or expend their markets, by influencing, directly or indirectly, the policy process. There is evidence that food industry actors use such political practices, which poses a significant threat to public health. Our study objective was to identify the political practices of the food industry in Chile. Results: In Chile, food industry actors supported community initiatives, particularly those targeted at children and those focused on environmental sustainability. Food industry actors also funded research through prizes, scholarships, and by supporting scientific events. Food industry actors lobbied against the development and implementation of a front-of-pack nutrition labelling policy, including with support from the Ministries of Economy, Agriculture and Foreign Affairs. Food industry actors, for example, claimed that there would be unintended negative consequences for society and the economy, and that the policy would breach trade agreements. The same arguments were used against a proposed tax increase on sugar-sweetened beverages. Food industry actors stressed their crucial role in the Chilean economy and claimed to be part of the solution in the prevention and control of obesity, with a particular focus on their efforts to reformulate food products, and their support of physical activity initiatives. Interviewees noted that the political influence of the food industry is often facilitated by the neo-liberal and market-driven economy of Chile. Nevertheless, this system was questioned through social protests that started in the country during data collection. Conclusions: In Chile, food industry actors used numerous action-and argument-based CPA practices which may influence public health policy, research, and practice. Despite strong influence from the food industry, Chile adopted a front-of-pack nutrition labelling policy. While the country has some measures in place to manage the interactions between government officials or public health professionals, and the industry, there is still a need to develop robust mechanisms to address undue influence from corporations.

The NOVA classification categorizes foods according to the extent of industrial processing. NOVA has been used in dietary guidelines of some countries including Brazil and Uruguay. This article aimed to investigate knowledge and perceptions of a sample of Brazilian adults regarding NOVA. A qualitative study was conducted in Dourados city, Mato Grosso do Sul, Brazil. First, participants (N= 24) were asked to classify a series of 24 pictures of foods and beverages using NOVA, which define the four major food groups: unprocessed or minimally processed foods; processed culinary ingredients; processed foods; and ultra-processed foods. Next, participants were asked to explain their classification through semi-structured interviews. Data from the classification activity were analyzed using non-metric multidimensional scaling and interviews using exploratory content analysis and summative content analysis. Participants seemed to understand NOVA in terms of food processing, food production, and additives used. They easily identified unprocessed or minimally processed foods and ultraprocessed foods; processed culinary ingredients and processed foods were harder to identify. Professionals, researchers and government organisations in Brazil or abroad could consider the results of this study in order to optimize this tool's potential for research and policy in nutrition and public health.

Background: In Colombia, public health policies to improve food environments, including front-of-pack nutrition labelling and marketing restrictions for unhealthy products, are currently under development. Opposition to these policies by the food industry is currently delaying and weakening these efforts. This opposition is commonly known as 'corporate political activity' (CPA) and includes instrumental (action-based) strategies and discursive (argumentbased) strategies. Our aim was to identify the CPA of the food industry in Colombia. Methods: We conducted a document analysis of information available in the public domain published between January-July 2019. We triangulated this data with interviews with 17 key informants. We used a deductive approach to data analysis, based on an existing framework for the CPA of the food industry. Results: We identified 275 occurrences of CPA through our analysis of publicly available information. There were 197 examples of instrumental strategies and 138 examples of discursive strategies (these categories are not mutually exclusive, 60 examples belong to both categories). Interview participants also shared information about the CPA in the country. The industry used its discursive strategies to portray the industry in a 'better light', demonstrating its efforts in improving food environments and its role in the economic development of the country. The food industry was involved in several community programmes, including through public private initiatives. The industry also captured the media and tried to influence the science on nutrition and non-communicable diseases. Food industry actors were highly prominent in the policy sphere, through their lobbying, close relationships with high ranking officials and their support for self-regulation in the country. Conclusions: The proximity between the industry, government and the media is particularly evident and remains largely unquestioned in Colombia. The influence of vulnerable populations in communities and feeling of insecurity by public health advocates is also worrisome. In Colombia, the CPA of the food industry has the potential to weaken and delay efforts to develop and implement public health policies that could improve the healthiness of food environments. It is urgent that mechanisms to prevent and manage the influence of the food industry are developed in the country.

Introduction Health at Every Size (HAES) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes and on enhancing pleasure derived from consuming food to achieve sustainable healthy eating outcomes. However, to the best of our knowledge, there are no studies in the literature assessing the effects of the HAES approach on perceptions of eating pleasure. Objective We qualitatively investigated the perceptions of obese women about eating pleasure before and after a new interdisciplinary, nonprescriptive intervention based on the HAES approach.

Transformations in eating practices are reflected in the multiplicity of competing food-related discourses. These discourses contribute to different food categorizations among individuals. Scientists have long argued that food categorizations may help understanding cultural systems of health beliefs. However, not enough work has been conducted to improve the understanding of the dimensions of food categorizations and their interface with food choices, tastes, and culturally defined food systems. This study aims at describing and interpreting how lowincome women living in three urban settings in Santos, Brazil, classify and give meaning to foods. We used the pile sorting method to investigate categorizations created by 90 women, following 6 steps: (1) creating units of analysis, (2) sorting the units of analysis into piles, (3) running multidimensional scaling analysis, (4) running cluster analyses on the multidimensional scaling coordinates, (5) labelling the clusters, and (6) analyzing consensus among the participants. The final solution to food categorizations comprised six clusters, namely: home meals, convenience foods, special meals, fish, breads and cereals, and hot dogs. Additionally, we observed four rationales for food categorization: frequency of consumption, degree of healthfulness, personal taste, and meals in which the food was usually part of. These categories highlight the importance of considering personal taste and the type of meal that the food is culturally consumed in, to propose meaningful interventions and appropriate education tools, towards promoting healthy eating practices, especially among vulnerable populations.

The aim of this study is to have an exploratory insight on how a sample of Brazilian adults classify food, attempting to identify the main factors involved in this process, and to compare these classifications to the NOVA food classification of the 2014 Brazilian dietary guidelines. An exploratory and qualitative approach was conducted with a selected sample of teachers, administrative technicians, and students (N = 24) from the Federal University of Grande Dourados, Brazil. First, using the pile sort method, participants were asked to freely classify 24 pictures of food (sourced from examples of the four food groups specified in NOVA) into food groups meaningful to them. Next, in semi-structured interviews, participants were asked to describe the food groups they created. The food groups created by participants were analyzed using non-metric multidimensional scaling followed by hierarchical cluster analysis, and the interviews were analyzed using content analysis. Participants had a mean age of 30 (± 9.4) years. A total of 128 food groups were created by 24 participants (an average of five food groups per person); and a total of 55 non-mutually exclusive groups names were used by them to describe these food groups. Sixteen themes emerged from the content analysis. The most recurrent themes were food groups, nutrients, foods I consume, foods I do not consume, and food processing. Contrasting themes such as real food and junk foods, meals and ready-made foods, healthy foods and unhealthy foods were also noted. Six clusters emerged from the cluster analysis, each related to one or more themes. Overall, a striking similarity was observed between the ways the individuals classified food and the NOVA food classification.

Visual representations of food-based dietary guidelines (FBDG) express diverse dietary and sociocultural norms, especially as they relate to healthy eating habits. This article investigates government recommendations for healthy eating habits expressed in the visual representation of Latin American FBDGs. Drawing on 15 images published between 1991 and 2017, we conducted an anthropological visual analysis guided by the methodology proposed by James Collier and Malcolm Collier: unstructured analyses, open viewing analyses, structured analyses and microanalyses. Here, we explore government recommendations based on visual representation shapes, food classification systems, lifestyle recommendations and embedded sociocultural elements. Our main findings relate to how dietary and sociocultural norms are used to promote eating practices considered healthy. Dietary norms focus on variety, proportionality, and moderation, as expressed in terms of food classification and food standards considered healthy. Sociocultural norms are referenced by the use of cultural symbols as strategies to promote traditional foods, cooking practices, commensality, water consumption and physical activity. Ultimately, we argue that FBDG visual representations contain embedded messages that counsel individuals to plan, buy, prepare and consume food with family; to consume foods considered healthy; to pay full attention to their meals, without distractions, such as television and cell phones; and to celebrate traditional, local and/or native foods and culinary preparations.

This study investigates the processes of acculturation, interculturality and interactions in the eating habits of Syrian refugees who had a Syrian food venue in the city of São Paulo, Brazil. We conducted a qualitative study, with an ethnographical design, with ten participants, using semi-structured interviews and participant and non-participant observation. There were changes in the preparation of consumed and served food products. These changes were accompanied by tensions, connected to the acculturation strategies and intercultural relations. Even with these changes, consuming Syrian food allowed our participants to maintain connections with their original country, despite the sudden temporal and spatial separation.

Health at Every Size ® (HAES ®) is a weight-neutral approach focused on promoting healthy behaviors in people with different body sizes. This study examined multiple physiological, attitudinal, nutritional, and behavioral effects of a newly developed, intensive, interdisciplinary HAES ®-based intervention in obese women. This was a prospective, seven-month, randomized (2:1), controlled, mixed-method clinical trial. The intervention group (I-HAES ® ; n = 39) took part in an intensified HAES ®-based intervention comprising a physical activity program, nutrition counseling sessions, and philosophical workshops. The control group (CTRL; n = 19) underwent a traditional HAES ®-based intervention. Before and after the interventions, participants were assessed for physiological, psychological, and behavioral parameters (quantitative data) and took part in focus groups (qualitative data). Body weight, body mass index, and waist and hip circumferences did not significantly differ within or between groups (P > 0.05). I-HAES ® showed increased peak oxygen uptake and improved performance in the timed-stand test (P = 0.004 and P = 0.004, between-group comparisons). No significant within-or between-group differences were observed for objectively measured physical activity levels, even though the majority of the I-HAES ® participants indicated that they were engaged in or had plans to include physical activity in their routines. I-HAES ® resulted in improvements in eating attitudes and practices. The I-HAES ® group showed significantly improved all Body Attitude Questionnaire subscale and all Figure Rating Scale

We investigated the eating practices of socially vulnerable overweight and obese Brazilian mothers, exploring the relationships between eating practices, capitals, fields and excess-weight. We conducted a qualitative study involving in-depth interviews of 21 women living in three vulnerable urban regions. Content analyses were performed and codes were used to locate actors in relation to each other in terms of 'capitals' and 'fields', forming a typology based on Bourdieu's theory with five groups. Socioeconomic conditions during childhood and liking to cook were the main characteristics related to each group's distinct eating practices. While socioeconomic conditions during childhood were related to region of origin and food tastes, liking to cook worked as a type of cultural capital, called culinary capital, which produced pleasure and status. For each pattern of eating practices, different factors seemed to contribute to participants' excess weight, including liked foods, enjoying cooking, and financial constraints. One group combined a highly vulnerable economic situation and health problems, shedding light onto a habitus that demands special attention from public health studies and interventions. This study illustrates the complexity of practices within a seemingly homogeneous group and reinforces that health studies should not assume homogeneity within a group of overweight/obese low-income women.

Context: The growing use of interventions based on the Health at Every Size® (HAES®) in obesity management. Objective: This study aimed to summarize the health-related effects of HAES®based interventions on people with overweight and obesity.

objective: To perform the psychometric evaluation of the Disordered Eating Attitude Scale (DEAS) for adolescents. Methods: Sample consisted of 1,119 Brazilian adolescents (12-18 years old; 59.6% female) studying at technical schools in São Paulo state-Brazil, who answered an online survey with the DEAS, the Eating Attitude Test (EAT-26), and the Restraint Scale (RS). The internal consistency of the DEAS was assessed using Cronbach's alpha. The convergent validity of DEAS was evaluated by means of Pearson's coefficient correlation with EAT-26 and RS. The test-retest reliability was evaluated using a sub-sample of 61 adolescents. Knowngroups validity was determined by comparing female student mean scores with scores of 33 female adolescents with eating disorders. results: The reliability of the DEAS was 0.79. EAT-26 and RS scores were positively correlated with DEAS scores (EAT: 0.78 for females and 0.59 for males, p < 0.001; RS: 0.63 for females and 0.48 for males, p < 0.001). The DEAS total and subscale scores differentiated students and patients with eating disorders (p < 0.001). The intra-class correlation coefficient for test-retest reliability was 0.87. conclusion: Results indicate that the DEAS adolescent version showed good internal consistency, convergent validity, known-groups validity, and test-retest reliability, suggesting its potential in identifying disordered eating attitudes among adolescents. It could also be helpful in identifying adolescents at risk from eating disorders, assisting in prevention programs.

objective: To perform the psychometric evaluation of the Disordered Eating Attitude Scale (DEAS) for adolescents. Methods: Sample consisted of 1,119 Brazilian adolescents (12-18 years old; 59.6% female) studying at technical schools in São Paulo state-Brazil, who answered an online survey with the DEAS, the Eating Attitude Test (EAT-26), and the Restraint Scale (RS). The internal consistency of the DEAS was assessed using Cronbach's alpha. The convergent validity of DEAS was evaluated by means of Pearson's coefficient correlation with EAT-26 and RS. The test-retest reliability was evaluated using a sub-sample of 61 adolescents. Knowngroups validity was determined by comparing female student mean scores with scores of 33 female adolescents with eating disorders. results: The reliability of the DEAS was 0.79. EAT-26 and RS scores were positively correlated with DEAS scores (EAT: 0.78 for females and 0.59 for males, p < 0.001; RS: 0.63 for females and 0.48 for males, p < 0.001). The DEAS total and subscale scores differentiated students and patients with eating disorders (p < 0.001). The intra-class correlation coefficient for test-retest reliability was 0.87. conclusion: Results indicate that the DEAS adolescent version showed good internal consistency, convergent validity, known-groups validity, and test-retest reliability, suggesting its potential in identifying disordered eating attitudes among adolescents. It could also be helpful in identifying adolescents at risk from eating disorders, assisting in prevention programs.

Objective: To describe and compare strategies adopted by overweight and obese low-income mothers living in different vulnerable contexts to deal with food constraints and feed their families. Design: Qualitative in-depth interviews. Data were analyzed with exploratory content analysis and the number of segments per theme was used to compare neighborhoods. Setting: Three low-income neighborhoods in Santos, Brazil. Participants: A purposive sample of 21 overweight or obese mothers. Results: We identified three main types of strategies, namely, food acquisition, cooking, and eating. Food acquisition included social support and food-sourcing strategies. Social support strategies ranged from macro (governmental programs) to micro (family) levels. Food-sourcing strategies involved price research and use of credit to buy foods. Cooking approaches included optimizing food (e.g., adding water to beans), avoiding wastefulness, and substitutions (e.g., using water instead of milk when making cakes). Eating themes ranged from lack of quantity to lack of quality. Strategies to deal with the lack of food were affected by family dynamics, such as prioritizing provision of fruits to children. Food choices (e.g., low consumption of fruits and high consumption of fatty meats) derived from strategies may help promote overweight and obesity. Furthermore, for participants, financial constraints were perceived as barriers to following nutritionists' recommendations and weight loss. Conclusions: This study highlights the barriers that low-income women face in adopting a healthy diet and sheds light on the importance of the symbolic value of food, even in the context of food insecurity. Finally, it suggests that environmental aspects could increase the accessibility to fruits and vegetables. These findings could be used to inform the planning and implementation of interventions.

This article reviews and discusses scientific papers on eating practices that have used Pierre Bourdieu's concepts presented in Distinction: A Social Critique of the Judgement of Taste. It aims to synthesize and analyze theoretical and empirical studies on the theme in order to present Bourdieu's contributions to the field, advances in his theories, and directions for future research. Exclusion criteria were: not written in Portuguese, English, Spanish, or French; not published in a peer-reviewed journal; not analyzing food or eating; and not using Bourdieu's concepts as presented in Distinction as the main theoretical framework. In this narrative review, we found 38 articles, which were categorized main themes: food choice and provisioning, taste, social class, food symbolism, the body, and the scientific field of food and eating. The taste of luxury and the taste of necessity were broadly applied on the works found in this review and were observed among the lower and upper classes, manifesting differently in each class. These studies show that while Bourdieu's theories are still highly relevant to understanding contemporary social groups, they may be improved when combined with other frameworks and theorists. We highlight as directions for future research manners in which gender and the environment interact with the habitus and food choices. Finally, this review points to new areas of investigation that may help improve the use of Bourdieu's concepts in exploring health inequalities, such as differences in eating practices and habitus within populations with low socioeconomic status.

Aim: This study aimed to analyse nutrition students' experiences with constructing a portfolio about food and culture. The study examined what was gained from the experience at its completion and retained after a period of 1 year. Methods: For the module 'Human food in historical and social contexts', nutrition undergraduate students were required to create a portfolio. Twenty-nine (of 49) students agreed to have their portfolios analysed in this qualitative study. The messages that were kept and recorded during the development of the portfolio were analysed by the discourse of collective subject method (DCS). Eleven students also participated in focus groups aimed to assess the impact of the portfolio on the students, as well as the process of its creation, in the long term. Transcripts of the focus groups were analysed using the DCS method. Results: In the portfolios, we noted important messages linking eating to history, culture, respect and commensality. In the focus groups, students highlighted that the portfolio helped them to reflect and to change their view of nutrition. The creation of the portfolio was considered exciting, involving and demanding. Conclusions: Through the analyses of the portfolio and the focus groups, it was possible to observe that students were stimulated towards a critical, humanised and complex practice that respected the historical, social, cultural, sensorial, nutritional and political nature of eating. The portfolio seemed a suitable learning method for complex themes, such as food and culture, providing a different and collaborative formation process.

Los estudios de género, florecientes a partir de la década de los setentas del siglo pasado, problematizaron el rol de la mujer, en términos de género, en la alimentación. Décadas más tarde-durante los primeros años de este siglo-, surgieron las investigaciones pioneras que relacionaron las alimentaciones con las sexualidades; pensando, más tarde, las posibles interfaces con la salud pública. Desde la práctica de la federastía, un uso erótico-sexual de la comida, hasta la existencia de colectivos que se apropian subversivamente de las barrigas prominentes para transformarlas en objetos de deseo, las investigaciones que intersectan alimentaciones y sexualidades están logrando cierta visibilidad. Este trabajo pretende exponer el estado de situación acerca de la articulación, poco explorada, entre estos aspectos así como comunicar los resultados iniciales de una investigación específica que se realiza en la ciudad de San Pablo, Brasil, y que abarca un colectivo homoerótico que se autodenomina "osos".

Disordered eating attitude scale was able to distinguish eating disorder patients. • Similarities and differences are highlighted by means of relationship with food. • Anorexia and bulimia nervosa patients presented more dysfunctional eating attitudes. • Obese and binge eating disorder patients presented interesting differences.

This study aimed to assess the relative validity of a food frequency questionnaire (FFQ) developed to assess food intake of schoolchildren from the Brazilian Western Amazon. The dietary intakes of 61 schoolchildren, aged between six and nine 9 years, were measured using two 24-hour dietary recalls and one FFQ, conducted with the children's, mother or guardians. Validity of the FFQ compared to the mean of the two dietary recalls was assessed using Pearson's correlation coefficient adjusted for attenuation and energy intake, Bland & Altman plots and evaluation of agreement levels between the two assessment methods. Energy-adjusted and deattenuated correlation coefficients ranged from-0.03 for vitamin C, to 0.93 for calcium. The mean coefficient was 0.46. The mean proportion of subjects classified within one quintile by the two methods was 66%. The Bland & Altman plots indicated good agreement for almost all nutrients, with a mean limit of agreement of 108%. These results indicate that, although there was a lack of accuracy for certain nutrients, such as vitamins A and C, the FFQ ensures reliable estimates of intake of most nutrients.

The assessment of food intake is essential for the development of dietetic interventions. Accuracy is low when intake is assessed by questionnaires, the under-reporting of food intake being frequent. Most such studies, however, were performed in developed countries and there is little data about the older population of developing nations. This study aimed to verify the total energy expenditure (TEE) of independent older Brazilians living in an urban area, through the doubly labelled water (DLW) method and to compare it with the reported energy intake obtained through the application of a food frequency questionnaire (FFQ). Initially, 100 volunteers aged from 60 to 75 years had their body composition determined by dual-energy X-ray absorptiometry (DEXA). Five volunteers of each quartile of body fat percentage had their energy expenditure determined by DLW. The mean age of the subjects included in this phase of the study was 66.4 W 3.5 years, and ten of the subjects were men. The mean TEE was 2565 W 614 and 2154 W 339 kcal.day À1 for men and women, respectively. The Physical Activity Level (PAL) was 1.58 W 0.31 and 1.52 W 0.22, respectively. Under-reporting of food intake was highly prevalent, with a mean percentage of reported intake in relation to measured TEE of À17.7%. Thus, under-reporting of food intake is highly prevalent among Brazilian independent older persons. The DLW method is an important tool in nutritional studies and its use is to be recommended in developing countries.

for their assistance in the literature search and statistical analyses, particu-Nakano for their assistance in the literature search and statistical analyses, particularly the factorial analysis and psychometrics involved in the study analysis.