Renda, consumo alimentar e estado nutricional como indicadores complementares à insegurança alimentar e nutricional no Programa Bolsa Família
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Data
2016-05-13
Autores
Cardozo, Daiane Roncato [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: identificar potenciais indicadores complementares à percepção da insegurança alimentar e nutricional para o monitoramento de programas sociais de transferência de renda, tomando como referência o Programa Bolsa Família (PBF) em Araraquara/SP. Métodos: Foi realizado um estudo transversal incluindo 100 famílias beneficiárias e 50 não beneficiárias do PBF. Com um formulário semiestruturado foram obtidas informações sócio-demográficas e socioeconômicas, de percepção da insegurança alimentar e nutricional (Escala Brasileira de Medida de Insegurança Alimentar – EBIA), o estado nutricional (peso e altura para o Índice de Massa Corporal – IMC) e o padrão de consumo e hábitos alimentares. Associações entre exposições e desfecho foram testadas usando testes Qui-quadrado para variáveis categóricas e ANOVA para variáveis contínuas. A razão de prevalência (r) e intervalos de confiança de 95% (IC) foram avaliados utilizando modelo de Regressão de Poisson. A identificação de padrões alimentares foi realizada usando análise de Cluster e o estudo do poder preditivo de potenciais indicadores à percepção da insegurança alimentar foi avaliada utilizando a Curva ROC (Receiver Operating Characteristic). Foram considerados significativos valores p iguais ou menores do que 0,05. Resultados: Foram identificados três padrões alimentares: restrito, saudável e tradicional. O padrão restrito foi associado a um menor grau de escolaridade, relatos de anemia pregressa, percepção da insegurança alimentar e com maior idade media dos moradores do domicilio. Na análise não ajustada e ajustada para a idade média dos moradores da família encontrou-se maior prevalência de famílias com insegurança alimentar moderada ou grave no padrão restrito (1,55; IC95% 1,00 – 2,42 e 1,57 IC95% 099 – 2,49, respectivamente). No estudo dos potenciais indicadores de insegurança alimentar, componentes da renda cobriram mais de 70% da área sobre a curva ROC entre beneficiários do PBF, destacando-se os gastos com alimentação e com gás de cozinha. Conclusão: O padrão alimentar restrito relacionou-se com a proporção de insegurança alimentar moderada e grave da população estudada, enquanto a escolha do padrão alimentar saudável ou tradicional esteve associada à origem das famílias. Entre os potenciais indicadores estudados, a renda mostrou melhor desempenho na predição de insegurança alimentar e nutricional entre beneficiários de programas de transferência de renda, principalmente em relação à proporção da renda gasta com despesas básicas da família, como o aluguel e gás de cozinha.
Objective: This study aimed to identify potential complementary indicators of food and nutrition security for monitoring social program of income transfers, using as a reference the allowance family program (AFP) in Araraquara, SP. Methods: In a cross sectional study design, 100 beneficiary and 50 nonbeneficiary families of the AFP. Social demographic, economic, nutrition status, food consumption, and of food and nutrition security perception (EBIA) was collected using a pre-tested form. The association between exposure and outcome variables was tested using the chi-square test for categorical variables, and the ANOVA for numerical variables. The prevalence ratio (r) and confidence interval of 95% (CI95%) were assessed using the poisson regression model. Food patterns were identified using the cluster analysis and the predictive value of potential indicators of food and nutrition insecurity was tested using the ROC (Receiver Operating Characteristic) curve methodology. P-values below 0.05 were considered significant. Results: Three food patterns were identified: Restrictive, Healthy, and Traditional. The restrictive food pattern was related to a lower education level, reports of prior anemia, food and nutrition insecurity, and higher family age average. In the non-adjusted and in the analysis adjusted for the family average age, families with moderate or severe food and nutrition insecurity were more likely to adhere to a restrictive food pattern (1.55; CI95% 1,00 – 2,42 e 1.57 CI95% 099 – 2,49, respectively). In the study of the potential indicators of food and nutrition insecurity, the income components covered more than 70% of the ROC curve among the AFP beneficiaries, which can be considered as a acceptable predictive value. The proportion of the income spent on elementary facilities, such as domestic gas cooking and the rent, had the major predictive values. Conclusion: The restrictive food pattern was related to higher proportion of the population in moderate and severe food and nutrition insecurity; whereas the healthy or the traditional food pattern was more likely to be followed by families in security or minor food and nutrition insecurity. Among the potential indicators, the income has shown the best performance in predicting the food and nutrition insecurity for AFP beneficiary families, mainly for the proportion of the income spent with the elementary household expenses, such as the rent and domestic gas cooking.
Objective: This study aimed to identify potential complementary indicators of food and nutrition security for monitoring social program of income transfers, using as a reference the allowance family program (AFP) in Araraquara, SP. Methods: In a cross sectional study design, 100 beneficiary and 50 nonbeneficiary families of the AFP. Social demographic, economic, nutrition status, food consumption, and of food and nutrition security perception (EBIA) was collected using a pre-tested form. The association between exposure and outcome variables was tested using the chi-square test for categorical variables, and the ANOVA for numerical variables. The prevalence ratio (r) and confidence interval of 95% (CI95%) were assessed using the poisson regression model. Food patterns were identified using the cluster analysis and the predictive value of potential indicators of food and nutrition insecurity was tested using the ROC (Receiver Operating Characteristic) curve methodology. P-values below 0.05 were considered significant. Results: Three food patterns were identified: Restrictive, Healthy, and Traditional. The restrictive food pattern was related to a lower education level, reports of prior anemia, food and nutrition insecurity, and higher family age average. In the non-adjusted and in the analysis adjusted for the family average age, families with moderate or severe food and nutrition insecurity were more likely to adhere to a restrictive food pattern (1.55; CI95% 1,00 – 2,42 e 1.57 CI95% 099 – 2,49, respectively). In the study of the potential indicators of food and nutrition insecurity, the income components covered more than 70% of the ROC curve among the AFP beneficiaries, which can be considered as a acceptable predictive value. The proportion of the income spent on elementary facilities, such as domestic gas cooking and the rent, had the major predictive values. Conclusion: The restrictive food pattern was related to higher proportion of the population in moderate and severe food and nutrition insecurity; whereas the healthy or the traditional food pattern was more likely to be followed by families in security or minor food and nutrition insecurity. Among the potential indicators, the income has shown the best performance in predicting the food and nutrition insecurity for AFP beneficiary families, mainly for the proportion of the income spent with the elementary household expenses, such as the rent and domestic gas cooking.
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Palavras-chave
Programa Bolsa Família, Segurança alimentar e nutricional, Indicadores, Padrão alimentar, Renda, EBIA, Food and nutrition security, Health indicators, Food patterns, Income