Contextos alimentares, ato de cozinhar e participação no planejamento e no preparo de refeições: um estudo exploratório com adolescentes

Abstract

Objectives: Investigate eating contexts, cooking at home and participation in the planning and in the cooking process of meals in adolescents, estimating their associations with sociodemographic factors, food consumption by degree of industrial processing and overweight indicators. Methods: The data analyzed in this thesis comes from a school-based cross-sectional health and nutrition survey, realized from 2018 to 2019, in a probabilistic sample of adolescents between 14 and 19 years old, enrolled in 29 public schools located within the urban area of the city of Juiz de Fora, MG, Southeast Brazil (n = 835). To investigate eating contexts, an exploratory questionnaire of 23 original questions was developed, whose content was based on the recommendations about modes of eating presented in the second edition of the Brazilian Dietary Guidelines (Guide), which discourses on the regularity of meals, places where they occur, and if they take place with attention and in company. Subsequently, this questionnaire was submitted to cluster analysis and, hence, three clusters were identified: cluster 1 (n = 595), “appropriate eating contexts at breakfast, lunch, and dinner”; cluster 2 (n = 144), “inappropriate eating context at breakfast”; and cluster 3 (n = 96) “inappropriate eating context at dinner”. In order to investigate cooking at home and the participation in the planning and cooking process of meals, another exploratory questionnaire of 12 original questions was developed, whose content was based on culinary recommendations presented of the Guide, which encourages acquisition, development and share of culinary skills, with no gender distinction, including children and young people. Two 24-hour dietary recalls were applied, on non-consecutive weekdays, whose foods were classified according to the NOVA system, which considers the nature, extent, and purpose of the industrial processing to which the foods and food products are submitted before acquisition and consumption. Body mass index for age (BMI-for-age), waist circumference and body fat percentage were evaluated. Regarding the statistical analysis, multinomial logistic regression, linear regression and Poisson regression were performed, with adjustment for sociodemographic characteristics. Results: Inappropriate eating contexts at breakfast and/or at dinner (which refers to the habit of having these meals less frequently, outside their homes, in noisy environment, sitting/lying on the couch or bed, standing or walking, in front of screens and unaccompanied) were associated with: female sex [cluster 2: OR = 1.60 (95% CI: 1.06; 2.40); and cluster 3: OR = 2.15 (95% CI: 1.31; 3.54)]; younger age range, 14- 15-year-olds [cluster 2: OR = 0.46 (95% CI: 0.25; 0.86)]; white race and ethnicity [cluster 3: OR = 1.89 (95% CI: 1.21; 2.94)]; mother’s schooling higher than incomplete elementary school [cluster 3: illiterate or incomplete elementary school, OR = 0.20 (95% CI: 0.04; 0.95); complete elementary school or incomplete high school, OR = 0.29 (95% CI: 0.15; 0.54); and complete high school, OR = 0.43 (95% CI: 0.24; 0.79)]; reduction in the energy fraction from unprocessed or minimally processed foods and culinary ingredients [cluster 2: β = -3.61% (95% CI: -6.40; - 0.82)]; an increase in the energy fraction from ultra-processed foods [cluster 2: β = 2,55% (95% CI: 0.50; 5.05); and cluster 3: β = 4,18% (95% CI: 1.21; 7.14)]; an increase of BMI-for-age [cluster 2: β = 0.23 z-score (95% CI: 0.01; 0.46); and cluster 3: β = 0.27 z-score (95% CI: 0.02; 0.54)]; and an increase of body fat [cluster 2: β = 1.21% (95% CI: 0.23; 2.64)]. Most adolescents were not use to participate with the meal planning (“never, rarely, or sometimes”, 61.1%), and in the food selection/acquisition (“never, rarely, or sometimes”, 67.4%); in addition, these negative behaviours were more prevalent among male adolescents (respectively, 65.5% and 68.2%). Those who belonged to a low socioeconomic status were more likely to cook by themselves, at home, meals destined for the entire family consumption [PR = 1.10 (95% CI: 1.01; 1.18]]. The habit of preparing only snackable foods was associated with reduction in the energy fraction from unprocessed or minimally processed foods and culinary ingredients [β = -2.42 (95% CI: -4.81; -0.92)]; and the habit of not participating in the food planning was associated with reduction in the energy fraction from processed foods [β = -1.14% (95% CI: -2.03; -0.25)]. Conclusions: Inappropriate eating contexts at breakfast and/or at dinner were associated with sociodemographic factors (sex, age range, race and ethnicity, and mother’s schooling), with greater consumption of ultra-processed foods, and with weight and body fat gain. The participation in the planning of meals and in the food or culinary ingredients selection/acquisition was not habitual, especially among male adolescents. Overall, the lack of involvement with domestic culinary was associated with lesser consumption of unprocessed or minimally processed foods, culinary ingredients and processed foods, which are the basis for an adequate and healthy nutrition, usually used to compose traditional culinary preparations. The findings of this exploratory study, pioneer of Brazil, may incite others confirmatory surveys and, moreover, provide aids to outline more effective actions and interventions, since the traditional efforts aimed at stimulating healthy, accessible and sustainable nutritional patterns, and, simultaneously, preventing weight excess, have not been successful.