Nathália Gioia’s research while affiliated with Children's Hospital Sabara and other places

Objective: To investigate the relationship between the biopsychosocial environment and eating habits and behaviors that lead to the selection and consumption of certain food from the earliest stages of life. To clarify whether there is an interaction between genetic and epigenetic factors, and how they shape eating habits. Data source: A narrative review based on research in PubMed and Web of Science electronic databases was carried out over the last 10 years, searching the title and summary fields using the keywords Children OR adolescents Feeding Behavior eating OR Dietary Habits OR Eating Behavior OR Eating Habits OR Children obesity. Data synthesis: The generational transmission of eating habits is related to the home, community, and school environments, mainly during the first years of life, and can exert the modulation of habits during all stages of life. During childhood, the family's role in consolidating eating habits is very broad and ranges from choosing foods to prioritizing family meals, including the lifestyle. Conclusions: Eating habits are transmitted from parents to children in different ways: environmental, emotional, social, and educational. In cases of obesity, a greater association of genetic influence can be observed.

Objetivo: Avaliar o consumo, perfil nutricional e fontes de alimentos consumidos no café da manhã por crianças com dificuldades alimentares. Métodos: Estudo transversal com 137, lactentes, pré-escolares, e crianças em idade escolar de um centro de referência em nutrição e dificuldades alimentares em São Paulo, Brasil. Características sociodemográficas foram retiradas da anamnese clínica. Café da manhã foi definido como a primeira refeição do dia após um longo período de sono, consumido entre 5 e 10 horas da manhã. Crianças que não apresentaram consumo de acordo com essa definição foram consideradas como não consumidoras de café da manhã. Os pais relataram o consumo alimentar de seus filhos. Perfil nutricional e fontes de alimentos do café da manhã foram identificados. Estatística descritiva e testes de Kruskal-Wallis, e t-Student foram utilizados com nível de significância de 5% (p<0.05). Resultados: A maioria das crianças consomem café-da-manhã (80,3%), e apresentam uma mediana de energética de 54,67kcal/dia. Crianças com fobia alimentar apresentaram menor consumo de energia, carboidrato, proteínas e outros nutrientes comparadas às crianças seletivas e com apetite limitado. Seletivos apresentaram menor consumo de vitamina E, cálcio, fibras, potássio, riboflavina, vitamina K e açúcar total. Fórmulas e cereais infantis, leite e pães foram as principais fontes de energia consumidas, independentemente do grupo etário, sexo e tipo de dificuldades alimentares. Conclusão: Consumo de café da manhã em crianças com dificuldades alimentares não é satisfatório e destaca a necessidade de ações para melhoria do consumo regular e equilibrado.

Despite the lack of a “gold-standard” definition and identification of influential factors for identifying feeding difficulties in children, many international studies have been published in recent years on the subject. Thus, the aim was to examine studies on children with feeding difficulties and their associated factors that impact on their difficulties. Feeding difficulties were identified as limit the variety of food intake, and/or avoiding food due to sensory stimulus, i.e., food appearance, aroma, and flavor. A literature search in three databases was performed up to April 2021. English language articles were included if they investigated preschool and school age children using an observational or experimental design evaluating feeding difficulties and their factors. Findings indicate that almost 60% of the studies evaluated picky/fussy eaters, followed by 20% evaluating food neophobia. Parental influence, mainly mothers, were seemed to be the most reported influence. Studies have shown a lower consumption of fruit and vegetables and higher intake of discretionary foods among picky and food neophobic children. Most of the studies showed that children were on normal weight to overweight status. Few studies identified socio-demographics (i.e., age, sex, race/ethnicity, and birth age), emotional distress and other lifestyle behaviors (screen-time use during meals). Studies were mixed in terms of positive effects on breastfeeding and introduction to foods. Improved feeding difficulties in this population group are dependent from these factors, whereas they should be used to inform policies, strategies, and use in clinical practices.

Objective To publish a consensus on the milky feeding of children aged between 1 and 5 years old, in the face of the nonuniformity of indication and the lack of standardization, in Brazil, on the nomenclature and classification of milky products produced for this stage. Methods Literature review and members discussion. Results The review showed the nutrition deficiencies among Brazilian children and the position of different medical societies. Conclusions Recommendations of milky feeding are proposed for government area, industry and health care professionals.