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      Evaluation of the nutritional status of workers of transformation industries adherent to the Brazilian Workers’ Food Program. A comparative study

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          Abstract

          The objective of this study was to assess whether the Brazilian Workers’ Food Program (WFP) is associated with changes in the nutritional status of workers in the transformation industry. We conducted a cross-sectional, observational, comparative study, based on prospectively collected data from a combined stratified and two-stage probability sample of workers from 26 small and medium size companies, 13 adherent and 13 non-adherent to the WFP, in the food, mining and textile sectors. Study variables were body mass index (BMI), waist circumference (WC), and dietary intake at lunch obtained by 24-hour dietary recall. Data were analyzed with nested mixed effects linear regression with adjustment by subject variables. Sampling weights were applied in computing population parameters. The final sample consisted of 1069 workers, 541 from WFP-adherent and 528 from WFP non-adherent companies. The groups were different only in education level, income and in-house training. Workers in WFP-adherent companies have greater BMI (27.0 kg/m2 vs. 26.0 kg/m2, p = 0.002) and WC (87.9 cm vs. 86.5, p = 0.04), higher prevalence of excessive weight (62.6% vs. 55.5%, p<0.001) and of increased WC (49.1% vs. 39.9%). Workers of WFP companies have lower intake of saturated fat (–1.34 g, p<0.01) and sodium (–0.3 g, p<0.01) at lunch. In conclusion, this study showed that workers of companies adherent to the Brazilian WFP have greater rates of excessive weight and increased cardiovascular risk—a negative finding—as well as lower intake of sodium and saturated fat—a positive finding. Therefore, the WFP needs to be revisited and its aims redefined according to the current epidemiological status of the target population of the program.

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          Mobilisation of public support for policy actions to prevent obesity.

          Public mobilisation is needed to enact obesity-prevention policies and to mitigate reaction against their implementation. However, approaches in public health focus mainly on dialogue between public health professionals and political leaders. Strategies to increase popular demand for obesity-prevention policies include refinement and streamlining of public information, identification of effective obesity frames for each population, strengthening of media advocacy, building of citizen protest and engagement, and development of a receptive political environment with change agents embedded across organisations and sectors. Long-term support and investment in collaboration between diverse stakeholders to create shared value is also important. Each actor in an expanded coalition for obesity prevention can make specific contributions to engaging, mobilising, and coalescing the public. The shift from a top-down to a combined and integrated bottom-up and top-down approach would need an overhaul of current strategies and reprioritisation of resources.
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            Intraclass correlation coefficients for cluster randomized trials in primary care: the cholesterol education and research trial (CEART).

            Cluster randomization trials are increasingly being used in primary care research. The main feature of these trials is that patients are nested within large clusters such as physician practices or communities and the intervention is applied to the cluster. This study design necessitates calculation of intraclass correlation coefficients in order to determine the required sample size. The purpose of this study is to determine intraclass correlation coefficients for a number of outcome measures at the primary care practice level. The CEART study is a randomized trial testing the effectiveness of translating ATP III guidelines into clinical practice, with primary care physician practices as the unit of randomization and patients as the unit of data collection. The intraclass correlation coefficient (ICC) was<0.02 and the design effect ranged from 1.0 to 2.3, respectively, for weight, total cholesterol, LDL, non-HDL, glucose, creatinine, and % at non-HDL goal. For smoking status, body mass index, systolic blood pressure, HDL cholesterol triglycerides, total cholesterol/HDL ratio and % at LDL goal, the ICC was 0.02-0.047 and the design effect was 2.6-4.1. The largest ICCs (0.05-0.12) and design effects (4.4-9.4) were found for height and diastolic blood pressure. These findings suggest that cluster randomization may substantially increase the sample size necessary to maintain adequate statistical power for selected outcomes such as diastolic blood pressure studies compared with simple randomization for most outcomes evaluated in this study where the design effect is small to moderate. Overall, the ICCs presented will be useful in calculating sample sizes at the primary care level.
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              [The Brazilian Workers' Food Program and its impact on weight gain and overweight].

              To evaluate the impact of worker food programs on weight gain and overweight.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                9 February 2017
                2017
                : 12
                : 2
                : e0171821
                Affiliations
                [1 ]Department of Nutrition, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
                [2 ]Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
                [3 ]Department of Administration Sciences, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
                Institut de recherche pour le developpement, FRANCE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: IWLB AGO.

                • Data curation: AGO.

                • Formal analysis: AGO.

                • Investigation: IWLB LGBP CMMM.

                • Methodology: IWLB AGO.

                • Project administration: IWLB.

                • Supervision: LMBS.

                • Visualization: WWLB AGO.

                • Writing – original draft: IWLB AGO.

                • Writing – review & editing: IWLB AGO.

                Author information
                http://orcid.org/0000-0003-4861-870X
                Article
                PONE-D-16-36367
                10.1371/journal.pone.0171821
                5300183
                28182763
                73baace7-8e02-4c94-8e66-ddc0317b03c5
                © 2017 Bezerra et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 September 2016
                : 26 January 2017
                Page count
                Figures: 0, Tables: 4, Pages: 11
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Biology and Life Sciences
                Nutrition
                Medicine and Health Sciences
                Nutrition
                People and places
                Geographical locations
                South America
                Brazil
                Biology and Life Sciences
                Biochemistry
                Lipids
                Fats
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Regression Analysis
                Linear Regression Analysis
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Food Consumption
                Medicine and Health Sciences
                Physiology
                Physiological Processes
                Food Consumption
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                Biology and Life Sciences
                Nutrition
                Diet
                Food
                Medicine and Health Sciences
                Nutrition
                Diet
                Food
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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                Uncategorized

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