de Morais Sato Priscila, Unsain Ramiro Fernandes, Gittelsohn Joel, Sanches Tavares da Silva João Gabriel, Gonçalves Perez Isabel Cristina, Baeza Scagliusi Fernanda
Department of Health, Clinics and Institutions, Institute of Health and Society, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Santos/SP, CEP: 11015-020, Santos/SP, Brazil.
Department of Health, Clinics and Institutions, Institute of Health and Society, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136 - Santos/SP, CEP: 11015-020, Santos/SP, Brazil.
Appetite. 2017 Apr 1;111:63-70. doi: 10.1016/j.appet.2016.12.033. Epub 2016 Dec 26.
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.
Qualitative in-depth interviews. Data were analyzed with exploratory content analysis and the number of segments per theme was used to compare neighborhoods.
Three low-income neighborhoods in Santos, Brazil.
A purposive sample of 21 overweight or obese mothers.
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.
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.
描述并比较生活在不同弱势环境中的超重及肥胖低收入母亲为应对食物限制并养活家人所采取的策略。
定性深入访谈。采用探索性内容分析法对数据进行分析，并使用每个主题的片段数量来比较不同社区。
巴西桑托斯的三个低收入社区。
21名超重或肥胖母亲的目的抽样样本。
我们确定了三种主要策略类型，即食物获取、烹饪和饮食。食物获取包括社会支持和食物采购策略。社会支持策略涵盖从宏观（政府项目）到微观（家庭）层面。食物采购策略涉及价格调研和使用信贷购买食物。烹饪方法包括优化食物（如往豆类中加水）、避免浪费以及替代（如制作蛋糕时用水代替牛奶）。饮食主题包括从数量不足到质量不足。应对食物短缺的策略受到家庭动态的影响，比如优先为孩子提供水果。源自这些策略的食物选择（如水果消费量低和高脂肪肉类消费量高）可能有助于促进超重和肥胖。此外，对参与者而言，经济限制被视为遵循营养师建议和减肥的障碍。
本研究凸显了低收入女性在采用健康饮食方面面临的障碍，并揭示了食物象征价值的重要性，即便在粮食不安全的背景下亦是如此。最后，研究表明环境因素可增加水果和蔬菜的可及性。这些研究结果可用于为干预措施的规划和实施提供参考。
