Bezerra Ingrid W Leal, Oliveira António Gouveia, Pinheiro Liana G B, Morais Célia M M, Sampaio Luciano M B
Department of Nutrition, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Department of Pharmacy, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
PLoS One. 2017 Feb 9;12(2):e0171821. doi: 10.1371/journal.pone.0171821. eCollection 2017.
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.
本研究的目的是评估巴西工人食品计划（WFP）是否与转型行业工人的营养状况变化相关。我们基于对食品、采矿和纺织行业26家中小型公司（13家加入WFP，13家未加入WFP）工人的分层两阶段概率抽样前瞻性收集的数据，进行了一项横断面观察性比较研究。研究变量包括体重指数（BMI）、腰围（WC）以及通过24小时饮食回顾获得的午餐饮食摄入量。数据采用嵌套混合效应线性回归分析，并根据个体变量进行调整。在计算总体参数时应用了抽样权重。最终样本包括1069名工人，其中541名来自加入WFP的公司，528名来自未加入WFP的公司。两组仅在教育水平、收入和内部培训方面存在差异。加入WFP公司的工人BMI更高（27.0kg/m²对26.0kg/m²，p = 0.002），WC更大（87.9cm对86.5cm，p = 0.04），超重患病率更高（62.6%对55.5%，p<0.001），WC增加的患病率更高（49.1%对39.9%）。WFP公司的工人午餐时饱和脂肪摄入量更低（-1.34g，p<0.01），钠摄入量更低（-0.3g，p<0.01）。总之，本研究表明，加入巴西WFP公司的工人超重率和心血管疾病风险增加率更高——这是一个负面发现——同时钠和饱和脂肪摄入量更低——这是一个正面发现。因此，需要重新审视WFP，并根据该计划目标人群的当前流行病学状况重新定义其目标。
