Efetividade da multimistura como suplemento dietético destinado à promoção da saúde.

Abstract

Recent data have shown that the prevalence of infant malnutrition has been importantly reduced everywhere in Brazil. It still affects thousands of children, and has been maintained as a serious public health problem in the country, especially in areas of the north and northeast regions. Because of that and together the efforts of the government, the civil society has sought alternative solutions to resolve the problem. In this context, emerged the proposal of the food alternative which has as its main consequence the development of the called multimixture (MM), a flour made of the non-used parts of a food that is utilized as a supplement of the usual diet of diet of children. That flour is being used by health professionals in a large number of Brazilian cities. However, the relevance of such use has been seriously questioned in academic circles. For this reason, this dissertation was made with the aim of evaluating the effectiveness of MM as a dietary supplement to improve the health of children at nutritional risk. To develop the theme, two articles were made. In the first, known as Chemical composition and effectiveness of multimixture as dietary supplements: a literature review there is an updated analysis on the chemical composition, the bioavailability of its minerals and effectiveness of MM: the data obtained show that it is a source of minerals (iron, calcium, zinc, copper, manganese, selenium) and vitamins (A, B2, B6, C, folic acid, biotin and pantothenic acid), but there is yet some doubts about the bioavailability of these nutrients. The possibility of poisoning by cyanide coming from sheet of cassava is not discarded. A great number of studies, especially those conducted with humans, pointing to its ineffectiveness to promote the appropriate nutritional status. The second article identified as The Effects of multimixture consumption of children nutritional status: Community test involving kids of a hantytown, in the periphery of Maceió Alagoas , was made from the results obtained in an experimental study of a Community test type, which included children (6 to 60 months), allocated in block after a draw selection for the Control Group (Sector A, n = 50) or the Multimixture Group (Sector B, n = 48). At this group, the supplementation consisted of two spoons of soup per day in the usual fractioned food. Anthropometric evaluations were performed before and after the experimental phase (10 months). The incidence of aggravating risks to the health was studied through fortnight investigations of morbidity. The adequacy of food consumption survey was looked into by a dietary recall of 24 hours, for 3 days. The determination of the haemoglobin (Hemocue®) and the serum retinol (HPLC) was done at the end of the experimental phase. According to each situation, a statistical parametric or non-parametric analysis was made for the significance (p<0.05) of the results. No differences were observed (p&#8805;0.05) between the results obtained in the anthropometric and dietary evaluations, between the averages of haemoglobin and serum retinol in the incidence of diarrhea, vomiting and fever. Respiratory infections, however, occurred more intensely in the children of the control group (24.3% vs. 16.9%, OR = 1.59; 1.13-2.24 = 95, p<0.01). Taking into consideration that it is based on the nutritional recommendations for the age group under study, it was found that food consumption of children, regardless of the group to which they were allocated, did not meet the recommendations for energy, calcium, vitamin A, iron and zinc contents, while proteins had an exceeding adequacy of 100%. It was concluded that supplementation with MM has not changed the anthropometric profile or the anemia frequency and hypovitaminosis A among children, but reduced the incidence of respiratory infections. Taking into account the relationship between risks and benefits, it is recommended the discontinuation of its use on health services, where effective measures are known for intervention and should be implemented. It is, accordingly, the nutritional education based on the adoption of healthy eating habits, with recovery of regional foods. In addition, it is necessary to emphasize that suitable food is a right of the human being, inherent to his dignity and indispensable to act upon the rights enshrined in the Federal Constitution, where the State must adopt the necessary politics to guarantee nutritional and safety food for the population.