Loading...
Publication
Escolhas alimentares de atividade física: fatores moduladores das opções dos adolescentes
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.46 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
RESUMO
Introdução: Um estilo de vida adequado, especialmente ao nível dos hábitos
alimentares e de atividade física, é crucial para uma vida saudável. Hábitos iniciados a
partir da infância e perpetuados pela vida adulta, apresentam impacto considerável na
saúde do indivíduo e na saúde pública, estando associados às principais causas de
morte e a gastos em saúde.
Os determinantes das opções alimentares e de atividade física são diversos e
interagem de uma forma complexa. A compreensão desta rede de fatores, na fase da
adolescência, é especialmente importante, sendo o objetivo principal deste trabalho.
Esta é uma fase de transição e de importante oportunidade de intervenção para alterar
determinantes dos comportamentos. Este estudo pretende identificar e caracterizar
determinantes das escolhas alimentares e de atividade física dos adolescentes.
Material e Métodos
Realizou-se um estudo transversal, sobre uma amostra de adolescentes, com idades
compreendidas entre 14 e 18 anos de idade, provenientes de duas escolas de
Coimbra. De uma abordagem quantitativa, passou-se a uma abordagem qualitativa.
Para o estudo quantitativo aplicaram-se as escalas: EHA (escala de hábitos
alimentares), IPAQ (questionário internacional de atividade física), TAA-25 (teste de
atitudes alimentares) e a GSQ (escala de autoeficácia geral). Estudaram-se as
variáveis: sexo, idade e escalão socioeconómico, tal como as decorrentes da
aplicação das escalas, aplicando testes estatísticos. Para o estudo qualitativo, a partir
dos resultados da abordagem quantitativa, foram selecionados subgrupos com
características diferentes: Grupo A: alunos com elevado score de comportamentos
alimentares (EHA≥160) e padrão adequado de atividade física (moderada ou elevada),
subdividido em A1. (boa autoeficácia e sem risco de patologia do comportamento
alimentar) ou A2. (alunos com risco de patologia alimentar; razoável autoeficácia) e
Grupo B: alunos com baixo score de EHA (EHA≤125), subdividido em B1.
(sedentários; sem risco de patologia do comportamento alimentar; com baixa
autoeficácia) ou B2. (bom padrão de atividade física; com risco de patologia do
comportamento alimentar) ou B3. (com bom padrão de atividade física, sem risco de
patologia do comportamento alimentar). Procedeu-se então a uma abordagem do tipo
grounded theory, com entrevista semiestruturada e codificação aberta pelo método de
Charmaz. Pesquisaram-se determinantes biológicos, ambientais e socioculturais
percecionados pelos adolescentes.Escolhas Alimentares e de Atividade Física dos Adolescentes
Resultados
Existem diferenças significativas entre os sexos, ao nível das escolhas alimentares,
atitudes alimentares, atividade física e perceção de autoeficácia geral. As raparigas
apresentam hábitos alimentares mais adequados (t=3,84; p<,0001; r2 ajustado=,037,
p<,0001), sobretudo no que respeita às subdimensões qualidade e quantidade. Os
rapazes apresentam menos 5,5 valores de média em escala EHA do que as raparigas.
As raparigas omitem mais frequentemente o pequeno-almoço, ingerem menos
alimentos ricos em fibra, ingerem mais doces entre refeições, petiscam mais, bebem
menos água e ingerem menor quantidade de peixes gordos. No entanto, tendo em
conta os restantes itens e a classificação da escala no geral, as raparigas apresentam
melhores hábitos alimentares.
As raparigas referem também fazer menos atividade física (2(2)= 28,2, p<,001) e
apresentam maior risco de desenvolver patologia do comportamento alimentar (t=3,54;
p<,0001; OR=4,04). Este risco parece dever-se especialmente a uma diferente
motivação para a magreza e perceção de menor autoeficácia geral (t=2,45; p =,015),
obtendo piores resultados sobretudo ao nível das subdimensões iniciativa e
persistência e eficácia social. Através de regressão multinomial verifica-se que o sexo
e a autoeficácia geral assumem influência relevante sobre os hábitos alimentares. Os
ideais de beleza podem influenciar este efeito registado ao nível dos sexos. As
raparigas desenvolvem estratégias para perder peso, o que pode passar pela omissão
do pequeno-almoço e por comportamentos que predispõem para o distúrbio do
comportamento alimentar. Já os rapazes, para os quais o ideal de beleza inclui o corpo
mesomórfico, referem maior atividade física, associado ao objetivo de conseguir maior
massa muscular. A resistência à adversidade será, para eles, uma das subdimensões
da autoeficácia geral com maior peso nas escolhas, estando associada igualmente à
perceção de autocontrolo.
A perceção de autoeficácia, cujo efeito assume maior relevância para os rapazes,
funcionará como um fator protetor que reduzirá as opções pouco saudáveis.
Quer os hábitos alimentares, quer o padrão de atividade física, apresentam correlação
significativa com as atitudes alimentares e com o risco de desenvolvimento de
patologia do comportamento alimentar (rSP=,203; p<,001 e rSP=,181, p<,001
respetivamente) e autoeficácia geral (r=,26, p<,001 e rSP=,179, p<,001,
respetivamente). As situações de risco de desenvolvimento de patologia do
comportamento alimentar surgem ao nível dos adolescentes com melhores hábitos
alimentares.Escolhas Alimentares e de Atividade Física dos Adolescentes
A partir das entrevistas realizadas aos subgrupos de hábitos alimentares antagónicos,
identificaram-se determinantes da escolha alimentar percecionados pelos
adolescentes de ambos os grupos. Os mais referenciados foram (por ordem
decrescente): a influência da família, preferências em termos de paladar, hábitos
familiares, regras de alimentação saudável e disponibilidade. Os determinantes
referenciados por maior número de adolescentes foram influência da família e hábitos
familiares, perceção do risco, conhecimento das regras de alimentação saudável e
preferências alimentares. Juntam-se às mencionadas referências, fatores como
perceção de autocontrolo, sensações de bem ou mal-estar, influência dos pares,
fome/saciedade, o facto de se encontrarem a desenvolver ou não tarefas,
impulsividade, tempo disponível, humor/stress e preço dos alimentos.
Para a atividade física foram sobretudo referidos como determinantes da escolha o
bem-estar e a saúde. Alguns referiram a companhia como motivadora e, como
limitadores, a preguiça e o tempo disponível.
Conclusões
As diferenças encontradas ao nível dos sexos, justificam intervenções diferenciadas.
Fatores como a autoimagem poderão ser trabalhados.
A família deverá ser considerada como integrante das intervenções ao nível da
educação para a saúde e estas intervenções deverão fazer parte dos currículos
escolares.
Medidas administrativas tomadas pelas escolas e pelos agentes governativos,
concretamente no que toca ao funcionamento das cantinas escolares e organização
de horários, poderão facilitar as escolhas mais saudáveis, modulando o efeito de
determinantes como tempo disponível e disponibilidade.
ABSTRACT Introduction: A proper lifestyle, especially in what food habits and physical activity are concerned, are crucial to a healthy life. Habits that have been initiated during childhood and are perpetuated throughout adulthood, have an important impact on the individual’s health and in public health, and are associated to the main causes of death and to the health spending. The factors that determine the options that we make in food and physical activity are different and interact in a complex way. Understanding this network of factors is the main goal of this work and it is especially important during adolescence. This is a time of transition and it is an important opportunity to intervene in order to alter some factors that determine behaviors. This study aims at identifying and characterizing the factors that determine the adolescents’ food and physical activity choices. Material and methods It was done a transversal study, based on a sample of 358 adolescents, aged between 14 and 18, from two schools in the area of Coimbra. From a quantitative approach, we moved to a qualitative approach. To the quantitative study were used the scales: EHA (eating habits scale), IPAQ (international physical activity questionnaire), TAA-25 (eating attitudes test) and the GSQ (general self-efficacy questionnaire). The following variables were studied: gender, age and socioeconomic level, as well as the ones that derive from the application of the scales, using statistic tests. To the qualitative study, after analyzing the results of the quantitative approach, we selected subgroups with different characteristics: Group A: students with a high score in eating behaviors (EHA≥160) and a good pattern of physical activity (moderated and high), divided in A1. (good self-efficacy and without a risk of an eating disturbances) or A2. (students with a risk of pathology, a reasonable self-efficacy) and Group B: students with a low EHA score, that had inappropriate eating behaviors (EHA≤125), divided in B1. (sedentary individuals, with no risk of pathology, all of them with low self-efficacy), or B2. (with a risk of pathology, a good pattern of physical activity) or B3. (with a good pattern of physical activity and without a risk of pathology). Then we moved into an approach of the type grounded theory, with a semi-structured interview and coding by the Charmaz method. There were researched the determinant factors that were perceived by the adolescents, such as biological, environmental and sociocultural factors. Results There are significant differences between different genders, in what food choices,Escolhas Alimentares e de Atividade Física dos Adolescentes physical activity, eating attitudes and general self-efficacy are concerned. Girls present more appropriate eating habits (t=3,84; p<,0001; r2 ajustado=,037, p<,0001), especially relating to the sub dimensions quality and quantity. Boys present less 5,5 values in the EHA scale than girls. Girls skip breakfast more often, ingest less food items rich in fiber, ingest more sweets between meals, snack more, drink less water and ingest a smaller amount of fat fishes. Nevertheless, taking into account the other items and the classification of the scale in general, girls present better eating habits. Girls refer to develop less physical activity (2(2) 28,2, p<,001) and a higher risk of developing an eating disturbances (t=3,54; p<,0001; OR=4,04). This risk is likely to be caused by a different motivation to be thin and a lower general self-efficacy (test t=2,45; p<,015), getting lower results especially in the sub dimensions initiative and persistence and social efficiency. Through the multinomial regression, we can see that gender and general self-efficacy have a big influence on eating habits. The ideals of beauty can influence this effect that is registered in what genders are concerned. Girls develop strategies to lose weight, that can be to skip breakfast and that can lead to behaviors that may predispose to an eating disorder. However, in the case of boys, whose ideal of beauty include a mesomorphic body, develop a more frequent physical activity to get a greater muscle mass. Resisting adversity will be one of the general self-efficacy sub dimensions that have a bigger importance in the choices, being also associated to selfcontrol. Self-efficacy perception, whose effect is more relevant in boys, will work as a protective factor that will reduce unhealthy options. Both eating habits and also the physical activity pattern present a significant correlation with the eating attitudes/risk of developing an eating pathology (rSP=,203; p<,001 and rSP=,181, p<,001 respectively), and general self-efficacy (r=,26, p<,0001 and rSP=,179, p<,001, respectively). The situations of risk to develop an eating pathology appear in adolescents with better eating habits. Through the interviews that were done to the subgroups of different eating habits, it was possible to identify determinant factors that were perceived by adolescents in both groups. The ones that were more often mentioned (in a decreasing order) were family influence, taste preferences, family habits, healthy eating rules and availability. The ones that were mentioned by a bigger number of adolescents were family influence and family habits, risk perception, knowledge of healthy eating rules and eating preferences. At the same other factors are mentioned, such as self-control, feeling well or bad, peer influence, feeling hungry or full, developing a task or not, impulsiveness,Escolhas Alimentares e de Atividade Física dos Adolescentes time available, humor/stress and cost. In what refers to physical activity, the factors that were mentioned were especially wellbeing and health. Some pointed out company as motivating, and as limiters, lazyness and available time. Conclusions The differences found in gender, can justify differentiated interventions. Factors like self-image can be worked on. Family must be considered as an integrating part of the interventions that are related to health education and these interventions should be part of school curricula. Administrative measures, taken by schools and government agents, especially in what concerns the way school canteens work and the way timetables are organized can make healthy choices easier, modulating the effect that determinant factors such as available time and availability may have.
ABSTRACT Introduction: A proper lifestyle, especially in what food habits and physical activity are concerned, are crucial to a healthy life. Habits that have been initiated during childhood and are perpetuated throughout adulthood, have an important impact on the individual’s health and in public health, and are associated to the main causes of death and to the health spending. The factors that determine the options that we make in food and physical activity are different and interact in a complex way. Understanding this network of factors is the main goal of this work and it is especially important during adolescence. This is a time of transition and it is an important opportunity to intervene in order to alter some factors that determine behaviors. This study aims at identifying and characterizing the factors that determine the adolescents’ food and physical activity choices. Material and methods It was done a transversal study, based on a sample of 358 adolescents, aged between 14 and 18, from two schools in the area of Coimbra. From a quantitative approach, we moved to a qualitative approach. To the quantitative study were used the scales: EHA (eating habits scale), IPAQ (international physical activity questionnaire), TAA-25 (eating attitudes test) and the GSQ (general self-efficacy questionnaire). The following variables were studied: gender, age and socioeconomic level, as well as the ones that derive from the application of the scales, using statistic tests. To the qualitative study, after analyzing the results of the quantitative approach, we selected subgroups with different characteristics: Group A: students with a high score in eating behaviors (EHA≥160) and a good pattern of physical activity (moderated and high), divided in A1. (good self-efficacy and without a risk of an eating disturbances) or A2. (students with a risk of pathology, a reasonable self-efficacy) and Group B: students with a low EHA score, that had inappropriate eating behaviors (EHA≤125), divided in B1. (sedentary individuals, with no risk of pathology, all of them with low self-efficacy), or B2. (with a risk of pathology, a good pattern of physical activity) or B3. (with a good pattern of physical activity and without a risk of pathology). Then we moved into an approach of the type grounded theory, with a semi-structured interview and coding by the Charmaz method. There were researched the determinant factors that were perceived by the adolescents, such as biological, environmental and sociocultural factors. Results There are significant differences between different genders, in what food choices,Escolhas Alimentares e de Atividade Física dos Adolescentes physical activity, eating attitudes and general self-efficacy are concerned. Girls present more appropriate eating habits (t=3,84; p<,0001; r2 ajustado=,037, p<,0001), especially relating to the sub dimensions quality and quantity. Boys present less 5,5 values in the EHA scale than girls. Girls skip breakfast more often, ingest less food items rich in fiber, ingest more sweets between meals, snack more, drink less water and ingest a smaller amount of fat fishes. Nevertheless, taking into account the other items and the classification of the scale in general, girls present better eating habits. Girls refer to develop less physical activity (2(2) 28,2, p<,001) and a higher risk of developing an eating disturbances (t=3,54; p<,0001; OR=4,04). This risk is likely to be caused by a different motivation to be thin and a lower general self-efficacy (test t=2,45; p<,015), getting lower results especially in the sub dimensions initiative and persistence and social efficiency. Through the multinomial regression, we can see that gender and general self-efficacy have a big influence on eating habits. The ideals of beauty can influence this effect that is registered in what genders are concerned. Girls develop strategies to lose weight, that can be to skip breakfast and that can lead to behaviors that may predispose to an eating disorder. However, in the case of boys, whose ideal of beauty include a mesomorphic body, develop a more frequent physical activity to get a greater muscle mass. Resisting adversity will be one of the general self-efficacy sub dimensions that have a bigger importance in the choices, being also associated to selfcontrol. Self-efficacy perception, whose effect is more relevant in boys, will work as a protective factor that will reduce unhealthy options. Both eating habits and also the physical activity pattern present a significant correlation with the eating attitudes/risk of developing an eating pathology (rSP=,203; p<,001 and rSP=,181, p<,001 respectively), and general self-efficacy (r=,26, p<,0001 and rSP=,179, p<,001, respectively). The situations of risk to develop an eating pathology appear in adolescents with better eating habits. Through the interviews that were done to the subgroups of different eating habits, it was possible to identify determinant factors that were perceived by adolescents in both groups. The ones that were more often mentioned (in a decreasing order) were family influence, taste preferences, family habits, healthy eating rules and availability. The ones that were mentioned by a bigger number of adolescents were family influence and family habits, risk perception, knowledge of healthy eating rules and eating preferences. At the same other factors are mentioned, such as self-control, feeling well or bad, peer influence, feeling hungry or full, developing a task or not, impulsiveness,Escolhas Alimentares e de Atividade Física dos Adolescentes time available, humor/stress and cost. In what refers to physical activity, the factors that were mentioned were especially wellbeing and health. Some pointed out company as motivating, and as limiters, lazyness and available time. Conclusions The differences found in gender, can justify differentiated interventions. Factors like self-image can be worked on. Family must be considered as an integrating part of the interventions that are related to health education and these interventions should be part of school curricula. Administrative measures, taken by schools and government agents, especially in what concerns the way school canteens work and the way timetables are organized can make healthy choices easier, modulating the effect that determinant factors such as available time and availability may have.
Description
Keywords
adolescentes, escolhas alimentares, atividade física, atitudes alimentares, autoeficácia. adolescents, food choices, physical activity, eating attitudes, self-efficacy