title: Nutritional quality of dietary patterns of children: are there differences inside and outside school?
abstract: OBJECTIVE
  To describe the dietary patterns of children inside and outside school and investigate their associations with sociodemographic factors and nutritional status.
  
  
  METHODS
  This was a multicenter cross-sectional study in which children of both sexes, aged 1-6 years, attending private and public daycare centers and preschools in Brazil, were evaluated (n=2979). Demographic, socioeconomic and dietary data (weighed food records and estimated food records) were collected. Dietary patterns were derived by factor analysis from 36 food groups.
  
  
  RESULTS
  Four dietary patterns were identified inside school, and three outside. Inside school, the "traditional" pattern was associated to low income and presented high nutritional quality. The "dual" pattern was associated with low income and with high intake of added sugar and glycemic load. The "snack" pattern was associated with children enrolled at private schools and with high intake of added sugar and glycemic load. The "bread and butter" pattern was associated with high intake of added sugar and trans fat. Outside school, the "traditional" pattern was associated with high intake of saturated fat, trans fats, sodium, and total fiber. The "bread and butter" pattern was associated with high intake of trans fats and glycemic load, whereas the "snack" pattern was associated with overweight, private schools, high income, and high intake of trans fats, sodium, and total fiber.
  
  
  CONCLUSIONS
  There are differences in the nutritional quality of dietary patterns inside and outside school, and heterogeneity in adherence to these patterns were observed across regions and socioeconomic classes.
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, SP, Brazil.
authors.forename: Diva Aliete Dos Santos
authors.initials: DA
authors.lastname: Vieira
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, SP, Brazil.
authors.forename: Michelle Alessandra
authors.initials: MA
authors.lastname: Castro
authors.affiliation: Hospital Infantil Sabará, Instituto PENSI, Centro de Dificuldades Alimentares, São Paulo, SP, Brazil.
authors.forename: Mauro
authors.initials: M
authors.lastname: Fisberg
authors.affiliation: Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, SP, Brazil. Electronic address: regina.fisberg@gmail.com.
authors.forename: Regina Mara
authors.initials: RM
authors.lastname: Fisberg
mesh_terms: D001938:Brazil; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior; D005260:Female; D005502:Food / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D009753:Nutritive Value; D012574:Schools; D012959:Socioeconomic Factors
keywords: Alimentação escolar; Análise fatorial; Children; Consumo alimentar; Crianças; Dietary patterns; Factor analysis; Food consumption; Padrões alimentares; School feeding