Body composition assessed by dual-energy x-ray absorptiometry on metabolic profile and cardiovascular risk in obese patients prior to bariatric surgery / Composição corporal avaliada pela absortometria radiológica de dupla energia sobre o perfil metabólico e o risco cardiovascular em obesos antes da cirurgia bariátrica

ABSTRACT BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19-5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19-5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76-4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.

RESUMO RACIONAL: O tecido adiposo, músculos e ossos representam órgãos endócrinos, capazes de interferir no perfil metabólico e risco cardiovascular. Relacionar esses componentes será importante para estratégias de intervenção precoce, em obesos. OBJETIVOS: Avaliar a influência dos compartimentos da massa corporal, sobre o perfil metabólico e risco cardiovascular, no pré-operatório de cirurgia bariátrica. MÉTODOS: Estudo transversal, com pacientes admitidos para cirurgia bariátrica, em hospital universitário. A composição corporal foi avaliada pela absortometria radiológica de dupla energia e o risco cardiovascular pelo escore de risco de Framingham. Foram analisadas variáveis antropométricas, clínicas e de estilo de vida. Foi avaliado perfil lipídico (colesterol total, HDL-c, LDL-c, triglicerídeos), glicemia e vitamina D, utilizando a metodologia padrão. RESULTADOS: Foram analisados 60 pacientes, 86,7% apresentavam comorbidades, 33,3% risco cardiovascular moderado/elevado e 71,4% insuficiência/deficiência de vitamina D. Menor massa corporal magra associou-se à gravidade da obesidade. O índice de massa corpórea e a circunferência da cintura correlacionaram-se negativamente com a massa corporal magra (r=-0,52; p<0,01)/r=-0,36; p<0,01). A massa corporal magra correlacionou-se negativamente com a massa gorda (r=-0,26; p<0,05), gordura troncular (r=-0,29; p<0,05), glicemia de jejum (r=-0,26; p<0,05) e densidade mineral óssea (r=-0,26; p<0,05). Ao todo, 84,2% dos indivíduos com menos gordura troncular apresentaram tendência a baixo risco cardiovascular (p=0,05). Contudo, inatividade física (razão de prevalência ajustada 2,14; IC95% 1,19-5,54) e risco de dependência alcoólica foram as únicas variáveis independentemente associadas ao risco cardiovascular. CONCLUSÕES: Os pacientes obesos em pré-operatório de cirurgia bariátrica com menos gordura troncular, apresentaram tendência a baixo risco cadiovascular. Contudo, o risco cardiovascular também não foi associado aos demais componentes da massa corporal.

Vitamin d levels and lipid profile in patients undergoing bariatric surgery / Níveis de vitamina d e perfil lipídico em pacientes submetidos à cirurgia bariátrica

ABSTRACT BACKGROUND: Vitamin, mineral, and metabolic deficiencies occur in the postoperative period of bariatric surgery, in the short and long term, and are worrisome intercurrences. AIMS: To evaluate the association of serum vitamin D levels with the lipid profile in obese patients undergoing bariatric surgery. METHODS: Case series of patients assisted from 2010 to 2018, in a private hospital of medium and high complexity, who underwent bariatric surgery using sleeve gastrectomy or Roux-en-Y gastric bypass techniques, monitored by the same surgeon. Sociodemographic, clinical, laboratory, and anthropometric data were collected preoperatively and at 6, 12, and 24 months after surgery. RESULTS: A total of 156 individuals, mostly female (75.6%) were monitored. The most frequent comorbidities were hepatic steatosis (76.3%) and hypertension (48.27). Regarding preoperative vitamin D levels, only 18.9% of the population had a satisfactory level (≥30 ng/mL). There was a reduction in weight and an improvement in the lipid profile after surgery. Significant correlations were observed between the lipid profile and vitamin D concentration only in the sample submitted to the Roux-en-Y gastric bypass technique: negative correlation between total cholesterol and vitamin D two years after surgery; positive correlation between triglycerides and vitamin D one year after surgery; and negative correlation between high-density lipoprotein and vitamin D two years post-surgery. CONCLUSIONS: It is essential to routinely monitor vitamin D levels and lipid profile pre- and postoperatively in order to avoid damage associated with this vitamin deficiency.

RESUMO RACIONAL: Deficiências vitamínicas, minerais e metabólicas ocorrem no pós-operatório de cirurgia bariátrica, a curto e longo prazo, sendo intercorrências preocupantes. OBJETIVOS: Avaliar a associação dos níveis séricos de vitamina D com o perfil lipídico, em pacientes obesos submetidos à cirurgia bariátrica. MÉTODOS: Série de casos de pacientes atendidos de 2010 até 2018, em hospital privado de média e alta complexidade, submetidos à cirurgia bariátrica pelas técnicas da gastrectomia vertical e derivação gástrica em Y de Roux, acompanhados pelo mesmo cirurgião. Foram coletados dados sociodemográficos, clínicos, dados laboratoriais e antropométricos no pré-operatório, 6 meses, 12 meses e 24 meses após cirurgia. RESULTADOS: Foram acompanhados 156 indivíduos, maioria sexo feminino (75,6%), comorbidades mais frequentes foram esteatose hepática (76,3%) e hipertensão (48,27). Em relação aos níveis de vitamina D pré-operatórios, apenas 18,9% da população apresentaram níveis satisfatórios (=30 ng/mL). Observou-se redução do peso e melhora do perfil lipídico pós-cirúrgico. Sobre as correlações entre o perfil lipídico e concentração de vitamina D foram observadas correlações significativas apenas na amostra que passou pela técnica cirúrgica derivação gástrica em Y de Roux: correlação negativa entre o colesterol total e vitamina D após 2 anos de cirurgia; correlação positiva entre triglicerídeo e vitamina D 1 ano pós-operatório; e correlação negativa entre HDL e vitamina D 2 anos pós-operatório. CONCLUSÕES: é essencial acompanhar os níveis de vitamina D e perfil lipídico no pré e pós-operatório de forma rotineira a fim de evitar danos relacionados a deficiência dessa vitamina.

Dietary patterns among adolescent freshmen attending a public university / Padrões alimentares de adolescentes recém-ingressos em uma universidade pública

ABSTRACT Objective To identify the association between dietary patterns and nutritional status in adolescent freshmen at a public university in Northeastern Brazil. Methods In this cross-sectional study anthropometric variables, body composition and food intake were collected and assessed using the food frequency questionnaire. Dietary patterns were evaluated through factor analysis using the principal component extraction method. Results Two dietary patterns were identified: "Western" pattern, consisting of foods with high energy density and low nutritional value, and the "traditional Brazilian" pattern, with foods from Brazilian cuisine such as rice, beans, corn, roots and tubers, fruits, greens and vegetables. The multiple regression analysis revealed a negative association between the "traditional Brazilian" pattern and both excess weight and body fat in females. Conclusion A healthy dietary pattern with typical local cuisine foods can offer protection to health and should be encouraged.

RESUMO Objetivo Identificar a associação entre padrões alimentares e estado nutricional em adolescentes recém-ingressos em uma universidade pública do Nordeste brasileiro. Métodos Neste estudo transversal foram coletados dados antropométricos, composição corporal e consumo alimentar, verificado pelo questionário de frequência alimentar. Os padrões alimentares foram derivados através da análise fatorial pelo método de extração de componentes principais. Resultados Dois padrões alimentares foram identificados: o padrão "Ocidental", composto por alimentos de elevada densidade energética e de baixo valor nutricional, e o padrão "tradicional brasileiro", contendo alimentos da culinária brasileira como arroz, feijão, milho, raízes e tubérculos, frutas, verduras e legumes. A análise de regressão múltipla mostrou associação negativa entre o excesso de peso e de gordura corporal e o padrão alimentar "tradicional brasileiro" no sexo feminino. Conclusão Um padrão alimentar saudável e com alimentos típicos da culinária local pode conferir proteção à saúde, devendo ser incentivado.

Eating disorders in the preoperative phase of bariatric surgery / Transtornos alimentares durante o pré-operatório de cirurgia bariátrica

Introduction: Bariatric surgery is considered the most effective obesity treatment. Obese patients have a high prevalence of eating disorders. Objectives: Evaluate the occurrence of eating disorders and eating patterns in candidates for bariatric surgery and associate eating disorders with sociodemographic and clinical characteristics. Methods: A retrospective study was conducted using electronic charts of candidates for bariatric surgery. Data were collected on sex, age, marital status, schooling, occupation, non-communicable diseases, body mass index (BMI), eating disorders, and eating patterns. Results: Among the 281 patients evaluated, eating disorders were detected in 26.7%; 10.3% had binge eating disorder, 6.6% had bulimia nervosa, and 5.3% had the night-eating syndrome. The specific eating patterns were overeating (46.6%), binge eating during periods of stress (9.3%), eating sweets (4%), and snaking (1.3%). BMI ranged from 35.38 to 59.03 kg/m² (mean: 44.37 ± 5.89). All individuals (100%) had systemic arterial hypertension, and 23.3% had type 2 diabetes mellitus or dyslipidemia. Conclusions: The frequency of eating disorders was low in the sample studied, the most common of which was binge eating disorder. Non-communicable diseases were associated with eating disorders. Among the eating patterns observed, the most frequent was overeating (AU)

Introdução: A cirurgia bariátrica é considerada o tratamento mais eficaz para a obesidade. Pacientes obesos possuem elevada prevalência de transtornos alimentares. Objetivos: Avaliar a presença de transtornos alimentares e padrões alimentares em candidatos à cirurgia bariátrica, associando os transtornos alimentares aos dados sociodemográficos e clínicos. Métodos: Estudo retrospectivo de cunho documental, com base em prontuários eletrônicos de pacientes candidatos à cirurgia bariátrica. Foram obtidas variáveis como sexo, idade, estado civil, nível de escolaridade, ocupação, doenças crônicas não transmissíveis, índice de massa corporal (IMC), transtorno e padrão alimentar. Resultados: Dos 281 pacientes avaliados, foi detectado 26,7% de transtornos alimentares, sendo 10,3% transtorno de compulsão alimentar periódica, 6,6% de bulimia nervosa e 5,3% de síndrome do comer noturno. Os padrões alimentares específicos encontrados foram: glutões (46,6%), compulsivos alimentares em períodos de estresse (9,3%), comedores de doces (4%) e beliscadores (1,3%). O IMC variou de 35,38 a 59,03 kg/m² (44,37±5,89), com 100% do grupo apresentando Hipertensão Arterial Sistêmica e 23,3% com Diabetes Mellitus tipo 2 ou dislipidemia. Conclusões: Constatou-se baixa frequência de transtornos alimentares na amostra estudada, sendo o transtorno de compulsão alimentar periódica o mais observado. Doenças crônicas não transmissíveis foram associadas com a presença de transtornos alimentares. Dentre os padrões alimentares observados, os glutões foram os mais frequentes (AU)

Physical activity, sedentary time and nutritional status in Brazilian children with cerebral palsy

Abstract Objective: This study had the purpose investigate the physical activity (PA) and sedentary time profile of children with cerebral palsy and its association with body composition. Methods: A cross-sectional study evaluated 53 children, between 2 and 10 years old, enrolled in three health services Recife-city, northeast of Brazil. Sedentary and PA were measured for a week using the ActiGraph GTX3 accelerometer. Body composition was assessed by anthropometry and an electrical bioimpedance device. Results: Time on PA was one hour longer among the mild/moderate CP compared to severe ones, but, sedentary time is similar. Dyskinetic children spent more time in PA, but also in sedentary activities (15.5 hours a day) than spastic ones (12.8). Stunting occurred in 15 (30%) of the sample, all children with stunting had severe impairment. Underweight occurred in 25% of the severe group and 11.8% in the mild/moderate group. Overweight affected 3% of the sample; no overweight children were in the severe group. Body fat% was inversely related to time spent in moderate to vigorous PA. Conclusions: Children with CP spend more than a half of their daily time in sedentary activity. In contrast, children with mild to moderate CP spent twice as much time in moderate to vigorous PA and had a tendency (p = 0.07) to spend 50% more time in light PA. Moreover, time spent on moderate to vigorous activity was inversely related to fat mass.

Growth of infants with gastrointestinal manifestations of cow's milk protein allergy / Crescimento de lactentes com manifestações gastrointestinais de alergia à proteína do leite de vaca

ABSTRACT Objective To assess linear growth and weight gain in infants with suspected cow's milk protein allergy with gastrointestinal manifestations, seen at a gastropediatrics clinic. Methods A retrospective cohort study conducted with demographic, clinical, anthropometric and dietary information on 84 infants first seen between 2015 and 2018 and followed-up for six months. Stature-for-age, weight-for-age, and body mass index-for-age in z-scores were evaluated according to the cut off points established by the World Health Organization in 2006. Accelerated growth or catch-up was considered a gain ?0.67 in the z-score of the referred indices, evaluated at 3 and 6 months. Results Median age at baseline was 4.0 months and 88.1% of the infants were already in diet exclusion. Regarding the anthropometric evaluation short stature frequency was 15.5% and the underweight frequency was 8.3% and 3.6% respectively based on the weight-for-age and body mass index-for-age indices. High recovery growth was observed during the follow-up period but was not considered catch up. In boys, the gains in weight-for-age and body mass index-for-age were significant (p=0.02 and p=0.01 respectively) and close to the threshold that characterizes the catch up, 0.58 and 0.59, respectively. In girls, significant gains in stature-for-age and weight-for-age (0.38 and 0.37 respectively, p=0.02 for both) were observed. Conclusion Infants with suspected cow's milk protein allergy with gastrointestinal manifestations should have early access to specialized nutritional counseling to avoid exposure to allergenic food and control allergy symptoms, thereby avoiding malnutrition and ensuring adequate nutritional recovery.

RESUMO Objetivo Avaliar o crescimento linear e o ganho de peso de lactentes com suspeita de alergia à proteína do leite de vaca, com manifestações gastrointestinais, atendidos em um ambulatório de gastropediatria. Métodos Estudo de coorte retrospectivo, com informações demográficas, clínicas, antropométricas e dietéticas de 84 lactentes que iniciaram atendimento entre 2015 e 2018 e foram acompanhados durante seis meses. Foram avaliados os índices estatura/idade, peso/idade e índice de massa corporal/idade em escore-z, segundo os pontos de corte da Organização Mundial de Saúde de 2006. Considerou-se crescimento acelerado (ou catch-up growth) um ganho ?0,67 escore-z nos referidos índices, avaliados em três e seis meses. Resultados No baseline, a mediana de idade foi 4,0 meses e 88,1% dos lactentes já estavam em dieta de exclusão. A frequência de baixa estatura foi de 15,5% e a de baixo peso foi de 8,3% e de 3,6% segundo os índices peso/idade e índice de massa corporal/idade, respectivamente. Houve elevado crescimento de recuperação durante o período de acompanhamento, mas que não configurou catch up. Nos meninos, ganhos no peso/idade e índice de massa corporal/idade foram significantes (p=0,02 e p=0,01) e próximos do limiar que caracteriza catch up: 0,58 e 0,59, respectivamente. Nas meninas, foram observados ganhos significantes na estatura/idade e peso/idade, de 0,38 e 0,37 (p=0,02 para ambos). Conclusão Demonstrou-se que lactentes com suspeita de alergia à proteína do leite de vaca, com manifestações gastrointestinais, deveriam ter acesso precoce ao aconselhamento nutricional para evitar exposição ao alimento alergênico, controlar sintomas e, assim, evitar a desnutrição ou garantir recuperação nutricional adequada.

Food consumption, anthropometry and body composition of patients diagnosed with Parkinson's disease / Consumo alimentar, antropometria e composição corporal de pacientes diagnosticados com doença de Parkinson

ABSTRACT Objective The aim of the present study was to evaluate the consumption of risk and protective foods for chronic noncommunicable diseases and to investigate associations with anthropometric parameters and body composition in individuals with Parkinson's disease. Methods A case-series study was conducted with 79 adult and elderly patients of both genders in outpatient care. Food intake was evaluated using a food frequency questionnaire for the identification of foods with greater daily consumption, stratified by gender. The consumption frequency of each food was converted into scores of two food groups characteristics: risk and protection. The conceptual model took into account sociodemographic, behavioral and anthropometric variables as well as body composition. Results A total of 72.1% of the participants in the sample had excess weight based on the body mass index and 43.5% had excess body fat. The consumption of protective foods was greater among individuals with a higher body mass index and with a greater rate of body fat. Conclusion The data indicate a situation of reverse causality and reveal the complexity of the relationship among food intake, body fat and chronic noncommunicable diseases.

RESUMO Objetivo Este estudo visou avaliar o consumo de alimentos de risco e proteção para as doenças crônicas não transmissíveis e sua associação com parâmetros antropométricos e de composição corporal em pacientes com doença de Parkinson. Métodos Estudo do tipo série de casos, com 79 pacientes adultos e idosos, de ambos os sexos, atendidos ambulatorialmente. O consumo alimentar desses pacientes foi avaliado por um questionário de frequência alimentar, sendo identificados inicialmente os alimentos com maior frequência de consumo diário por sexo e, em seguida, a frequência de consumo de cada alimento foi convertida em escores, sendo constituídos dois grupos de alimentos: risco e proteção. O modelo conceitual considerou variáveis sociodemográficas, comportamentais, antropométricas e de composição corporal. Resultados Ao todo, 72,1% dos pacientes apresentaram excesso de peso segundo o índice de massa corporal e 43,5% apresentaram excesso de gordura corporal. O consumo de alimentos protetores foi maior nos pacientes com maior índice de massa corporal e maior percentual de gordura corporal. Conclusão Os dados apontam para uma condição de causalidade reversa e revelam a complexidade envolvida na relação entre consumo alimentar, gordura corporal e doenças crônicas não transmissíveis.

Pre and post-operatory anthropometric and laboratory differences of patients submitted to Roux-en-Y gastric bypass and sleeve gastrectomy

ABSTRACT Objective: To evaluate anthropometric and laboratory differences in the pre and postoperative period of patients undergoing gastric bypass surgery (RYGB) and sleeve gastrectomy (SG). Methods: Retrospective study, conducted with patients undergoing surgery between 2013-2018, in Northeastern Brazil. The following data were collected by reviewing patient medical records: sociodemographic (sex and age), anthropometric (height, weight and body mass index), clinical (comorbidities and use of multivitamins) laboratory (vitamin D levels - 25OHD and total lymphocyte count - TLC). At the 6 and at 12 months postoperative periods, weight and laboratory data were again collected. Statistical analyses were performed with SPSS 20.0 software, a significance level of 5% was adopted. Results: 646 patients were evaluated, with a mean age of 48.0 ± 11.7 years; 78.6% had RYGB and 21.4% SG. Postoperatively, patient weight and BMI decreased, regardless of technique (p<0.001), however, RYGB patients had greater weight loss. All patients had hypovitaminosis D, but SG patients had an increase in 25OHD in the postoperative period (p<0.00001). Regarding TLC, there was a decrease in the postoperative period for both techniques (p<0.0001). Conclusion: RYGB patients had higher weight and BMI and greater weight loss. 25OHD was better in the postoperative period for SG patients. There was a reduction in TLC in the postoperative period of all patients.

RESUMEN Objetivo: Evaluar las diferencias antropométricas y de laboratorio en el período pre y posoperatorio de pacientes sometidos a cirugía de bypass gástrico (BGYR) y gastrectomía en manga (SG). Métodos: Estudio retrospectivo, realizado con pacientes sometidos a cirugía entre 2013-2018, en el noreste de Brasil. Los datos se recogieron consultando la historia clínica del paciente: sociodemográficos (sexo y edad), antropométricos (talla, peso e índice de masa corporal), clínicos (comorbilidades y uso de multivitamínicos) y de laboratorio (niveles de vitamina D - 25OHD y total recuento de linfocitos (TLC). A los 6 y 12 meses del postoperatorio, se recogieron nuevamente los datos de peso y de laboratorio. Los análisis estadísticos se realizaron con el software SPSS 20.0, se adoptó un nivel de significancia del 5%. Resultados: Se evaluaron 646 pacientes, con edad media de 48,0±11,7 años; El 78,6% se había sometido a RYGB y el 21,4% a SG. En el postoperatorio, el peso y el IMC de los pacientes disminuyeron, independientemente de la técnica (p<0,0001), pero los pacientes sometidos a BGYR tuvieron una mayor pérdida de peso. Todos los pacientes tenían hipovitaminosis D, pero los sometidos a SG tuvieron un aumento de 25OHD en el postoperatorio (p<0,0001). En cuanto a la TLC, hubo una disminución del postoperatorio para ambas técnicas (p<0,0001). Conclusión: Los individuos sometidos a RYGB tenían mayor peso e IMC y mayor pérdida de peso. La 25OHD fue mejor en el postoperatorio de SG. Hubo una reducción de la TLC en el postoperatorio de todos los pacientes.

Excessive interdialytic weight gain and associated factors

ABSTRACT Excessive interdialytic weight gain (IDWG) may be associated with numerous factors that are discussed little in the literature. The aim of the present study was to evaluate factors associated with excessive IDWG in patients on hemodialysis. A cross-sectional study was conducted with 197 adults on hemodialysis at a satellite clinic in the city of Jaboatão dos Guararapes, Brazil. We calculated %IDWG by the mean difference among 12 hemodialysis sessions, with >4.5% considered excessive. The conceptual model considered socioeconomic, demographic, clinical, anthropometric and laboratorial variables. Excessive IDWG was found in 28.4% of the sample. In the final adjusted Poisson regression model, three variables remained independently associated with excessive IDWG: age between 20 and 59 years (adjusted prevalence ratio [PRadjusted]= 1.87, 95% CI: 1.21-2.88), household income between one and two times the minimum monthly salary (PRadjusted=2.14, 95% CI: 1.36-3.44) and

RESUMEN El aumento de peso interdiálisis (APID) excesivo puede asociarse a numerosos factores, pero todavía es poco discutido en la literatura. El objetivo fue evaluar los factores asociados al APID excesivo de pacientes en hemodiálisis (HD). Estudio transversal, que incluyó a 197 pacientes adultos en HD, y fue realizado en una clínica satélite ubicada en Jaboatão dos Guararapes/PE. Para el análisis del % APID, se calculó el promedio de la diferencia de peso de 12 sesiones de hemodiálisis, considerándose excesivo el valor >4,5%. El modelo conceptual consideró variables socioeconómicas, demográficas, clínicas, antropométricas y de laboratorio. El APID excesivo estuvo presente en el 28,4% de la muestra y, tras el ajuste para el modelo final obtenido por la regresión de Poisson, tres variables permanecieron independientemente asociadas al APID excesivo: edad entre 20 y 59 años (razón de prevalencia ajustada - RPajustada= 1,87 IC95% 1,21-2,88), renta familiar entre 1 y 2 sueldos mínimos (RPajustada= 2,14 IC95% 1,36-3,44) y nivel educacional <9 años de estudio (RPajustada= 1,78 IC95% 1,15-2,76). Los resultados mostraron una asociación entre APID excesivo con algunos factores, siendo la renta familiar baja la más fuertemente asociada, seguida por la edad adulta no-anciana y el bajo nivel educacional.

Influence of sodium intake and sociodemographic, lifestyle and anthropometric variables on blood cholesterol of hypertensive women

The restriction of sodium intake, one of the pillars of antihypertensive treatment, has been associated with the increase in cholesterol levels. Given this, we hypothesize that a sodium intake restriction may increase cholesterol levels in hypertensive women. The present study aimed to evaluate the influence of sodium intake, sociodemo-graphic, lifestyle and anthropometric variables on the blood cholesterol levels of hypertensive women. This was a cross-sectional study with hypertensive and nondiabetic women aged 20 to 59 years, recruited from the primary healthcare units of Maceio, Alagoas, in the Brazilian Northeast. Sodium intake was estimated by the 24-hour urinary excretion of sodium; and blood cholesterol was estimated by capillary blood. Age (years), education level (<4 or ≥4 years), race (white or nonwhite), smoking and alcohol consumption were evaluated. The weight, height and waist circumference were measured and body mass index, conicity index and waist-to-height ratio were quantified. The percentage of body fat was measured using a tetrapolar bioelectrical impedance device. The relationship between blood cholesterol and other variables was assessed by multiple regression analysis. A significance level of 5% was used in the final model. This study included 165 hypertensive women. In linear regression, blood cholesterol was directly proportional to age (p<0.001), education level (p=0.01) and race (p=0.04). These variables, as well as sodium intake (p = 0.07) and conicity index (p = 0.12), were included in the multiple regression analysis. Sodium intake (p=0.03) and age (p=0.001) were related, in an inverse and a direct way, respectively, to the blood choles-terol in the hypertensive women studied. (AU)

ção da ingestão de sódio, um dos pilares do tratamento anti-hipertensivo, tem sido associada ao aumen-to dos níveis de colesterol. Diante disso, levantou-se a hipótese de que a ingestão de sódio influencia os níveis de colesterol de mulheres hipertensas, independentemente de outros fatores associados. Trata-se de um estudo transversal realizado com mulheres hipertensas e não diabéticas, na faixa etária entre 20 e 59 anos, recrutadas em unidades básicas de saúde de Maceió, Alagoas, situada no Nordeste do Brasil. A ingestão de sódio foi estimada pela excreção urinária de sódio de 24 horas; e o colesterol sérico foi mensurado por coleta de sangue capilar. Foram ava-liados idade (anos), escolaridade (<4 ou ≥4 anos), raça (branca ou não branca), tabagismo e consumo de álcool. O peso, a estatura e a circunferência da cintura foram aferidos e o índice de massa corporal, índice de conicidade e razão cintura/estatura foram calculados. A porcentagem de gordura corporal foi medida usando um dispositivo de impedância bioelétrica tetrapolar. A relação entre o colesterol sérico e as outras variáveis em estudo foi avalia-da por meio de análise de regressão múltipla, adotando-se um nível de significância de 5% no modelo final. Este estudo incluiu 165 mulheres hipertensas. Na análise de regressão linear, o colesterol sérico foi relacionado à idade (p<0,001), escolaridade (p=0,01) e raça (p=0,04). Essas variáveis, assim como o consumo de sódio (p=0,07) e o índice de conicidade (p=0,12), foram incluídas na análise de regressão múltipla. As variáveis que permaneceram no modelo final foram ingestão de sódio (p=0,03) e idade (p=0,001). A ingestão de sódio e a idade foram as variáveis que influenciaram o colesterol sérico de mulheres hipertensas. (AU)

Percepção do peso corporal acima do ideal, perfil antropométrico e estilo de vida em adolescentes de Recife, PE, Brasil / Perception of body weight above the ideal, anthropometric profile and lifestyle among adolescents in the city of Recife, Brazil

Resumo O objetivo da pesquisa foi analisar a percepção do peso corporal acima do ideal em adolescentes de Recife/PE e sua associação com o perfil antropométrico e estilo de vida. Trata-se de um estudo transversal com 2.480 escolares participantes do Estudo de Riscos Cardiovasculares em Adolescentes (Erica). O modelo conceitual também considerou variáveis demográficas e socioeconômicas. A percepção do peso foi analisada por meio da pergunta "Na sua opinião o seu peso atual é?", sendo as respostas: "abaixo do ideal", "ideal" e "acima do ideal". As associações foram identificadas por meio da regressão de Poisson. A média da idade foi de 14,7 anos (DP = 1,6), 53,7% eram do sexo feminino e 70,7% eram eutróficos, de acordo com o índice de massa corporal/idade (IMC/I). A percepção do peso foi respondida por 48,8% dos adolescentes. Desses, 36,8% e 63,2% se percebiam com baixo peso e peso acima do ideal, respectivamente. Após os ajustes, as variáveis associadas à percepção do peso acima do ideal foram: sexo feminino, idade entre 12 e 14 anos, escolaridade materna maior que oito anos, IMC/I de eutrofia e de excesso de peso, estágio pós-púbere e realização de café da manhã e refeição com os pais ocasionalmente. Portanto, variáveis demográficas, antropométricas e do estilo de vida se associaram à maior chance de percepção do peso corporal acima do ideal.

Abstract This study investigated the perception of above ideal body weight among adolescents in the city of Recife, Brazil, and its association with anthropometric profile and lifestyle. A cross-sectional study was conducted with a sample of 2480 adolescents from the "Study of Cardiovascular Risks in Adolescents." The conceptual model also assessed demographic and socioeconomic variables. Body weight perception was analyzed by asking the question: "In your opinion, your current body weight is … ?" Answers included: below ideal, ideal and above ideal body weight. Statistics were identified using Poisson Regression analysis. The mean age was 14.7 years (SD = 1.6), 53.7% were female, and 70.7% were eutrophic according to the body mass index/age (BMI/A). Perception of body weight was answered by 48.8% of the adolescents. 36.8% and 63.2% saw themselves as below and above their ideal weight, respectively. After adjustments, the variables associated with the perception of body weight above the ideal (outcome variable) were the female sex, age 12 to 14 years, mother's schooling > 8 years, BMI/A in the ideal range, being postpubescent, having breakfast and meals with parents occasionally. Demographic, anthropometric and lifestyle variables were more likely to be associated with body weight perception above the ideal.

Globalização e Processamento de Alimentos: Consumo Alimentar no Nordeste Brasileiro / Globalization and Food Processing: Food Consumption in Northeastern Brazil

Introdução: O atual modelo globalizado de produção de alimentos acarreta homogeneização na alimentação, com diminuição no consumo de alimentos in natura e grande participação de ultraprocessados. Objetivo: Investigar os fatores associados ao consumo alimentar de adultos, considerando os níveis de processamento de alimentos. Métodos: Estudo transversal com adultos no estado de Pernambuco que avaliou o consumo alimentar e variáveis socioeconômicas, demográficas, segurança alimentar e outras relacionadas ao modo e prática de aquisição de alimentos. Foi utilizado questionário de frequência alimentar para investigação do consumo, com divisão dos alimentos conforme o nível de processamento, com posterior análise através de escores. Avaliou-se a associação entre consumo alimentar e variáveis explicativas através dos testes "U" de Mann Whitney e Kruskal Wallis, com aplicação, neste último caso, do teste "U" de Mann Whitney a posteriori. Foram consideradas estatisticamente significantes associações com valor de p<0,05. Resultados: Foram entrevistados 1.066 adultos, cuja maioria possuía baixa escolaridade, baixa renda, com participação em programa de transferência de renda e em situação de insegurança alimentar. Essas variáveis mostraram associação com o consumo de determinados grupos alimentares. Também foram observadas diferenças no consumo conforme características como local de moradia, sexo, faixa etária, modo de aquisição de alimentos, local de compra e hábito de leitura do rótulo. Conclusões: Diante do contexto globalizado de estímulo aos industrializados, aspectos como gênero, condições econômicas, local de moradia, ambiente e práticas de compra de alimentos podem se mostrar como protetores para maior consumo de alimentos minimamente processados ou de risco para o consumo de ultraprocessados.

Introduction: The current globalized model of food production leads to the homogenization of diet, with a reduction in the consumption of unprocessed foods and the considerable participation of ultra-processed foods. Objective: Investigate factors associated with food consumption among adults considering the degree of food processing. Methods: A cross-sectional study was conducted with adults in the state of Pernambuco involving the assessment of food consumption. Data were also collected on sociodemographic characteristics, food insecurity and aspects related to food acquisition. A food frequency questionnaire was used to investigate food intake, with the categorization of foods according to the degree of processing and the subsequent analysis of consumption scores. Associations between food consumption and explanatory variables were evaluated using the Mann-Whitney U test and Kruskal- Wallis test, the latter of which was complemented with the post hoc Mann-Whitney U test. Associations with a p-value <0.05 were considered statistically significant. Results: One thousand sixty-six adults were interviewed. Most had a low level of schooling and low income, were beneficiaries of the income transfer program and were in a situation of food insecurity. These variables were associated with the consumption of particular food groups. Differences in consumption were found according to place of residence, sex, age group, mode of food acquisition, place of purchase and the habit of reading food labels. Conclusions: In the globalized context that stimulates the consumption of industrialized foods, aspects such as sex, economic status, place of residence and food purchasing environment and practices can serve as protective factors that ensure the greater consumption of minimally processed foods or risk factors for the consumption of ultra-processed foods products.

Marcadores de consumo alimentar de crianças com até cinco anos de idade vivendo em abrigos na cidade de Fortaleza, Ceará / Markers of food consumption in children up to five years of age living in shelters in the city of Fortaleza, Ceará

Introdução: Alimentação é um direito assegurado por lei, e as instituições de acolhimento devem garanti-lo às crianças acolhidas, fornecendo alimentação saudável para evitar distúrbios nutricionais e doenças crônicas não transmissíveis. Objetivo: Avaliar o consumo alimentar de crianças institucionalizadas. Método: estudo realizado em cinco instituições de acolhimento na cidade de Fortaleza, Ceará, Brasil, com 62 crianças de 0-5 anos de idade, entre maio e agosto de 2017. As variáveis estudadas foram sexo, idade, idade quando do acolhimento na instituição, tempo de acolhimento e consumo alimentar. Para avaliar o consumo alimentar, utilizou-se o formulário "Marcadores do Consumo Alimentar" do Sistema de Vigilância Alimentar e Nutricional, que considera marcador de alimentação saudável o consumo de frutas, verduras e feijão; e não saudável, o consumo de alimentos ultraprocessados. Para análise dos dados do consumo alimentar, seguiram-se as recomendações do documento Orientação para Avaliação de Marcadores de Consumo Alimentar na Atenção Básica. Os dados foram coletados por um nutricionista em entrevistas presenciais. Resultados: Predominaram crianças do sexo feminino, com idade média de 30,19±16,67meses. Verificou-se que 92,7% das crianças apresentavam algum indicador de consumo alimentar não saudável para sua faixa etária. O consumo de alimentos ultraprocessados e bebidas adoçadas pelas crianças com idade de 6-23 meses e 29 dias foi alto (83,33%). Conclusão: A maioria das crianças apresentava algum indicador de consumo alimentar não saudável para sua faixa etária, além de alta frequência de consumo de alimentos ultraprocessados, sobretudo de bebidas adoçadas em todas as instituições.

ntroduction: Food is a right ensured by law, and foster care institutions must ensure it to the children they admit by providing healthy food to avoid nutritional disorders and non-communicable diseases. Objective:To assess food consumption in institutionalized children. Method: a study was carried out in five foster care institutions in the city of Fortaleza, Ceará, Brazil, with 62 children aged 0-5 years between May and August 2017. The variables studied were sex, age, age at admission to the institution, duration of foster care and food consumption. Food consumption was assessed using the "Food Consumption Markers" form designed by the Food and Nutrition Surveillance System, which considers the consumption of fruits, vegetables and beans as markers of healthy eating and the consumption of ultra-processed foods as a marker of unhealthy eating. Food consumption data were analyzed based on the recommendations of the Guidelines for the Assessment of Food Consumption Markers in Primary Care. Data were collected by a nutritionist in face-to-face interviews. Results: There was a predominance of female children, with a mean age of 30.19±16.67 months. In all, 92.7% of the children exhibited some indicator of unhealthy food consumption for their age group. The consumption of ultra-processed foods and sweetened beverages by children aged 6-23 months and 29 days was high (83.33%). Conclusion: Most children exhibited some indicator of unhealthy food consumption for their age group in addition to the high frequency of consumption of ultra-processed foods, especially sweetened beverages, in all institutions.

Associations between nutritional risk at hospital admission and incidence of complications, hospitalization time and mortality

ABSTRACT The early identification of nutritional risk is essential for the earliest possible implementation of nutritional therapy. The aim of the present study was to evaluate the association between nutritional risk and the incidence of clinical complications. An observational study was conducted at the internal medicine infirmary of a Brazilian public hospital involving patients admitted between January 2016 and December 2017. The NRS-2002, anthropometrics and laboratory exams (initial and final) were used for the evaluation of nutritional risk. The prevalence of nutritional risk was 63.6%. Nutritional risk upon admission to hospital was associated with the occurrence of complications, a longer hospitalization time and death. In correlation analysis, considering anthropometrics and laboratory exams compared to hospitalization time and time elapsed prior to the onset of the diet, serum albumin was inversely correlated with both hospitalization time and nutritional risk. Based on the present findings, knowledge on the nutritional status of patients and adequate nutritional therapy can lead to fewer complications during hospitalization.

RESUMEN La identificación del riesgo nutricional precoz es esencial para que un procedimiento nutricional sea implementado. El objetivo fue evaluar la asociación entre el riesgo nutricional con incidencia de complicaciones clínicas. Estudio observacional, realizado en la enfermería de una clínica médica de un hospital público brasileño, con pacientes admitidos entre enero de 2016 y diciembre de 2017. Para evaluación nutricional, se utilizaron la NRS-2002, antropometría y análisis laboratoriales inicial y final. La frecuencia de riesgo nutricional fue del 63,6%. El riesgo nutricional en la admisión se mostró asociado a incidencia de complicaciones, mayor tiempo de hospitalización y muerte. La albúmina sérica mostró una correlación inversa con el tiempo de internamiento y riesgo nutricional. Se concluye que el conocer el estado nutricional de los pacientes y el acompañamiento nutricional adecuado minimizará las complicaciones durante el internamiento.

Glomerular filtration rate and its relationship with visceral and subcutaneous adiposity: a study with patients from Northeast Brazil / Tasa de filtración glomerular y su relación con la adiposidad visceral y subcutánea: un estudio con pacientes del noreste brasileño

ABSTRACT Objective: evaluate the relationship between visceral/subcutaneous adipose tissue (VAT/SAT) and glomerular filtration rate (GFR). Methods: A case series study was conducted with 146 male and female adult outpatients at a hospital in Northeast Brazil. VAT and SAT were quantified using computed tomography and GFR was estimated using the formula proposed by the CKD Epidemiology Collaboration. The conceptual model also considered socio-demographic, clinical, anthropometric and lifestyle variables. Results: Females accounted for 71.9% of the sample and mean age was 52.5±13.2 years. Mean body mass index indicated obesity in both sexes (men:30.4±5.9 kg/m2; women: 31.6±6.1 kg/m2). For the same mean age and BMI, men had more VAT and a higher VAT/SAT ratio. Mean GFR was similar between sexes and within the normal range. Simple linear regression analysis revealed that 21.8% of the reduction in GFR in males could be explained by the VAT/SAT ratio (p=0.002). Among females, both VAT alone and the VAT/SAT ratio were predictors of GFR reduction (r2=4.8%, p=0.025 and r2=5.3%, p=0.019, respectively). Conclusion: Mean VAT and VAT/SAT ratio were compatible with abdominal obesity in both sexes and were related to a reduction in GFR.

RESUMEN Objetivo: Evaluar la relación entre el tejido adiposo visceral (TAV) y subcutáneo (TAS) con la tasa de filtración glomerular. Métodos: Estudio tipo serie de casos, en 146 pacientes adultos de ambos sexos, atendidos en un ambulatorio de un hospital de referencia en el Nordeste brasileño. El TAV y el TAS se cuantificaron por tomografía computadorizada y la tasa de filtración glomerular (TFG) estimada por la fórmula del grupo Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). El modelo conceptual también consideró variables sociodemográficas, clínicas, antropométricas y de estilo de vida. Resultados: Pacientes con edad promedio de 52,5 ± 13,2 años y el 71,9% de sexo femenino. El promedio del IMC en ambos sexos se encuentra en el rango de obesidad (hombres= 30,4 ± 5,9 kg/m2 vs mujeres= 31,6 ± 6,1 kg/m2). Para un mismo promedio de edad e IMC, los hombres presentaron mayor TAV y mayor razón TAV/TAS que las mujeres. El promedio de la TFG fue similar entre los sexos y se encuentra en el rango normal. A través de regresión lineal simple, se evidenció que, en el sexo masculino, la disminución de la TFG puede explicarse en el 21,8% por la razón TAV/TAS (p=0,002). En el sexo femenino, tanto el TAV aislado como la razón TAV/TAS fueron predictores de disminución de la TFG (r2= 4,8%; p=0,025 e r2= 5,3%; p=0,019), respectivamente. Conclusión: Se evidenciaron valores muy elevados de los parámetros antropométricos de obesidad abdominal y promedio de TAV y de la razón TAV/TAS compatible con obesidad visceral en ambos sexos, siendo que estos dos últimos parámetros estuvieron relacionados al descenso de la TFG.

Influence of weight gain on the lipid profile of adolescents / Influencia de la ganancia de peso sobre el perfil lipídico en adolescentes

The objective of this study was to assess the influence of weight gain on the lipid profile of 135 adolescents between 10 - 14 years at baseline and 15 - 19 years at follow-up, enrolled in public schools in Recife, Brazil. The results showed that a BMI z-score correlated with triglycerides (TG) and with high density trigliceride lipopoteine ratio (TG/HDL-c) in males. In females, high z-score correlated with total cholesterol (TC) and low density lipoprotein (LDL-c). In males, for each unit increase in z-score, TG increased by 14.7 mg/dL and the TG/HDL-c ratio increased by 0.4. Among females, TC increased by 9.4 mg/dL, LDL-c increased by 11.6 mg/dL, non-HDL cholesterol increased by 11.8 mg/dL, and HDL-c decreased by 2.3 mg/dL. In males, excessive weight gain was associated with an increase in TG and TG/HDL-c; in females, it was associated with a higher increase in TG/HDL-c and non-HDL cholesterol. However, z-score variation can be a good predictor of lipid profile changes, even in those that are within the normal range.

El objetivo de este estudio fue evaluar la influencia del aumento de peso en el perfil lipídico de 135 adolescentes de edades entre 10 y 14 años de edad al inicio del estudio y de 15 a 19 años en el seguimiento. Los adolescentes pertenecían a escuelas públicas de Recife, Brasil. Los resultados mostraron que el alto puntaje z de indice de masa corporase (IMC) correlacionaba con triglicéridos (TG) y con relación de triglicéridos con lipoproteínas de alta densidad (TG/HDL-c) en los hombres. En las mujeres, puntaje z de IMC se correlacionó con CT y lipoproteína de baja densidad (LDL-c). En los hombres, por cada unidad de aumento en el puntaje z, los TG aumentaron en 14,7 mg/dL y la relación TG / HDL-c aumentó en 0,4; en las mujeres, el CT aumentó en 9,4 mg/dL, el LDL-c aumentó en 11,6 mg/dL, el colesterol no HDL aumentó en 11,8 mg / dL y el HDL-c disminuyó en 2,3 mg/dL. En los hombres, el aumento de peso excesivo se asoció con un aumento de TG y TG/HDL-c; en las mujeres, con un aumento mayor en TG/HDL-c y colesterol no HDL. Sin embargo, la variación z-score puede ser un buen predictor de cambios en el perfil lipídico, incluso en aquellos que se encuentran dentro del rango normal.

Early menarche and its association with anthropometric and body composition variables in young university students / Menarquia precoz y su asociación con parámetros antropométricos y de composición corporal en jóvenes universitarias

OBJECTIVE: Evaluate the association between early menarche and anthropometric/body composition variables in young female university students. METHODS: Cross-sectional study involving female university students at a public university in northeastern Brazil. Anthropometric and body composition data were collected, along with a self-report of age at menarche. The conceptual model considered demographic, socioeconomic and lifestyle variables as well as the perception of weight in childhood and at menarche. RESULTS: Among the 162 students analyzed, 62.3% were less than 20 years of age. The frequency of underweight and overweight was 8.6% and 22.3%, respectively. The frequency of above-average body fat and obesity was 32.1% and 14.8%, respectively. Early menarche was reported in 35.2%. The frequency of self-reported excess weight in childhood and at menarche was 31.3% and 25.9%, respectively. A statistically significant association was found between early menarche and height < 1st tertile (< 1.62 m). A tendency toward an association was found between early menarche and both weight, circumference in the risk range and the perception of excess weight in childhood and at menarche. CONCLUSION: Current excess weight was more associated with excess weight in childhood and at menarche than the occurrence of early menarche.

OBJETIVO: Evaluar asociación entre menarquia precoz, parámetros antropométricos y de composición corporal en jóvenes universitarias. MÉTODOS: Estudio transversal en 162 jóvenes universitarias del Nordeste brasileño. Se recogieron datos antropométricos, de composición corporal y relato sobre la edad de la menarquia. Se consideraron, además, variables demográficas, socioeconómicas, estilo de vida e histórico del peso. RESULTADOS: De las 162 jóvenes el 62,3% tenía menos de 20 años de edad. Un 8,6% y 22,3% presentaron bajo peso, y exceso de peso respectivamente. La frecuencia de grasa corporal y obesidad por encima de la media fue de 32,1% y 14,8%, respectivamente. La menarquia temprana fue reportada en el 35,2% de los casos. El 31,3% y 25,9% repostaron tener exceso de peso en la infancia y en la menarquia respectivamente. Se verificó asociación estadísticamente significativa entre menarquia precoz y talla <1 tercil (<1,62cm). Además de una tendencia de asociación entre menarquia precoz, circunferencia de la cintura y exceso de peso, tanto en la infancia como en la edad de menarquia. CONCLUSIÓN: el exceso de peso actual está, mas asociado con el exceso de peso en la infancia y la edad de la menarquia que con la menarquia precoz.

Síndrome lipodistrófica do HIV e seus fatores associados: um estudo em um hospital universitário / Lipodystrophic syndrome of HIV and associated factors: a study in a university hospital

Resumo O uso de antirretroviral aumentou a sobrevida dos portadores do HIV, porém pode acarretar efeitos colaterais, como a síndrome lipodistrófica. O objetivo deste artigo é identificar a frequência da síndrome lipodistrófica e seus fatores associados em pacientes portadores do HIV em uso de terapia antiretroviral. Estudo transversal com pacientes acompanhados ambulatorialmente. A síndrome foi avaliada pela associação de dois parâmetros: emagrecimento periférico através da escala de gravidade de lipodistrofia e acúmulo de gordura central, mensurado pela relação cintura quadril. Para identificar as variáveis associadas foi realizada a análise de Regressão de Poisson. Dos 104 pacientes avaliados, 27,9% apresentaram a síndrome. Após ajuste, ser do sexo feminino (RPajustada = 2,16 IC95%1,43-3,39), ter excesso de peso (RPajustada = 2,23 IC95%1,35-2,65) e um maior tempo de uso dos antirretrovirais (RPajustada = 1,64 IC95%1,16-2,78) permaneceram positivamente associados à síndrome. Por outro lado, foi observada uma associação negativa com a contagem de CD4 £ 350 (RPajustada = 0,39 IC95%0,10-0,97). A alta prevalência da síndrome e sua associação com grupos específicos reforçam a necessidade do adequado acompanhamento e identificação precoce como forma de intervir nos fatores modificáveis.

Abstract The use of antiretroviral drugs has increased the survival of HIV patients, but may have side effects, such as lipodystrophic syndrome. This article aims to identify the frequency of the lipodystrophic syndrome and its associated factors in patients with HIV using antiretroviral therapy. It involved a cross-sectional study with HIV patients, monitored on an outpatient basis. The syndrome was evaluated by the association of two parameters: peripheral weight loss through the lipodystrophy severity scale and central fat accumulation, measured by the hip waist ratio. Poisson regression analysis was performed to identify the associated variables. Of the 104 patients evaluated, 27.9% presented the syndrome. After adjustment, the female sex (PRadjusted = 2.16 CI95% 1.43-3.39), being overweight (PRadjusted = 2.23 CI95% 1.35-2.65) and a longer period of use of antiretrovirals (PRadjusted = 1.64 CI95% 1.16-2.78), remained positively associated with the syndrome. On the other hand, a negative association with CD4 count £ 350 (PRadjusted = 0.39 CI95% 0.10-0.97) was observed The high prevalence of the syndrome and its association with specific groups reinforce the need for adequate follow-up and early identification to intervene in modifiable factors.

Overweight in adolescents: food insecurity and multifactoriality in semiarid regions of pernambuco / Excesso de peso em adolescentes: insegurança alimentar e multifatorialidade no cenário do semiárido de pernambuco

ABSTRACT Objective: To investigate context of overweight adolescents from the semiarid and rural areas of Pernambuco, considering the multifactorial nature of the determinants of being overweight, and the food and nutritional insecurity conditions of the region. Methods: A population based cross-sectional study was conducted from September to October 2015. The nutritional status of adolescents was assessed by body mass index (BMI) and classified by the BMI/Age indicator, according to sex. To analyze the factors associated with being overweight, the variables were grouped into: socioeconomic, demographic, environmental, lifestyle, psychological, biological and food and nutritional security. Poisson regression was used to verify the association between being overweight and independent variables. Results: The prevalence of excessive weight found was 20.1%, namely: 13.4% overweight and 6.7% obese. After adjusting for the confounding variables, the variables: occupancy situation (rented house), alcohol consumption, food security and light food insecurity, body perception (overweight and obese) and age range (10 to 14 years), were associated with being overweight. High food and nutritional insecurity was identified in 80.4% of the population. The moderate and severe forms were more frequent, and precarious social conditions were still prevalent in the region. Conclusions: The prevalence of being overweight was high, exceeding the expected for a population with better living conditions. The determinants of being overweight were: alcohol consumption, occupancy situation, self-perceived weight, age and food security/mild food insecurity.

RESUMO Objetivo: Investigar o excesso de peso em adolescentes do Sertão e Agreste de Pernambuco, considerando a multifatoriedade dos determinantes do excesso de peso e as condições de insegurança alimentar e nutricional da região. Métodos: Estudo transversal, de base populacional, realizado no período de setembro a outubro de 2015. O estado nutricional dos adolescentes foi avaliado pelo índice de massa corpórea (IMC) e classificado pelo indicador IMC/idade, segundo o sexo. Para analisar os fatores associados ao excesso de peso, as variáveis foram agrupadas em: socioeconômicas, demográficas, ambientais, de estilo de vida, psicológicas, biológicas e segurança alimentar e nutricional. A regressão de Poisson foi utilizada para verificar a associação entre o excesso de peso e as variáveis independentes. Resultados: A prevalência de excesso de peso encontrada foi de 20,1%, sendo 13,4% de sobrepeso e 6,7% de obesidade. Após o ajuste para as variáveis de confusão, as variáveis regime de ocupação (casa cedida, alugada), consumo de álcool, segurança alimentar, insegurança alimentar leve, percepção corporal (sobrepeso e obesidade) e faixa etária (10 a 14 anos) mostraram-se associadas ao excesso de peso. Destaca-se a elevada insegurança alimentar e nutricional, em 80,4% da população, sendo as formas moderadas e graves as mais frequentes, como também as precárias condições sociais ainda prevalentes na região. Conclusões: A prevalência de excesso de peso foi elevada, superando o esperado para uma população com melhores condições de vida. Os determinantes do excesso de peso foram: consumo de álcool, regime de ocupação, autopercepção do peso, faixa etária e segurança alimentar/insegurança alimentar leve.

Changes in weight and body composition among students after entering the university: a systematic review / Cambios en el peso y la composición corporal entre los estudiantes después de ingresar a la universidad: una revisión sistemática

OBJECTIVE: Conduct a literature review to provide an estimate of changes in weight and body composition among university students and evaluate whether these changes are exclusive to the first year of academic life. METHODS: Searches were performed in the PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, LILACS and SciELO databases for relevant articles published between 2007 and 2018. Only longitudinal studies involving concomitant evaluations of changes in weight and body composition were included. Two independent researchers performed the selection of the articles. RESULTS: Eleven articles met the eligibility criteria and were included in the review. The tendency toward an increase in weight and body fat during academic life was confirmed, especially in the first year. Gains in weight and body fat in the freshman year of university were reported in all studies and ranged from 1.0 to 2.1 kg and 0.7 to 1.3%, respectively. Among the majority of students, the gain in body weight was the result of an increase in body fat. CONCLUSION: University students experience gains in weight and body fat during their academic lives, especially in the first year of university.

OBJETIVO: Realizar una revisión de la literatura para proporcionar una estimación de los cambios en el peso y la composición corporal entre los estudiantes universitarios y evaluar si estos cambios son exclusivos del primer año de la vida académica. MÉTODOS: Se realizaron búsquedas en las bases de datos PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, LILACS y SciELO para artículos relevantes publicados entre 2007 y 2018. Solo se incluyeron estudios longitudinales que incluyeron evaluaciones concomitantes de cambios en el peso y la composición corporal. Dos investigadores independientes realizaron la selección de los artículos. RESULTADOS: Once artículos cumplieron con los criterios de elegibilidad y se incluyeron en la revisión. La tendencia hacia un aumento en el peso y la grasa corporal durante la vida académica se confirmó, especialmente en el primer año. Las ganancias en peso y grasa corporal en el primer año de la universidad se informaron en todos los estudios y variaron de 1.0 a 2.1 kg y 0.7 a 1.3%, respectivamente. Entre la mayoría de los estudiantes, el aumento en el peso corporal fue el resultado de un aumento en la grasa corporal. CONCLUSION: Los estudiantes universitarios experimentan aumentos de peso y grasa corporal durante su vida académica, especialmente en el primer año de la universidad.