Reference percentiles for bioimpedance body composition parameters of healthy individuals: A cross-sectional study

Abstract Objectives: The aim of this study was to estimate the percentage distribution of body composition parameters for healthy people at different ages from the assessment of electrical bioimpedance. Methods: A cross-sectional study of healthy Brazilian aged 5 years and older. Were evaluated: total body fat; percent body fat; fat-free mass; percent lean mass; fat mass index; and fat-free mass index. Results: Of 1240 participants, with a median age of 27.0 years, 52.5% were female, and 73.7% were Caucasian. Most of the body composition variables were associated with age. The fat-free mass increased from youth to adult and decreased in the elderly in both sexes, with higher values in males than in females. In males, the percentage of lean mass has higher values in adolescence compared to childhood, and in adults compared to the elderly, when analyzed from the 50th percentile. In women, fat-free mass compared to adulthood, values were higher in childhood and lower in older ages. Conclusions: The study is the first to describe the Brazilian reference values for most clinical parameters of bioimpedance in percentiles stratified by different life cycles and sex. These findings can be very useful in clinical practice for health promotion and monitoring the nutritional status of the individual.

Association between children and adolescents' body composition with family income / Associação entre a composição corporal de crianças e adolescentes e renda familiar

ABSTRACT Objective To evaluate the association between children and adolescents' body composition with family income. Methods Cross-sectional study, participants between 5 and 19 years were included. A standardized questionnaire assessed socioeconomic variables. The outcome variables were z-score of Body Mass Index and bioimpedance parameters (skeletal muscle mass, fat-free mass, and fat percentage) and predictor variables (age, sex, race, place of residence, father's education, birth weight and breastfeeding) were analyzed using the quantile regression model and data from the 50th percentile are presented. The tests were bidirectional and the differences were considered significant with p<0.05. Results Among the 529 participants included, 284 (53.6%) were female and the mean age was 11.41±3.9 years. The Body Mass Index z-score was the only outcome that did not show differences between sexes (p=0.158). In the crude model, lower family income was associated with lower skeletal muscle mass (Difference=-7.70; 95% CI -9.32 to -5.89), p<0.001), lower fat-free mass (Difference= -13.40; 95% CI -16.40 to -10.39, p<0.001) and the lowest percentage of fat was associated with lower family income (Difference= -5.01, 95% CI -9.91 to -0.11, p=0.027). The z-score of BMI was not associated with family income. Conclusion Family income is directly associated with lower fat-free mass, fat percentage, and skeletal muscle mass in children and adolescents.

RESUMO Objetivo Avaliar a associação entre a composição corporal de crianças e adolescentes com a renda familiar. Métodos Estudo transversal, foram incluídos participantes entre 5 e 19 anos. As variáveis socioeconômicas foram avaliadas por meio de questionário padronizado. As variáveis de desfecho foram escore Z do índice de massa corporal e parâmetros de bioimpedância (massa muscular esquelética, massa livre de gordura e percentual de gordura) e variáveis preditoras (idade, sexo, raça, local de residência, escolaridade do pai, peso ao nascer e aleitamento materno) foram analisados pelo modelo de regressão quantílica e são apresentados os dados do percentil 50. Os testes foram bidirecionais, e as diferenças foram consideradas significativas com p<0,05. Resultados Entre os 529 participantes incluídos, 284 (53,6%) eram do sexo feminino e a média de idade foi de 11,41±3,9 anos. O escore Z do índice de massa corporal foi o único desfecho que não apresentou diferenças entre os sexos (p=0,158). No modelo bruto, uma menor renda familiar foi associada a menor massa muscular esquelética (Diferença= -7,70; IC 95% -9,32 a -5,89), p<0,001), menor massa livre de gordura (Diferença= -13,40; IC 95% -16,40 a -10,39, p<0,001) e o menor percentual de gordura associou-se à menor renda familiar (Diferença= -5,01, IC 95% -9,91 a -0,11, p=0,027). O escore Z do IMC não foi associado à renda familiar. Conclusão A renda familiar está diretamente associada à menor massa magra, ao percentual de gordura e à massa muscular esquelética em crianças e adolescentes.

68Ga-Prostate-specific membrane antigen (PSMA) positron emission tomography (pet) in prostate cancer: a systematic review and meta-analysis

ABSTRACT Introduction: Prostate cancer (PC) is the second most commonly diagnosed cancer in males. 68Ga-PSMA PET/CT, a non-invasive diagnostic tool to evaluate PC with prostate-specific membrane antigen (PSMA) expression, has emerged as a more accurate alternative to assess disease staging. We aimed to identify predictors of positive 68Ga-PSMA PET and the accuracy of this technique. Materials and methods: Diagnostic accuracy cross-sectional study with prospective and retrospective approaches. We performed a comprehensive literature search on PubMed, Cochrane Library, and Embase database in search of studies including PC patients submitted to radical prostatectomy or radiotherapy with curative intent and presented biochemical recurrence following ASTRO 1996 criteria. A total of 35 studies involving 3910 patients submitted to 68-Ga-PSMA PET were included and independently assessed by two authors: 8 studies on diagnosis, four on staging, and 23 studies on restaging purposes. The significance level was α=0.05. Results: pooled sensitivity and specificity were 0.90 (0.86-0.93) and 0.90 (0.82-0.96), respectively, for diagnostic purposes; as for staging, pooled sensitivity and specificity were 0.93 (0.86-0.98) and 0.96 (0.92-0.99), respectively. In the restaging scenario, pooled sensitivity and specificity were 0.76 (0.74-0.78) and 0.45 (0.27-0.58), respectively, considering the identification of prostate cancer in each described situation. We also obtained specificity and sensitivity results for PSA subdivisions. Conclusion: 68Ga-PSMA PET provides higher sensitivity and specificity than traditional imaging for prostate cancer.

Can skinfold thickness equations be substituted for bioimpedance analysis in children?

Abstract Objective: The aim of the present study was to evaluate the agreement between the most used skinfold thickness equations with multi-frequency bioimpedance analysis in the prediction of body fat levels in children. Method: A cross-sectional study of healthy Brazilian community-dwelling individuals. The anthropometric assessment included height, body mass, arm circumference, and waist circumference. The percentage of body fat was obtained by measuring skinfold thickness equations and using bioimpedance analysis, and skinfold thickness was measured using a scientific skinfold caliper. Bland-Altman plot analysis was used to verify the agreement between the methods. Results: There were 439 children and adolescents evaluated, with a mean age of 11.6 ± 3.7 years. The mean body fat by bioimpedance analysis was 22.8% ± 10.4%, compared to 22.4% ± 8.8% by Slaughter (1), 20.4% ± 9.2% by Slaughter (2), 19.6% ± 4.4% by Goran, and 24.7% ± 10.0% by Huang equations. Bland-Altman plot analysis revealed limits of agreement greater than 8% between the bioimpedance analysis approach and equations, exceeding the clinically acceptable limit predefined a priori. None of the equations had good agreement with bioimpedance analysis. Conclusion: It was concluded that skinfold thickness and bioimpedance analysis should not be used interchangeably in children and adolescents.

Health-related quality of life in post-infectious bronchiolitis obliterans: agreement between children and their proxy / Qualidade de vida relacionada à saúde na bronquiolite obliterante pós-infecciosa: concordância entre as crianças e seus cuidadores

Abstract Objective: To assess the level of agreement in health-related quality of life between children with Post-infectious Bronchiolitis Obliterans and their parent (so-called proxy). Methods: Participants aged between 8and 17 years who had been previously diagnosed with Post-infectious Bronchiolitis Obliterans were regularly followed up at a pediatric pulmonology outpatient clinic. Parents or legal guardians (caregivers) of these patients were also recruited for the study. A validated and age-appropriate version of the Pediatric Quality of Life Inventory 4.0 was used for the assessment of health-related quality of life. Caregivers completed the corresponding proxy versions of the questionnaire. The correlation between self and proxy reports of health-related quality of life was determined by intra-class correlation coefficient and dependent t-tests. Results: The majority of participants were males (79.4%), and the average age was 11.8 years. Intra-class correlations between each of the Pediatric Quality of Life Inventory 4.0 domains and the total score were all lower than 0.6, with a range between 0.267 (poor) and 0.530 (fair). When the means of each domain and the total score of the questionnaires were compared, caregivers were observed to have a significantly lower health-related quality of life score than children, with the exception of the social domain in which the difference was not significant. However, the differences in score exceeded the critical threshold difference of four points in all other domains. Conclusion: Proxies of children and adolescents with Post-infectious Bronchiolitis Obliterans appear to consistently perceive their children as having lower health-related quality of life than how the patients perceive themselves.

Resumo: Objetivo: Avaliar o nível de concordância a respeito da qualidade de vida relacionada à saúde entre crianças com bronquiolite obliterante pós-infecciosa e seus pais (responsáveis). Métodos: Os participantes entre 8-17 anos, anteriormente diagnosticados com bronquiolite obliterante pós-infecciosa, foram acompanhados regularmente no ambulatório de pneumologia pediátrica. Os pais ou responsáveis legais (cuidadores) desses pacientes também foram convidados a participar do estudo. Uma versão validada e adequada para a idade do Inventário Pediátrico de Qualidade de Vida, versão 4.0, foi utilizada para a avaliação da qualidade de vida relacionada à saúde. Os cuidadores concluíram as versões do questionário correspondentes aos responsáveis. A correlação entre os autorrelatos e os relatos dos responsáveis da qualidade de vida relacionada à saúde foi determinada pelo coeficiente de correlação intraclasse e pelos testes t dependentes. Resultados: A maior parte dos participantes era do sexo masculino (79,4%) e a idade média foi 11,8 anos. As correlações intraclasse entre cada um dos domínios do Inventário Pediátrico de Qualidade de Vida e o escore total foram todas inferiores a 0,6, com intervalo entre 0,267 (baixo) e 0,530 (justo). Quando as médias de cada domínio e o escore total dos questionários foram comparados, observamos que os cuidadores apresentaram qualidade de vida relacionada à saúde significativamente menor em comparação com as crianças, com exceção do domínio social, no qual a diferença não foi significativa. Contudo, as diferenças no escore ultrapassaram o limite de diferença essencial de 4 pontos em todos os outros domínios. Conclusão: Os responsáveis pelas crianças e adolescentes com bronquiolite obliterante pós-infecciosa parecem perceber de forma consistente que suas crianças possuem qualidade de vida relacionada à saúde menor que os próprios pacientes.

Efeitos da prática orientada de exercícios físicos em pacientes do SUS no município de Canela, Brasil / Effects of guided physical exercise in public patients in the city of Canela, Brazil / Efectos de la práctica de ejercicios físicos en pacientes del SUS en el municipio de Canela, Brasil

Resumo Foram avaliados os efeitos da prática orientada de exercícios físicos em pacientes encaminhados por médicos das equipes da Estratégia de Saúde da Família do município de Canela, Rio Grande do Sul, Brasil. Os exercícios foram feitos em academia de ginástica do SUS sob supervisão direta do professor de educação física. Os 120 participantes, 99 mulheres e 21 homens, entre 10 e 78 anos, foram acompanhados durante seis meses. Constatou-se melhoria do VO2máx (20,07 ± 14,14 para 31,68 ± 12,18 p < 0,001) e do tempo em segundos para percorrer uma milha (1.171 ± 228 para 954 ± 163 p < 0,001), entre outras variáveis quantitativas. A qualidade de vida percebida com o questionário WHOQOL-BREF evidenciou melhoria em todos os domínios: físico (67,6 ± 15,5 para 74,7 ± 12,4 p < 0,001); psicológico (62,4 ± 14,9 para 70,7 ± 12,6 p < 0,001); social (70,3 ± 16,8 para 76,4 ± 16,0 p < 0,001) e ambiental (62,8 ±12,4 para 68,2 ± 12,1 p < 0,001).

Abstract The effects of guided practice physical exercise in patients referred by medical teams of the Health Strategy Family of the municipality of Canela, Rio Grande do Sul, Brazil were evaluated. The exercises were performed in the fitness SUS under direct supervision of a physical education teacher. The 120 participants, 99 women and 21 men, aged 10 to 78 years, were followed for 6 months. It found improvement in VO2máx (20.07 ± 14.14 to 31.68 ± 12.18 p < 0.001) and time in seconds to travel 1 mile (1171 ± 228 to 954 ± 163 p < 0.001), among other quantitative variables. The perceived quality of life with the WHOQOL -BREF questionnaire showed improvement in all domains: physical (67.6 ± 15.5 to 74.7 ± 12.4 p < 0.001), psychological (62.4 ± 14.9 to 70.7 ± 12.6 p < 0.001), social (70.3 ± 16.8 to 76.4 ± 16.0 p < 0.001) and environmental (62.8 ± 12.4 to 68.2 ± 12, 1 p < 0.001).

Resumen Se evaluaron los efectos del ejercicio físico en pacientes derivados por médicos de los equipos de la Estrategia de Salud de la Familia del municipio de Canela, Rio Grande do Sul, Brasil. Los ejercicios se realizaron en el gimnasio del SUS bajo la supervisión directa de un profesor de educación física. Se hizo un seguimiento de 6 meses de los 120 participantes, 99 mujeres y 21 hombres, entre 10 y 78 años. Se encontró una mejoría en su VO2máx. (de 20,07 ± 14,14 a 31,68 ± 12,18; p <0,001) y el tiempo en segundos para correr 1 milla (de 1.171 ± 228 a 954 ± 163; p <0,001) entre otras variables cuantitativas. La percepción de la calidad de vida con el cuestionario WHOQOL-BREF mostró una mejora en todos los ámbitos: físico (de 67,6 ± 15,5 a 74,7 ± 12,4; p <0,001), psicológico (de 62,4 ± 14,9 a 70,7 ± 12,6; p <0,001), social (de 70,3 ± 16,8 a 76,4 ± 16,0; p <0,001) y del entorno (de 62,8 ± 12,4 a 68,2 ± 12,1; p <0,001). Esta mejora no está relacionada con el número de clases a las cuales asistieron.

Evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents: systematic review / Evidência sobre técnicas e parâmetros de avaliação nutricional para crianças e adolescentes: revisão sistemática

Abstract This article aims to review systematically the evidence on nutritional assessment techniques and parameters used to determine the nutritional status of children and adolescents. The literature review and the selection of publications were performed using the Medline, Lilacs, SciELO, Embase, personal files. 17 studies were identified, 7 addressed the anthropometric indices as the main outcome, 7 analyzed the growth and development of children and adolescents through growth curves, and the remainder surveyed body composition. In general, all met the quality criteria, unless 6 of the articles who did not discuss the limitations. The literature review suggests several techniques and parameters that can be applied to determine the nutritional status of children and adolescents from different countries. Growth graphs are essential to assess the health of children, but depend greatly of the growth tables used. Although BMI can be practical, it does not distinguish body fat from lean mass. The best interpretation of anthropometry will depend of valid reference values for age range of the study population. BIA is a quick feasible method, but the measurement has some various nationalities.

Resumo O objetivo deste artigo é revisar sistematicamente as evidências sobre as técnicas de avaliação nutricional e parâmetros utilizados para determinar o estado nutricional em crianças e adolescentes. Revisão da literatura com busca nas bases de dados, Medline, Lilacs, SciELO e Embase, além de arquivos pessoais. Identificamos 17 artigos que relatavam dados de diferentes populações, sete estudos abordaram os índices antropométricos, quatro o crescimento e o desenvolvimento de crianças e adolescentes por meio de curvas de crescimento, e o restante a composição corporal. Todos preencheram os critérios de qualidade, com exceção das limitações. A revisão da literatura sugere diversas técnicas e parâmetros que podem ser aplicados para determinar o estado nutricional de crianças e adolescentes de diferentes países. Gráficos de crescimento são essenciais para avaliar a saúde de crianças, mas depende muito das tabelas de crescimento utilizadas. Embora o IMC seja prático, não distingue a gordura corporal de massa magra. Existem várias técnicas para avaliar proporções, tamanho e composição corporal. A melhor interpretação da antropometria dependerá de valores de referência válidos para a faixa etária da população estudada. BIA é um método factível, mas tem algumas limitações para a realização do exame.

Health-related quality of life in patients with bronchiolitis obliterans / Qualidade de vida relacionada à saúde em pacientes com bronquiolite obliterante

Abstract Objective: To evaluate the overall health-related quality of life in patients with bronchiolitis obliterans. Methods: Participants with a diagnosis of post-infectious bronchiolitis obliterans, who were being followed-up at two specialized outpatient clinics of Pediatric Pulmonology in Porto Alegre, Brazil, and controls aged between 8 and 17 years, of both genders, were included in the study. Controls were paired by gender, age, and socioeconomic level in relation to the group of participants with post-infectious bronchiolitis obliterans. The version of the Pediatric Quality of Life Inventory (PedsQ) tool validated for Brazil was applied for the assessment of Health-related Quality of Life, through an interview. The comparison of the Health-related Quality of Life means between the groups was performed using Student's t-test for independent samples and the chi-squared test, for categorical variables. Results: 34 patients diagnosed with post-infectious bronchiolitis obliterans and 34 controls participated in the study. The mean age of the children included in the study was 11.2 ± 2.5 years, and 49 (72%) of them were males. The groups showed no significant differences in relation to these variables. The quality of life score was significantly and clinically lower in the post-infectious bronchiolitis obliterans group when compared with controls in the health (72.36 ± 15.6, 81.06 ± 16.4, p = 0.031) and school domains (62.34 ± 20.7, 72.94 ± 21.3, p = 0.043), as well as in the total score (69.53 ± 14.9, 78.02 ± 14.8, p = 0.024), respectively. Conclusion: Patients with post-infectious bronchiolitis obliterans presented lower health-related quality of life scores when compared with healthy individuals in the total score and in the health and school domains.

Resumo Objetivo: Avaliar a qualidade de vida relacionada à saúde geral em participantes com bronquiolite obliterante. Métodos: Foram incluídos no estudo participantes com diagnóstico de bronquiolite obliterante pós-infecciosa que estavam em acompanhamento em dois ambulatórios especializados de pneumologia pediátrica em Porto Alegre, Brasil e controles, entre 8 e 17 anos, de ambos os sexos. Os controles foram pareados por sexo, idade e nível socioeconômico em relação ao grupo de participantes com bronquiolite obliterante pós-infecciosa. Para avaliação da Qualidade de Vida Relacionada à Saúde geral foi aplicado a versão validada para o Brasil do instrumento PedsQL (Pediatric Quality of Life Inventory), por meio de entrevista. A comparação entre as médias da Qualidade de Vida Relacionada à Saúde entre os grupos foi realizada mediante o teste t para amostras independentes e para as variáveis categóricas por teste qui-quadrado. Resultados: Participaram do estudo 34 pacientes com diagnóstico de bronquiolite obliterante pós-infecciosa e 34 controles. A média da idade das crianças incluídas foi de 11,2 ± 2,5 anos e 49 (72%) deles eram do sexo masculino. Os grupos não apresentaram diferenças significativas em relação a essas variáveis. O escore de qualidade de vida foi significativamente e clinicamente menor no grupo bronquiolite obliterante pós-infecciosa em comparação com o controle nos domínios saúde: (72,36 ± 15,6; 81,06 ± 16,4; p = 0,031); escolar: (62,34 ± 20,7; 72,94 ± 21,3; p = 0,043) e no escore total (69,53 ± 14,9; 78,02 ± 14,8, p = 0,024), respectivamente. Conclusão: Os pacientes com bronquiolite obliterante pós-infecciosa apresentam escores de qualidade de vida relacionados à saúde menor do que indivíduos saudáveis no escore total e nos domínios saúde e escolares.

Resultados da primeira fase do Programa Esporte e Saúde em Canela, Rio Grande do Sul: avaliação do perfil nutricional / Results of the first phase of the Sport and Health Program in Canela, Rio Grande do Sul state, Brazil: Evaluation of the nutritional profile

OBJETIVOS: Apresentar os resultados da avaliação nutricional de crianças e adolescentes, como parte de um programa municipal voltado à saúde de escolares. MÉTODOS: Um estudo transversal realizado entre fevereiro e abril de 2017 avaliou o perfil nutricional de pré-escolares e escolares do município de Canela, Rio Grande do Sul. Foram incluídos estudantes da pré-escola ao nono ano das escolas públicas municipais, atendidos pelo Programa Esporte e Saúde em Canela. Para avaliação nutricional foram aferidas a massa corporal e a estatura, sendo o estado nutricional classificado segundo o Escore Z para o índice de massa corporal. RESULTADOS: Foram avaliados 2691 pré-escolares e escolares, sendo 1408 (52,3%) do sexo masculino. A média de idade foi de 9,63±3,1 anos, o peso médio de 38,59±16,4 kg, a altura média de 139±18 cm e o índice de massa corporal médio 18,9±4,3 kg/m2 . Quanto ao estado nutricional, 44 (1,7%) foram classificados como magreza, 1725 (64,1%) como eutrofia e 922 (34,2%) tinham peso excessivo, sendo sobrepeso 528 (19,6%), obesidade 286 (10,6%) e obesidade grave 108 (4%). CONCLUSÕES: Um número expressivo dos estudantes da rede pública do município de Canela apresentava sobrepeso ou obesidade, o que reforça a necessidade de programas de prevenção e tratamento da obesidade nessa população. O Programa Esporte e Saúde em Canela tem como proposta colocar em prática estratégias de incentivo aos estudantes para a prática de atividade física e alimentação saudável.

AIMS: To present the results of the nutritional evaluation of children and adolescents, as part of a municipal program aimed at the health of schoolchildren. METHODS: A cross-sectional study conducted between February and April 2017 evaluated the nutritional profile of preschool children and schoolchildren in the city of Canela, Rio Grande do Sul state, Brazil. Students from pre-school to the ninth grade of the municipal public schools attended by the Sport and Health Program in Canela were included. For nutritional evaluation, body mass and height were measured, and the nutritional status was classified according to the Z score for body mass index. RESULTS: We evaluated 2691 preschoolers and schoolchildren, with 1408 (52.3%) males. The mean age was 9.63±3.1 years, the mean weight was 38.59±16.4 kg, the mean height was 139±18 cm and the mean body mass index was 18.9±4.3 kg/m2 . Regarding nutritional status, 44 (1.7%) were classified as thinness, 1725 (64.1%) as eutrophic and 922 (34.2%) were overweight, being overweight 528 (19.6%), obesity 286 (10.6%) and severe obesity 108 (4%). CONCLUSIONS: A significant number of students from public schools in the municipality of Canela were overweight or obese, which reinforces the need for programs to prevent and treat obesity in this population. The Sport and Health Program in Canela aims to put into practice strategies to encourage students to practice physical activity and healthy eating.

Effects of vitamin D in the prevention of acute viral bronchiolitis: systematic review / Efeitos da vitamina D na prevenção da bronquiolite viral aguda: revisão sistemática

Aims: Published evidence suggests that Vitamin D supplementation may have a protective effect on infectious disease of the lower respiratory tract. The objective of this review was to critically appraise the effects of vitamin D intake in the prevention of acute viral bronchiolitis in children. Methods: We searched the databases Medline, EMBASE, Web of Science, LILACS, and Cochrane Central Register of Controlled Trials, until December 2014, using the keywords: "Vitamin D" or cholecalciferol or ergocalciferol and "bronchiolitis, viral" or "viral bronchiolitis" or "bronchiolitides, viral" or "viral bronchiolitides". Studies evaluating the effect of vitamin D intake in the prevention of acute viral bronchiolitis in young children were included. Studies with less than two weeks of intervention and review articles were excluded. Results: The search identified 241 articles, among which 20 articles were selected for full reading and two articles were included in the systematic review, comprising 296 children. No study measured serum levels of vitamin D. One of the included studies was a clinical trial, where the number of episodes of acute viral bronchiolitis was significantly lower in children supplemented with vitamin D (Group I: mean 0.6±0.7 Group II: mean 1.4±0.9; P=0.001). The other, a case-control study, did not find a significant relationship between the occurrence of acute viral bronchiolitis cases and the intake of vitamin D (odds ratio 1.7, 95% confidence interval 0.7-4.0). Conclusions: Current scientific evidence is insufficient to prove clinical benefits of vitamin D in preventing acute viral bronchiolitis.

Objetivos: Evidências publicadas sugerem que a suplementação da vitamina D pode ter efeito protetor nas infecções do trato respiratório inferior. O objetivo desta revisão foi avaliar os efeitos da ingestão de vitamina D na prevenção da bronquiolite viral aguda em crianças. Métodos: Foram feitas buscas nas bases de dados Medline, EMBASE, Web of Science, LILACS e Cochrane Central Register of Controlled Trials, até dezembro de 2014, usando os descritores "Vitamin D" ou cholecalciferol ou ergocalciferol e "bronchiolitis, viral" ou "viral bronchiolitis" ou "bronchiolitides, viral" ou "viral bronchiolitides". Foram incluídos estudos que avaliaram o efeito da ingesta da vitamina D na prevenção da bronquiolite viral aguda em crianças. Estudos com intervenção menor que duas semanas e artigos de revisão foram excluídos. Resultados: A busca identificou 241 artigos, entre os quais 20 artigos foram selecionados para leitura na íntegra e dois artigos foram incluídos na revisão sistemática, incluindo 296 crianças. Nenhum estudo mediu os níveis séricos de vitamina D. Um dos estudos incluídos foi um ensaio clinico, no qual o número de episódios de bronquiolite foi significativamente menor nas crianças suplementadas com vitamina D (Grupo I: média 0,6±0,7 Grupo II: média 1,4 ±0,9; P=0,001). No outro, um estudo de casos e controles, não se encontrou relação significativa entre casos de bronquiolite viral aguda e ingesta de vitamina D (odds ratio 1,7 ­ intervalo de confiança 95% 0,7-4,0). Conclusões: As evidências científicas atuais são insuficientes para comprovar os benefícios clínicos da vitamina D na prevenção da bronquiolite viral aguda.