Association of dietary patterns and body phenotypes in Brazilian adolescents / Associação entre padrões alimentares e fenótipos corporais em adolescentes brasileiros

Abstract Objectives: to investigate the association between dietary patterns, physical activity, and body phenotypes in adolescents. Methods: this school-based cross-sectional study involved 1,022 adolescents aged ten to 19 years. Dietary patterns and body phenotypes were defined using a principal component analysis. Body phenotype was defined using anthropometry, body composition, biochemistry, sexual maturation, and dietary patterns from 19 food groups, using a food frequency questionnaire. The association between the dietary patterns and body phenotypes was assessed using a linear regression model. Results: five body phenotypes (BP1adiposity, BP2puberty, BP3biochemical, BP4muscular, BP5lipids_biochemical) and five dietary patterns (DP1ultraprocessed_foods, DP2fresh_foods, DP3bread_rice_beans, DP4culinary_preparations, DP5cakes_rice_beans) were identified. There were higher BP_adiposity scores for obese adolescents, but energy expenditure was similar for obese and non-obese adolescents. Physical activity was positively associated with BMI, BP_adiposity, and BP_puberty. We observed a negative association between DP_ultraprocessed_foods and BMI, and a positive association between DP_fresh_food. DP_fresh_foods was positively associated with BP_adiposity; DP_ultraprocessed_foods and DP_culinary_preparations were negatively associated with this phenotype. BP_biochemical was negatively associated with DP_fresh_foods. Conclusion: we identified a negative association between a dietary pattern composed mainly of ultra-processed foods, fresh foods, and BP_adiposity. These associations need to be better explored, especially in adolescents, as both dietary patterns and phenotypes were defined using multivariate analysis.

Resumo Objetivos: investigar associação entre padrão alimentar (PA), atividade física (AF) e fenótipos corporais (FC) em adolescentes. Métodos: estudo transversal de base escolar com 1.022 adolescentes de dez a 19 anos. Padrão alimentar e fenótipo corporal foram definidos por meio da análise de componentes principais. O fenótipo corporal foi definido usando antropometria, composição corporal, bioquímica e maturação sexual, e padrão alimentar a partir de 19 grupos de alimentos de um questionário de frequência alimentar. A associação entre padrão alimentar e fenótipo corporal foi avaliada por modelo de regressão linear. Resultados: foram identificados cinco fenótipos corporais (FC1adiposidade, FC2puberdade, FC3bioquímico, FC4muscular, FC5lipídios_bioquímico) e cinco padrões alimentares (PA1alimentos_ultraprocessados, PA2alimentos_frescos, PA3pão_arroz_feijão, PA4preparações_culinárias, PA5bolos_arroz_feijão). Há maiores escores de FC_adiposidade para adolescentes com obesidade, mas o gasto energético foi semelhante para adolescentes com e sem diagnóstico de obesidade. Atividade física associou-se positivamente com IMC, FC_adiposidade e FC_puberdade. Observamos associação negativa entre PA_ultraprocessados e IMC, e positiva entre PA_alimentos_frescos. PA_alimentos_frescos associou-se positivamente com FC_adiposidade; PA_ultraprocessados e PA_preparações_culinárias se associaram negativamente a este fenótipo. FC_bioquímico associou-se negativamente com PA_alimentos_frescos. Conclusão: identificamos associação negativa entre padrão alimentar composto principalmente por alimentos ultraprocessados e alimentos in natura e FC_adiposidade. Essas associações devem ser exploradas com o mesmo público em estudos futuros, principalmente em adolescentes, pois tanto o padrão alimentar quanto o fenótipo foram definidos por meio de análise multivariada.

Dietary Patterns for Prevention and Treatment of Cardiometabolic Disease： Interpretation and Thinking Based on Traditional Chinese Medicine Theory / 中国实验方剂学杂志

Cardiometabolic disease （CMD） is a clinical syndrome in which there is a causal relationship between metabolic abnormalities and cardiovascular damage. The incidence and mortality rates of CMD remain high despite the use of potent pharmacologic interventions and clinical therapeutic approaches. There is an urgent need for effective evidence-based comprehensive management measures to improve patients' lifespan and quality of life. From the concept of "nourishing through food" proposed in the Huangdi's Internal Classic （Huang Di Nei Jing） to the widespread application of modern dietary patterns such as dietary restriction， plant-based diets， and Jiangnan cuisine， dietary regulation plays a significant role in preventing diseases， early treatment of existing diseases， and recovery. This article systematically reviewed the traditional Chinese medicine （TCM） theory related to dietary patterns， elucidated the cutting-edge evidence and mechanisms of modern dietary patterns like dietary restriction in preventing and treating CMD， and explored the strategy of integrating TCM theory with dietary patterns， aiming to establish a new food-nutrition-medicine approach that combines traditional Chinese and western medicine and provide novel insights and directions for the clinical management of CMD.

Examining the relationship between fast-food and sitdown restaurant consumption frequency and dietary patterns among adults in Riyadh City, Saudi Arabia

@#Introduction: This study assessed the association between dietary patterns and the frequency of eating at fast-food or sit-down restaurants. Methods: A crosssectional study, with a sample of adults living in Riyadh, Saudi Arabia (SA), was conducted between January and March 2021. An online, self-administered survey was conducted using social media and WhatsApp. A total of 399 adults living in Riyadh were included; 40.4% were males, with a mean age of 35 and standard deviation (SD) of 12 years, and had no significant health problems. Results: Using principal component analysis to analyse 15 food groups based on the food items consumed, four dietary patterns were extracted: Western, unhealthy, plant-based, and healthy. After adjusting for potential covariates, a higher frequency of eating at fast-food restaurants was significantly associated with unhealthy dietary patterns [odds ratio (OR) = 4.85, 95.0% confidence interval (CI) = 1.80, 12.59]. In contrast, participants in the highest tercile of the frequency of eating at fast-food restaurants showed lower odds of adhering to a healthy dietary pattern (OR = 0.29, 95.0% CI = 0.11, 0.71). No significant association was found between participants in the highest tercile of the frequency of eating at sit-down restaurants and their dietary patterns. Conclusion: Frequently eating at fast-food restaurants was associated with increased odds of adherence to less healthy dietary patterns and negatively associated with adherence to a healthy pattern. No association was found between sit-down restaurants and any of the identified dietary patterns. The present findings can assist stakeholders and policymakers in developing strategic plans and policies for targeted interventions for this population.

Association of dietary pattern and childhood obesity with cardiovascular disease in patients from Tangail city, Bangladesh

@#Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh. Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes. Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents. Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.

Association between dietary patterns during pregnancy and gestational diabetes mellitus / 预防医学

Objective @#To examine the association between dietary patterns during pregnancy and gestational diabetes mellitus (GDM), so as to provide the evidence for guiding the establishment of healthy and balanced dietary patterns and reducing the prevalence of GDM.@*Methods@#Pregnant women who underwent oral glucose tolerance tests in Hangzhou Obstetrics and Gynecological Hospital from 2020 to 2021 were enrolled, and their demographic information were collected using questionnaires. Pregnant women's diets during the past three months were collected using Food Frequency Questionnaires (FFQs), and dietary patterns were extracted using principal component analysis. In addition, the association between dietary patterns and risk of GDM was examined using a multivariable logistic regression model.@*Results@# A total of 1 689 pregnant women were included, with a median age of 28.53 (interquartile range, 2.47) years and a median gestational age of 26.00 (interquartile range, 2.00) weeks. Five dietary patterns were identified according to pregnant women's types of diets, including meat-based diets, dessert-fruit-refined grain diets, plant-based diets, eggs-milk-nut diets and whole-grain diets, with a cumulative contribution rate of 58.76%. The prevalence of GDM was 24.57% (415 cases) among the study subjects. Multivariable logistic regression analysis showed that pregnant women with scores in the highest quartile (Q4) of the meat-based diets had an increased risk of GDM (OR=1.372, 95%CI: 1.043-2.055) relative to those with scores in the lowest quartile (Q1), and pregnant women with Q4 scores of the dessert-fruit-refined grain diets had an increased risk of GDM (OR=1.743, 95%CI: 1.397-2.432) relative to those with Q1 scores, while pregnant women with Q4 scores of the plant-based diets had a reduced risk of GDM (OR=0.382, 95%CI: 0.346-0.613) relative to those with Q1 scores.@*Conclusion@#A plant-based dietary pattern may reduce the risk of GDM, while meat-based and dessert-fruit-refined grain dietary patterns may increase the risk of GDM.

Dietary intervention for the treatment of psoriasis / 中华皮肤科杂志

This review summarizes dietary characteristics of patients with psoriasis, discusses effects of gluten-free diet, Mediterranean diet and dietary intervention-induced weight loss on psoriasis, and analyzes the efficacy of dietary supplements in the treatment of psoriasis, such as fish oil, vitamin D, vitamin B12, selenium, and probiotics.

Dietary patterns and type 2 diabetes: A cohort study / 中华内分泌代谢杂志

Objective:To explore the association between dietary patterns and the incidence of type 2 diabetes mellitus(T2DM), so as to provide insights for the prevention and management of T2DM.Methods:Participants were recruited from the " The Tianjin Chronic Inflammation and Health Cohort Study(TCLSIH)" cohort study from 2013 to 2018, who had completed the modified semiquantitative food frequency questionnaire(FFQ) and blood glucose testing( n=26 425), free of cardiovascular disease, cancer, or diabetes at baseline. The relevant information collected includes food frequency, blood glucose concentration, and other confounding factors. In this study, the correlation between dietary patterns and T2DM was tested using Cox proportional risk regression model, and the gender stratification analysis and body mass index stratification analysis of different gender groups were carried out. All statistical analysis was performed using SAS 9.3 software. Results:The age of all participants was (41.0±11.5)years, and the cumulative incidence was 3.84% for T2DM. The cumulative incidence of T2DM in male population was 5.29%, while that in female population was 2.16%. There were significant differences in the incidence of T2DM among different genders( P <0.001). The multivariable-adjusted hazard ratios( HR) and corresponding 95% CI of T2DM across the plant-based dietary pattern score were 1.09(95% CI 0.91-1.31), 0.80(95% CI 0.66-0.97), and 0.76(95% CI 0.62-0.94; Ptrend =0.010). Moreover, no statistically significant differences were observed between animal and traditional northern Chinese diets with the incidence of T2DM. Conclusions:The plant-based dietary patterns were associated with substantially lower risk of developing T2DM, and there were no significant association between animal and traditional northern Chinese dietary patterns with T2DM. Plant-based dietary patterns characterized by a variety of fruit, leeks, onions, seaweed may be beneficial to the prevention and control of T2DM.

Association between dietary patterns during pregnancy and gestational diabetes mellitus / 预防医学

Objective@#To explore the association between dietary patterns during pregnancy and the development of gestational diabetes mellitus (GDM), so as to provide the guidance of diet balance and GDM prevention for pregnant women.@*Methods@#Pregnant women who underwent prenatal examination at the First Affiliated Hospital of Xinjiang Medical University from December 2021 to July 2022 were selected as the subjects. The oral glucose tolerance test (OGTT) was employed at 24 to 28 weeks of gestation to diagnose GDM. The questionnaire of "The Survey on Nutrition and Health of Pregnant Women in China" was used to collect general information, food intake frequency and amount during a month before OGTT. Dietary patterns were determined by factor analysis, and the association between dietary patterns and the development of GDM was identified using a multivariable logistic regression model. @*Results@#Totally 449 pregnant women were included, with a median (interquartile range) age of 31.00 (5.00) years and a median (interquartile range) gestational age of 35.00 (3.00) weeks. There were 7 dietary patterns named potato-cereal pattern, poultry-meat-dessert pattern, milk-egg-aquatic product pattern, mushroom-vegetable-offal pattern, fruit-bean pattern, pickle-wheaten food pattern, and beverage-nut pattern according to the food types with high factor loads. There were 89 cases diagnosed as GDM, with a prevalence rate of 19.82%. Multivariable logistic regression analysis showed that the development of GDM was associated with the poultry-meat-dessert pattern (OR=0.242, 95%CI: 0.086-0.678) and the fruit-bean pattern (OR=0.093, 95%CI: 0.025-0.342), compared with the potato-cereal pattern. @*Conclusion@#Compared to the potato-cereal pattern, the poultry-meat-dessert pattern and the fruit-bean pattern may reduce the risk of GDM. Key words： gestational diabetes mellitus dietary pattern pregnant woman low carbohydrate diet

Recent progress on associations of dietary nutrition and lifestyle with Parkinson's disease / 环境与职业医学

With the expansion of aging population in China, the increasingly serious situation of Parkinson's disease (PD) threatens the physical and mental health and quality of life of middle-aged and elderly people, posing a great challenge to increase healthy life expectancy and realize the Healthy China Strategy. Previous studies showed some connections between dietary and lifestyle factors and PD and suggested that excessive intake of red meat might increase the risk of PD; however, coffee and tea, dietary antioxidants, n-3 polyunsaturated fatty acids, vitamin D, and vitamin B were associated with reducing the risk of PD or delaying the progression of PD, and dietary patterns with high intakes of fresh vegetables and fruits, legumes, whole grains, fish, and poultry meat were also associated with a reduced risk of PD. In addition, physical activity was a protective factor for PD, and smoking was also associated with a reduced risk of PD, but the related mechanisms were still unclear. This paper evaluated the relationships of factors like foods, nutrients, dietary patterns, and lifestyle with PD based on published literature, summarized the limitations of relevant studies, and provided useful enlightenment for PD prevention and control.

Association of epidemiological characteristics and dietary patterns with risk of type 2 diabetic nephropathy / 公共卫生与预防医学

Objective To study the prevalence of diabetic nephropathy (DN) and the relationship between dietary pattern and risk. Methods From August 2018 to May 2021, 655 T2DM patients in Wuhan Puren Hospital, including 338 males and 317 females, were divided into T2DM group (n=368 cases) and DN group (n=287 cases) according to whether patients had DN. The uniformly trained staff of our hospital used the simplified version of food intake frequency questionnaire designed for diabetes to investigate the reasonable dietary intake of patients in nearly one year. Clinical data of patients in the two groups were collected and the intake of protein, fat, carbohydrate and dietary fiber in the two groups was statistically analyzed. Logistics regression was used to analyze the formula independent risk factors of DN in T2DM, and Pearson correlation analysis was performed on the incidence of diabetic nephropathy and dietary pattern. Results Among of 655 T2DM patients, there were 287 (43.82%) patients with DN, including 149 males and 138 females. The average age, duration of diabetes, smoking in DN group were significantly higher than those in T2DM group (P0.05). Energy, protein intake, carbohydrate and fat intake in DN group were significantly higher than those in T2DM group (P<0.05). Multivariate logistic regression analysis showed that protein, carbohydrate and fat intake were independent risk factors for DEVELOPING DN in T2DM patients (P<0.05). According to Pearson correlation analysis, the risk of developing DN in T2DM patients was positively correlated with protein and fat intake (r=0.449 , 0.517, P<0.05). Conclusion PATIENTS with T2DM have a higher risk of DEVELOPING DN, which is closely related to dietary intake. Reasonable allocation of dietary intake can reduce the risk of developing DN.

Dietary patterns of preschool children based on factor analysis combined with cluster / 公共卫生与预防医学

Objective To investigate the dietary intake of preschool children in Northwest China, and provide scientific basis for studying the dietary patterns and characteristics of preschool children and formulating targeted dietary interventions. Methods Using the self-designed “Semi-quantitative Food Frequency Questionnaire for Preschool Children in Northwest China“, a convenient sampling method was used to investigate the dietary intake of children aged 3 to 7 years in Northwest China. The factor analysis combined with the cluster method was used to extract the dietary pattern. Results Through factor analysis of the average daily food intake of preschool children, the results show that the KMO test value was 0.82, Bartlett’s test value was 4 528.97, and the associated probability was <0.001, so factor analysis can be performed. In order to obtain more typical factor components so that the results were easier to explain, under the guidance of nutrition experts, the first 4 common factors were finally retained for analysis, and the cumulative variance contribution rate was 62.17%. On this basis, the number of clusters was 4, and the K-means cluster analysis method was used to cluster the factor scores of various foods for preschool children. According to the proportions of various foods and the characteristics of the foods, The dietary patterns of preschool children can be divided into staple food-based dietary patterns, high-protein dietary patterns, healthy dietary patterns, and high-sugar dietary patterns. Conclusion Using factor analysis method, the scores of each food factor of preschool children were continuous variables, and the results were highly repeatable, and subsequent analysis can be carried out. The factor analysis combined with cluster analysis method extracting the dietary pattern of preschool children that had certain degree of science. According to the characteristics of the four dietary patterns extracted in this study, children's dietary interventions can be targeted to promote children's physical and mental health.

Physical growth and dietary characteristics of children with attention deficit hyperactivity disorder: a cross-sectional study / 中国当代儿科杂志

OBJECTIVES@#To investigate the physical growth and dietary characteristics of children with attention deficit hyperactivity disorder (ADHD), and to analyze their relationship with core symptoms of ADHD.@*METHODS@#A total of 268 children who were newly diagnosed with ADHD in Children's Hospital of Nanjing Medical University from June to December 2020 were included in the ADHD group, and 102 healthy children who underwent physical examination during the same period were selected as the control group. Physical evaluations and dietary surveys were conducted for both groups. ADHD diagnosis and scoring were performed according to the Diagnostic and Statistical Manual of Mental Disorders (5th edition). Factor analysis, Spearman correlation analysis, and mediation analysis were used to study the relationship between core symptoms of ADHD, dietary patterns, and physical growth.@*RESULTS@#The rate of overweight/obesity in the ADHD group was significantly higher than that in the control group (35.8% vs 21.6%, P<0.05). Three dietary patterns were extracted from the food frequency questionnaire: vegetarian dietary pattern, traditional dietary pattern, and snack/fast food pattern. The factor score for the snack/fast food pattern in the ADHD group was higher than that in the control group (P<0.05). There was a significant positive correlation between ADHD symptom scores, snack/fast food pattern factor scores, and body fat percentage (P<0.05). The mediation analysis showed that the snack/fast food pattern played a partial mediating role in the relationship between ADHD symptom scores and body fat percentage, with a mediation proportion of 26.66%.@*CONCLUSIONS@#The rate of overweight/obesity in children with ADHD is higher than that in non-ADHD children. Core symptoms of ADHD are related to dietary patterns and physical growth, with the snack/fast food pattern playing a partial mediating role in the relationship between core symptoms of ADHD and physical growth.

Changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease / Mudanças nos comportamentos de estilo de vida durante a pandemia COVID-19 em crianças e adolescentes com cardiopatia congênita

Abstract Objective: To describe the changes in lifestyle behaviors during the COVID-19 pandemic in children and adolescents with congenital heart disease and to investigate the association of congenital heart disease complexity with lifestyle behavior changes. Methods: Cross-sectional study with 127 children and adolescents with congenital heart disease, who underwent cardiac procedure (mean postoperative time: 10.11±3.13 years), conducted between December 2020 and January 2021. Lifestyle behaviors, such as dietary intake, physical activity, sedentary behavior, and sleep, were assessed through telephone interview based on validated questionnaires. Dietary patterns were identified using principal component analysis. Frequency of general and specific combinations of healthy and unhealthy lifestyle behavior changes was evaluated. Multinomial logistic regressions were used to test the association between congenital heart disease complexity and changes in lifestyle behavior. Results: The main lifestyle behaviors acquired during pandemic were: 83.5% decreased physical activity; 37.0% increased sedentary behavior; 26.0% slept more than usual; and 23.6% adopted a less-healthy dietary pattern. Almost half of the participants (41.8%) had at least one unhealthy change in lifestyle behavior. Complex congenital heart diseases were associated with increased sedentary behavior (OR 3.49, 95%CI 1.23-9.90). Conclusions: Children and adolescents with congenital heart disease had unhealthy lifestyle behavior during the pandemic, mainly in the form of reduced physical activity and increased sedentary behavior.

Resumo Objetivo: Descrever as mudanças nos estilos de vida durante a pandemia em crianças e adolescentes com cardiopatia congênita e investigar a associação da complexidade da cardiopatia congênita com as mudanças de estilo de vida. Métodos: Estudo transversal com 127 crianças e adolescentes com cardiopatia congênita, que realizaram procedimento cardíaco (tempo médio de pós-operatório: 10,11 (3,13) anos), realizado entre dezembro de 2020 e janeiro de 2021. O estilo de vida (alimentação, atividade física, comportamento sedentário e sono) foi avaliado por entrevista telefônica, com base em questionários validados. Padrões alimentares foram identificados por meio da análise de componentes principais. Frequência de combinações gerais e específicas de mudanças de estilo de vida saudável e não saudável foram avaliadas. Regressões logísticas multinominais foram utilizadas para testar associações. Resultados: Os principais comportamentos de estilo de vida adquiridos durante a pandemia foram: 83,5% reduziram a atividade física, 37,0% aumentaram o comportamento sedentário, 26,0% dormiram mais e 23,6% mudaram para um padrão alimentar menos saudável. Quase metade (41,8%) dos participantes teve pelo menos uma mudança não saudável no estilo de vida. Cardiopatias congênitas complexas foram associadas ao aumento do comportamento sedentário durante a pandemia (odds ratio 3,49, IC95% 1,23-9,90). Conclusões: Crianças e adolescentes com cardiopatia congênita apresentaram estilo de vida não saudável durante a pandemia, principalmente na forma de redução da atividade física e aumento do comportamento sedentário.

Association Between Social Determinants and Dietary Diversity Among Indian Tribal Children- Insights from NFHS-4.

Background: Early childhood nutrition is an important stage in human development characterized by rapid cognitive development. The study aimed to determine the consumption of food patterns and dietary diversity among indigenous children according to socioeconomic status. Subjects/Methods: We used cross-sectional data from the National Family Health Survey (NFHS-4, 2015–16). Our study included 13,963 tribal children aged six to twenty-three months. A 24-hour dietary recall questionnaire was used to collect data from the mother on 21 foods, 7 food categories, and an ADDI was calculated. The relationship between household wealth, maternal education, food consumption, and ADDI was studied using multivariate regression models. The study used two models. MODEL 1: Adjusted for sex, birth order, religion, children's age, mother education, house type, and family type. Model 2: only for sex and age. Results: The median (IQR) age of the 13963 children was 14 (10-19) months, with a female/male ratio of 1:1.06. Overall, the mean score for dietary diversity was low (2.47, 95% [CI] 2.44–2.49), and the prevalence of ADDI was only 26.9 percent. In model 1, higher-income households were shown to be as likely to consume dairy products. (aOR 2.20; 95% CI 1.90-2.54) and eggs (aOR 1.28; 95% CI 1.06-1.55) than those from poor households. Higher educated mothers were more likely to consume dairy products (aOR 1.52; 95 percent CI 1.26-1.83), eggs (aOR 1.32; 95 percent CI 1.02-1.69), and other fruits and fresh vegetables (aOR 1.32; 95 percent CI 1.04-1.67) compared to mothers with no education. Conclusion: The diverse dietary consumption of Indian tribal children was inadequate. Efforts should be taken to improve their nutritional status through nutrition education and nutrient sensitive farming, including kitchen gardens.

Metodologias de identificação de padrões alimentares a posteriori em adultos: uma revisão integrativa / Methods of a posteriori identification of food patterns in adults: an integrativereview / Métodos de identificación posteriori de patrones alimentarios en adultos: una revisión integradora

Introdução:São poucos os estudos que identificaram os padrões alimentares em adultos sem patologias associadas utilizando metodologias de abordagem a posteriori, o que representa um grande e importante campo de pesquisa na epidemiologia nutricional a ser explorado para melhor entender o hábito alimentar das diferentes populações no mundo e suas relações com demais fatores.Objetivo:Analisar as metodologias deidentificação dos padrões alimentares em adultos saudáveis que utilizaram a abordagem a posteriori.Metodologia:Trata-se de uma revisão integrativa. Foram incluídos somente artigos originais publicados em português ou inglês que identificaram padrão alimentar de adultos saudáveis por meio de abordagem a posteriori, de 2013 a 2018. Os artigos foram selecionados por meio de busca em 4 bases de dados, sendo resgatadas 328 publicações.Resultados:Apenas 9 artigos identificaram padrões alimentares por meio de abordagem a posteriori em adultos, sendo 7 do tipo transversal e 2 longitudinal.O método de abordagem exploratória mais utilizado foi a análise fatorial, abordada em sete estudos. Um artigo utilizou o método de análise de agrupamento, enquanto outros dois utilizaram o método RRR, sendo um deles associado ao método ACP. Conclusões:As metodologias de avaliação do padrão alimentar possuem limitações, o que torna absolutamente importante que os estudos sejam bem delineados, com escolha de inquéritos alimentares mais convenientes, tamanho e seleção da amostra relevantes e testes estatísticos que orientem as decisões do pesquisador da melhor forma possível, para que os resultados retratem padrões e agrupamentos bem fidedignos (AU).

Introduction:There are few studies that have identified dietary patterns in adults without associated pathologies using a posteriori approach methodologies, which represents a large and important field of research in nutritional epidemiology to be explored to better understand the eating habits of different populations in the world and their relationships with other factors. Objective:To analyze the methodologies for identifying dietary patterns in healthy adults who used the a posteriori approach. Methodology:This is an integrative review. Only original articles published in Portuguese or English that identified the dietary pattern of healthy adults through an a posteriori approach, from 2013 to 2018, were included. Results:Only 9 articles identified eating patterns through a posteriori approach in adults, 7 of which were transverse and 2 were longitudinal.The most used exploratory approach method was factor analysis, addressed in seven studies. One article used the cluster analysis method, while two others used the RRR method, one of them associated with the ACP method. Conclusions:The dietary pattern assessment methodologies have limitations, which makes it absolutely important that the studies are well designed, with the choice of more convenient food surveys, relevant sample size and selection, and statistical tests that guide the researcher's decisions in the best possible way, so that the results depict very reliable patterns and groupings (AU).

Introducción: Existen pocos estudios que hayan identificado patrones alimentarios en adultos sin patologías asociadas utilizando metodologías de abordaje a posteriori, lo que representa un amplio e importante campo de investigación en epidemiología nutricional a explorar para comprender mejor los hábitos alimentarios de diferentes poblaciones en el mundo y sus relaciones con otros factores. Objetivo: Analizar las metodologías para la identificación de patrones dietéticos en adultos sanos que utilizaron el enfoque a posteriori.Metodología:Esta es una revisión integradora. Se incluyeron solo artículos originales publicados en portugués o inglés que identificaron el patrón dietético de adultos sanos a través de un enfoque a posteriori, de 2013 a 2018. Resultados: Solo 9 artículos identificaron patrones de alimentación mediante abordaje a posteriori en adultos, 7 de los cuales fueron transversales y 2 longitudinales.El método de abordaje exploratorio más utilizado fue el análisis factorial, abordado en siete estudios. Un artículo utilizó el método de análisis de conglomerados, mientras que otros dos utilizaron el método RRR, uno de ellos asociado al método ACP.Conclusiones: Las metodologías de evaluación del patrón dietético tienen limitaciones, por lo que es absolutamente importante que los estudios estén bien diseñados, con la elección de encuestas alimentarias más convenientes, tamaño y selección de muestras relevantes y pruebas estadísticas que guíen las decisiones del investigador de la mejor maneraposible, para que que los resultados representan patrones y agrupaciones muy fiables (AU).

Relationship between tooth loss, nutritional status and consumption of macro and micronutrients in elderly people from southern Brazil

Maintaining a functional natural dentition plays an important role in keeping a satisfactory nutritional status. The aim of this study was to evaluate the relationship between oral health conditions determined by the presence of edentulism and the number of missing teeth, nutritional status and consumption of nutrients by the elderly. This cross-sectional study comprised 494 independent elderly of both genders, over 60 years of age, registered at the Brazilian public health service in Londrina, southern Brazil. The data collection included: oral examinations; anthropometric measurements by calculating the Body Mass Index (BMI); analysis of food consumption based on a multiple pass 24-hour dietary recall and a food intake frequency questionnaire; and structured interviews to obtain sociodemographic information. Multiple linear regression, the Fisher's Exact test, chi-square and Mann-Whitney tests, were applied at a 5% significance level. The prevalence of edentulism was 47.3%; this predominated in females, age group from 65 to 74 years, low education level and low/medium economic classification. A larger numberof underweight and fewer number of overweight elderly were recorded among the edentulous versus dentate participants (< 0.0001). Significantly lower consumption of several nutrients, as well as fruit, was recorded among the edentulous group. In particular, carbohydrates, vitamins (B1, B9 and C), and the majority of the minerals studied were associated with a larger number of missing teeth. In conclusion, tooth loss was associated with the food consumption pattern of some macro-and micronutrients and the nutritional status of the Brazilian elderly.

Association between dietary pattern and cognitive function of elderly in Tianjin / 上海预防医学

ObjectiveTo determine the association of dietary diversity and dietary pattern with cognitive function in elderly in community. MethodsA cross-sectional study was conducted to randomly select 143 elderly people over 65 years old in Wangdingdi Community of Tianjin. Self-designed questionnaire was used and then dietary diversity index was calculated. Wechsler Adult Intelligence Scale-Chinese Revised （WAIS-RC） was used to measure intelligence quotient （IQ） to assess cognitive function. Factor analysis and multivariate linear regression model were used to extract dietary patterns and determine the association of dietary diversity index and dietary patterns with cognitive function， respectively. ResultsFactor analysis revealed four dietary patterns， which were meat and cereal dietary pattern， fish and poultry milk dietary pattern， bean vegetable dietary pattern， and egg dietary pattern. Multivariate linear regression showed that egg dietary pattern was significantly associated with performance IQ （P<0.05）， suggesting that egg dietary pattern may have a protective effect on IQ of the elderly. There was no significant association between dietary diversity and cognitive function in the elderly （P>0.05）. ConclusionEgg dietary pattern may protect cognitive function in the elderly. Therefore， the elderly should increase the intake of eggs in daily diet.

Dietary patterns and associated factors of children under two years of age born prematurely / Padrões alimentares e fatores associados de crianças menores de dois anos nascidas prematuramente

ABSTRACT Objective: To identify the dietary patterns and associated factors of children aged between 6 and 23 months, born prematurely and assisted at a University Hospital in Curitiba, state of Paraná, Brazil. Methods: The parents or guardians of the 135 children were asked about their children's eating habits and the family's socioeconomic and demographic conditions. Information regarding birth and health history were obtained from medical records. Data on food consumption were subjected to exploratory factor analysis and the principal component analysis method was used to estimate the factor loads. Multiple linear regression was performed to verify possible associations. Results: Two dietary patterns were observed: "unhealthy" and "healthy." The "unhealthy" pattern was significantly associated with maternal age, the child's corrected age, and gestational age at birth. The "healthy pattern" was associated with the child's corrected age. Maternal age and child's corrected age remained significant after multiple regression analyses. For the "unhealthy" pattern, a positive effect was observed, suggesting that the consumption of this pattern is higher as the child's age increases and less intense for children with mothers aged 30 years or older. For the "healthy" dietary pattern, the same two variables showed statistical significance. The authors observed a direct proportion between the age and consumption of food groups in both patterns. Conclusions: These results indicate the importance of nutritional education for younger mothers regarding their children's eating practices, especially as the child grows.

RESUMO Objetivo: Identificar os padrões alimentares e fatores associados de crianças entre seis e 23 meses de idade, nascidas prematuramente e assistidas em um Hospital Universitário de Curitiba, Paraná. Métodos: Os pais ou responsáveis pelas 135 crianças foram questionados quanto aos hábitos alimentares dos filhos e as condições socioeconômicas e demográficas da família. Informações relativas ao nascimento e ao histórico de saúde foram obtidas dos prontuários. Os dados de consumo alimentar foram submetidos a análise fatorial exploratória e o método dos componentes principais foi utilizado para estimar as cargas fatoriais. Regressão linear múltipla foi realizada para verificar possíveis associações. Resultados: Foram observados dois padrões alimentares distintos. Aquele denominado de "não saudável" apresentou associação significativa com a idade materna, a idade corrigida da criança e a idade gestacional ao nascer. Por sua vez, o padrão denominado de "saudável" esteve associado à idade corrigida da criança. As variáveis idade materna e idade corrigida da criança permaneceram significativas após as análises de regressão múltipla. Para o padrão "não saudável", observou-se um efeito positivo, o que sugere que seu consumo é maior conforme a idade da criança aumenta e menos intenso para crianças com mães de 30 anos de idade ou mais. Para o padrão "saudável", as mesmas duas variáveis mostraram significância estatística. Observamos uma proporção direta entre idade e consumo dos grupos alimentares em ambos os padrões. Conclusões: Esses resultados apontam para a importância da educação nutricional de mães mais jovens quanto às práticas alimentares de seus filhos, especialmente à medida que a criança cresce.

Research progress on plant-based diets for the prevention and management of chronic kidney disease / 公共卫生与预防医学

Diet management is the key part in the prevention and treatment of chronic kidney disease (CKD). A plant-based diet is a diet consisting mostly or entirely of foods derived from plants, with little or no animal foods. In recent years, research on plant-based diets for chronic kidney disease has been increasing. Large-scale epidemiological studies and interventional studies consistently suggest that plant-based diets could reduce the risk of CKD and related complications and slow down CKD progression. This article reviews the research progress of plant-based diets in the prevention and control of CKD.

The Patterns of Complementary Feeding and Growth among 12 to 23 Month-Old Children in China / 生物医学与环境科学（英文）

Objective@#This study aimed to understand the characteristics of dietary patterns among children aged 12 to 23 months and discusses the relationship between dietary patterns and the growth of children.@*Method@#Cross-sectional data were selected from the National Nutrition and Health Systematic Survey for 0 to 18 year-old children in China ( @*Results@#Four dietary patterns were identified among the children @*Conclusion@#Although China is undergoing rapid urbanization and economic development, there is still a phenomenon of insufficient intake of protein-rich foods and dairy-based dietary patterns at the stage of complementary food introduced among children aged 12 to 23 months.