Efecto de la dieta CAF sobre la capacidad de EX4 de modular la expresión de marcadores proteicos de oxidación de ácidos grasos y termogénesis en músculo de ratones / Effect of the CAF diet on the ability of EX4 to modulate the expression of protein markers of fatty acid oxidation and thermogenesis in mouse muscle

El ambiente obesogénico promueve la obesidad al facilitar el acceso y consumo de una amplia variedad de alimentos palatables altos en calorías. La activación del receptor de GLP1 (GLP1R) reduce la ingesta de alimentos, enlentece el vaciamiento gástrico y promueve un balance energético negativo a través de su acción en distintos órganos como el músculo esquelético, disminuyendo así el peso corporal. La obesidad inducida por dieta alta en grasa disminuye el efecto anorexigénico de la administración sistémica vía intra-peritoneal de EX4 (agonista de GLP1R). Sin embargo, se desconoce si la exposición a un ambiente obesogénico previo a la manifestación de obesidad disminuye los efectos anorexigénicos de EX4 o un posible efecto de EX4 sobre marcadores de oxidación de ácidos grasos y termogénesis en músculo esquelético. El objetivo de esta investigación fue determinar el efecto a corto plazo de la dieta CAF, un modelo del ambiente obesogénico humano, sobre la capacidad de EX4 de reducir la ingesta y modular la expresión de marcadores proteicos de oxidación de ácidos grasos y termogénesis (CPT1 y UCP2) en músculo de ratones. Nuestros datos muestran que una inyección intraperitoneal de EX4 a ratones C57BL/6J alimentados con dieta CAF o dieta control durante 10 días no altera la ingesta calórica total, peso corporal, o la expresión de proteínas marcadoras de los procesos de beta-oxidación y de termogénesis (CPT1 y UCP2). Estos datos sugieren que protocolos alternativos de administración de EX4 son necesarios para observar los efectos fisiológicos de la activación de GLP1R.

The obesogenic environment promotes obesity by facilitating access to and consumption of a wide variety of palatable, high-calorie foods. Activation of the GLP1 receptor (GLP1R) reduces food intake, slows gastric emptying, and promotes a negative energy balance by acting on organs such as skeletal muscle, thus decreasing body weight. Obesity induced by a high-fat diet decreased the anorexigenic effect of intraperitoneal systemic administration of EX4 (GLP1R agonist). However, it is unknown whether exposure to an obesogenic environment before the manifestation of obesity diminishes the anorexigenic effects of EX4 or a possible effect of EX4 on markers of fatty acid oxidation and thermogenesis in skeletal muscle. This investigation aimed to determine the short-term effect of the CAF diet, a model of the human obesogenic environment, on the ability of EX4 to reduce intake and modulate the expression of protein markers of fatty acid oxidation and thermogenesis (CPT1 and UCP2) in mouse muscle. Our data show that intraperitoneal injection of EX4 to C57BL/6J mice fed CAF diet or control diet for ten days does not alter total caloric intake, body weight, or expression of proteins markers of beta-oxidation and thermogenesis processes (CPT1 and UCP2). These data suggest that alternative EX4 administration protocols are necessary to observe the physiological effects of GLP1R activation.

Effects of Gundelia tournefortii L. on biochemical parameters, antioxidant activities and DNA damage in a rat model of experimental obesity / Efeitos de Gundelia tournefortii L. em parâmetros bioquímicos, atividades antioxidantes e danos ao DNA em um modelo de obesidade experimental de rato

The present study was designed to investigate the effects of Gundelia tournefortii L. plant extract on different tissues in terms of DNA damage, biochemical and antioxidant parameter values in rats with high-calorie diets. With this aim, Wistar albino male rats were divided into 4 groups containing 6 rats each and the study was completed over 12 weeks duration. At the end of the implementation process over the 12 weeks, rats were sacrificed and blood and tissue samples were obtained. Analyses were performed on blood and tissue samples. According to results for DNA damage (8-OHdG), in brain tissue the OG2 group was significantly reduced compared to the NC group. For MDA results in liver tissue, OG1 and OG2 groups were determined to increase by a significant degree compared to the control group, while the OG2 group was also increased significantly compared to the obese group. In terms of the other parameters, comparison between the groups linked to consumption of a high calorie diet (HCD) and administration of Gundelia tournefortii L. in terms of antioxidant activities and serum samples obtained statistically significant results. Gundelia tournefortii L. plant extracts had effects that may be counted as positive on antioxidant parameter activity and were especially identified to improve DNA damage and MDA levels in brain tissues. Additionally, consumption of Gundelia tournefortii L. plant extract in the diet may have antiobesity effects; thus, it should be evaluated for use as an effective weight-loss method and as a new therapeutic agent targeting obesity.

O presente estudo foi desenhado para investigar os efeitos do extrato da planta Gundelia tournefortii L. em diferentes tecidos em termos de danos ao DNA, valores de parâmetros bioquímicos e antioxidantes em ratos com dietas hipercalóricas. Com esse objetivo, ratos Wistar albinos machos foram divididos em 4 grupos contendo 6 ratos cada e o estudo foi concluído ao longo de 12 semanas de duração. No final desse processo de implementação, os ratos foram sacrificados e amostras de sangue e tecido foram obtidas. As análises foram realizadas em amostras de sangue e tecido. De acordo com os resultados para danos ao DNA (8-OHdG), no tecido cerebral o grupo OG2 foi significativamente reduzido em comparação com o grupo NC. Para os resultados de MDA no tecido hepático, os grupos OG1 e OG2 aumentaram significativamente em comparação ao grupo controle, enquanto o grupo OG2 também aumentou significativamente em comparação ao grupo obeso. Quanto aos demais parâmetros, a comparação entre os grupos ligados ao consumo de dieta hipercalórica (DC) e à administração de Gundelia tournefortii L. em termos de atividades antioxidantes e amostras de soro obteve resultados estatisticamente significativos. Os extratos de plantas de Gundelia tournefortii L. tiveram efeitos que podem ser considerados positivos na atividade dos parâmetros antioxidantes e foram especialmente identificados para melhorar os danos ao DNA e os níveis de MDA nos tecidos cerebrais. Além disso, o consumo de extrato vegetal de Gundelia tournefortii L. na dieta pode ter efeitos antiobesidade; portanto, deve ser avaliado para uso como um método eficaz de perda de peso e como um novo agente terapêutico voltado para a obesidade.

A study on diabetes-related self-care plan and its determinants among diabetes patients in a Warangal region, Telangana, India

Abstract The prevalence of epidemiological diseases, including diabetes, has continued to increase because of the adaption of Western culture and the lack of self-care activities among patients with diabetes. Therefore, in this cross-sectional study, we aimed to assess self-care plans and determinants among diabetes outpatients in Warangal. We conducted a prospective observational study among diabetes outpatient clinic in Warangal, India over 6 months from October 2019 to March 2020. We used the expanded Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A P value of less than < 0.05 was considered statistically significant. Respondents (mean age, 52.3 (standard deviation (SD), 11.01) years) had an overall SDSCA score of 49.18 ± 3.57 (SD). Mean scores for the diet, physical activity, foot care, medication adherence, and blood sugar testing scales were 12.79 (SD, 1.61), 10.24 (SD, 1.77), 15.67 (SD, 1.5), 5.66 (SD, 1.17), and 4.80 (SD, 0.68), respectively. Patients' age, education, disease duration and hemoglobin A1C (HbA1C) levels of <7.5% (P < 0.001)) had significantly higher mean scores for blood sugar testing, diet, physical activity, and adherence (P < 0.001). The employment status is associated with all the domains of Summary of Diabetes Self-Care Activities (P < 0.001). Taken together, our results revealed that patients with diabetes in Warangal had poor self-care planning, highlighting the need for strengthening initiatives that generate awareness regarding diabetes and improving related self-care practices

Research advances on the influence of poor dietary habits on the development of keloids / 中华烧伤杂志

Long-term poor dietary habits can cause changes in the intestinal flora, resulting in the production of a large number of lipopolysaccharide, increase intestinal mucosal permeability, and activate the entrance of a large number of inflammatory factors into the portal vein. In addition, a high carbohydrate diet can increase liver metabolic burden, increase mitochondrial oxidative phosphorylation, leading to oxidative stress, generate new fat during adenosine triphosphate synthesis, and thus resulting in ectopic fat accumulation, which further activate nuclear factor-κB signaling pathway and release inflam- matory factors such as tumor necrosis factor-α, interleukin-1β (IL-1β), IL-6, and so on. This leads to obesity and insulin resis- tance, ultimately triggering systemic low-grade inflammation. This article reviews the mechanism of poor dietary habits leading to systemic low-grade inflammation, the clinical and experimental research progress of keloids and systemic low-grade inflammation, the association between dietary habits and keloid constitution, and puts forward the hypothesis that poor dietary habits may lead to the occurrence and development of keloids.

A relação entre a dieta e a fisiopatologia da diverticulite: revisão integrativa / The relation between the diet and the diverticulitis pathophysiology: an integrative review

ABSTRACT BACKGROUND: Diverticulitis is an acute inflammatory process that affects individuals with diverticular disease. Given the sharp increase in the diagnostic rate of such a pathological process, there was also an increased interest in elucidating the possible causes related to the development of this clinical condition. Among the main factors investigated, diet excels, the object of study of this integrative literature review. METHODS: After searching the virtual health library and PubMed databases, five prospective cohort studies were selected that best answered the guiding question: "Is there a relationship between diet and the incidence of diverticulitis?". RESULTS: It was observed that the high intake of red meat and the low intake of dietary fiber were the most strongly associated dietary factors with the incidence of this inflammatory process. CONCLUSION: Therefore, it is evident that choosing healthy eating habits can considerably reduce the incidence of diverticulitis and, consequently, potentially more serious complications directly related to it.

RESUMO CONTEXTO: A diverticulite é um processo inflamatório agudo que afeta indivíduos com doença diverticular. Diante do acentuado aumento da taxa diagnóstica desse processo patológico, também houve o aumento do interesse em elucidar as possíveis causas relacionadas ao desenvolvimento dessa condição clínica. Entre os principais fatores investigados, destaca-se a dieta; objeto de estudo desta revisão integrativa da literatura. MÉTODOS: Após pesquisa nas bases de dados da biblioteca virtual em saúde e PubMed, foram selecionados cinco estudos de coorte prospectivos que melhor responderam à questão norteadora "Há relação entre dieta e incidência de diverticulite?". RESULTADOS E CONCLUSÃO: Observou-se que o alto consumo de carnes vermelhas e o baixo consumo de fibra alimentar são os fatores dietéticos mais fortemente associados à incidência desse processo inflamatório. Fica evidente, portanto, que a escolha de hábitos alimentares saudáveis pode reduzir consideravelmente a incidência de diverticulite e, consequentemente, de possíveis complicações mais graves diretamente relacionadas a ela.

Role of osteopontin in diet-induced brown gallstone formation in rats / 中华医学杂志(英文版)

BACKGROUND@#Although osteopontin (OPN) is expressed in the liver and pigment gallstones of patients with hepatolithiasis, its role in pigment gallstone formation remains unclear. This study aimed to explore the function of OPN in pigment gallstone formation.@*METHODS@#Rats were fed a chow diet (CD) or lithogenic diet (LD) for 10 consecutive weeks; blocking tests were then performed using an OPN antibody (OPN-Ab). Incidence of gallstones and levels of several bile components, OPN, tumor necrosis factor alpha (TNF-α), and cholesterol 7 alpha-hydroxylase (CYP7A1) were analyzed. To determine TNF-α expression in hepatic macrophages and both CYP7A1 and bile acid (BA) expression in liver cells, recombinant rat OPN and recombinant rat TNF-α were used to treat rat hepatic macrophages and rat liver cells, respectively. Chi-square or Fisher exact tests were used to analyze qualitative data, Student t-test or one-way analysis of variance were used to analyze qualitative data.@*RESULTS@#Incidence of gallstones was higher in LD-fed rats than in CD-fed rats (80% vs. 10%, P < 0.05). BA content significantly decreased in bile (t = -36.08, P < 0.01) and liver tissue (t = -16.16, P < 0.01) of LD-fed rats. Both hepatic OPN protein expression (t = 9.78, P < 0.01) and TNF-α level (t = 8.83, P < 0.01) distinctly increased in the LD group; what's more, CYP7A1 mRNA and protein levels (t = -12.35, P < 0.01) were markedly down-regulated in the LD group. Following OPN-Ab pretreatment, gallstone formation decreased (85% vs. 25%, χ2 = 14.55, P < 0.01), liver TNF-α expression (F = 20.36, P < 0.01) was down-regulated in the LD group, and CYP7A1 expression (F = 17.51, P < 0.01) was up-regulated. Through CD44 and integrin receptors, OPN promoted TNF-α production in macrophage (F = 1041, P < 0.01), which suppressed CYP7A1 expression (F = 48.08, P < 0.01) and reduced liver BA synthesis (F = 119.4, P < 0.01).@*CONCLUSIONS@#We provide novel evidence of OPN involvement in pigmented gallstone pathogenesis in rats.

Impacto do consumo de alimentos ultraprocessados na saúde de crianças, adolescentes e adultos: revisão de escopo / Impacto del consumo de alimentos ultraprocesados en la salud de niños, adolescentes y adultos: revisión de alcances / Impact of the consumption of ultra-processed foods on children, adolescents and adults' health: scope review

O objetivo deste trabalho foi realizar uma revisão de escopo da literatura acerca da associação entre o consumo de alimentos ultraprocessados e desfechos em saúde. A busca foi realizada nas bases PubMed, Web of Science e LILACS. Foram elegíveis os estudos que avaliaram a associação entre o consumo de alimentos ultraprocessados identificados com base na classificação NOVA e os desfechos em saúde. O processo de revisão resultou na seleção de 63 estudos, os quais foram analisados em termos de qualidade com base em ferramenta do Instituto Nacional de Saúde dos Estados Unidos. Os desfechos encontrados incluíram indicadores de obesidade, marcadores de risco metabólico, diabetes, doenças cardiovasculares, câncer, asma, depressão, fragilidade, doenças gastrointestinais e mortalidade. A evidência foi particularmente consistente para obesidade (ou indicadores relacionados a ela) em adultos, cuja associação com o consumo de ultraprocessados foi demonstrada, com efeito dose-resposta, em estudos transversais com amostras representativas de cinco países, em quatro grandes estudos de coorte e em um ensaio clínico randomizado. Grandes estudos de coorte também encontraram associação significativa entre o consumo de alimentos ultraprocessados e o risco de doenças cardiovasculares, diabetes e câncer, mesmo após ajuste para obesidade. Dois estudos de coorte demonstraram associação do consumo de alimentos ultraprocessados com depressão e quatro estudos de coorte com mortalidade por todas as causas. Esta revisão sumarizou os resultados de trabalhos que descreveram a associação entre o consumo de alimentos ultraprocessados e as diversas doenças crônicas não transmissíveis e seus fatores de risco, o que traz importantes implicações para a saúde pública.

El objetivo de este estudio fue realizar una revisión de alcance de la literatura sobre la asociación entre el consumo de alimentos ultraprocesados y los resultados de salud. La búsqueda se realizó en las bases de datos PubMed, Web of Science y LILACS. Fueron elegibles los estudios que evaluaron la asociación entre el consumo de alimentos ultraprocesados identificados según la clasificación NOVA y los resultados de salud. El proceso de revisión resultó en la selección de 63 estudios, cuya calidad se analizó con base en una herramienta delo Instituto Nacional de Salud de Estados Unidos Los resultados encontrados incluyeron indicadores de obesidad, marcadores de riesgo metabólico, diabetes, enfermedad cardiovascular, cáncer, asma, depresión, fragilidad, enfermedad gastrointestinal y mortalidad. La evidencia fue particularmente consistente para la obesidad (o indicadores relacionados con ella) en adultos, cuya asociación con el consumo de alimentos ultraprocesados se demostró, con un efecto dosis-respuesta, en estudios transversales con muestras representativas de cinco países, en cuatro grandes estudios de cohortes y en un ensayo clínico aleatorizado. Grandes estudios de cohortes también encontraron una asociación significativa entre el consumo de alimentos ultraprocesados y el riesgo de enfermedades cardiovasculares, diabetes y cáncer, incluso después de ajustar la obesidad. Dos estudios de cohortes mostraron una asociación entre el consumo de alimentos ultraprocesados y la depresión y cuatro estudios de cohortes con mortalidad por todas las causas. Esta revisión resumió los resultados de estudios que describieron la asociación entre el consumo de alimentos ultraprocesados y las diversas enfermedades crónicas no transmisibles y sus factores de riesgo, lo que tiene importantes implicaciones para la salud pública.

The aim of this study was to conduct a literature scope review of the association between the consumption of ultra-processed foods and health outcomes. The search was carried out in the PubMed, Web of Science and LILACS databases. Studies that assessed the association between the consumption of ultra-processed foods, identified on the NOVA classification, and health outcomes were eligible. The review process resulted in the selection of 63 studies, which were analyzed in terms of quality using a tool from the National Institutes of Health. The outcomes found included obesity, metabolic risk markers, diabetes, cardiovascular diseases, cancer, asthma, depression, frailty, gastrointestinal diseases and mortality indicators. The evidence was particularly consistent for obesity (or indicators related to it) in adults, whose association with the consumption of ultra-processed foods was demonstrated, with dose-response effect, in cross-sectional studies with representative samples from five countries, in four large cohort studies and in a randomized clinical trial. Large cohort studies have also found a significant association between the consumption of ultra-processed foods and the risk of cardiovascular diseases, diabetes and cancer - even after adjusting for obesity. Two cohort studies have shown an association of ultra-processed foods consumption with depression and four cohort studies with all-cause mortality. This review summarized the studies' results that described the association between the consumption of ultra-processed foods and various non-communicable diseases and their risk factors, which has important implications for public health.

A Brazilian regional basic diet-induced chronic malnutrition drives liver inflammation with higher ApoA-I activity in C57BL6J mice

Malnutrition is still considered endemic in many developing countries. Malnutrition-enteric infections may cause lasting deleterious effects on lipid metabolism, especially in children living in poor settings. The regional basic diet (RBD), produced to mimic the Brazilian northeastern dietary characteristics (rich in carbohydrate and low in protein) has been used in experimental malnutrition models, but few studies have explored the effect of chronic RBD on liver function, a central organ involved in cholesterol metabolism. This study aimed to investigate whether RBD leads to liver inflammatory changes and altered reverse cholesterol metabolism in C57BL6/J mice compared to the control group, receiving a standard chow diet. To evaluate liver inflammation, ionized calcium-binding adapter protein-1 (IBA-1) positive cell counting, interleukin (IL)-1β immunohistochemistry, and tumor necrosis factor (TNF)-α and IL-10 transcription levels were analyzed. In addition, we assessed reverse cholesterol transport by measuring liver apolipoprotein (Apo)E, ApoA-I, and lecithin-cholesterol acyltransferase (LCAT) by RT-PCR. Furthermore, serum alanine aminotransferase (ALT) was measured to assess liver function. RBD markedly impaired body weight gain compared with the control group (P<0.05). Higher hepatic TNF-α (P<0.0001) and IL-10 (P=0.001) mRNA levels were found in RBD-challenged mice, although without detectable non-alcoholic fatty liver disease. Marked IBA-1 immunolabeling and increased number of positive-IBA-1 cells were found in the undernourished group. No statistical difference in serum ALT was found. There was also a significant increase in ApoA mRNA expression in the undernourished group, but not ApoE and LCAT, compared with the control. Altogether our findings suggested that chronic RBD-induced malnutrition leads to liver inflammation with increased ApoA-I activity.

Cafeteria diet in breastfeeding dams promotes anxiolytic effects, accumulation of adipose tissue, and impacts offspring development / La dieta de la cafetería en las madres que amamantan promueve los efectos ansiolíticos y la acumulación de tejido adiposo, y afecta el desarrollo de la descendencia

The aim of this study was to evaluate the nutritional and behavioral effects of a cafeteria diet in dams during the breastfeeding period and in their offspring from weaning until early adulthood (70 days old). Pregnant Wistar rats were fed a chow diet until delivery. Postnatally (D0), litters were culled to 8 pups and lactating dams received control (CTRL n= 6) or cafeteria (CAF n= 6) diets and water ad libitum. At the end of the breastfeeding period, male offspring were placed in individual boxes receiving the same treatment from their respective dams (CTRL or CAF) until adulthood (70 days). All nutritional and behavioral evaluations were performed with the dams (n= 12) during the breastfeeding phase and with the male offspring (n= 24) after weaning to adulthood. CAF dams demonstrated a lower caloric and protein intake; higher intake of fats; loss of weight; greater accumulation of adipose tissue; and an anxiolytic effect. CAF male offspring showed lower caloric intake; higher intake of fats; and accumulation of adipose tissue. In addition, these animals continued to have decreased body weight, body length and tibia-femur length in relation to CTRL. In dams, a cafeteria diet promoted alterations in body composition and anxiety, and in offspring the diet resulted in adequate development.

El objetivo de este estudio fue evaluar los efectos nutricionales y de comportamiento de la dieta de la cafetería en las madres durante el período de lactancia materna y en su descendencia desde el destete hasta la edad adulta temprana (70 días de edad). Ratas Wistar embarazadas fueron alimentadas con una dieta estándar hasta el parto. Postnatalmente (D0), las camadas se ajustaron en 8 crías y las madres lactantes recibieron las dietas control (CTRL n= 6) o cafetería (CAF n= 6) además de agua ad libitum. Al final del período de lactancia materna, las proles machos fueron colocados en cajas individuales recibiendo el mismo tratamiento de sus respectivas madres (CTRL o CAF) hasta la edad adulta (70 días). Todas las evaluaciones nutricionales y comportamentales se realizaron con las madres (n= 12) durante la fase de lactancia y con la prole masculina (n= 24) después del destete hasta la edad adulta. Las madres CAF demostraron una menor ingesta calórica y proteica; mayor ingestión de grasas; pérdida de peso; mayor acumulación de tejido adiposo; y un efecto ansiolítico. La prole masculina CAF presentó menor consumo calórico; mayor ingestión de grasas; y la acumulación de tejido adiposo. Además, estos animales presentaron menor peso corporal, longitud corporal, y longitud de la tibia-fémur, en relación a CTRL. En las madres, la dieta de cafetería promovió cambios en la composición corporal y ansiedad, y en la prole la dieta comprometió el desarrollo adecuado.

Impacto da dieta usual no risco de doença hepática gordurosa não alcoólica (DHGNA) / Impact of current diet at the risk of non-alcoholic fatty liver disease (nafld)

ABSTRACT The nonalcoholic fatty liver disease (NAFLD) affects approximately 20%-30% of general population and is even more prevalent among obese individuals. The risk factors mainly associated with NAFLD are diseases related to the metabolic syndrome, genetics and environment. In this review, we provide a literature compilation evaluating the evidence behind dietary components, including calories intake, fat, protein, fibers and carbohydrate, especially fructose which could be a trigger to development and progression of the NAFLD. In fact, it has been demonstrated that diet is an important factor for the development of NAFLD and its association is complex and extends beyond total energy intake.

RESUMO A doença hepática gordurosa não alcoólica (DHGNA) afeta aproximadamente de 20% a 30% da população geral sendo prevalente entre os indivíduos obesos. Os fatores de risco associados à DHGNA são: doenças relacionadas à síndrome metabólica, fatores genéticos e meio ambiente. Nesta revisão, fornecemos uma compilação bibliográfica avaliando como as evidências relacionadas aos componentes da dieta, incluindo ingestão calórica, de gorduras, de proteínas, de fibras e de carboidratos, especialmente a frutose, poderiam ser um estímulo para o desenvolvimento e progressão da DHGNA. Foi demonstrado que a dieta é um fator importante para o desenvolvimento da DHGNA e sua associação se estende além do consumo total de calorias.

Stress and Food Consumption Relationship in Hypertensive Patients / Estresse e Consumo Alimentar em Pacientes Hipertensos

Abstract Background: Stress is a state of threat to the balance of the organism, which can cause biological and psychological changes. In hypertensive patients, stress can interfere with blood pressure levels, influence on food choices and neglect of the diet. Objective: This study aims to describe the relationship between stress and dietary intake of hypertensive patients. Methods: A transversal study was carried out at the Arterial Hypertension Clinic of the Cardiology Institute of Rio Grande do Sul, Brazil. The participants were aged ≥ 18 years and hypertensive. Blood pressure, food consumption and anthropometric measurements were collected. The variables related to stress were evaluated by the Lipp's Stress Symptoms Inventory (LSSI) for adults. Significance level of 5% has been considered for all analyzed data. Results: The number of participants was 100. There was a higher prevalence of the female sex (67%), the mean age of the study population was 55.87 ± 12.55 years. Among the participants, 86% were classified in some of the stress phases, on which 57% were in the resistance phase. It was observed that there was no correlation between the presence of stress (as well as their actions), pressure levels and food consumption. The consumption of foods rich in lipids and individuals with a prevalence of psychological symptoms of stress displayed a significant association. Conclusions: Rich in fat dietary has been the first choice in patients with psychological symptoms of stress. Further studies regarding remodeled dietary intake and blood pressure levels in relation to the stress phases are suggested. These findings are important to contribute to the development of prevention and treatment strategies for cardiovascular diseases.

Resumo Fundamento: O estresse é um estado de ameaça ao equilíbrio do organismo, podendo causar alterações biológicas e psicológicas. No paciente hipertenso o estresse pode interferir nos níveis pressóricos e gerar influência nas escolhas alimentares e negligência da dieta. Objetivo: Este estudo tem como objetivo descrever a relação entre o estresse e consumo alimentar de pacientes hipertensos. Métodos: Estudo transversal, desenvolvido no Ambulatório de Hipertensão Arterial do Instituto de Cardiologia do Rio Grande do Sul. Participaram da pesquisa indivíduos hipertensos com idade > 18 anos. Foram coletados dados de pressão arterial, consumo alimentar e medidas antropométricas. As variáveis relacionadas ao estresse foram avaliadas pelo inventário de sintomas de stress para adultos de Lipp (ISSL). Em todas as análises foi considerando um nível de significância 5% (p < 0,05). Resultados: O número de participantes foi de 100. Houve maior prevalência no sexo feminino (67%), a idade média da população estudada foi 55,87 ± 12,55 anos. Dos participantes, 86% se classificaram em alguma das fases do estresse, sendo que destes, 57% estavam na fase de resistência. Observou-se que não houve correlação entre a presença de estresse (bem como suas fases), níveis pressóricos e consumo alimentar. O consumo de alimentos ricos em lipídios em hipertensos com sintomas de estresse apresentou significância estatística. Conclusão: Os alimentos ricos em gordura prevaleceram entre as escolhas alimentares nos pacientes com sintomas psicológicos de estresse. Sugere-se mais estudos em relação a alteração do consumo alimentar e níveis pressóricos em relação às fases do estresse.

Outbreaks of nutritional cardiomyopathy in pigs in Brazil / Surtos de cardiomiopatia nutricional em suínos no Brasil

Dilated cardiomyopathy (DCM) is a condition that affects the myocardium, seldom reported in pigs. The DCM is characterized by ventricular dilation, which results in systolic and secondary diastolic dysfunction and can lead to arrhythmia and fatal congestive heart failure. This study described the clinical, pathological, chemical and toxicological findings of nutritional dilated cardiomyopathy (DCM) in nursery pigs through natural and experimental studies. Naturally occurring cases of DCM in three swine farms were investigated through necropsy (fourteen pigs), microscopic, virological, chemical and toxicological exams for the detection of the etiology. The experimental study was conducted with nine 40 days-old piglets, which were divided into three groups of three piglets each. Group 1 was fed with the suspected diet of the naturally occurring cases, Group 2 with half of the suspected diet and half of a control diet, and Group 3 received only the control diet. Clinical signs were recorded. All pigs were submitted of euthanized, necropsie and collection sample for laboratories exams, after 15 days of experiment onset. At the necropsy, all naturally occurring cases had bilateral cardiac dilatation associated to hepatic enhanced lobular pattern (nutmeg liver) and lungs edema. Microscopically, the heart revealed severe hypertrophy and vacuolization of cardiomyocytes, as well as myofiber disarray. Feed analysis revealed low-quality standard soybean meal. After the suspected feed was replaced, clinically ill pigs recovered, and mortality ceased. At the experimental study, two piglets from Group 1 had cough, dyspnea and diarrhea. At the necropsy, these animals had similar gross and microscopic lesions to the natural cases. The nutritional DCM in pigs may be associated to the diet with low-quality soybean meal, as it was further confirmed through an experimental study.(AU)

Cardiomiopatia dilatada (CMD) é uma condição que afeta o miocárdio, raramente relatada em porcos. A DCM é caracterizada por dilatação ventricular, que resulta em disfunção sistólica e disfunção diastólica secundária e pode levar a arritmias e insuficiência cardíaca congestiva fatal. Este estudo descreve os achados clínicos, patológicos, químicos e toxicológicos da CMD em suínos de creche através de estudos naturais e experimentais. Investigaram-se três granjas com surtos de mortalidade por CMD através de exames de necropsia (catorze suínos), microscópicos, virológicos, químicos e toxicológicos para a detecção da etiologia. O estudo experimental foi conduzido com nove leitões de 40 dias de idade, divididos em três grupos de três leitões cada. O grupo 1 foi alimentado com a dieta suspeita dos casos naturais; o 2 com metade da dieta suspeita e metade de dieta controle; e o 3 recebeu apenas a dieta controle. Sinais clínicos foram registrados. Todos os suínos foram submetidos a eutanásia, necropsia para a coleta de amostras para exames laboratoriais após 15 dias do início do experimento. Na necropsia, todos os leitões dos casos naturais apresentavam dilatação cardíaca bilateral associada a padrão lobular hepático aumentado (fígado de noz-moscada) e edema pulmonar. Microscopicamente, o coração revelou hipertrofia severa e vacuolização de cardiomiócitos, bem como desordem de miofibras. A análise da ração demonstrou que o farelo de soja apresentava baixa solubilidade o que indica baixa qualidade. Após a substituição da ração suspeita, os porcos clinicamente doentes recuperaram e a mortalidade cessou. No estudo experimental, dois leitões do grupo 1 apresentaram tosse, dispneia e diarreia. Na necropsia, esses animais apresentavam lesões macroscópicas e macroscópicas similar aos casos naturais. A CMD nutricional em suínos pode estar associado à dieta com farelo de soja de baixa qualidade, como foi confirmado através de um estudo experimental.(AU)

Diet, physical activity, obesity and related cancer risk: strategies to reduce cancer burden in the Americas / Dieta, actividad física, obesidad y riesgo de cáncer: estrategias para reducir la carga del cáncer en las Américas

Abstract: With increased globalization, Latin America is experiencing transitions from traditional lifestyle and dietary practices to those found in higher income countries. Healthy diets, physical activity and optimal body fat can prevent approximately 15% of cancers in low-income and 20% in high-income countries. We discuss links between diet, obesity, physical activity and cancer, emphasizing strategies targeting children to decrease risk of obesity, control obesity-related risk factors, and reduce sedentary lifestyles, as this will have high impact on adult cancer risk. We focus on individual behaviors, economic, cultural and societal changes that may guide future interventions in the Americas.

Resumen: América Latina está experimentando transiciones desde estilos de vida tradicional y prácticas dietéticas a las de países de ingresos altos. Las dietas saludables, la actividad física y la grasa corporal óptima pueden prevenir aproximadamente el 15% de cánceres en países de bajos ingresos y 20% en países de ingresos altos. Discutimos los vínculos entre la dieta, obesidad, actividad física y cáncer; haciendo hincapié en estrategias dirigidas a niños, para disminuir el riesgo de obesidad y reducir la vida sedentaria. Nos enfocamos en comportamientos individuales, cambios económicos, culturales y sociales que pueden guiar futuras intervenciones en las Américas.

La ingesta de "once", en reemplazo de la cena, se asocia al riesgo de presentar síndrome metabólico / Five o'clock tea and the risk of metabolic syndrome

Background: Seventy four percent of Chileans replaced the traditional dinner for the consumption of "five o'clock tea" (5CT), a mealtime that includes bread and is simliar to western breakfast. The latter favors the intake of unhealthy foods. Aim: To study whether the consumption of "5CT", instead of dinner, could be a risk factor for the development of metabolic syndrome (MetSyn). Material and Methods: Anthropometric parameters, mean blood pressure, lipid profile, thyroid stimulating hormone and fasting glucose were measured in 489 subjects aged 39 ± 12 years (33% women) who attended a primary cardiovascular prevention (CV) program. A 24-hour recall and usual meal times were registered during a dietary interview. To determine the association between the consumption of "5CT" or dinner and the probability of presenting two or more components of MetSyn, we built an odds proportional model adjusted by age and sex. In addition, severity for MetSyn was calculated. Results: Nineteen percent of participants had MetSyn and 39%, two or more MetSyn components. Those who consumed "5CT" instead of dinner, had 54% more probability of having 2 or more MetSyn components (Odds ratio = 1.54, confidence intervals 1.032.32, p = 0.04). Participants who included processed carbohydrates in their last meal had a higher probability of having components of MetSyn. This probability decreased among participants who ate dinner with a low proportion of refined carbohydrates. Conclusions: Subjects who eat "5CT", instead of dinner as the last meal, have a higher cardiometabolic risk and MetSyn severity.

Factores ambientales en el desarrollo y evolución de la enfermedad inflamatoria intestinal / Environmental risk factors in the development and evolution of inflammatory bowel disease

Environmental factors may influence the development of Inflammatory Bowel Disease and modify its natural history. The objective of this review is to evaluate current evidence about environmental factors associated with the disease. A better knowledge about the pathogenesis of the disease can lead to better treatment strategies and suggestions to prevent the disease.

Dietary patterns of pregnant women, maternal excessive body weight and gestational diabetes / Padrões alimentares de gestantes, excesso de peso materno e diabetes gestacional

ABSTRACT OBJECTIVE To investigate the relationship between the dietary patterns of pregnant women with maternal excessive body weight and gestational diabetes mellitus. METHODS A cross-sectional study conducted with a convenience sample of 785 adult pregnant women attended by the Unified Health System of Ribeirão Preto, state of São Paulo, between 2011 and 2012. Two 24-hour dietary recalls, corrected by the multiple source method, were employed . For the classification of the body mass index and the diagnosis of gestational diabetes mellitus, the criteria by Atalah and the World Health Organization were used, respectively. Dietary patterns were obtained by principal component analysis using the Varimax rotation method. The relationship between adherence to patterns, overweight and obesity was analyzed by multinomial logistic regression models and the relationship with gestational diabetes mellitus by adjusted unconditional logistic regression models. RESULTS We identified four dietary patterns: "traditional Brazilian"; "snacks"; "coffee" and "healthy". Women with a higher adherence to the "Healthy" (OR = 0.52; 95%CI 0.33-0.83) and "Brazilian Traditional" patterns (OR = 0.61; 95%CI 0.38-0.96) presented a lower chance of obesity, when compared to women with lower adherence, regardless of confounding factors. After adjustment for maternal excessive body weight, there was no association between dietary patterns and gestational diabetes mellitus. CONCLUSIONS Among the pregnant women, greater adherence to "traditional Brazilian" and "healthy" patterns was inversely associated with obesity, but no relationship was identified with gestational diabetes mellitus after adjusting for excessive body weight. Prospective studies are recommended to investigate the relationship between dietary patterns, overweight and gestational diabetes mellitus, reducing the chance of reverse causality.

RESUMO OBJETIVO Investigar a relação entre os padrões alimentares de gestantes com o excesso de peso materno e o diabetes mellitus gestacional. MÉTODOS Estudo transversal conduzido em uma amostra de conveniência de 785 gestantes adultas atendidas pelo Sistema Único de Saúde de Ribeirão Preto, SP, entre 2011 e 2012. Dois inquéritos recordatórios de 24 horas, corrigidos pelo multiple source method, foram empregados . Para a classificação do índice de massa corporal e do diagnóstico do diabetes mellitus gestacional, utilizou-se os critérios de Atalah e da Organização Mundial da Saúde, respectivamente. Os padrões alimentares foram obtidos por análise de componentes principais, utilizando o método de rotação Varimax . A relação entre a adesão aos padrões e sobrepeso e obesidade foi analisada por modelos de regressão logística multinomial e a relação entre adesão aos padrões e diabetes mellitus gestacional, por modelos de regressão logística não condicional ajustados. RESULTADOS Identificamos quatro padrões alimentares: "tradicional brasileiro"; "lanches"; "café" e "saudável". Observou-se que mulheres com maior adesão ao padrão "saudável" (OR = 0,52; IC95% 0,33-0,83) e "tradicional brasileiro" (OR = 0,61; IC95% 0,38-0,96) apresentaram menor chance de obesidade que as mulheres com menor adesão, independentemente de fatores de confusão. Após ajuste pelo excesso de peso materno, não houve associação entre os padrões alimentares e o diabetes mellitus gestacional. CONCLUSÕES Entre as gestantes, a maior adesão aos padrões "tradicional brasileiro" e "saudável" foi inversamente associada à obesidade, mas nenhuma relação foi identificada com o diabetes mellitus gestacional após ajuste pelo excesso de peso. Estudos prospectivos são recomendados para investigar a relação entre padrões alimentares e excesso de peso e diabetes mellitus gestacional, reduzindo a chance de causalidade reversa.

Associação entre a pontuação Dieta Mind (Mediterranean - Dash Intervention for Neurodegenerative Delay) e Transtornos Mentais Comuns em idosos de São Paulo: Estudo de Base Populacional / Association between Mind Diet score (Mediterranean - Dash Intervention for Neurodegenerative Delay) and Common Mental Disorders in the elderly of São Paulo: Population Based Study

Introdução: Dentre as diferentes manifestações de saúde que acometem os idosos, pode-se destacar os Transtornos Mentais Comuns (TMC). Sugere-se que a adesão a padrões alimentares específicos, como a dieta MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), possa atenuar ou reduzir os riscos relacionados ao envelhecimento. A Dieta MIND tem como princípio ingestão elevada de frutas vermelhas, vegetais verdes folhosos e demais vegetais, aves, peixes, oleaginosas, leguminosas, grãos integrais, azeite de oliva extra-virgem, vinho tinto, e por sua vez, uma ingestão baixa de carnes vermelhas, doces e massas, queijos, manteiga, margarina, além dos alimentos convencionalmente chamados de "fast food". Objetivo: este estudo tem como objetivo identificar, em idosos, a pontuação do padrão dietético MIND e investigar a associação entre essa pontuação e a presença de TMC. Métodos: a amostra para o presente estudo é derivada do Inquérito de Saúde - ISA Capital Nutrição, no período de 2015. Foram estudados, nessa amostra, 545 idosos (acima de 60 anos), de ambos os sexos. Os dados alimentares da amostra foram obtidos a partir de dois recordatórios alimentares de 24 horas, que foram corrigidos para identificação da dieta habitual, e calculados quanto à ingestão dos grupos alimentares que constituem a dieta MIND. Além disso, a pontuação à dieta MIND foi identificada a partir da mediana da ingestão dos grupos determinados. A presença de TMC foi avaliada por meio da aplicação do SRQ-20 (Self-Reported Questionnaire). Foram ainda consideradas algumas variáveis de ajuste (sexo, idade, raça, nível de atividade física de lazer, presença de doenças crônicas como hipertensão arterial sistêmica, dislipidemia e diabetes mellitus, renda familiar total, Índice de Massa Corporal e escolaridade). Resultados: os participantes avaliados eram em sua maioria mulheres, inativas, com presença de doenças crônicas. Não houve associação significativa quanto a adesão à pontuação da dieta MIND e TMC, contudo, alguns componentes da dieta, quando associados isolados, mostraram associação significativa e protetora (vegetais verdes folhosos, outros vegetais não folhosos e leguminosas). Por sua vez, o consumo de carnes vermelhas mostrou correlação negativa para TMC. Conclusão: O presente estudo não encontrou associação significativa entre a pontuação 7 da dieta MIND e TMC entre os idosos, entretanto, quando se analisou os componentes do padrão dietético MIND isolados em relação a TMC, encontrou-se correlação positiva para os grupos de vegetais verdes folhosos, outros vegetais e leguminosas e correlação negativa para o grupo de carnes vermelhas. Desse modo, estratégias nutricionais voltadas à saúde da função cerebral, com foco em um maior consumo de alimentos protetores e menor consumo de alimentos não-protetores presentes na dieta MIND, podem auxiliar beneficamente a população, especialmente os idosos

Introduction: Among the different health manifestations that affect the elderly, we can highlight Common Mental Disorders (CMD). In turn, it is suggested that adherence to specific dietary patterns, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay, may attenuate or prevent mental disorders related to aging. The MIND Diet has as a principle a relatively high intake of healthy foods such as red fruits, leafy green vegetables and other vegetables, poultry, fish, oilseeds, legumes, whole grains, extra virgin olive oil, red wine, a relatively low intake of unhealthy foods such as red meats, sweets and pasta, cheeses, butter, margarine, and food conventionally called fast food. Objective: This study aims at analyzing, in the elderly, the score of the MIND dietary pattern, and to investigate the association between this score and the presence of CMD. Methods: The sample for the present study is derived from the Health Survey - ISA Capital Nutrition, in the period of 2015. In this sample, 545 elderly (over 60 years) of both sexes were studied. The dietary data of the sample were obtained from two 24-hour dietary reminders that were corrected for intrapersonal variability to identify the usual diet and calculated for the intake of the dietary groups that constitute the MIND diet. In addition, adherence to the MIND diet was identified from the median ingestion of the previously determined groups. The presence of CMD was assessed by the application of SRQ-20. Some adjustment variables (gender, age, physical activity pattern, presence of chronic diseases, income and schooling) were also considered. Results: the participants were mostly female, inactive, with chronic diseases. There was no significant association with adherence to the MIND and CMD scores, however, some dietary components, when associated alone, showed a significant and protective association (green leafy vegetables, other no-leafy vegetables and legumes). In turn, the consumption of red meat showed a significant and harmful association. Conclusion: The present study did not find a significant association between the MIND and TMC diet scores among the elderly, however, when analyzing the components of the isolated MIND dietary pattern in relation to the TMC, a positive correlation was found for the leafy green vegetable groups, other vegetables and legumes and negative correlation for the red meat group. Thus, nutritional strategies focused on brain function health, with a focus on higher consumption of protective foods and lower consumption of non-protective foods present in the MIND diet, can benefit the population, especially the elderly

Relationship between minimally and ultra-processed food intake during pregnancy with obesity and gestational diabetes mellitus / A relação entre consumo de alimentos minimamente processados e ultraprocessados durante a gestação e obesidade e diabetes mellitus gestacional / La relación entre el consumo de comida mínimamente procesada y ultraprocesada durante embarazos con obesidad y diabetes mellitus gestacional

This study aimed to investigate the relationship between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight, obesity, and gestational diabetes mellitus conditions. This is a cross-sectional study conducted among 785 adult women in singleton pregnancies (between 24th and 39th weeks of gestation) in Brazil. Usual food intake was estimated by the Multiple Source Method, using two 24-hour dietary recalls. The food groups of interest in this study were the unprocessed or minimally processed foods and ultra-processed foods. The World Health Organization criteria for the diagnosis of gestational diabetes mellitus and the Atalah criteria for excess weight were used. Adjusted multinomial logistic regression models were used to assess the relationship between energy contribution (%E) from foods with overweight and obesity conditions and, adjusted logistic regression models for gestational diabetes mellitus. In total, 32.1% participants were overweight, 24.6% were obese, and 17.7% of women were diagnosed with gestational diabetes mellitus . After adjustments, an inverse association between the highest tertile of %E from the intake of unprocessed or minimally processed foods and obesity was found [0.49 (0.30-0.79)]. Moreover, a positive association between the highest tertile of %E from ultra-processed food intake [3.06 (1.27-3.37)] and obesity was observed. No association between food intake (considering the nature, extent, and purpose of food processing) during pregnancy and overweight or gestational diabetes mellitus was found. The findings suggest a role of food processing in obesity but not in gestational diabetes mellitus. Further research is warranted to provide robust evidence on the relationship between the role of processed foods in obesity and gestational diabetes mellitus.

O objetivo deste estudo foi investigar a relação entre o consumo de alimentos (considerando a natureza, extensão e propósito do processamento de alimentos) durante a gestação e sobrepeso, obesidade e diabetes mellitus gestacional. Estudo transversal realizado com 785 mulheres adultas com gestações únicas (24ª-39ª semanas de gestação) no Brasil. O consumo usual de alimentos foi estimado usando o Multiple Source Method, usando recordatórios alimentares de 24 horas. Os grupos alimentares de interesse neste estudo foram os alimentos não-processados e minimamente processados e os alimentos ultraprocessados. Os critérios da Organização Mundial da Saúde para diagnóstico de diabetes mellitus gestacional e critérios de Atalah para excesso de peso foram usados. Modelos de regressão logística multinomial foram empregados para avaliar a relação entre a contribuição energética (%E) de alimentos e sobrepeso e obesidade, e modelos de regressão logística ajustados foram usados para diabetes mellitus gestacional. No total, 32,1% das gestantes estavam com sobrepeso, 24,6% com obesidade e 17,7% foram diagnosticadas com diabetes mellitus gestacional. Após ajustes, uma associação inversa entre obesidade e o maior tercil de %E do consumo de alimentos não-processados ou minimamente processados foi encontrada [0,49 (0,30-0,79)]. Além disso, uma associação positiva entre obesidade e o maior tercil de %E do consumo de alimentos ultraprocessados [3,06 (1,27-3,37)] foi observada. Nenhuma associação entre consumo de alimentos (considerando a natureza, extensão e propósito do processamento de alimentos) durante a gestação e sobrepeso ou diabetes mellitus gestacional foi encontrada. Os resultados sugerem o papel do processamento de alimentos na obesidade, mas não na diabetes mellitus gestacional. Pesquisas adicionais são necessárias para fornecer evidências robustas sobre a relação entre o papel do processamento de alimentos na obesidade e na diabetes mellitus gestacional durante a gestação.

El objetivo del presente estudio fue investigar la relación entre el consumo de comida (considerando la naturaleza, alcance, y propósito del procesamiento de comida) durante el embarazo y el sobrepeso, obesidad, y diabetes mellitus gestacional. Se realizó un estudio transversal con 785 mujeres adultas de embarazos únicos (24ª-39ª semanas de gestación) en Brasil. El consumo habitual se estimó mediante un Multiple Source Method, usando dos encuestas de 24-hour en relación con los hábitos alimentarios. Los grupos de comidas de interés en el presente estudio fueron los mínimamente procesados o sin procesar y los productos de comida ultraprocesada. Se utilizaron criterios de la Organización Mundial de la Salud para el diagnostico de diabetes mellitus gestacional, y los criterios Atalah para el sobrepeso. Se utilizaron modelos ajustados de regresión logística multinomial para evaluar la relación entre la contribución energética (%E) de comidas con el sobrepeso y la obesidad, y modelos ajustados de regresión logística para la diabetes mellitus gestacional . En total, un 32,1% sufrían sobrepeso, un 24,6% eran obesas, y un 17,7% de las mujeres fueron diagnosticadas con diabetes mellitus gestacional. Tras los ajustes, se encontró una asociación inversa entre el tercil más alto de %E, procedente del consumo de comidas sin procesar o mínimamente procesadas con la obesidad [0,49 (0,30-0,79)]. Asimismo, se encontró una asociación positiva entre el tercil más alto de %E de comida ultraprocesada [3,06 (1,27-3,37)] y la obesidad. No se encontró ninguna asociación entre el consumo de comida (considerando la naturaleza, alcance, y propósito de la comida procesada) durante el embarazo y el sobrepeso, respecto a la diabetes mellitus gestacional. Los resultados sugieren la importancia de la comida procesada en la obesidad pero no así en la diabetes mellitus gestacional. Son necesarias más investigaciones para proporcionar evidencias sólidas sobre la relación entre el papel de la comida procesada en la obesidad y diabetes mellitus gestacional durante el embarazo.

Relación entre la disponibilidad alimentaria y la mortalidad por cáncer colorrectal en América / Association between food availability and mortality due to colorectal cancer in the Americas

RESUMEN Con el objetivo de describir la relación entre la disponibilidad alimentaria y la tasa de mortalidad por cáncer colorrectal en los países de América en el año 2010, se analizaron datos provistos por la International Agency for Research on Cancer y la Food and Agriculture Organization mediante un estudio ecológico. Se observó una gran variabilidad excepto en disponibilidad calórica. La disponibilidad alimentaria fue abundante para calorías, grasas totales, grasa animal, carnes rojas y bebidas alcohólicas. Para frutas y vegetales fue crítica en un 80% de los países. Los países con más alta tasa de mortalidad por cáncer colorrectal fueron Uruguay, Barbados, Argentina y Cuba, y con las tasas más bajas fueron Guatemala, Canadá, México y Honduras. Las relaciones más fuertes se dieron entre la tasa de mortalidad por cáncer colorrectal y la disponibilidad alimentaria de grasa animal, carne roja, bebidas alcohólicas y calorías. No se encontró efecto protector de la disponibilidad alimentaria de frutas y vegetales sobre la tasa de mortalidad por cáncer colorrectal. Sería recomendable mejorar los registros de incidencia de tumores y de formas directas de evaluar la dieta para ser analizados en futuros estudios en lugar de los datos aquí utilizados.

ABSTRACT With the aim of describing the association between food availability and the mortality rate due to colorectal cancer in the countries of the Americas in 2010, data provided by the International Agency for Research on Cancer and the Food and Agriculture Federation were analyzed in an ecological study. Great variability was observed except in caloric supply. Food availability was abundant for calories, total fats, animal fat, red meat and alcoholic beverages. Availability was critically low for fruits and vegetables in 80% of the countries. The countries with the highest colorectal cancer mortality rates were Uruguay, Barbados, Argentina and Cuba, while those with the lowest rates were Guatemala, Canada, Mexico and Honduras. The strongest relationships were found between colorectal cancer mortality rate and the availability of animal fat, red meat, alcoholic beverages and calories. No protective effect of availability of fruits and vegetables on the colorectal cancer mortality rate was found. It would be advisable to improve the records of tumor incidence and direct ways of evaluating diet to be analyzed in future studies instead of the data used here.

Association between dietary pattern and cardiometabolic risk in children and adolescents: a systematic review / Associação entre padrão alimentar e risco cardiometabólico em crianças e adolescentes: uma revisão sistemática

Abstract Objective: To evaluate the association between dietary patterns and cardiometabolic risk factors in children and adolescents. Data source: This article followed the recommendations of PRISMA, which aims to guide review publications in the health area. The article search strategy included searches in the electronic databases MEDLINE via PubMed, Scopus, and LILACS. There was no date limitation for publications. The descriptors were used in English according to MeSH and in Portuguese according to DeCS. Only articles on dietary patterns extracted by the a posteriori methodology were included. The question to be answered was: how much can an "unhealthy" dietary pattern influence biochemical and inflammatory markers in this population? Data synthesis: The studies showed an association between dietary patterns and cardiometabolic alterations. The patterns were characterized as unhealthy when associated to the consumption of ultraprocessed products, poor in fiber and rich in sodium, fat, and refined carbohydrates. Despite the associations, in several studies, the strength of this association for some risk markers was reduced or lost after adjusting for confounding variables. Conclusion: There was a positive association between "unhealthy" dietary patterns and cardiometabolic alterations in children and adolescents. Some unconfirmed associations may be related to the difficulty of assessing food consumption. Nevertheless, studies involving dietary patterns and their association with risk factors should be performed in children and adolescents, aiming at interventions and early changes in dietary habits considered to be inadequate.

Resumo Objetivo: Avaliar a associação encontrada nos estudos entre padrão alimentar e fatores de risco cardiometabólicos em crianças e adolescentes. Fonte dos dados: Este artigo seguiu as recomendações do Prisma, que objetiva orientar as publicações de revisão na área da saúde. A estratégia de busca dos artigos incluiu pesquisas nas bases eletrônicas Medline via PubMed, Scopus e Lilacs. Não houve data limite de publicação. Os descritores foram usados em inglês de acordo com MeSH e em português segundo os DeCS. Apenas artigos de padrão alimentar extraídos pela metodologia a posteriori foram incluídos. A pergunta a ser respondida foi: quanto um padrão alimentar "não saudável" pode influenciar nos marcadores bioquímicos e inflamatórios dessa população? Síntese dos dados: Os estudos demonstraram haver associação entre os padrões alimentares e alterações cardiometabólicas. Os padrões eram caracterizados como não saudáveis marcados pelo consumo de produtos ultraprocessados, pobres em fibras e ricos em sódio, gordura e carboidratos refinados. Apesar das associações, em vários estudos, a força dessa associação para alguns marcadores de risco era reduzida ou perdida após os ajustes para as variáveis de confusão. Conclusão: Houve associação positiva entre os padrões alimentares "não saudáveis" e as alterações cardiometabólicas em crianças e adolescentes. Algumas associações não confirmadas podem estar relacionadas à própria dificuldade de avaliar o consumo alimentar. Apesar disso, estudos que envolvem padrões alimentares e sua associação com fatores de risco devem ser feitos em crianças e adolescentes com objetivo de intervenções e modificações precoces nos hábitos alimentares tidos como não adequados.