Effects of HAART in the nutritional status of children and adolescents infected by HIV in Brazil: a systematic review / Efeitos da HAART no estado nutricional de crianças e adolescentes infectados pelo HIV no Brasil: uma revisão sistemática

Abstract The verification of factors associated with growth, body composition and nutritional and nutritional aspects after HIV infection in children or adolescents in Brazil is fundamental for progress in this area. We selected articles published until 2018, available on the platforms PubMed and Lilacs, using the keywords The following descriptors and their associations were used, extracted from MeSH: "Children", "Adolescent", "Anthropometry", "Nutritional Assessment", "HIV", "Brazil" adding the filter "and" for advanced searches. A total of 1,450 articles were found, and after selection and full reading, 19 were selected. The studies agreed that children and adolescents living with HIV present or may present alterations in bone metabolism, lipid metabolism and body composition due to infection or associated with therapy. Significant differences were observed in weight and height in infected infants compared to uninfected infants. The evaluation and monitoring of diet quality, as well as serum micronutrient monitoring, are fundamental to guarantee the clinical and treatment conditions of these patients, as well as to prevent disorders due to low nutrient intakes.

Resumo A verificação de fatores associados ao crescimento, composição corporal e aspectos alimentares e nutricionais, após a infecção pelo HIV em crianças ou adolescentes no Brasil é fundamental para avanços nesta área. Foram selecionados artigos publicados até 2018, disponibilizados nas plataformas PubMed e Lilacs, extraídas do MeSH: "Children", "Adolescent", "Anthropometry", "Nutritional Assessment", "HIV", "Brazil" adicionadas do filtro "and" para as pesquisas. Foram encontrados 1.450 artigos e após seleção e leitura integral foram selecionados 19. Os estudos concordaram que crianças e adolescentes vivendo com HIV apresentam ou podem apresentar alterações no metabolismo ósseo, de lipídeos e na composição corporal devido à infecção ou associadas à terapia. Observou-se diferença significativa do peso e estatura em crianças infectadas em relação às não infectadas. Percebe-se que a avaliação e o monitoramento da qualidade da dieta, bem como o acompanhamento sérico de micronutrientes, são fundamentais para garantir as condições clínicas e de tratamento destes pacientes, bem como para prevenir desordens por baixo consumo de nutrientes.

Acompanhamento fonoaudiológico nas dificuldades alimentares no câncer infanto-juvenil: uma série de casos / Speech therapy follow-up for eating difficulties with juvenile child cancer: a series of cases / Seguimiento fonoaudiológico en las dificultades de alimentación en el cáncer infantojuvenil: una serie de casos

Objetivo: Este estudo teve como objetivo relatar o acompanhamento fonoaudiológico nas dificuldades alimentares no câncer infanto-juvenil. Métodos: O estudo de série de casos retrospectivo e descritivo-qualitativo teve amostra composta por 3 indivíduos com idade variando entre 8 e 14 anos, em acompanhamento com a equipe do Serviço de Oncologia Pediátrica do Hospital da Criança Santo Antônio - Irmandade Santa Casa de Misericórdia de Porto Alegre, com solicitação de avaliação fonoaudiológica para investigação de deglutição/alimentação. A coleta foi realizada por meio de dados extraídos de prontuário eletrônico da instituição, onde constavam as evoluções dos casos dos pacientes internados e atendidos em ambulatório, de março de 2018 a agosto de 2019. Resultados: Nos 3 casos relatados, os pacientes apresentaram deglutição normal, com indicação de via alternativa para alimentação pelo prejuízo na ingestão oral de alimentos durante e/ou após o tratamento oncológico. As queixas alimentares devido aos efeitos colaterais do tratamento foram inapetência, alteração de paladar, náusea e vômitos. Os casos foram acompanhados durante a internação e em ambulatório de fonoaudiologia. Dois dos pacientes permaneceram com a via alternativa por tempo prolongado e um deles reestabeleceu a alimentação por via oral exclusiva. Conclusão: O fonoaudiólogo inserido na equipe multidisciplinar de cuidados ao paciente com câncer infanto-juvenil é um dos responsáveis pelo acompanhamento das dificuldades alimentares provocadas pela doença e tratamentos, com olhar além da disfagia orofaríngea. A sua atuação deve envolver estratégias que promovam a nutrição adequada, seja por via alternativa ou via oral, visando segurança e conforto, com respeito à autonomia do paciente.

Objective: This study was aimed to report speech therapy follow-up for eating difficulties with childhood cancer. Methods: The retrospective and descriptive-qualitative case series study was sampled composed of patients aged between 8 and 14 years, under follow-up with the Pediatric Oncology Service of the Hospital da Criança Santo Antônio - Irmandade Santa Casa de Misericórdia de Porto Alegre, with a request for speech therapy evaluation for swallowing/feeding research. The collection was performed through data extracted from the institution's electronic medical records, with the evolution of the cases of patients hospitalized and attended in an outpatient clinic, from March 2018 to August 2019. Results: In the 3 reported cases, the patients presented normal swallowing, with indication of feeding tubes by impairment in oral food intake during and/or after cancer treatment. The dietary complaints due to the side effects of treatment were inapetence, taste change, nausea and vomiting. The cases were followed during hospitalization and in the speech therapy outpatient clinic. Two of the patients remained on a feeding tube for a long time and one of them reestablished exclusive oral feeding. Conclusion: The speech therapist inserted in the multidisciplinary team of care for patients with childhood cancer is one of those responsible for follow-up of eating difficulties caused by the disease and treatments, with a look beyond oropharyngeal dysphagia. Its performance should involve strategies that promote adequate nutrition, either alternatively or orally, aiming at safety and comfort, with respect to the patient's autonomy.

Objetivo: Este estudio tenía como objetivo de relatar el seguimiento fonoaudiológico en las dificultades de alimentación en el cáncer infantil. Métodos: El estudio retrospectivo y descriptivo-cualitativo de la serie de casos estaba compuesto por 3 individuos de entre 8 y 14 años, bajo seguimiento con el equipo de Servicio de Oncología Pediátrica del Hospital da Criança Santo Antônio - Irmandade Santa Casa de Misericórdia de Porto Alegre, con solicitud de evaluación fonoaudiológica para la investigación de la deglutición/alimentación. La recopilación se realizó a través de datos extraídos de la historia clínica digitalizada institucional con la evolución de los casos de pacientes hospitalizados y atendidos en un servicio de consulta externa, de marzo de 2018 a agosto de 2019. Resultados: En los 3 casos reportados, los pacientes presentaron deglución normal, con indicación de vía alterna de alimentación por presentar dificultad en la ingesta oral de alimentos durante y/o después del tratamiento oncológico. Las quejas alimenticias asociadas a los efectos secundarios del tratamiento fueron la pérdida del apetito, alteración en el sentido del gusto, náuseas y vómito. Los casos fueron acompañados por el fonoaudiólogo durante la hospitalización y el servicio de consulta externa. Dos de los pacientes permanecieron con via alterna de alimentación durante un tiempo prolongado y uno de ellos restableció la alimentación por vía oral por completo. Conclusión: El fonoaudiólogo como parte del equipo multidisciplinario de atención en pacientes con cáncer infantil, es uno de los responsables del seguimiento de las dificultades de alimentación causadas por la enfermedad y los tratamientos, con una mirada más allá de la disfagia orofaríngea. Su actuación debe incluir estrategias que promuevan una nutrición adecuada, ya sea por vía alterna o vía oral, con el objetivo de garantizar la seguridad y comodidad del paciente y respetando su autonomía.

Complementary feeding practices in Mexican healthy infants: How close are they to the current guidelines? / Prácticas de alimentación complementaria en lactantes sanos en México: ¿qué tan apegadas se encuentran al consenso actual?

Abstract Background: The foundations for the growth and optimal development of every human being are laid in the first 2 years of life. Exclusive breastfeeding (EBF) up to 6 months of age and the introduction of complementary feeding (CF) from this age are considered the preventive interventions with the most significant impact on a child's life. The objective of this study was to determine if pediatricians base their recommendations by following the Guidelines for CF in Healthy Infants (GCFHI) and if mothers have any awareness and knowledge of these recommendations. Methods: Surveys based on the GCFHI were conducted in a group of mothers (n = 377) and pediatricians (n = 104) living in Mexico. Results: Not all pediatricians recommended the EBF, and 76% recommended infant formula before 6 months of age. Regarding mothers, 76.9% practiced the EBF for the first 6 months. Vegetables were the leading starting food of CF suggested by pediatricians and mothers (87% and 91%, respectively), contrasting with food sources of iron (44%), which are the foods of choice according to the GCFHI. The practices performed by the mothers were statistically different from the recommendations of the pediatricians. Conclusions: The results reflect a lack of updating regarding CF. It is imperative to reinforce efforts to maintain the EBF for 6 months and to continue it together with the CF, as well as to promote the beginning of CF based on macro- and micro-nutrients.

Resumen Introducción: En los primeros dos años de vida se crean las bases para el crecimiento y desarrollo óptimo de todo ser humano. La lactancia materna exclusiva (LME) hasta los 6 meses de edad y la introducción de alimentación complementaria (AC) a partir de esta edad están consideradas como las intervenciones preventivas de mayor impacto en la vida de un niño. El presente trabajo evalúa en qué medida los pediatras basan sus recomendaciones en el Consenso para las prácticas de alimentación complementaria en lactantes sanos (CALCS) y si las madres están familiarizadas con estas recomendaciones. Métodos: Se realizaron encuestas para madres (n = 377) y pediatras (n = 104) residentes en México basadas en el CALCS. Resultados: Se detectó que no todos los pediatras recomendaron la LME, y el 76% la complementa con sucedáneos de la leche materna antes de los 6 meses. El 76.9% de las madres practicaron la LME por 6 meses. Las verduras fueron el principal alimento de inicio de AC sugerido por pediatras y madres (87% y 91%, respectivamente), lo que contrasta con alimentos fuente de hierro (44%) que según el CALCS son los alimentos de elección. Las prácticas de las madres tuvieron diferencias significativas con las recomendaciones de los pediatras. Conclusiones: Hay una falta de formación y actualización en esta materia. Es imperativo reforzar los esfuerzos para mantener la LME por 6 meses y continuarla junto con la AC, así como promover el inicio de la AC con base en los macro y micronutrientes.

Feeding difficulties and eating disorders in pediatric patients with cancer / Trastornos y dificultades en la alimentación en pacientes pediátricos con cáncer

Abstract Background Feeding difficulties and disorders are a common problem in the pediatric population, which involve a series of deficient behaviors about nutrition processes that can adversely affect psychomotor, psychosocial, and physical development of children. This study aimed to describe the frequency of feeding difficulties or disorders in pediatric patients with cancer. Methods A prospective study which included 125 children from 1-19 years treated at the Department of Oncology of the Instituto Nacional de Pediatría, Mexico City, was conducted. The diagnosis of eating disorders and feeding difficulties was determined during the first 48 h since admission, and the age of the patient influenced the type of disorder and feeding difficulties. Results Children older than 11 years presented more frequently an intense resistance of feeding because of discomfort pain (fear of feeding) than younger children (11.4 ± 4.7 vs. 7.4 ± 4.9, p ≤ 0.001). The most frequent alteration associated with malnutrition was loss of appetite (odds ratio [OR]: 8.8, confidence interval [CI] 95% 2.9-26.9, p<0.001), followed by fear of feeding (OR: 3.14, CI 95% 1.24-7.9, p=0.015), and the organic causes showed the highest risk for malnutrition (OR: 3.1, CI 95% 0.98-9.7, p=0.054). Conclusions Over 90% of the studied population demonstrated at least one eating disorder or feeding difficulty. The principal effect is inadequate nutritional intake due to limited appetite and fear of feeding, which can result in undernutrition. For this reason, the identification of alterations in nutrition processes should be part of the comprehensive assessment of cancer patients.

Resumen Introducción Los trastornos y dificultades para la alimentación son problemas comunes en la edad pediátrica. Estas situaciones conllevan una serie de comportamientos inadecuados respecto de los procesos de nutrición que pueden afectar de manera adversa el desarrollo psicomotor, psicosocial y físico del niño. El objetivo de este trabajo fue describir la frecuencia de desórdenes y dificultades en la alimentación en niños con cáncer a través de un estudio prospectivo. Métodos Se incluyeron 125 niños de 1 a 19 años de edad del Servicio de Oncología del Instituto Nacional de Pediatría, Ciudad de México. El diagnóstico de desorden y dificultad en la alimentación se determinó en las primeras 48 horas del ingreso. Resultados Los niños mayores de 11 años presentan con mayor frecuencia resistencia a comer debido a dolor o malestar (miedo a comer) (11.4±4.7 años versus 7.4±4.9 años; p≤0.001). La alteración más frecuente asociada a malnutrición fue la disminución del apetito (razón de momios [RM]: 8.8; intervalo de confianza [IC] 95%: 2.9-26.9; p<0.001), seguido del miedo a comer (RM: 3.14; IC 95%: 1.24-7.9; p=0.015) y las causas con mayor riesgo de malnutrición fueron las orgánicas (RM: 3.1; IC 95%: 0.98-9.7; p=0.054). Conclusiones Se encontró que en más del 90% de esta población se presentó por lo menos un desorden alimentario o dificultad al alimentarse. El principal efecto es la ingesta nutricional inadecuada debida al apetito limitado y al miedo a alimentarse, lo que puede resultar en desnutrición. Por esta razón, la identificación de alteraciones en los procesos de nutrición deben ser parte de la valoración integral de los pacientes con cáncer.

La alimentación complementaria: una práctica entre dos saberes / Complementary feeding: a practice between two knowledges

Resumen: Introducción: La alimentación complementaria (AC) comprende un periodo en la vida del lactante que inicia cuando se introducen alimentos diferentes a la leche materna. Está determinada por fac tores sociales y del medio ambiente, que facilitan o limitan el inicio adecuado de esta práctica, inci diendo directamente en el estado nutricional y de salud de los niños. Objetivo: Identificar barreras y facilidades para el seguimiento de las recomendaciones nutricionales en relación al inicio temprano de la AC en niños y niñas entre 0 y 24 meses de edad en una población perteneciente a un programa de atención integral a la primera infancia. Sujetos y métodos: Estudio cualitativo fenomenológico, longitudinal, seleccionando a través de una muestra intencionada 43 madres, a las que se les realizó entrevistas en profundidad y 11 grupos focales. Las categorías predefinidas fueron el contexto de la madre, representaciones y experiencias frente a la gestación, significados y experiencias de la lactan cia materna (LM), y la AC. El análisis comprendió las relaciones entre las unidades de significado y categorías predefinidas y emergentes. Resultados: AC es una práctica social que resulta de la mezcla de saberes médicos y populares, sin embargo, el grado de influencia que tienen estos últimos en las madres es mayor debido al grado de acompañamiento que tienen de su círculo cercano, en especial madres, abuelas y mujeres de la familia. El desconocimiento sobre lactancia materna exclusiva (LME) y AC en términos conceptuales y prácticos, impide que las madres puedan llevar a cabo prácticas ade cuadas. La gran mayoría no tiene claridad sobre lo que implica la exclusividad de la LM, resultando en un inicio temprano de la AC, o no cuentan con criterios objetivos para valorar su producción de leche. A pesar de haber recibido capacitación, la AC inició de manera temprana en la mayoría de los casos, hecho en el que la influencia familiar cercana fue decisiva. Conclusiones: La experiencia de la AC está fuertemente influenciada por el entorno cercano de la madre y las recomendaciones que reciben de profesionales de la salud no son suficientes para transformar sus prácticas. Por lo anterior se hace necesario el mejoramiento de las intervenciones de apoyo en materia de AC.

Abstract: Introduction: The complementary feeding (CF) comprises a period in the life of the infant that starts with the introduction of foods other than breast-milk. It is determined by social and environmental factors which facilitate or limit the appropriate initiation of this practice, directly affecting the nutri tional and health status of children. Objective: To identify barriers and facilities for the follow-up of nutritional recommendations regarding the early start of CF in children between 0 and 24 months of age belonging to a comprehensive early childhood care program. Materials and methods: Phenome nological, longitudinal, qualitative study in which 43 in-depth interviews and 11 focus-groups were carried out. Predefined categories were the context of the mother, representations and experiences of gestation, meanings and experiences of breastfeeding (BF), and CF. The analysis included the rela tionships between the units of meaning and predefined and emerging categories. Results: The CF is a social practice which is the result of medical and popular knowledge mixture, however, the degree of influence that the latter has on mothers is higher due to the degree of support that they have from their close circle, especially from mothers, grandmothers, and women of the family. The lack of con ceptual and practical knowledge about exclusive breastfeeding (EBF) and CF prevents mothers from carrying out good practices. Most of them do not know clearly what is involved in the EBF, resulting in an early start of CF, or do not have objective criteria to assess their milk production. Despite having received specific training, CF started early in most cases, a fact in which close family influence was decisive. Conclusions: The CF experience is strongly influenced by sociocultural aspects not only of the mother but of her immediate circle, and the recommendations they received from health pro fessionals are not enough to change their practices. Therefore, it is necessary to improve CF support interventions.

Mejora del conocimiento y conducta alimentaria de los adolescentes con una intervención educativa basada en orientación alimentaria / Improvement of knowledge and feeding behavior of adolescents with an educational intervention based on food orientation

Métodos: estudio cuasiexperimental, con 32 adolescentes entre 15 y 17 años. Se aplicó un cuestionario estructurado pretest y postest de un programa educativo de orientación alimentaria con base en la NOM-043-SSA2-2012. Los datos se analizaron con estadística descriptiva y t de Student no paramétrica para observar la diferencia (p ≤ 0.05). Resultados: el 56.2% de los adolescentes de ambos sexos se encuentran en Normopeso. El sobrepeso fue mayor en hombres (44.5%) que en mujeres (35.7%). Hubo incremento en el consumo de agua pura (20%) y disminución del consumo de refresco o agua de sabor (8%). También aumentó el consumo de frutas y verduras (18%), cereales y tubérculos (16%), y alimentos de origen animal (9%). La diferencia pretest y postest fue significativa (p ≤ 0.05). Conclusión: la intervención educativa basada en orientación alimentaria tiene un efecto positivo sobre el conocimiento reforzando la conducta alimentaria de los adolescentes.

Introduction: Adolescents are susceptible to unhealthy eating behaviors that trigger health problems such as obesity, malnutrition or eating disorders. Objective: To evaluate the effect of an educational intervention based on food orientation to improve knowledge and eating behavior of high school students. Methods: Quasi-Experimental study, with 32 adolescents between 15 and 17 years old. A structured pre-test and post-test questionnaire was applied to an educational food orientation program based on NOM-043-SSA2-2012. The data were analyzed with descriptive statistics and nonparametric Student t to observe the difference (p ≤ 0.05). Results: 56.2% of adolescents of both sexes are in Normopeso. Overweight was higher in men (44.5%) than in women (35.7%). There was an increase in the consumption of pure water (20%) and a decrease in the consumption of soft drink or water of flavor (8%). The consumption of fruits and vegetables (18%), cereals and tubers (16%) and foods of animal origin (9%) also increased. The pretest and posttest difference was significant (p ≤ 0.05). Conclusions: The educational intervention based on food orientation has a positive effect on knowledge by reinforcing the adolescents' eating behavior.

Estado nutricional materno e sua associação com o peso ao nascer em gestações de alto risco / Maternal nutritional status and its association with birth weight in high-risk pregnancies

Resumo O estado clínico e o nutricional da gestante representam importantes variáveis para o risco de inadequações de peso ao nascer. Assim, o presente estudo visou avaliar o estado nutricional de gestantes de alto risco e sua associação com o peso ao nascer de seus conceptos. Estudo transversal com gestantes de alto risco assistidas no Hospital Universitário de Maceió-AL e seus recém-nascidos. O estado nutricional das gestantes e de seus conceptos foi avaliado segundo o Índice de Massa Corporal para a idade gestacional e o peso ao nascer, respectivamente. A associação entre fatores maternos (comorbidades e estado nutricional) e o peso ao nascer foram realizadas pelos testes de qui-quadrado e correlação de Pearson, adotando um nível de confiança de 95% (α = 0,05). Foram estudadas 149 gestantes, com 19,7% delas com baixo peso; 32,0% eutróficas e 48,3% com excesso de peso. Entre os recém-nascidos, 39,6% eram pequenos para idade gestacional (PIG); 26,8% adequados para a idade gestacional (AIG) e 33,6% grandes para a idade gestacional (GIG). O excesso de peso gestacional e a presença de comorbidades metabólicas se associaram com o nascimento de recém-nascidos GIG e o ganho ponderal gestacional insuficiente com o nascimento de recém-nascidos PIG, sendo fundamentais intervenções para redução desses desfechos.

Abstract The clinical and nutritional status of pregnant women are important variables for birth-weight risk inadequacies. Thus, this study sought to evaluate the nutritional status of high-risk pregnant women and its association with birth weight of their offspring. It involved a cross-sectional study with high-risk pregnant women assisted at the university hospital of Maceio in the State of Alagoas and their newborns. The nutritional status of pregnant women and their offspring was evaluated according to body mass index for gestational age and birth weight, respectively. The association between maternal factors (comorbidities and nutritional status) and birth weight was assessed by the chi-square test and Pearson correlation, by adopting a confidence level of 95%. One hundred and forty-nine pregnant women were studied, 19.7% of whom were of normal weight; 32% were underweight; and 48.3% were overweight. Among newborns, 39.6% referred to as small for gestational age (SGA); 26.8% appropriate for gestational age (AGA) and 33.6% large for gestational age (LGA). LGA offspring were associated with overweight and the presence of metabolic comorbidities and SGA offspring were associated with insufficient gestational weight gain, whereby interventions are needed to reduce these outcomes.

Factores maternos que inciden en amenaza de parto pretérmino en adolescentesgestantes del cantón San Jacinto de Yaguachi / Maternal factors that affect thethreat of preterm delivery in pregnantadolescents of San Jacinto deYaguachi canton

Introducción:La amenaza de parto pre término consiste en la presencia de contracciones regulares después de las 20 y antes de las 37 semanas de gestación Objetivo: Determinar los factores maternos que inciden la amenaza de parto pretérmino en las mujeres gestantes que acuden al Hospital Básico de Yaguachi.Métodos:Sé realizo un Estudio cuantitativo, descriptivo, y transversal en el Hospital Básico "Dr. José Cevallos Ruiz", con una muestra de 20 adolescentes de sexo femenino, con el diagnostico amenaza de parto pretérmino, a las que se les aplicó una encuesta que constó con 5 preguntas entre ellas: Edad, educación, domicilio, controles prenatales y patología asociada a su embarazo.Resultados:Predominó el grupo de adolescentes correspondiente a los 17-19 años con un65%, instrucción secundaria el 55%, el 80% de las gestantes residía en la zona rural. En cuanto a los controles prenatales el 60% de las adolescentes asistieron de 1 a 4 controles, y el 50% de las adolescentes presentaron como factor de riesgo para la amenaza de parto pretérmino, la rotura prematura de membranas como patología asociada a su embarazo. Conclusiones:El factor materno que predominó fue la rotura prematura de membranas, sin embargo la infección de vías urinarias y los trastornos hipertensivosdel embarazo, también se encontraron presentes y por ello, la educación prenatal debe ser tomada en gran consideración

Introduction:The threat of preterm birth consists in the presence of regular contractions after 20 and before 37 weeks of gestation. Objective: To determine the maternal factors that affect the threat of preterm delivery in pregnant women who come to the Basic Hospital of YaguachiMethods:Aquantitative, descriptive, and transversal study in the Basic Hospital "Dr. José Cevallos Ruiz ", with a sample of 20 female adolescents, with the diagnostic threat of preterm delivery, to which a survey was applied that consisted of 5 questions including: Age, education, home, prenatal check-ups and associated pathology to your pregnancy.Results:The group of adolescents corresponding to 17-19 years old predominated with 65%, secondary instruction 55%, 80% of pregnant women resided in the rural area. Regarding the prenatal controls, 60% of the adolescents attended from 1 to 4 controls, and 50% of the adolescents presented as a risk factor for the threat of preterm delivery, the premature rupture of the membranes as a pathology associated with their pregnancy.Conclusions:The maternal factor that predominated was the premature rupture of membranes, nevertheless the infection of urinary tract and the hypertensive disorders of pregnancy, were also present and therefore, prenatal education should be taken into great consideration

Evaluación antropométrica según el Indice de Masa Corporal en universitarios de Quito / Anthropometric assessment according to body mass index in a university of Quito / Avaliação antropométrica de acordo com o Índice de Massa Corporal em estudantes universitários de Quito

RESUMEN Objetivo Evaluar el estado nutricional según el índice de masa corporal de los estudiantes universitarios de pregrado de la Universidad Central del Ecuador (UCE) y de la Universidad Tecnológica Equinoccial (UTE) de la ciudad de Quito, estableciendo sujetos de estudio con un perfil entre los 19 a 24 años de edad a través del uso de indicadores antropométricos. Metodología Se estableció una muestra conformada por 235 estudiantes que regularmente utilizan los comedores universitarios; de este estudio el 53% eran mujeres y el 47% hombres. Para esto se tomó como dimensión un estudio comprendido entre el periodo julio de 2013 a marzo de 2014. Resultados Entre los principales resultados se determinó que existió una prevalencia de malnutrición de 28,1%, en donde se evidenció una mayor presencia de exceso de peso (22,1%) que de déficit (6,0%); estos datos fueron más críticos para los hombres, con un 34,2% frente al 22,6% de las mujeres. Conclusión Los resultados de sobrepeso y obesidad encontrados en los estudiantes universitarios ecuatorianos fueron de 18,3% y 3,8%, respectivamente, inferiores que los reportados para el país, en la Encuesta Nacional de Salud y Nutrición en 2013.(AU)

ABSTRACT Objective To evaluate the nutritional status of undergraduate university students aged between 19 and 24 years, from the Universidad Central de Ecuador (UCE) and the Universidad Tecnológica de Ecuador (UTE) of Quito, according to the body mass index (BMI) and using anthropometric indicators. Materials and Methods A sample was established consisting of 235 students who regularly use university canteens (53% women; 47% men). The study was carried out between July 2013 and March 2014. Results A prevalence of malnutrition was found in 28.1% of the sample, evidencing a higher percentage of overweight (22.1%) than of low weight (6.0%). These data were more critical in men (34.2%) than in women (22.6%). Conclusion Overweight and obesity in Ecuadorian university students were 18.3% and 3.8%, respectively, which is lower than the figures reported for the country in the National Health and Nutrition Survey.(AU)

RESUMO Objetivo Avaliar o estado nutricional de estudantes universitários de graduação com idade entre 19 e 24 anos, da Universidad Central de Ecuador (UCE) e da Universidad Tecnológica de Ecuador (UTE) de Quito, segundo o índice de massa corporal (IMC) e por meio de indicadores antropométricos. Materiais e métodos Estabeleceu-se uma amostra de 235 alunos que frequentam regularmente cantinas universitárias (53% mulheres; 47% homens). O estudo foi realizado entre julho de 2013 e março de 2014. Resultados Foi encontrada prevalência de desnutrição em 28,1% da amostra, evidenciando maior percentual de sobrepeso (22,1%) do que de baixo peso (6,0%). Esses dados foram mais críticos nos homens (34,2%) do que nas mulheres (22,6%). Conclusão O sobrepeso e a obesidade em estudantes universitários equatorianos eram de 18,3% e 3,8%, respectivamente, o que é inferior aos dados relatados para o país na Pesquisa Nacional de Saúde e Nutrição.(AU)

Factores asociados a la lactancia materna en mujeres de un municipio colombiano / Breastfeeding determinants in women of a Colombian municipality

Introducción: la lactancia materna es una de las estrategias más costo-efectivas para disminuir la morbimortalidad infantil. UNICEF afirma que la lactancia materna exclusiva en la población infantil mundial fue 38%. La Encuesta Nacional de Demografía y Salud reportó que Caldas-Risaralda-Quindío tienen la menor duración de Lactancia materna en Colombia, y la Lactancia materna Exclusiva en Risaralda es de 2.1 meses. Identificar los factores que determinaron la adherencia y el abandono de la lactancia materna en madres de dos comunidades de Dosquebradas, Colombia y el papel del profesional de la salud. Métodos: estudio de corte transversal sobre una muestra de 117 madres a quienes se aplicó una encuesta que indagó por aspectos biopsicosociales que impactan sobre la lactancia materna. Resultados: la duración de la lactancia materna exclusiva tuvo una mediana de 5 meses y la complementaria una mediana de 10 meses La principal causa de adherencia fue “es el alimento ideal” (27,9%) y de abandono fue “poca producción de leche” (58,1%). Los factores que impactaron significativamente la duración la lactancia materna exclusiva fueron la ocupación de la madre, incomodidad al lactar, uso de sucedáneos de la leche y tiempo de lactancia materna complementaria. El rol del profesional de salud no impactó la duración de la lactancia materna. Conclusiones: existe una amplia brecha entre lo recomendado por la Organización Mundial de la Salud y lo practicado por las comunidades.

Introduction: breastfeeding is one of the most cost-effective strategies to decrease infant morbidity and mortality. UNICEF affirms that exclusive breastfeeding is 38 % for infant world population. The Encuesta Nacional de Demografía y Salud reported that Caldas-Risaralda-Quindío have the shortest breastfeeding periods in Colombia, and exclusive breastfeeding periods averaging 2.1 months in Risaralda. Identify the factors that influence adherence and abandonment of breastfeeding, and the role of health care professionals, in mothers of two Colombian communities. Methods: it is a cross-sectional study on a representative sample of 117 mothers who completed a survey of biopsychosocial aspects that have an impact on breastfeeding. Results: a median of 5 months of exclusive breastfeeding and a median of 10 months of total breastfeeding was found. The main adherence reason was “it’s the ideal food” (27,9 %) and the main abandonment reason was “low milk supply” (58,1 %). It became clear that mother’s occupation, breastfeeding discomfort, use of breast-milk substitutes and complementary feeding duration, significantly impacts on exclusive breastfeeding duration. The role of health care professional didn’t impact on the breastfeeding time. Conclusions: there is a huge gap between the World Health Organization recommendations and the practice of the community.

Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial

Background: Iron deficiency and iron-deficiency anaemia are associated with oxidative stress, but their role is largely unclear. Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans.

Aims: This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin, and decreasing oxidative stress among iron-deficient female adolescents in Gaza, Palestine.

Methods: A total 131 iron-deficient female adolescents were recruited and allocated randomly into 3 different groups. The iron supplementation group [A] received 200 mg of ferrous fumarate weekly during the 3-month intervention, the iron supplementation with nutrition education group [B] received iron supplements with nutrition education sessions, and the control group [C] did not receive any intervention. The levels of haemoglobin, ferritin and malonyl dialdehyde were measured at baseline, after 3 months [at which point the intervention was stopped], and then 3 months later. Trial registration number: ACTRN12618000960257.

Results: Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage [3 months after stopping the intervention], iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased. In Group A, haemoglobin, ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention. No changes were seen in Group C.

Conclusions: A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine

Isotonic sports drink promotes rehydration and decreases proteinuria following karate training / Suplemento hidroeletrolítico favorece reidratação e diminui proteinúria pós-treino em atletas karate

Abstract Introduction: Adequate hydration status in the sport is essential for good health, yet the relationship between hydration, proteinuria and sports is little studied. Objective: To analyze the influence of an isotonic sports drink as rehydration strategy on the hydration status and proteinuria after karate training. Methods: Ten athletes participated in this study. In the first session of standard training, called observation training session (STO), the athletes hydrated themselves according to their habits, and in the second session of standard training, called nutritional intervention training session (STIN), an ideal practice of hydration protocol was followed, using an isotonic sports drink as a rehydration liquid during the training. The hydration status was verified by monitoring the body weight before and after training, the urine specific gravity pre-and post-training and the urine volume post-training. To observe the influence of practice of hydration on the renal function post exercise proteinuria was measured. Results: We observed a statistically significant difference in urine density between the samples pre- and post-exercise only on STIN (p = 0.047). When we compare the sessions, there was a lower variation in body weight (p = 0.011) and higher urinary volume (p < 0.001), on nutritional intervention training. In STO, there was a higher percentage of athletes who showed proteinuria (70%) compared to the STIN (50%) in the urine sample after training. Conclusion: The use of isotonic sports drink as practice of hydration by karate athletes promoted rehydration during one session of training and reduce post-training proteinuria.

Resumo Introdução: Um adequado estado de hidratação durante a atividade esportiva é essencial para a manutenção da boa saúde, porém a relação entre hidratação, proteinúria e esportes é pouco estudada. Objetivo: analisar a influência de suplemento hidroeletrolítico (bebida esportiva isotônica) como estratégia de reidratação sobre o estado de hidratação e proteinúria após treino de Karate. Métodos: Dez atletas participaram deste estudo. Na primeira sessão de treino padronizado, denominada sessão de treino de observação (STO), os atletas se reidrataram segundo seus hábitos; na segunda sessão de treino padronizado, denominada sessão de treino de intervenção nutricional (STIN), foi seguido um protocolo ideal de prática de hidratação, utilizando-se de suplemento hidroeletrolítico como líquido reidratante durante o treino. O estado de hidratação foi verificado pelo monitoramento do peso corporal antes e após o treino, pela gravidade específica da urina pré e pós-treino e pelo volume urinário pós-treino. De forma a observar a influência da prática de hidratação sobre a função renal, a proteinúria pós-exercício foi medida. Resultados: Observou-se uma diferença estatisticamente significativa na densidade urinária entre as amostras coletadas pré e pós-exercício apenas na STIN (p = 0,047). Quando comparados entre sessões, houve menor variação ponderal (p = 0,011) e maior volume urinário (p < 0,001) no treino com intervenção nutricional. Na STO, houve um percentual mais elevado de atletas que apresentaram proteinúria (70%) em comparação a STIN (50%) na amostra de urina coletada após o treino. Conclusão: O uso de suplemento hidroeletrolitico como prática de hidratação por atletas de karate favoreceu a reidratação durante uma sessão de treino e reduziu a proteinúria pós-treino.

Implementation of a peer-mediated health education model in the United Arab Emirates: addressing risky behaviours among expatriate adolescents

Tobacco use among young people is increasing in the United Arab Emirates, and the country is ranked 15th in the world for prevalence of type II diabetes. Expatriates comprise a majority of the population, making them an important subset to study. We aimed to test whether an educational intervention would be effective in this cultural setting. We designed 2 peer-to-peer health workshops: tobacco use and nutrition/physical activity. One workshop was randomly assigned to 18 classrooms in private schools in Abu Dhabi. Surveys were administered before and after the workshops to assess intervention effectiveness. The tobacco workshop significantly improved responses [P < 0.05]. The nutrition and physical activity workshop resulted in decreased satisfaction with personal activity levels. This study provides evidence to support the national adoption of a peer-to-peer health education model as an intervention for tobacco use but not for nutrition and physical activity choices

Nutritional knowledge and habits of adolescents aged 9 to 13 years in Sharjah, United Arab Emirates: a crosssectional study

Good nutritional knowledge and behaviour among adolescents is important to avoid health problems that can continue into adulthood. This cross-sectional study aimed to provide baseline data on nutritional knowledge and eating habits of adolescents in Sharjah. Data were collected from 300 adolescents aged 9-13 years attending 4 private schools using a validated self-administered questionnaire. Most students [86%] had poor nutritional knowledge, especially in key areas: nutritional terms, what constitutes healthy snacks and foods, daily nutritional requirements and components of food [e.g. fibre, fat, sugar]. Only 34% of the students had healthy eating behaviour: 33% had eaten none or 1 vegetable only in the previous week, 25% had eaten unhealthy snacks 3 or more times, 19% had eaten frequently or daily at fast food outlets, and 36% had skipped breakfast frequently or daily. Culturally-specific, school-based educational interventions are warranted to build sound nutritional knowledge among adolescents and motivate the diet and behaviour changes needed to promote health throughout the lifespan

Social portrayal of nourishment and repercussions in nutritional habits of pregnant adolescents / Representações sociais da alimentação e suas repercussões no comportamento alimentar de gestantes adolescentes

The aim of this study was to analyze the impact of social repercussions in nutritional habits of pregnant adolescents conducted by a Primary Health Care Unit in the county of Sobral, Ceará. Using a qualitative approach, exploratory and descriptive, the data was collected through semi-structured interviews at the homes of 15 pregnant adolescents in 2014. Using the material obtained from the thematic perspective, the core issues were analyzed: the nutritional habits during pregnancy; myths/taboos, and intrinsic changes of pregnancy. Changes were observed in nutritional habits related to regularity in meal times and the consumption of fruits and vegetables. During the speeches there was the valorization about proper nourishment, however, the consumption of high-calorie foods coexists. Regarding the myths/taboos, they indicated the existence of 'strong' and 'weak' foods and the need to 'eat for two'. It can be determined that the intrinsic change can interfere with nutrition. It was evident that their beliefs permeated during pregnancy, bringing repercussions in eating behavior, and that health professionals should understand the context experienced by pregnant adolescents, in order to provide adequate care.

O objetivo desse trabalho foi analisar as repercussões das representações sociais no comportamento alimentar de gestantes adolescentes acompanhadas por uma Unidade Básica de Saúde no município de Sobral-Ceará. Com abordagem qualitativa, do tipo exploratório descritivo, a coleta de dados ocorreu por meio de entrevista semiestruturada no domicílio de 15 gestantes adolescentes, em 2014. Analisou-se o material obtido com a técnica de análise temática, construindo-se os temas centrais: as práticas alimentares na gestação; mitos/tabus e alterações intrínsecas da gestação. Foram verificadas alterações nas práticas alimentares relacionadas à regularidade nos horários das refeições e o consumo de frutas e verduras. Houve nos discursos a valorização da boa alimentação, no entanto, o consumo de alimentos calóricos coexiste. Com relação aos mitos/tabus, destacaram-se a existência de alimentos fortes e fracos e a necessidade de comer por dois. Pode-se identificar que as alterações intrínsecas interferiram na alimentação. Ficou evidente que as crenças permeadas na gestação trazem repercussões no comportamento alimentar, e que os profissionais de saúde devem compreender o contexto vivenciado pelas gestantes adolescentes, a fim de prestar um adequado atendimento.

Consumo alimentar de magnésio, potássio e fósforo por adolescentes de uma escola pública / Intake of magnesium, potassium and phosphorus in diets for adolescents of a government-run school

O presente estudo, do tipo transversal, teve como objetivo avaliar o consumo alimentar de magnésio, potássio e fósforo por 207 adolescentes do sexo feminino e masculino, com faixa etária de 15-17 anos, de uma escola pública de Petrolina - Pernambuco. As atividades foram iniciadas com a coleta dos dados alimentares por meio do Recordatório 24hrs; para a quantificação dos minerais foram utilizadas a tabela de medidas caseiras, a tabela brasileira de composição de alimentos e a tabela de composição nutricional dos alimentos consumidos no Brasil. Para comparar a ingestão destes minerais segundo sexo e faixa etária, utilizou-se as recomendações dispostas pelas DRIs. Com relação ao consumo mediano, apenas os adolescentes do sexo masculino apresentaram consumo de fósforo acima do recomendado. Os percentuais de inadequação foram elevados em ambos os sexos, principalmente para o consumo de magnésio (96,2% e 96%) e potássio (100% e 98,7%). O percentual de inadequação de fósforo apresentou-se superior para os meninos (67,6%) em relação ao sexo feminino (41,4%). O baixo consumo destes minerais pode levar ao comprometimento futuro do estado nutricional desta população; portanto, é de extrema importância o desenvolvimento de intervenções objetivando a melhora do comportamento alimentar.

Current transversal study evaluated the intake of magnesium, potassium and phosphorus by 207 female and male adolescents, within the 15 ­ 17 years bracket, of a government-run school in Petrolina PE Brazil. Food data were collected by a 24-h food record. Food-measurement table, the Brazilian table for food compositions and nutrition composition of food consumed in Brazil were employed to quantify the minerals. Recommendations by DRIs were used to compare ingestion of minerals according to gender and age bracket. In the case of median intake, only males presented phosphorus intake above the recommended dose. Inadequate percentages were high for both genders, especially in the intake of magnesium (96.2% and 96%) and potassium (100% and 98.7%). Phosphorus inadequacy percentage was higher for males (67.6%) when compared to that of females (41,4%). Low intake of the minerals may compromise the nutritional state of the population under analysis. Interventions are highly important for an improvement in food intake behavior.

Factores que influyen en la falta de adherencia de la suplementación de micronutrientes en niños de 6 a 35 meses en el P.S. Punchauca Carabayllo-2015 / Factors that influence in the non-adherence of the micronutrient supplementation in children 6 to 35 months at the P.S. Punchauca, Carabayllo-2015

La prevalencia de anemia por carencia de hierro ocurre en niños menores de 3 años de edad, según datos del Instituto Nacional de Salud es muy poco el porcentaje que cumplen su tratamiento para dicha enfermedad, lo que significa que una importante proporción de nuestros niños van a tener problemas en su desarrollo cognoscitivo y psicomotor. Por tal razón, la Organización Panamericana de Salud (OPS) y la OMS han propuesto diferentes estrategias para disminuir la cifra de casos de deficiencia de hierro y de anemia, una de ellas es la suplementación con micronutrientes. Estos micronutrientes son utilizados para contribuir a la reducción de la prevalencia de anemia por deficiencia de hierro en niños menores de 36 meses de edad y a la protección del estado de salud y el desarrollo infantil temprano de este grupo poblacional. El presente estudio ôFactores que influyen en la falta de adherencia de la suplementación de micronutrientes en niños de 6 a 35 meses en el P.S. Punchaucaõ, tiene como objetivo determinar los factores que influyen en la falta de adherencia de la suplementación de micronutrientes de los niños. El presente estudio fue de tipo cuantitativo, nivel aplicativo, método descriptivo y de corte transversal; la muestra fue seleccionada a través de un muestreo aleatorio simple; el tamaño de la muestra fue de 57 madres de niños de 6 a 35 que reciben suplementación con micronutrientes. La técnica que se utilizó fue la entrevista, y como instrumento, un cuestionario. Los resultados fueron: del 100 por ciento (57) de madres encuestadas, el 59.6 por ciento (34) de madres mencionó que son los factores personales del cuidador son aquellos que influyen en la falta de adherencia de la suplementación de micronutrientes en sus niños, el 45.6 por ciento (26) de madres refiere que se encuentra presente los factores relacionados con el régimen terapéutico, el 38.6 por ciento (22) se encuentra presente los factores institucionales, sin embargo en un porcentaje...

The prevalence of anemia iron deficiency occurs in children under 3 years of age, according to the National Institute of Health is very little the percentage who meet treatment for the disease, which means that a significant proportion of our children go to have problems in their cognitive and psychomotor development. For this reason, the Pan American Health Organization (PAHO) and WHO have proposed different strategies to reduce the number of cases of iron deficiency and anemia, one of them is multimicronutrient supplementation. This multi-micronutrient is used to help reduce the prevalence of iron deficiency anemia in children under 36 months of age and the protection of the health and early childhood development of this population group. This study ôFactors influencing non-adherence micronutrient supplementation in children aged 6-35 months in the P.S. Punchaucaõ, it aims to determine the factors that influence non-adherence of micronutrient supplementation children. This study was quantitative, application level, descriptive method and cross section; the sample was selected through a simple random sampling; the sample size was 57 mothers of children aged 6 to 35 who receive micronutrient supplementation. The technique used was the interview, and as an instrument, a questionnaire. The results were: 100 per cent (57) of mothers surveyed, 59.6 per cent (34) of mothers mentioned that are personal factors are those that influence non-adherence of micronutrient supplementation in their children, 45.6 per cent (26) of mothers concerned that factors related to the therapeutic regimen is present, 38.6 per cent (22) institutional factors is present, however, in a significant percentage of 70.2 per cent (40) of mothers mentioned that is absent factor associated with the health team. As to personal factors, forgetfulness with 84.2 per cent (48) is the personal factor that influences the lack of adherence to micronutrient supplementation followed by distrust of the...

Evaluation of nutritional status of school-age children after implementation of "Nutrition Improvement Program" in rural area in Hunan, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the nutritional status of school-age children in rural area in Hunan, China from 2012 to 2015 and to evaluate the effectiveness of the "Nutrition Improvement Program for Compulsory Education Students in Rural Area" (hereinafter referred to as "Nutrition Improvement Program").</p><p><b>METHODS</b>The nutritional status of school-age children aged 6-14 years was evaluated after the implementation of the "Nutrition Improvement Program" and the changing trend of the children's nutritional status was analyzed. The statistical analysis was performed on the monitoring data of the school-age children aged 6-14 years in rural area in Hunan, China from 2012 to 2015, which came from "The Nutrition and Health Status Monitoring and Evaluation System of Nutrition Improvement Program for Compulsory Education Students in Rural Area".</p><p><b>RESULTS</b>In 2015, female students aged 6-7 years in rural area in Hunan, China had a significantly greater body length than the rural average in China (P<0.05). However, the other age groups had significantly smaller body length and weight than the rural averages in China (P<0.05). After the implementation of "Nutrition Improvement Program", the prevalence rate of growth retardation decreased (P<0.05), but the prevalence rate of emaciation increased (P<0.05). At the same time, the prevalence rate of overweight/obesity increased (P<0.05) and the prevalence rate of anemia decreased (P<0.05).</p><p><b>CONCLUSIONS</b>The implementation of "Nutrition Improvement Program" has achieved some success, but the nutritional status of school-age children has not improved significantly. Overweight/obesity and malnutrition are still present. Therefore, to promote the nutritional status of school-age children it is recommended to improve the measures for the "Nutrition Improvement Program".</p>

Nutrition in Chinese-Korean Children and Adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China.</p><p><b>METHODS</b>Data were obtained from the Chinese National Survey on Students' Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years. The number of the subjects included was 4789, 4704, 5875, and 5315, respectively.</p><p><b>RESULTS</b>The rate of the occurrence of stunting showed a declining trend from 1995 to 2010 (for boys: urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls: urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010). Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased (for boys: urban, 7.3% and 1.3% in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls: urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4% and 7.4% in 2010, respectively).</p><p><b>CONCLUSION</b>The ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.</p>