Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Polyunsaturated Fatty Acids: Health Impacts.

In order to encourage discussions on "polyunsaturated fatty acids" and health, the Brazilian branch of the International Life Sciences Institute (ILSI) promoted the XII International Workshop Series on Foods with Functional Properties and/or Health Claims (28-29 November 2013) which consolidated knowledge, presented scientific advances, and promoted exchange of experiences on "Polyunsaturated Fatty Acids: Health Impacts". Various topics were addressed at this meeting including: nutritional needs and consumption issues; impact on chronic diseases: cardiovascular diseases and cancer; influence on gene expression; immunological system and inflammation; sources of these fatty acids; benefits during pregnancy and childhood; cost and benefit of supplementation; and regulations (legislation). In general terms, the event presented evidence of the benefit of polyunsaturated fatty acids on cardiovascular diseases, pregnancy, breastfeeding, and infant development, as well as possible influence on gene expression, contributing to their relationship with the immunological system and, therefore, inflammatory processes. The recommendations of consumption and/or supplementation with these fatty acids are specific to particular groups and still require further studies. With respect to regulations in terms of legislation, each country/authority recommends different content properties and/or health claims. The event generated prospects for research fields, development, and regulation of polyunsaturated fatty acids in the scientific community and industries.

Mecanismos de ação de compostos bioativos dos alimentos no contexto de processos inflamatórios relacionados à obesidade: [revisão] / Effects of dietary bioactive compounds on obesity induced inflammation: [review]

É indiscutível o papel da dieta e dos alimentos na manutenção da saúde e na redução do risco de DCNT. Estudos epidemiológicos mostram que o aumento do consumo de alimentos de origem vegetal influencia positivamente a saúde, enquanto estudos in vitro e in vivo em modelo animal elucidam os mecanismos pelos quais compostos bioativos não nutrientes, presentes nos alimentos, atuam na manutenção da saúde e na redução do risco de doenças. A modulação da expressão de genes que codificam proteínas envolvidas em vias de sinalização celular ativadas em DCNT é um dos mecanismos de ação dos compostos bioativos, sugerindo que estes possam ser essenciais à manutenção da saúde. A biodisponibilidade dos compostos bioativos de alimentos, as suas rotas metabólicas e o modo de ação de seus metabólitos são importantes fatores no seu efeito nas DCNT. Todos esses aspectos são temas de investigações recentes, cujos resultados contribuem para a compreensão da ocorrência e desenvolvimento das DCNT e da sua relação com a dieta. Essa revisão visou discutir alguns dos mecanismos envolvidos na resposta inflamatória induzida pela obesidade, apresentar os compostos bioativos de alimentos que modulam essa resposta inflamatória e sua relação com o metabolismo desses compostos.

It is largely accepted the important role of food and feeding habits on health maintenance and development of non transmissible chronic diseases (NTCD). Epidemiologic evidences show that increasing vegetable consumption positively impacts health. On the other hand, in vivo and in vitro studies in animals show that non-nutrient bioactive food substances partly explain the role of food on the maintenance of health and on the risk reduction of these diseases. The modulation of gene expression of proteins that are involved in the cellular signaling pathways of NTCD is an important mechanism of the bioactive food substances, indicating their importance in disease prevention. Bioavailability, metabolic routes and the action of the resultant metabolites of bioactive food compounds are important aspects that may affect NTCD. All these aspects have actively been investigated in the last years and resulted in a greater understanding of the beginning, progression and prevention of NTCD. This review aimed at discussing the involved mechanisms of the inflammatory response induced by obesity and the role of bioactive food compounds in modulating such response.

Haematological alterations in protein malnutrition

Desnutrição protéico-calórica (DPC) é geralmente encontrada em crianças, idosos, pacientes com neoplasias ou doenças crônicas, pacientes submetidos à quimioterapia ou à nutrição parenteral. A DPC apresenta uma variedade de sinais e sintomas que são um resultado não apenas da(s) causa(s) que provocam a desnutrição, mas também de diferentes graus de deficiência de proteínas e carboidratos. Nesta revisão, nós apresentamos resultados a partir de estudos epidemiológicos observacionais e experimentais, que evidenciam que indivíduos desnutridos freqüentemente apresentam uma maior susceptibilidade para infecções com índices elevados de morbidade e mortalidade. Dados obtidos a partir da literatura e do nosso grupo evidenciam que a desnutrição modifica os processos de defesa do organismo, prejudicando órgãos linfo-hematopoéticos e alterando a resposta imune. As alterações hematológicas na desnutrição, tais como leucopenia e hipoplasia, foram descritas, com ênfase em relação aos resultados em desnutrição protéica experimental obtidos pelo nosso grupo, especialmente as alterações estruturais e ultra-estruturais da medula, baço e timo; alterações funcionais, como a redução da migração celular, da capacidade de espraiamento, da fagocitose, da atividade bactericida e fungicida, bem como alterações na produção de espécies reativas de oxigênio. As implicações das modificações do ambiente hematopoético em estados de desnutrição são ainda obscuras, contudo, parecem ser responsáveis pela hematopoese ineficiente, especialmente pela mielopoese ineficiente, e parecem ser irreversíveis em curto período de tempo.