Diagnóstico y manejo de la anemia en el embarazo: estudio comparativo en mujeres de zonas urbanas y rurales / Diagnosis and management of anemia in pregnancy: a comparative study of urban and rural women

Objetivo: Comparar el diagnóstico y manejo de la anemia durante el embarazo en mujeres de zonas urbanas y rurales. Métodos: Estudio descriptivo transversal, basado en un análisis de una encuesta nacional de salud del 2022. Se incluyeron registros de 18 889 mujeres con un embarazo en los últimos 5 años. Se estimaron frecuencias y porcentajes ponderados; además se aplicó la prueba chi cuadrado a un nivel de significancia del 0,05. Resultados: Al 94 % de mujeres se les realizó el descarte de anemia, este procedimiento fue más frecuente en zonas urbanas (94,9 %), comparado a las rurales (91,1 %). La mayor parte de las mujeres no recibió el diagnóstico de anemia, pero no hubo diferencias entre las zonas rurales (29,8 %) y urbanas (28,3 %). Respecto a la indicación y cumplimiento del tratamiento para la anemia, esto fue significativamente mayor en las parejas urbanas, con un porcentaje de 96,7 % y 65,5 %, respectivamente. Conclusión: En las zonas urbanas, fue mayor el porcentaje de mujeres en quienes se realizó descarte de anemia, así como la indicación del tratamiento y su cumplimiento. El diagnóstico de anemia no mostró diferencias entre ambas zonas(AU)

Objective: To compare the diagnosis and management of anemia during pregnancy in urban and rural women. Methods: Cross-sectional descriptive study, based on an analysis of a national health survey from 2022. Records of 18889 women with a pregnancy in the last 5 years were included. Frequencies and weighted percentages were estimated; in addition, the chi-square test was applied at a significance level of 0.05. Results: 94% of women were screened for anemia; this procedure was more frequent in urban areas (94.9%) compared to rural areas (91.1%). Most women were not diagnosed with anemia, but there was no difference between rural (29.8%) and urban (28.3%) areas. Regarding indication and adherence to treatment for anemia, this was significantly higher in urban couples, at 96.7% and 65.5%, respectively. Conclusion: In urban areas, the percentage of women of anemia ruling out, as well as treatment indication and compliance was higher. The diagnosis of anemia showed no differences between the two areas(AU)

Predicción de la valoración del recién nacido según el estado nutricional materno: modelo basado en árboles de decisión / Prediction of newborn assessment according to maternal nutritional status: a model based on decision trees

Objetivo: Determinar si es posible predecir la valoración del recién nacido según el estado nutricional materno a través de un modelo de árbol de decisión. Métodos: Estudio analítico transversal. Se revisaron 326 historias clínicas de gestantes de un hospital público peruano, 2021. Se valoró el recién nacido mediante el puntaje APGAR, edad gestacional al nacer, peso al nacer, peso y talla para la edad gestacional. El estado nutricional materno incluyó el índice de masa corporal pregestacional y la ganancia de peso gestacional. La predicción se realizó mediante un modelo de aprendizaje automático supervisado denominado "árbol de decisión". Resultados: No fue posible predecir mediante el estado nutricional materno, el puntaje APGAR al minuto y la talla para la edad gestacional. La probabilidad de tener edad gestacional a término al nacer es de 97,2 % cuando la ganancia de peso gestacional es > 5,4 Kg (p = 0,007). Las probabilidades más altas de peso adecuado al nacer fueron con ganancia de peso gestacional entre 4,5 Kg (p < 0,001) y 17 Kg (p < 0,001) y con índice de masa corporal pregestacional ≤ 36,523 Kg/m2 (p = 0,004). Finalmente, la mayor probabilidad de peso adecuado para la edad gestacional es cuando la ganancia de peso gestacional es ≤ 11,8 Kg (p < 0,001) y con un índice de masa corporal pregestacional ≤ 36,523 Kg/m2 (p = 0,005). Conclusiones: Es posible predecir la valoración del recién nacido a partir del estado nutricional materno mediante un aprendizaje automático(AU)

Objective: To determine whether it is possible to predict the assessment of the newborn according to maternal nutritional status through a decision tree model. Methods: Cross-sectional analytical study. A total of 326 medical records of pregnant women from a Peruvian public hospital were reviewed, in 2021. The newborn was assessed using the APGAR score, gestational age at birth, birth weight, weight and height for gestational age. Maternal nutritional status included pregestational body mass index and gestational weight gain. The prediction was made using a supervised machine learning model called a "decision tree." Results: The APGAR score at one minute and height for gestational age were not possible to predict by maternal nutritional status. The probability of having full-term gestational age at birth is 97.2% when gestational weight gain is > 5.4 kg (p = 0.007). The highest probabilities of adequate birth weight were with gestational weight gain between 4.5 kg (p < 0.001) and 17 kg (p < 0.001) and with pregestational body mass index ≤ 36.523 kg/m2 (p = 0.004). Finally, the highest probability of adequate weight for gestational age is when gestational weight gain is < 11.8 Kg (p < 0.001) and with a pregestational body mass index ≤ 36.523 Kg/m2 (p = 0.005). Conclusions: It is possible to predict the assessment of the newborn based on the mother's nutritional status using machine learning(AU)

Asociación de la salud cardiometabólica de preescolares y sus padres con características nutricionales y sociodemográficas familiares / Association of cardiometabolic health of preschoolers and their parents with family sociodemographic characteristics

Introducción: Existe escaso conocimiento sobre la asociación entre marcadores cardiometabólicos en preescolares con características nutricionales y sociodemográficos familiares. Objetivo: Determinar la asociación entre marcadores cardiometabólicos de preescolares y sus padres con las características nutricionales y sociodemográficas familiares. Materiales y Métodos: Estudio de corte transversal, de asociación y correlación entre variables Padre-Hijo/a de carácter multicéntrico, en el cual participaron 140 sujetos (70 preescolares y su respectivo padre o madre). Las variables fueron estado nutricional, composición corporal, fuerza prensil y presión arterial de padres/madres y sus hijos/as preescolares y variables sociodemográficas de las familias. Resultados: Existió diferencia significativa al 5% respecto de la obesidad de los padres con la de los hijos/as, se presentó correlación positiva (0,397) entre las variables "porcentaje de grasa" padres e hijos/as. En relación al "nivel de escolaridad de la madre" hubo diferencia significativa con el "porcentaje de grasa" de los hijos/as (p<0,011). Existió similarmente diferencia significativa (p=0,033) entre la variable "tener hermanos" respecto a la variable "porcentaje de grasa" de los hijos/as. Finalmente se presentó asociación entre "usa Tablet" (dispositivo audiovisual) y "presión arterial" de los hijos/as (p=0,030). La variable "usa Tablet" se asoció significativamente con la "fuerza prensil" de los hijos/as (p=0,044). Conclusiones: Padres obesos con alto porcentaje de grasa tienen hijos/as preescolares con bajo perfil cardiometabólico; las variables nivel educacional inferior de la madre y tener hermanos se asociaron a un mayor porcentaje de grasa en los hijos/as, conjuntamente el uso de Tablet en preescolares mostró mayores niveles de presión arterial y menor fuerza prensil(AU)

Introduction: Little is known about the association between cardiometabolic markers in preschoolers with family nutritional and socio- demographic characteristics. Objective: To determine the association between cardiometabolic markers in preschoolers and their parents with family nutritional and sociodemographic characteristics. Materials and methods: cross-sectional study of association and correlation between parent-child variables, multicenter, 140 subjects participated (70 preschoolers and their respective parents). The variables were nutritional status, body composition, prehensile strength and blood pressure of parents and their preschool children and sociodemographic variables of the families. Results: There was a significant difference at 5% between parents' obesity and children's obesity, with a positive correlation (0.397) between the variable "percentage of fat" parents/children. In relation to the "mother's level of schooling" there was a significant difference with the "percentage of fat" of the children (p<0.011). Similarly, there was a significant difference (p=0.033) between the variable "Having siblings" with respect to the variable "percentage of fat" of the children. Finally, there was an association between "Tablet use" (audiovisual device) and "blood pressure" of the children (p=0.030). The variable "Tablet use" was significantly associated with the "prehensile strength" of the children (p=0.044). Conclusions: Obese parents with a high percentage of fat have preschool children with a low cardiometabolic profile; the variables lower educational level of the mother and having siblings were associated with a higher percentage of fatness in children; together, the use of Tablet in preschoolers showed higher levels of blood pressure and lower prehensile strength(AU)

Social determinants and risks factors of nutrition and health during the first thousand days on human capital in low-middle-income countries / Determinantes sociales y factores de riesgo de la nutrición y salud durante los primeros mil días de vida sobre el Capital Humano en países de bajo y medio ingresos

Low- middle-income countries (LMICs) are facing challenges for reaching outstanding performance on indicators related to wellbeing during the first 1000 days of life, therefore it is expected to observe difficulties for improving their Human Capital Index (HCI). These come from the impact of inadequate antenatal care, maternal short stature, inadequate breastfeeding, prematurity, low birthweight, small for gestational age newborns, and pregnancy in adolescent years on human capital from the first thousand days of life to long term on life. Therefore, the aim of this study was to implement a non-systematic review of the existing literature between February 2000 and October 2022 using MeSH terms related to each factor. Results: in LMICs antenatal care does not meet the required goals. High rate of adolescent pregnancies, and lower maternal stature are being reported; 6.5 million newborns in LMICs are small for gestational age, 50% LBW newborns are preterm. Exclusive breastfeeding is low in LMICs: 28-70%. Survival, schooling, and health are strongly associated with growth and adult height showing the impact of the disadvantages experienced in early life over HC. We can conclude: the determinants of good health in the first 1000 days of life do not meet the goals needed to improve growth and health during this critical period of life in LMICs, leading to important obstacles for achieving adequate health conditions and reaching an optimal HCI(AU)

Los países con bajo y medianos ingresos (PBMIs) enfrentan el reto de disminuir las brechas para alcanzar las metas en los indicadores de bienestar durante los primeros 1000 días de vida, de lo contrario presentarán dificultades para mejorar los Índices de Capital Humano (ICH). El objetivo fue realizar una revisión no sistemática de la literatura reciente para abordar los problemas, brechas y omisiones dentro de los primeros 1000 días en los países PBMIs. Se utilizaron los términos MeSH relacionados con los factores de riesgo de impacto más prevalentes a corto y largo plazo: capital humano, atención prenatal inadecuada, talla baja materna, lactancia materna inadecuada, prematuridad, bajo peso al nacer, talla pequeña para la edad gestacional, embarazo adolescente para realizar una revisión descriptiva sobre el impacto de estos factores, entre febrero 2000-octubre 2022. Resultados: en PBMIs la consulta prenatal no llega a la meta sugerida y hay tasas altas de adolescentes embarazadas y baja estatura materna. 6,5 millones de recién nacidos en PBMIs con peso para la edad gestacional; 50% recién nacidos bajos para la edad gestacional son pretérminos. La lactancia materna exclusiva es baja en PBMIs: 28-70%. La supervivencia, escolaridad y salud tienen una fuerte asociación con la estatura y desarrollo del adulto, demostrando el impacto de las desventajas sobre el Capital Humano. Conclusión: los determinantes de la buena salud durante los primeros 1000 días de vida en los países PBMIs no alcanzan las metas necesarias para mejorar el crecimiento y la salud, convirtiéndose en obstáculos para alcanzar óptimos ICH(AU)

Ángulo de fase en pacientes diabéticos mellitus tipo 1 y pacientes sin diabetes mellitus tipo 1: estudio transversal / Phase angle in patients with type 1 diabetes mellitus and patients without type 1 diabetes mellitus: cross-sectional study

INTRODUCCIÓN: La bioimpedancia eléctrica, fundamentada en la resistencia de los tejidos biológicos a las corrientes eléctricas, ha emergido como una herramienta clave en la evaluación de la salud metabólica y nutricional en niños y adolescentes. En este contexto, el ángulo de fase, derivado de la bioimpedancia, se destaca como un indicador que proporciona información detallada sobre la integridad celular y la distribución del agua. OBJETIVO: Investigar la asociación del ángulo de fase con la salud celular en niños y adolescentes con Diabetes Mellitus Tipo 1 (DM1). MATERIALES Y MÉTODOS: Estudio transversal que incluyó treinta niños y adolescentes con DM1 obesos DM1 y eutrófico. RESULTADOS: Los hallazgos revelaron asociaciones no significativas entre el ángulo de fase y cambios en la salud celular y la distribución del agua en pacientes con DM1. DISCUSIÓN: A pesar de la falta de asociaciones significativas, la identificación de diferencias en la composición corporal sugiere que la bioimpedancia eléctrica y el ángulo de fase podrían ser útiles para evaluar la DM1 en niños y adolescentes CONCLUSIÓN: A pesar de no encontrarse asociaciones significativas entre el ángulo de fase y cambios en la salud celular y la distribución del agua en niños y adolescentes con DM1 en este estudio, se observaron diferencias significativas en la masa magra y el porcentaje de grasa corporal entre los grupos de pacientes. Estos hallazgos sugieren que la bioimpedancia eléctrica y el ángulo de fase podrían ser herramientas útiles para evaluar la composición corporal en esta población. Se requieren investigaciones adicionales para confirmar estos resultados y explorar más a fondo el papel del ángulo de fase en la evaluación de la DM1 en niños y adolescentes.

ABSTRACT: INTRODUCTION: Bioelectrical impedance, based on the resistance of biological tissues to electrical currents, has emerged as a key tool in assessing metabolic and nutritional health in children and adolescents. In this context, phase angle, derived from bioimpedance, stands out as an indicator that provides detailed information on cellular integrity and water distribution. OBJECTIVE: To investigate the association of phase angle with cellular health in children and adolescents with Type 1 Diabetes Mellitus (T1DM), MATERIALS AND METHODS: A cross-sectional study that included thirty children and adolescents with obese and eutrophic T1DM. RESULTS: The findings revealed non-significant associations between phase angle and changes in cellular health and water distribution in T1DM patients. DISCUSSION: Despite the lack of significant associations, the identification of differences in body composition suggests that bioelectrical impedance and phase angle could be useful for evaluating T1DM in children and adolescents. CONCLUSION: Despite not finding significant associations between phase angle and changes in cellular health and water distribution in children and adolescents with Type 1 Diabetes Mellitus (T1DM) in this study, significant differences were observed in lean mass and body fat percentage between patient groups. These findings suggest that bioelectrical impedance and phase angle could be useful tools for evaluating body composition in this population. Further research is needed to confirm these results and explore more deeply the role of phase angle in the evaluation of T1DM in children and adolescents.

Association between early childhood caries and nutritional status in children in a peruvian social program: a cross-sectional study / Asociación entre caries de la primera infancia y estado nutricional en niños de un programa social peruano: un estudio transversal

Introduction: Early childhood caries is still very prevalent, mainly in developing countries, and it is related to the quality of life of children due to early tooth loss. Objective: The study objective was to determine the association between dental caries and its clinical consequences on nutritional status in children of the "Vaso de Leche (Glass of Milk)'' social program, in Puno City, Peru, during the year 2020. Materials and Methods: An observational, descriptive-correlational, cross-sectional study; the sample consisted of 740 children between 1 and 5 years old who met the selection criteria; the clinical consequences of untreated dental caries were evaluated using the PUFA index and the prevalence of caries with def-t; the nutritional status was determined by the weight and height of the child according to protocols (NTS No. 357 - MINSA /2017/ DGIESP); the data were analyzed with the SPSS-v25 program, the association between variables was evaluated with the chi-square test, Mann-Whitney U test and Spearman's Rho test, considering significance at a p-value <0.05. Results: No significant relationship was found when dental caries was evaluated with the nutritional condition (p<0.05). However, when the def-t index values were related to the nutritional condition of the children, a significant difference was found (p<0.05). There was no significant difference with the PUFA index (p>0.05). Conclusions: There is no association between early childhood caries and nutritional status in children aged between 3 and 5 years; however, a significant relationship was found between the values of the def-t index and the nutritional status of the children.

Introducción: La caries infantil temprana sigue siendo muy prevalente, principalmente en los países en desarrollo, y está relacionada con la calidad de vida de los niños debido a la pérdida temprana de dientes Objetivo: El objetivo del estudio fue determinar la asociación entre la caries dental y sus consecuencias clínicas sobre el estado nutricional en niños del programa social "Vaso de Leche", en la ciudad de Puno, Perú, durante el año 2020. Materiales y Métodos: Estudio observacional, estudio descriptivo-correlacional, transversal; la muestra estuvo conformada por 740 niños entre 1 y 5 años que cumplieron con los criterios de selección, se evaluaron las consecuencias clínicas de la caries dental no tratada mediante el índice PUFA y la prevalencia de caries con d-t; el estado nutricional se determinó mediante el peso y talla del niño según protocolos (NTS N°357 MINSA/2017/DGIESP; los datos se analizaron con el programa SPSS-v25, la asociación entre variables se evaluó con el chi); -cuadrado, U de Mann-Whitney y Rho de Spearman, considerando significancia a un valor de p<0,05. Resultado: No se encontró relación significativa cuando se evaluó la caries dental con la condición nutricional (p<0,05). Sin embargo, cuando los valores del índice d-t se relacionaron con la condición nutricional de los niños, se encontró una diferencia significativa (p<0,05). No hubo diferencia significativa con el índice PUFA (p>0,05). Conclusión: No existe asociación entre caries de la primera infancia y el estado nutricional en niños de 3 a 5 años; sin embargo, se encontró una relación significativa entre los valores del índice d-t y el estado nutricional de los niños.

Anthropometric Characteristics, Body Composition and Nutritional Status of Younger Primary School Children in Montenegro: National Study / Características Antropométricas, Composición Corporal y Estado Nutricional de los Niños más Pequeños de la Escuela Primaria en Montenegro. Estudio Nacional

SUMMARY: This article has two aims: (a) first aim was to determine what is the most applicable and the simplest alternative for recommended BMI categories for underweight, overweight and obesity related to IOTF references, from the practical standpoint; (b) second aim was to determine the prevalence of the nutritional status in Montenegro on this representative sample of school children aged 9-13 years and compare them with peers from relevant and similar studies from both the local region and globally. A total sample of 1478 healthy children from Montenegro participated in this study divided into two sub-samples of 732 girls and 746 boys. According to the IOTF body mass index (BMI) reference values were used through ROC curve analysis to evaluate potential alternatives for estimation of the nutritional status of this sample of children. Only WHtR did not show significant age-related differences in the case of both genders. Considering the nutritional status of children from this study it has been found that boys have a considerably higher prevalence of being overweight (22.7 % vs. 16.4 %) and obese (7.5 % vs. 3.3 %) compared to girls. On the other hand, girls were more prevalent to be underweight (10.5 % vs. 7.5 %). WHtR seems like the best alternative for the estimation of obesity and being overweight due to simplicity and the equipment needed.

Este artículo tiene dos objetivos: (a) el primero fue determinar cuál es la alternativa más aplicable y más sencilla para las categorías de IMC recomendadas para bajo peso, sobrepeso y obesidad relacionadas con las referencias de la IOTF, desde el punto de vista práctico; (b) el segundo objetivo fue determinar la prevalencia del estado nutricional en Montenegro en esta muestra representativa de escolares de 9 a 13 años y compararlos con pares de estudios relevantes y similares tanto de la región local como a nivel mundial. En el estudio participaron 1478 niños sanos de Montenegro divididos en dos submuestras de 732 niñas y 746 niños. De acuerdo con el índice de masa corporal (IMC) de la IOTF, se utilizaron valores de referencia mediante análisis de curvas ROC para evaluar posibles alternativas para la estimación del estado nutricional de esta muestra en niños. Sólo el ICT no mostró diferencias significativas relacionadas con la edad en el caso de ambos sexos. Teniendo en consideración el estado nutricional de los niños, se determinó que los éstos tenían una prevalencia considerablemente mayor de sobrepeso (22,7 % frente a 16,4 %) y obesidad (7,5 % frente a 3,3 %) en comparación con las niñas. Por otro lado, las niñas tenían más prevalencia de bajo peso (10,5 % frente a 7,5 %). El WHtR parece la mejor alternativa para la estimación de la obesidad y el sobrepeso por su sencillez y equipamiento necesario.

Association between diet quality, nutritional status, and sarcopenia in people aged 80 years or older

Objective: To investigate the association between diet quality, nutritional status, and sarcopenia in a sample of the oldest old. Methods: Using a cross-sectional design, individuals aged ≥ 80 years were enrolled. To determine their energy and macronutrient intake, 24-hour dietary recall was used to calculate the Healthy Eating Index. Nutritional status was categorized based on Mini Nutritional Assessment (MNA) scores. Sarcopenia was diagnosed using both the 2010 and 2018 EWGSOP criteria. Electrical bioimpedance was used to calculate the muscle mass index. Muscle strength was measured through handgrip dynamometry, and muscle performance was determined with a 4-m gait speed test. To test the association between the HEI with sarcopenia, means of HEI scores were compared between sarcopenic and non-sarcopenic participants using indendent t-tests. Prevalence rate ratios were calculated using a Poisson Regression model with robust estimation of standard errors. Results: The study population consisted of 119 participants, predominantly women (n = 67; 56.3%), with a mean age of 83.4 (SD, 3.0) years. The prevalence of sarcopenia varied significantly according to the classification criteria, being higher according to EWGSOP 2010 than EWGSOP 2018 criteria (46.7 vs. 17.6%), as expected. Female participants and those categorized as malnourished presented higher prevalence of sarcopenia. Nutrition quality, estimated by the Healthy Eating Index, was not associated with the outcome. Reduced total energy and high protein intake were independently associated with both sarcopenia and severe sarcopenia, regardless of the diagnostic criteria. Conclusions: The Health Eating Index was not associated with sarcopenia in this sample of older adults ≥80 years. Sarcopenia prevalence, as defined by the EWGSOP 2018 criteria, was higher in those with MNA≤24 and with reduced daily total energy comsumption independently of age, sex and education attainment. Higher protein intake, oposed to expected, was indenpendently associated with sarcopenia, possibly due to protopathic bias. Large longitudinal studies are still required to investigate the relationship between nutrition quality and Sarcopenia in 80+ aged adults. (AU)

Nutritional management of muscle mass loss in patients with Post-COVID-19 Syndrome: a scoping review / Manejo nutricional na perda de massa muscular em pacientes com a Síndrome Pós-COVID-19: uma revisão de escopo

Post-Covid-19 Syndrome (PCS) is a condition that causes persistent symptoms and impacts nutritional status such as loss of muscle mass. The objective of this study was to review and map scientific evidence on nutritional management in the loss of muscle mass in patients with PCS. The scoping review protocol was prepared following the PRISMA-ScR guidelines. Review articles not written in English or those that included only hospitalized patients and pertained to conditions other than PCS were excluded. Data extraction followed the methodology outlined by the Cochrane Review Group. Of the 81 articles initially identified, only five met the inclusion criteria. The selected studies emphasized the importance of recovering muscle mass, higher protein and caloric intake, and physical strength exercises. Consequently, nutritional interventions aimed at mitigating muscle mass loss should prioritize strategies that increase caloric and protein consumption.

A Síndrome Pós-covid-19 (SPC) é uma condição que acarreta sintomas persistentes e impactam o estado nutricional, como a perda de massa. O objetivo deste estudo foi realizar revisão para mapear evidências científicas acerca do manejo nutricional na perda de massa muscular em pacientes com SPC. O protocolo da revisão de escopo foi elaborado de acordo com o PRISMA-ScR. Foram excluídos artigos de revisão que não estivessem em inglês ou português, que incluíssem apenas pacientes hospitalizados e com outras condições que não a SPC. Os dados foram extraídos com base no Cochrane Review Group. 81 artigos foram identificados e a amostra final incluiu cinco estudos. Para a recuperação da massa muscular, maior ingestão proteica, calórica e exercícios físicos de força foram descritos nos estudos. A intervenção nutricional para recuperar a perda de massa muscular deve considerar estratégias que visam o aumento do consumo calórico e proteico.

Mapping and projections of obesity in the Brazilian adult population assisted in Primary Health Care: impact of the COVID-19 pandemic / Mapeamento e projeções da obesidade na população adulta brasileira atendida na Atenção Primária à Saúde: impacto da pandemia de COVID-19

Objective: To map the temporal evolution of overweight and obesity in Brazilian adults and estimate the prevalence of obesity for 2025 and 2030, evaluating the potential impact of the COVID-19 pandemic. Method: Data were collected on the nutritional status of adults from 2008 to 2021 from the Food and Nutrition Surveillance System (SISVAN), from which we calculated the prevalence and average annual rates of the variation of overweight and obesity. The projection of obesity, using linear regression, was analyzed in three scenarios: PP: with data from the pre-pandemic period (2008-2019); outlier: with adjustment of the data trend (2008-2021), including the pandemic period, considering a return of scenario PP for projections from 2022; P: adjustment of pandemic data (2019-2021) to estimate the projection. Result: In the period 2008­2021, we observed an average annual rate of overweight increase of 0.48 %/year. The prevalence of obesity more than doubled during this period, from 14.5% in 2008 to 32.9% in 2021 (i.e., an increase of 1.42). In the outlier scenario, the prevalence projections for obesity are 38.8% and 45.5% for 2015 and 2030, respectively. In the PP scenario (without the pandemic), the expected prevalence for the same period would be approximately 36.8% and 43.4%, respectively. Conclusion: Obesity and overweight follow an increasing trend. The COVID-19 pandemic accelerated the increase in the prevalence of obesity in Brazil and impacted its projections for the coming years

Objetivo: Mapear a evolução temporal de sobrepeso e obesidade de adultos brasileiros e estimar as prevalências de obesidade para 2025 e 2030, avaliando o potencial impacto da pandemia de COVID-19. Método: Foram coletados dados do estado nutricional de adultos de 2008 a 2021 do Sistema de Vigilância Alimentar e Nutricional (SISVAN), a partir dos quais foram calculadas as prevalências e taxas médias anuais da variação de sobrepeso e obesidade. A projeção da obesidade, utilizando regressão linear, foi analisada em três cenários: PP: com dados do período pré-pandemia (2008-2019); outlier: com ajuste da endência de dados (2008-2021), incluindo o período da pandemia, considerando um retorno do cenário PP para projeções a partir de 2022; P: ajuste dos dados da pandemia (2019-2021) para estimativa da projeção. Resultado: No período de 2008 e 2021, observamos uma taxa anual média de aumento de sobrepeso de 0,48 %/ano. A prevalência de obesidade mais que dobrou nesse período, passando de 14,5% em 2008 para 32,9% em 2021 (i.e., um aumento de 1,42). No cenário outlier, as projeções das prevalências de obesidade são de 38,8% e 45,5% para os anos de 2015 e 2030, respectivamente. No cenário PP (sem a pandemia), a prevalência esperada para o mesmo período estaria em torno de 36,8% e 43,4%, respectivamente. Conclusão: A obesidade e o sobrepeso seguem uma tendência de aumento crescente. A pandemia de COVID-19 acelerou o aumento da prevalência de obesidade no Brasil e impactou a sua projeção para os próximos anos.

Fístula enterocutánea: un enfoque desde las generalidades y el estado nutricional / Enterocutaneous fistula: An approach based on generalities and nutritional status

Introducción. Una fístula es una conexión anormal entre dos superficies epitelizadas. Cerca del 80 % de las fístulas entero-cutáneas son de origen iatrogénico secundarias a cirugía, y un menor porcentaje se relacionan con traumatismos, malignidad, enfermedad inflamatoria intestinal o isquemia. La morbilidad y las complicaciones asociadas pueden ser significativas, como la desnutrición, en la que intervienen múltiples factores. Métodos. Se realizó una búsqueda de la literatura en las bases de datos de PubMed, Google Scholar y SciELO, utilizando las palabras claves descritas y se seleccionaron los artículos más relevantes de los últimos años. Resultados. La clasificación de las fístulas se basa en su anatomía, su gasto o secreción diaria y su localización. Existe una tríada clásica de las complicaciones: sepsis, desnutrición y anomalías electrolíticas. El control del gasto de la fístula, el drenaje adecuado de las colecciones y la terapia antibiótica son claves en el manejo precoz de estos pacientes. Los estudios recientes hacen hincapié en que la sepsis asociada con la desnutrición son las principales causas de mortalidad. Conclusiones. Esta condición representa una de las complicaciones de más difícil y prolongado tratamiento en cirugía abdominal y colorrectal, y se relaciona con importantes tasas de morbilidad, mortalidad y altos costos para el sistema de salud. Es necesario un tratamiento multidisciplinario basado en la reanimación con líquidos, el control de la sepsis, el soporte nutricional y el cuidado de la herida, entre otros factores.

Introduction. A fistula is an abnormal connection between two epithelialized surfaces. About 80% of enterocutaneous fistulas are of iatrogenic origin secondary to surgery, and a smaller percentage are related to trauma, malignancy, inflammatory bowel disease or ischemia. The associated morbidity and complications can be significant, such as malnutrition, in which multiple factors intervene. Methods. A literature search was carried out in the PubMed, Google Scholar and SciELO databases using the keywords described and the most relevant articles from recent years were selected. Results. The classification of fistulas is based on their anatomy, their daily secretion output, and their location. There is a classic triad of complications: sepsis, malnutrition and electrolyte abnormalities. Control of fistula output, adequate drainage of the collections and antibiotic therapy are key to the early management of these patients. Recent studies emphasize that sepsis associated with malnutrition are the main causes of mortality. Conclusions. This condition represents one of the most difficult and prolonged complications to treat in abdominal and colorectal surgery, and is related to significant rates of morbidity, mortality and high costs for the health system. Multidisciplinary treatment based on fluid resuscitation, sepsis control, nutritional support, and wound care, among other factors, is necessary.

Application of Global Leadership Initiative on Malnutrition criteria in patients with liver cirrhosis / 中华医学杂志(英文版)

BACKGROUND@#The Global Leadership Initiative on Malnutrition (GLIM) criteria were published to build a global consensus on nutritional diagnosis. Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria. However, there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings. This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition, as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.@*METHODS@#This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1, 2018, and February 28, 2022, at Beijing You-An Hospital, Capital Medical University. Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography (CT) examination during hospitalization were included in the study. These patients were randomly divided into a modeling group (cohort 1, 667 patients) and a validation group (cohort 2, 335 patients). In cohort 1, optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index (L3-SMI) were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups. Next, patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. Additionally, the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1. Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.@*RESULTS@#The optimal cut-off values of L3-SMI were 39.50 cm 2 /m 2 for male patients and 33.06 cm 2 /m 2 for female patients. Based on the cut-off values, 31.63% (68/215) of the male patients and 23.3% (28/120) of the female patients had CT-determined sarcopenia in cohort 2. The prevalence of GLIM-defined malnutrition in cirrhotic patients was 34.3% (115/335) and GLIM-defined malnutrition was an independent risk factor for in-hospital mortality in patients with liver cirrhosis ( Wald = 6.347, P  = 0.012).@*CONCLUSIONS@#This study provided reference values for skeletal muscle mass index and the prevalence of GLIM-defined malnutrition in hospitalized patients with liver cirrhosis. These reference values will contribute to applying the GLIM criteria in cirrhotic patients.

Analysis of iodine nutritional status of children aged 8-10 years in Zhejiang Province from 2016 to 2021 / 中华预防医学杂志

Objective: To analyze the iodine nutrition status of children aged 8 to 10 years in Zhejiang Province from 2016 to 2021. Methods: A multi-stage stratified sampling method was used to select non-residential children aged 8 to 10 years from 90 counties in Zhejiang Province. A total of 114 103 children were included in the study from 2016 to 2021. Direct titration method and arsenic-cerium catalytic spectrophotometry were used to detect salt iodine content and urinary iodine level, respectively, to evaluate the iodine nutritional status of children. Ultrasound was used to detect thyroid volume and analyze the current prevalence of goiter in school-age children. Results: The age of 114 103 children was (9.04 ± 0.81) years old, with 50.0% of (57 083) boys. The median of iodine content M (Q1, Q3) in children's household salt was 23.00 (19.80, 25.20) mg/kg, including 17 242 non-iodized salt, 6 173 unqualified iodized salt, and 90 688 qualified iodized salt. The coverage rate of iodized salt was 84.89%, and the coverage rate of qualified iodized salt was 79.48%. The proportion of non-iodized salt increased from 11.85% in 2016 to 16.04% in 2021 (χ2trend=111.427, P<0.001). The median of urinary iodine concentration M (Q1, Q3) in children was 182.50 (121.00, 261.00) μg/L, among which the proportions of iodine deficiency, iodine suitability, iodine over suitability, and iodine excess were 17.25% (19 686 cases), 39.21% (44 745 cases), 26.85% (30 638 cases), and 16.68% (19 034 cases), respectively. The median of urinary iodine concentration in children in inland areas [M (Q1, Q3): 190.90 (128.80, 269.00) μg/L] was significantly higher than that in children in coastal areas [M (Q1, Q3): 173.00 (113.00, 250.30) μg/L] (P<0.001). From 2016 to 2021, a total of 39 134 ultrasound examinations were conducted, and 1 229 cases of thyroid enlargement were detected. The goiter rate was 3.14% (95%CI: 2.97%-3.32%). The incidence of goiter in children in coastal areas [3.45% (95%CI: 3.19%-3.72%), 641/18 604] was higher than that in children in inland areas [2.86% (95%CI: 2.64%-3.10%), 588/20 530] (P=0.001). Conclusion: From 2016 to 2021, the iodine nutrition level of children aged 8-10 years in Zhejiang Province is generally suitable, and the rate of goiter in children meets the limit of iodine deficiency disease elimination standards.

Analysis of iodine nutritional status of children aged 8-10 years in Zhejiang Province from 2016 to 2021 / 中华预防医学杂志

Objective: To analyze the iodine nutrition status of children aged 8 to 10 years in Zhejiang Province from 2016 to 2021. Methods: A multi-stage stratified sampling method was used to select non-residential children aged 8 to 10 years from 90 counties in Zhejiang Province. A total of 114 103 children were included in the study from 2016 to 2021. Direct titration method and arsenic-cerium catalytic spectrophotometry were used to detect salt iodine content and urinary iodine level, respectively, to evaluate the iodine nutritional status of children. Ultrasound was used to detect thyroid volume and analyze the current prevalence of goiter in school-age children. Results: The age of 114 103 children was (9.04 ± 0.81) years old, with 50.0% of (57 083) boys. The median of iodine content M (Q1, Q3) in children's household salt was 23.00 (19.80, 25.20) mg/kg, including 17 242 non-iodized salt, 6 173 unqualified iodized salt, and 90 688 qualified iodized salt. The coverage rate of iodized salt was 84.89%, and the coverage rate of qualified iodized salt was 79.48%. The proportion of non-iodized salt increased from 11.85% in 2016 to 16.04% in 2021 (χ2trend=111.427, P<0.001). The median of urinary iodine concentration M (Q1, Q3) in children was 182.50 (121.00, 261.00) μg/L, among which the proportions of iodine deficiency, iodine suitability, iodine over suitability, and iodine excess were 17.25% (19 686 cases), 39.21% (44 745 cases), 26.85% (30 638 cases), and 16.68% (19 034 cases), respectively. The median of urinary iodine concentration in children in inland areas [M (Q1, Q3): 190.90 (128.80, 269.00) μg/L] was significantly higher than that in children in coastal areas [M (Q1, Q3): 173.00 (113.00, 250.30) μg/L] (P<0.001). From 2016 to 2021, a total of 39 134 ultrasound examinations were conducted, and 1 229 cases of thyroid enlargement were detected. The goiter rate was 3.14% (95%CI: 2.97%-3.32%). The incidence of goiter in children in coastal areas [3.45% (95%CI: 3.19%-3.72%), 641/18 604] was higher than that in children in inland areas [2.86% (95%CI: 2.64%-3.10%), 588/20 530] (P=0.001). Conclusion: From 2016 to 2021, the iodine nutrition level of children aged 8-10 years in Zhejiang Province is generally suitable, and the rate of goiter in children meets the limit of iodine deficiency disease elimination standards.

Fatores socioeconômicos, clínicos e nutricionais no ganho de peso interdialítico em usuários de hemodiálise / Factores socioeconómicos, clínicos y nutricionales en el aumento de peso interdialítico en usuarios de hemodiálisis / Socioeconomic, clinical and nutritional factors on interdialytic weight gain in haemodialysis users

Resumo Objetivo Avaliar os fatores associados ao ganho de peso interdialítico em usuários de serviços de hemodiálise em uma Região Metropolitana do Brasil. Métodos Estudo epidemiológico transversal envolvendo 1.024 indivíduos com doença renal crônica em hemodiálise no Brasil. O ganho de peso interdialítico foi avaliado pelo percentual de ganho de peso entre uma sessão de hemodiálise e outra. As variáveis incluídas na análise de regressão logística binária foram selecionadas considerando p< 0,10 no teste bivariado. Resultados Demonstramos que ter mais anos de estudo (OR=0,537;IC 95% = 0,310-0,931; p=0,027) e sobrepeso (OR=0,661;IC 95% = 0,461-0,948; p=0,024) ou obesidade ( OR=0,387;IC 95% = 0,246-0,608; p=<0,001) reduziu as chances de os usuários apresentarem alto ganho de peso interdialítico. Usuários sem trabalho remunerado (OR=2,025; IC 95% = 1,218-3,365; p=0,007) e que não adotavam medidas para reduzir o sal (OR=1,694; IC 95% = 1,085-2,645; p=0,020) tiveram maiores chances de ganho de peso interdialítico. Conclusão Os resultados apontam para associação entre o aumento do ganho de peso interdialítico e a ausência de trabalho remunerado e a não adoção de medidas para reduzir a ingestão de sal na dieta. Portanto, o conhecimento sobre esses fatores associados pode ser uma alternativa importante para o direcionamento individualizado dessa população.

Resumen Objetivo Evaluar los factores asociados al aumento de peso interdialítico en usuarios de servicios de hemodiálisis en una región metropolitana de Brasil. Métodos Estudio epidemiológico transversal que incluyó 1.024 individuos con enfermedad renal crónica en hemodiálisis en Brasil. El aumento de peso interdialítico se evaluó mediante el porcentaje de aumento de peso entre una sesión de hemodiálisis y otra. Las variables incluidas en el análisis de regresión logística binaria fueron seleccionadas considerando p< 0,10 en la prueba bivariada. Resultados Se demostró que tener más años de estudio (OR=0,537;IC 95 % = 0,310-0,931; p=0,027) y sobrepeso (OR=0,661;IC 95 % = 0,461-0,948; p=0,024) u obesidad ( OR=0,387;IC 95 % = 0,246-0,608; p=<0,001) redujo las chances de que los usuarios presenten un elevado aumento de peso interdialítico. Usuarios sin trabajo remunerado (OR=2,025; IC 95 % = 1,218-3,365; p=0,007) y que no adoptaban medidas para reducir la sal (OR=1,694; IC 95 % = 1,085-2,645; p=0,020) tuvieron más chances de aumento de peso interdialítico. Conclusión Los resultados señalan una relación entre el aumento de peso interdialítico y la ausencia de trabajo remunerado y la no adopción de medidas para reducir la ingesta de sal en la dieta. Por lo tanto, el conocimiento sobre estos factores asociados puede ser una alternativa importante para la orientación individualizada de esta población.

Abstract Objectives The study aimed to evaluate the factors associated with interdialytic weight gain in users of haemodialysis services in a metropolitan region of Brazil. Methods This is an cross-sectional epidemiological study with 1,024 individuals with chronic kidney disease on haemodialysis in Brazil. Interdialytic weight gain was evaluated by the percentage weight gain between one haemodialysis session and another. The variables included in the binary logistic regression analysis were selected by considering p< 0.10 in the bivariate test. Results We demonstrated that having more years of study (OR=0.537;CI 95% = 0.310-0.931; p=0.027) and be overweight (OR=0.661;CI 95% = 0.461-0.948; p=0.024) or obese (OR=0.387;CI 95% = 0.246-0.608; p=<0.001) reduced the chances of users having high interdialytic weight gain. Those who did not have paid work (OR=2.025;CI 95% = 1.218-3.365; p=0.007) and not adopting measures to reduce salt increased (OR=1.694;CI 95% = 1.085-2.645; p=0.020) increased the chances of interdialytic weight. Conclusion The results point to an association between the increase in interdialytic weight gain and the absence of paid work and the non-adoption of measures to reduce salt intake in the diet. Therefore, the need for knowledge about these associated factors can be an important alternative for the individual targeting of this population.

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

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

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

Anthropometric profile and body composition of children and adolescents with cerebral palsy on enteral diet / Perfil antropométrico e composição corporal de crianças e adolescentes com paralisia cerebral em uso de dieta enteral

ABSTRACT Objective To investigate the anthropometric variables and body composition of children and adolescents with cerebral palsy based on the type of enteral diet received. Methods A case-series study involving 38 individuals with spastic quadriparetic cerebral palsy, aged four to 18 years, fed only by the enteral route, followed up at a Reference Hospital in the city of Recife (PE), Brazil. One group received an exclusively industrialized enteral diet, while the other received a mixed diet (industrialized and homemade). Weight, stature, arm circumference, and arm muscle area were measured. Body composition was assessed using bioelectrical impedance analysis. Results There was no significant difference between the groups receiving industrialized and mixed diets, with a high stature deficit frequency (63.6% versus 68.7%; p=0.743), excess fat mass (93.3% versus 58.3%; p=0.060), and fat free mass deficit (73.3% versus 66.7%; p=1.000) observed in both groups. Regarding the nutritional composition of the enteral diet, 54.5% and 53.8% of the individuals in the industrialized and mixed diet groups, respectively, received an industrialized enteral diet with a hypercaloric, hyperlipidic, and hypoproteic nutritional composition. Conclusion It was concluded that there was no difference in anthropometric parameters and body composition based on the type of diet received. It should be considered that the nutritional composition of the most commonly used industrialized diet among the individuals in this study may have influenced the unfavorable outcomes, such as the high frequency of low muscle mass and excess fat mass. This highlights the need for the formulation and availability of an enteral diet that meets the nutritional needs of this population.

RESUMO Objetivo Investigar os parâmetros antropométricos e a composição corporal de crianças e adolescentes com paralisia cerebral em função do tipo de dieta enteral recebida. Métodos Estudo tipo série de casos, envolvendo 38 indivíduos com paralisia cerebral tetraparética espástica entre 4 e 18 anos, alimentados apenas por via alternativa, acompanhados em um Hospital de Referência em Recife, Pernambuco, Brasil. Um grupo recebia dieta enteral industrializada exclusiva e outro, dieta mista (industrializada e artesanal). Foram aferidos, peso, estatura, circunferência e área muscular do braço. A composição corporal se deu por meio da utilização de bioimpedância elétrica. Resultados Não houve diferença significante entre os grupos dieta industrializada e dieta mista, sendo constatada elevada frequência de déficit estatural (63,6% versus 68,7%; p=0,743), excesso de massa gorda (93,3% versus 58,3%; p=0,060) e déficit de massa livre de gordura (73,3% versus 66,7%; p=1,000), em ambos os grupos. Quanto à composição nutricional da dieta enteral ofertada, 54,5% e 53,8% dos indivíduos nos grupos dieta industrializada e dieta mista, respectivamente, recebiam dieta enteral industrializada de composição nutricional hipercalórica, hiperlipídica e hipoproteica. Conclusão Conclui-se que não houve diferença nos parâmetros antropométricos e na composição corporal em função do tipo de dieta recebida. Deve-se considerar que a composição nutricional da dieta industrializada mais utilizada pelos indivíduos dessa pesquisa pode ter influenciado os resultados desfavoráveis, como a elevada frequência de baixa massa muscular e excesso de massa gorda. Surgindo por sua vez, a necessidade da formulação e disponibilização de uma dieta enteral que atenda às necessidades nutricionais dessa população.

Association of nutritional status with handgrip strength in patients with chronic kidney disease / Associação do estado nutricional com a força de preensão palmar em pacientes com doença renal crônica

ABSTRACT Objective Evaluation of handgrip strength with indicators of nutritional status in chronic kidney disease patients. Methods This is a cross-sectional, descriptive study, with an analytical approach conducted at Hospital das Clínicas de Pernambuco, Recife, Brazil, between May and September 2022. Demographic, clinical, anthropometric and biochemical variables were evaluated. Individuals, males and females, were classified with low or high handgrip strength. The upper left or right limb was assessed, based on a national reference standard. Results: A total of 81 patients of both genders were included in the investigation. Their mean age was 54.69±16.03 years. According to the muscle mass index, 12.3% and 18.7% of adult and elderly patients were classified as malnourished respectively. Regarding handgrip strength (HGS), 92.4% of the participants were classified as low handgrip strength patients. These had a higher mean age (55.81±15.91), lower mean height (1.61±0.09) and reduced arm muscle circumference (23.48±4 .24), showing a statistical significance of p=0.025; 0.045 and 0.022 respectively. Conclusion It can be concluded that low handgrip strength is associated with patients' reduced muscle mass and older age, and it is suggested that handgrip strength can be used routinely in the clinical practice as a predictor of loss of lean mass in chronic kidney disease patients.

RESUMO Objetivo Avaliar a associação da força de preensão palmar com indicadores do estado nutricional em doentes renais crônicos. Métodos Trata-se de um estudo transversal, descritivo, com abordagem analítica. Realizado entre maio e setembro de 2022, no Hospital das Clínicas de Pernambuco, Recife, Brasil. Foram avaliadas variáveis demográficas, clínicas, antropométricas e bioquímicas. Os indivíduos foram classificados como baixa ou alta força de preensão palmar, segundo o sexo e o membro superior avaliado, a partir de um padrão de referência nacional. Resultados Foram incluídos 81 pacientes de ambos os sexos, com uma média de idade entre 54,69±16,03 anos. Segundo o índice de massa muscular 12,3% e 18,7% dos pacientes adultos e idosos respectivamente estavam classificados como desnutridos. Quanto à força de preensão palmar, 92,4% dos pacientes foram classificados como baixa força. Os pacientes com baixa força de preensão palmar, tinham uma maior média de idade (55,81±15,91), menor média de altura (1,61±0,09) e circunferência muscular do braço reduzida (23,48±4,24), mostrando uma significância estatística de p=0,025; 0,045 e 0,022 respectivamente. Conclusão Pode-se concluir que a baixa força de preensão palmar está associada a massa muscular reduzida e a idade elevada dos pacientes e sugere-se que a força de preensão palmar possa ser utilizada de rotina na prática clínica como preditor de perda de massa magra em pacientes com doença renal crônica.

Déterminants de l'introduction du poisson dans l'alimentation des enfants âgés de 6-23 mois en milieu urbain au Burkina Faso / NA

L'accumulation du capital humain commence dès l'enfance à travers une alimentation adéquate. Pour les pays en développement généralement caractériséspar la malnutrition infantile, la consommation du poisson constitue une opportunité pour améliorer le statut nutritionnel des enfants de 6-23 mois. Cet article vise à identifier les déterminants de l'introduction du poisson dans l'alimentation du jeune enfant. Pour y parvenir, des données ont été collectées auprès de 360 dans la la ville de Bobo-Dioulassoà travers une enquêtetransversale. Les données ont été principalement analysées à l'aide d'un modèle Logit simple. Selon les résultats, 76,9% des mères interrogées ont déjà introduit le poisson dans l'alimentation de l'enfanttandis que 43,1%ont donné du poisson au cours des 24 dernières heures précédant l'enquête. Des facteurs tels que la dépense journalière du ménage en poisson, l'âge de la mère de l'enfantet d'autres déterminantsont été identifiés comme ayant un impact significatif sur la pratique alimentaire. Les résultats obtenus plaident en faveur d'une intensification des politiques de pêche par la promotion de ce sous secteur économiqueà travers des actions de renforcement des capacités techniques, opérationnelles et institutionnelles des acteurs de la pêcheafin d'accroître l'offre nationale du poisson.En conclusion, l'étude permet de retenir que les interventions publiques de développement qui visent à améliorer les revenus des populations pauvres constituent des opportunités pour améliorer la consommation du poisson chez lesjeunes enfants.Mots clés: capital humain, poisson, enfants de 6-23 mois, Burkina Faso

The accumulation of human capital begins in childhood with adequate nutrition. For developing countries characterized by childhood malnutrition, fish consumption represents an opportunity to improve the nutritional status of children aged 6-23 months. This article aims to identify the determinants of the introduction of fish to young's children's diets. To achieve this, data was collected from 360 households in Bobo-Dioulasso through a cross-sectional survey. Data was essentially analyzed by using a simple Logit model. According to the results, 76.9% of the mothers interviewed had already introduced fish into their child's diet while 43.1% gave fish during the last 24 hours preceding the survey. Factors such as daily household expenditure on fish, age of the child's mother and other determinants were identified as having a significant impact on feeding practice. The results argue for fishing policies intensification by promoting that economic sub-sector through actions which strengthen technical, operational and institutional capacities of fishing stakeholders in order to increase the national supply of fish. , the study shows that public development development interventions aim to enhance poor population's income represent opportunities to improve fish consumption among young children.

Households' willingness to pay and associated factors for the nutrition services provided to women staying at maternity waiting homes in East Wollega, western Ethiopia

BACKGROUND: In Ethiopia, most maternity waiting homes lack government funding and rely on community contributions. However, the willingness of households to pay for nutrition services has not been widely studied. This study aimed to determine the maximum households' willingness to pay for nutrition services at maternity waiting homes and its associated factors in the East Wollega Zone of Oromia National Regional State, Ethiopia. METHODOLOGY: A community-based cross-sectional study using a double-bounded dichotomous choice contingent valuation method was conducted on 845 households. Data were entered using Epi-Data version 3.1 and analyzed with SPSS for Windows version 20. Binary and multivariable logistic regression analyses were performed. Explanatory variables with p-values less than 0.05 at a 95% confidence level were reported as significantly associated with the outcome variable using an adjusted odds ratio and confidence interval. RESULTS: The annual median maximum willingness to pay was 15 ETB (US$0.55) per household. Marital status (AOR = 3.533, 95% CI = 1.007-12.39, p-value = 0.05) and average monthly income (AOR = 3.287, 95% CI = 1.194-9.049, p-value = 0.04) were significant factors. Additionally, distance from the health facility (AOR = 3.64, 95% CI = 1.256-10.55, p-value = 0.03), availability of food (AOR = 3.714, 95% CI = 1.331-10.364, p-value = 0.05), sufficient bedding (AOR = 5.353, 95% CI = 2.207-13.010, p-value = 0.001), and cooking utensils (AOR = 4.044, 95% CI = 1.353-12.088, p-value = 0.05) at the housing facility were predictors. CONCLUSION AND RECOMMENDATION: The households' maximum willingness to pay for nutrition services at maternity waiting homes is relatively high. Demographic, socioeconomic, and institutional factors influenced households' willingness to pay. Health facility managers should ensure necessary utensils are available at maternity waiting homes to sustain the provision and utilization of services.