Food security and fruit and vegetable consumption among preschoolers: an exploratory study during the COVID-19 pandemic

Studies that assess food insecurity and its association with the consumption of fruits, legumes, and vegetables (FLV) can help identify groups and risk factors of inadequate food consumption, in order to propose assertive nutritional interventions. The aim of this study was to describe FLV consumption by children in different food security situations. This is an exploratory cross-sectional study, conducted with parents/guardians of 44 children from zero to four years old. The short version of the Brazilian Food Insecurity Scale and a Food Frequency Questionnaire were applied to parents/guardians via a telephone interview. The children were 2.6 years old on average, 56.8% were female, 67.5% were eutrophic, and 70.5% of the families were in a situation of food insecurity. For households in a situation of food security, the median consumption of FLV was 213.4 g/day (P25=97.89;P75=425.91). As for those in a situation of food insecurity, the median FLV was 105.4 g/day (P25=33.58;P75=205.16). It was concluded that the consumption of FLV by children from families in a situation of food security is higher than that of children in a situation of food insecurity, who are strongly influenced by the offer of cheap food with low nutritional quality. Public policies are needed to favor the guarantee of access to FLV of quality and at an affordable cost for all families.

Efficacy and safety of high-flow nasal cannula therapy in elderly patients with acute respiratory failure.

INTRODUCTION: To assess the efficacy and safety of high-flow nasal cannula (HFNC) in elderly patients with acute respiratory failure (ARF) not due to COVID-19, refractory to treatment with conventional oxygen therapy and/or intolerant to noninvasive ventilation (NIV) or continuous positive airway pressure (CPAP) and without criteria for admission to intensive care units (ICU). METHODS: Prospective observational study of patients with ARF treated with HFNC who presented clinical and arterial blood gas deterioration after 24 h of medical treatment and oxygenation by conventional systems. The degree of dyspnoea, gas exchange parameters (arterial O2 pressure/inspired O2 fraction ratio (PaO2/FiO2); oxygen saturation measured by oximetry/ inspired fraction of oxygen (Sp02/Fi02), ROX index), degree of patient tolerance and mortality were evaluated. These were measured at discharge from the emergency department (ED), 24 h after treatment with conventional oxygenation and 60, 120 min and 24 h after initiation of HFNC. The results were analyzed for all patients as a whole and for patients with hypercapnia (arterial carbon dioxide tension (PaCO2) < 45 mmHg) separately. RESULTS: 200 patients were included in the study between November 2019 and November 2020, with a mean age of 83 years, predominantly women (61.9%), obese (Body Mass Index (BMI) 31.1), with high comorbidity (Charlson index 4) and mild-moderate degree of dependence (Barthel 60). A number of 128 patients (64%) were hypercapnic. None had respiratory acidosis (pH 7.39). Evaluation at 60 min, 120 min and 24 h showed significant improvement in all patients and in the subgroup of hypercapnic patients with respect to baseline parameters in respiratory rate (RR), dyspnoea, ROX index, PaO2/FiO2, SpO2/FiO2 and patient comfort. No changes in PaCO2 or level of consciousness were observed. HFNC was well tolerated. Ten patients (5%) died due to progression of the disease causing ARF. CONCLUSIONS: HFNC is an effective and safe alternative in elderly patients with ARF not due to COVID-19, refractory to treatment with conventional oxygen therapy and/or intolerant to NIV or CPAP and without criteria for admission to ICU.