Cardiometabolic risk assessment: A school-based study in Brazilian adolescent.

BACKGROUND AND AIMS: Recently, new indices combining routine and low-cost anthropometric and biochemical measurements have emerged. Among them, the visceral adiposity index (VAI) and lipid accumulation product (LAP) are being investigated for the prediction of altered blood pressure (BP) and insulin resistance (IR). Therefore, this study aimed to evaluate whether visceral adiposity index (VAI) and height-corrected lipid accumulation product (HLAP) are predictors of cardiometabolic risk in Brazilian adolescents. METHODS AND RESULTS: Data were obtained from the Cardiovascular Risk in Adolescents (ERICA) study, a cross-sectional, national, multicenter, school-based survey conducted between 2013 and 2014 in Brazil. The sample consisted of 37,815 adolescents aged 12-17 years of both genders attending the last 3 years of elementary or secondary school from public and private schools located in 273 municipalities with more than 100,000 inhabitants. A Poisson regression was performed to verify associations between VAI and HLAP indices and the presence of altered BP and IR according to sex. In addition, receiver operating characteristic curve (ROC) analysis was applied to compare the predictive ability and determine the cut-off points of the VAI and HLAP indices in identifying cardiometabolic risk obtained by altered BP and IR. The prevalences of altered BP and IR were 24.49 % (95 % confidence interval [CI]: 23.14-25.87) and 24.22 % (95 % CI: 22.70-25.80), respectively. CONCLUSIONS: The VAI and HLAP indices are good predictors of cardiometabolic risk in Brazilian adolescents. HLAP showed better performance in identifying insulin resistance in males.

Effect of Nuts on Markers of Inflammation and Oxidative Stress: A Narrative Review.

Oxidative stress and inflammation are mediators in the pathophysiology of several non-communicable diseases (NCDs). Tree nuts and peanuts lower risk factors of cardiometabolic disease, including blood lipids, blood pressure and insulin resistance, among others. Given their strong antioxidant/anti-inflammatory potential, it is plausible that nuts may also exert a favorable effect on inflammation and oxidative stress. Evidence from systematic reviews and meta-analyses of cohort studies and randomized controlled trials (RCTs) suggest a modest protective effect of total nuts; however, the evidence is inconsistent for specific nut types. In this narrative review, the state of evidence to date is summarized for the effect of nut intake on biomarkers of inflammation and oxidative stress, and an attempt is made to define the gaps in research while providing a framework for future research. Overall, it appears that some nuts, such as almonds and walnuts, may favorably modify inflammation, and others, such as Brazil nuts, may favorably influence oxidative stress. There is a pressing need for large RCTs with an adequate sample size that consider different nut types, and the dose and duration of nut intervention, while evaluating a robust set of biomarkers for inflammation and oxidative stress. Building a stronger evidence base is important, especially since oxidative stress and inflammation are mediators of many NCDs and can benefit both personalized and public health nutrition.

Power of mortality prediction in patients awaiting liver transplantation according to the Global Leadership Initiative on Malnutrition criteria and Subjective Global Assessment and Royal Free Hospital Global Assessment scores.

OBJECTIVES: This study aimed to analyze the performance of the Global Leadership Initiative on Malnutrition (GLIM) criteria and Subjective Global Assessment (SGA) and Royal Free Hospital Global Assessment (RFH-GA) scores in predicting 12-mo mortality in patients awaiting liver transplantation. METHODS: This is a longitudinal observational study, carried out between March 2019 and November 2021. Clinical data were collected and nutritional assessment was performed through anthropometry and application of validated instruments, such as the SGA, GLIM criteria, and RFH-GA. A Cox regression model was carried out, in which the dependent variable was mortality in 1 y, and the independent variables were the classifications of nutritional status by the different methods. RESULTS: The sample consisted of 126 patients, most of them male (56.35%). Malnutrition was diagnosed in 85.71% of the patients according to the RFH-GA, 62.70% according to the SGA, and 56.31% according to the GLIM criteria. Malnutrition assessed by GLIM was related to a 3.79-fold increase in the chance of mortality over time in patients awaiting liver transplantation. Moreover, the GLIM criteria had good discriminatory power in identifying mortality in patients awaiting liver transplantation, compared with the initial and final SGA and RFH-GA scores and the Model for End-stage Liver Disease-Sodium (MELD-Na) index. CONCLUSIONS: The GLIM criteria were a good predictor of increased risk of mortality in malnourished patients with chronic liver disease awaiting liver transplantation, compared with the SGA and RFH-GA scores and the MELD-Na index.

Relationship between zinc-related nutritional status and the progression of multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. OBJECTIVE: To investigate plasma and erythrocyte zinc status and its relationship to MS. METHODS: Cross-sectional study, including 98 participants, distributed in groups: case (MS, n = 49), diagnosed with MS and control (n = 49), matched by age and sex with the case group. Zinc was analyzed by flame atomic absorption spectrophotometry, and superoxide dismutase (SOD) activity by spectrophotometry. RESULTS: Mean plasma zinc was 94.6 (22.1) µg/dL for MS patients and 81.5 (31.3) µg/dL for control group, with statistical difference (p = 0.023). The mean erythrocyte zinc was 83.6 (41.6) µg/gHb for case group and 72.6 (31.5) µg/gHb for control. Erythrocyte SOD activity was above reference values, significantly different for MS patients (p = 0.003). There was a significant direct correlation between erythrocyte zinc and SOD (r = 0.835; p < 0.001). SOD showed inverse correlation with MS outbreaks (r = -0.317; p = 0.027). CONCLUSION: Patients with MS have normal plasma and elevated erythrocyte zinc. Erythrocyte zinc showed positive correlation with SOD, which correlated inversely to outbreaks.

The omission of meals is associated with excess weight in adolescents

ABSTRACT The aim of this study was to investigate the association between skipping meals and excess weight in adolescents. This study used a secondary database based on cross-sectional research. Weight and height were measured for the classification of nutritional status and the omission of meals was determined from the 24-hour food record. Statistical analyses were performed on a sample stratified by age from 10 to 13 years and 14 to 19 years. There was a high prevalence of excess weight (overweight and obesity) in the sample and a high frequency of meal omission among adolescents. The omission of lunch and dinner among adolescents between 14 and 19 years and those between 10 to 13 years, respectively, was directly associated with excess weight.

RESUMEN El objetivo de este estudio fue investigar la asociación entre omisión de comidas y condición de exceso de peso en adolescentes. Este es un estudio con datos secundarios de una investigación transversal. El peso y la altura se midieron para clasificar el estado nutricional y la omisión de las comidas se determinó a partir del registro de alimentos de 24 horas. Los análisis estadísticos se realizaron en una muestra estratificada por edad de 10 a 13 años y de 14 a 19 años. Hubo una alta prevalencia de exceso de peso en la muestra y una alta frecuencia de omisión de comidas entre los adolescentes. La omisión del almuerzo y la cena, en los rangos de 14 a 19 años y de 10 a 13 años, respectivamente, se asoció directamente con el exceso de peso.