Food insecurity and nutritional status among older adults: a systematic review.

CONTEXT: Food insecurity (FI), characterized by difficulty or inability to access adequate food, has become a public health problem. OBJECTIVE: To analyze studies relating FI with nutritional status (NS) among older adults and the associated factors. DATA SEARCH: Articles published up to June 2020 were investigated in 5 databases: PubMed, Embase, Scopus, LILACS, and Web of Science. The search, selection, extraction, and quality evaluation were carried out by 2 reviewers. DATA EXTRACTION: The authors identified characteristics of the studies and the main data regarding the relationship of interest. RESULTS: Twenty-two studies were included in the review and their characteristics are summarized and presented using narrative synthesis. In 10 studies (45.4%), a relationship was observed between FI and malnutrition; in another 6 (27.3%), a relationship was observed between FI and being overweight. CONCLUSION: A relationship was identified between FI, especially severe forms, and malnutrition, as well as between FI, especially mild forms, and people being overweight. Thus, FI among older adults relates to a 2-fold burden of nutritional outcomes, depending on the level. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020185086.

Alcoholic beverage consumption, changes in blood pressure, and incidence of hypertension in the Longitudinal Adult Health Study (ELSA-Brasil).

OBJECTIVES: Alcohol consumption is generally associated with increased risk of hypertension. We aimed to investigate, prospectively, the effect of alcoholic-beverage consumption on blood pressure (BP) and incidence of hypertension, after a 4-y follow-up, in participants of the Longitudinal Adult Health Study (ELSA-Brasil). METHODS: We analyzed information from 3,990 participants (ages 35-74 y), men and women, from educational and research institutions, at baseline (2008-2010) and follow-up (2012-2014). Socioeconomic, hemodynamic, anthropometric, and health data were collected. Hypertension was defined as systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg and/or use of antihypertensive medication. Change in alcohol consumption (g/d) was estimated by subtracting total consumed at follow-up from total consumed at baseline, and was categorized in tertiles. RESULTS: The consumption of alcoholic beverages was associated with changes in BP and hypertension only in men. Individuals who reduced total consumption of alcohol showed a smaller increase in systolic BP (1.1 versus 2.3 mm Hg; P = 0.03) and diastolic BP (1.3 versus 2.2 mm Hg; P = 0.008) compared to individuals who increased consumption. In addition, individuals in the highest tertiles of total consumption of alcohol (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.14-2.29) and consumption of beer (OR, 1.51; 95% CI, 1.07-12.13), wine (OR, 1.71; 95% CI, 1.01-2.86), and spirits (OR, 2.01; 95% CI, 1.21-3.32) showed higher odds ratios for hypertension compared to the lowest tertile. CONCLUSIONS: Increased consumption of alcoholic beverages was positively associated with increased BP levels and higher chances of developing hypertension in men.

Sugar-sweetened soft drinks consumption and risk of hyperuricemia: Results of the ELSA-Brasil study.

BACKGROUND AND AIMS: The prospective association between sugar-sweetened beverages consumption and hyperuricemia is controversial. The aim was to investigate the association of the consumption of sugar-sweetened soft drinks and unsweetened fruit juices with the incidence of hyperuricemia and the levels of serum uric acid in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS AND RESULTS: Longitudinal analysis in ELSA-Brasil participants (baseline 2008-2010 and follow-up 2012-2014). The sample consisted of 10,072 civil servants (35-74 years, both sexes). The consumption of beverages estimated by a food frequency questionnaire (baseline) was divided into five categories: nonconsumption and quartiles (≥0.1 mL/day). Hyperuricemia was defined as uric acid ≥7.0 mg/dL (men) and ≥5.7 mg/dL (women). Poisson regression with robust variance and multiple linear regression were tested. The average consumption of soft drinks was 84 ± 191 mL/day in men and 42 ± 128 mL/day in women. After 4 years of follow-up, the higher consumption of soft drinks (men: 401 ± 303 mL/day; women: 390 ± 290 mL/day) increased the relative risk of hyperuricemia by 30% (men) and 40% (women), and was associated with increased mean uric acid (men: ß = 0.14 mg/dL; 95% CI 0.41-0.24; women: ß = 0.11 mg/dL; 95% CI 0.00-0.21). The consumption of unsweetened juice was not associated with hyperuricemia. CONCLUSION: High consumption of sugar-sweetened soft drinks is associated with an increased relative risk of hyperuricemia and elevated serum uric acid levels in Brazilian adults.

Diet and Lifestyle Changes During the COVID-19 Pandemic in Ibero-American Countries: Argentina, Brazil, Mexico, Peru, and Spain.

This study aimed to evaluate changes in dietary and lifestyle habits during the period of confinement due to the first wave of the COVID-19 pandemic in Ibero-American countries. A cross-sectional investigation was conducted with 6,325 participants of both genders (68% women), over 18 years of age and from five countries: Brazil (N = 2,171), Argentina (N = 1,111), Peru (N = 1,174), Mexico (N = 686), and Spain (N = 1,183). Data were collected during the year 2020, between April 01 and June 30 in Spain and between July 13 and September 26, in the other countries studied using a self-administered online survey designed for the assessment of sociodemographic, employment, physical activity, health status, and dietary habits changes. Most participants (61.6%), mainly those from Spain, remained constant, without improving or worsening their pattern of food consumption. Among those who changed, a pattern of better eating choices prevailed (22.7%) in comparison with those who changed toward less healthy choices (15.7%). Argentina and Brazil showed the highest proportion of changes toward a healthier pattern of food consumption. Peruvians and Mexicans were less likely to make healthy changes in food consumption (OR: 0.51; 95% CI: 0.4-0.6 and OR: 0.69; 95% CI: 0.4-0.8, respectively), when compared to Argentinians. Most respondents did not change their pattern of meal consumption, but those who did reduced their consumption of main meals and increased intake of small meals and snacks. Although most participants affirmed to be doing physical activity at home, about one-half reported perception of weight gain. Individuals with alterations in sleep pattern (either by increasing or decreasing sleep time) were more likely to change their diets to a healthier pattern. In contrast, individuals with confirmed diagnosis of COVID-19 and those who reported feeling anxious were more likely to perform changes to a less healthy eating pattern (OR: 1.72; 95% CI: 1.2-2.3 and OR: 1.21; 95% CI: 1.1-1.4, respectively). In conclusion, although most participants remained constant in their eating habits, lifestyle changes and anxiety feelings were reported. Among those who changed patterns of food consumption, healthier choices prevailed, with differences between countries. However, there were alterations in the distribution of meals, with higher consumption of snacks and small meals. These results can be used to guide policies to prevent deleterious consequences that may affect the incidence of chronic diseases.

Nutritional extremes among school children in a rural Brazilian municipality.

INTRODUCTION: Latin America is undergoing rapid demographic and nutritional transitions with the accompanying tendency to overweight as is common in countries emerging from poverty. In Brazil, changes due to the nutritional transition have affected the whole population, both urban and rural. Overweight in a large number of Brazilian children is one of the greatest public policy challenges. The objective of this 2009-2010 study was to estimate the prevalence of nutritional extremes among children from 7 to 10 years of age in a rural municipality on the state of Espírito Santo, Brazil. METHODS: The sample consisted of 901 school children. Socio-demographic (sex, school location, age and skin color) and anthropometric (weight and height) data were collected, as well as information on eating habits (breakfast, number of meals and presence of a companion during meals). The nutritional status was classified according to BMI per age with the cut-off points: BMI for age < 3rd percentile = underweight and BMI per age > 97th percentile = obesity. RESULTS: A prevalence of 3.4% underweight and 5% obesity was observed, the latter higher in urban areas (p<0.05). Living in an urban area and the habit of eating four or fewer meals/day were associated with obesity among children. Among urban located children 7.5% obesity was found, approximately twice that of rural children. CONCLUSION: Underweight has been regressing, possibly due to improvements in access to health and better living conditions, even in rural areas. However obesity was associated with this in the urban location of the area studied. Children who studied and lived in rural areas showed a lower prevalence of obesity, possibly due to lower socioeconomic conditions and more intense physical activity in their daily activities. The habit of eating four or fewer meals was associated with obesity. This could be explained by the alteration it causes to biological mechanisms. The promotion of physical activity is proposed, mainly in urban areas, and nutritional education aimed at improve eating habits in both urban and rural areas.

[Prevalence of metabolic syndrome in population-based study, Vitória, ES-Brazil]. / Prevalência de síndrome metabólica em estudo de base populacional, Vitória, ES-Brasil.

Metabolic Syndrome (MS) is a complex disorder including several factors predisposing to development of cardiovascular diseases and diabetes. Despite the importance of MS for the health system, the epidemiological characteristics of this condition in the Brazilian population are still scarce. The prevalence of MS as a function of gender, age and socioeconomic level was determined in a population-based study in Vitória, ES, Brazil, by using the NCEP-ATPIII diagnosis criteria. Socioeconomic, biochemical, anthropometric, and hemodynamic data were obtained in 1,663 individuals from a random sample of Vitória population (25-64 y). The estimated prevalence of MS was 29,8% (CI95 = 28-32%). No significant sex-related differences were observed. Prevalence increased from the youngest (26-34 y) to the oldest (55-64 y) group (15.8% and 48.3%, respectively). A progressive increase of MS frequency was observed in women from the higher to the lowest socioeconomic level. The most frequent trait of MS in males was high blood pressure, followed by hypertriglyceridemia, low HDL-c levels, hyperglycemia, and central obesity. In females, hypertension was also the most frequent factor, followed by low HDL-c levels, abdominal obesity, hypertriglyceridemia and hyperglycemia. Our data show that prevalence of MS is high in the studied population, even in the youngest group. Moreover, high blood pressure gives a significant contribution to the diagnosis of this syndrome in both sexes. The precocious control of risk factors is necessary to reduce the impact of cardiovascular morbidity and mortality.

Prevalência de síndrome metabólica em estudo de base populacional, Vitória, ES - Brasil / Prevalence of metabolic syndrome in population-based study, Vitória, ES - Brazil

Síndrome Metabólica (SM) é um transtorno representado pela agregação de fatores predisponentes para desenvolvimento de doenças cardiovasculares e diabetes. Apesar da importância da SM, há carência de dados sobre as características epidemiológicas desta condição na população brasileira. Determinamos a prevalência da SM por sexo, faixa etária e nível socioeconômico na população da cidade de Vitória, ES, Brasil, utilizando os critérios do NCEP/ATPIII. Foram coletados dados socioeconômicos, bioquímicos, antropométricos e hemodinâmicos em 1.663 indivíduos de amostra randômica da população (25-64 anos) de Vitória. A prevalência foi de 29,8 por cento (IC95 = 28-32 por cento), sem diferença entre sexos. De 25 a 34 anos, a prevalência foi 15,8 por cento, alcançando 48,3 por cento na faixa de 55 a 64 anos. Verificou-se aumento progressivo de prevalência em mulheres do maior para o menor nível socioeconômico. O parâmetro da SM mais freqüente em homens foi hipertensão, seguido de hipertrigliceridemia, baixo HDL-colesterol, hiperglicemia e obesidade abdominal. Nas mulheres, hipertensão em primeiro lugar, seguida do baixo HDL-colesterol, obesidade abdominal, hipertrigliceridemia e hiperglicemia. Conclui-se que a prevalência de SM é elevada, inclusive nos mais jovens, com grande contribuição da hipertensão para o seu diagnóstico. Controle dos fatores de risco deve ser promovido visando reduzir o impacto das doenças cardiovasculares na mortalidade geral.

Metabolic Syndrome (MS) is a complex disorder including several factors predisposing to development of cardiovascular diseases and diabetes. Despite the importance of MS for the health system, the epidemiological characteristics of this condition in the Brazilian population are still scarce. The prevalence of MS as a function of gender, age and socioeconomic level was determined in a population-based study in Vitória, ES, Brazil, by using the NCEP-ATPIII diagnosis criteria. Socioeconomic, biochemical, anthropometric, and hemodynamic data were obtained in 1,663 individuals from a random sample of Vitória population (25-64 y). The estimated prevalence of MS was 29,8 percent (CI95 = 28-32 percent). No significant sex-related differences were observed. Prevalence increased from the youngest (26-34 y) to the oldest (55-64 y) group (15.8 percent and 48.3 percent, respectively). A progressive increase of MS frequency was observed in women from the higher to the lowest socioeconomic level. The most frequent trait of MS in males was high blood pressure, followed by hypertriglyceridemia, low HDL-c levels, hyperglycemia, and central obesity. In females, hypertension was also the most frequent factor, followed by low HDL-c levels, abdominal obesity, hypertriglyceridemia and hyperglycemia. Our data show that prevalence of MS is high in the studied population, even in the youngest group. Moreover, high blood pressure gives a significant contribution to the diagnosis of this syndrome in both sexes. The precocious control of risk factors is necessary to reduce the impact of cardiovascular morbidity and mortality.