Association between Sedentary Behavior and Cognitive Performance in Middle-Aged and Elderly Adults: Cross-Sectional Results from ELSA-Brasil.

BACKGROUND: This study aimed to verify the association between Sedentary Behavior (SB) and performance on cognitive function tests in middle-aged and elderly adults. METHODS: This cross-sectional study included 6505 participants (55.2% women) of ELSA-Brasil, with a median age of 61 years. The different types of SB considered were sitting time and screen time. The scores obtained in the memory, language, and executive function tests were used to assess cognitive performance (CP). The association between SB and CP was assessed using linear regression. RESULTS: For men, sitting time was associated with better performance in memory, language, and executive function tests. Screen time on the weekend, showed a favorable association with performance in the executive function test. Occupational screen time on weekdays was positively associated with language test performance. For women, sitting time and occupational screen time were positively associated with performance on memory tests. SB was favorably associated with performance in language tests and executive function tests. CONCLUSIONS: SB seems to favor CP in this population without evident dementia and with a high level of education. The type of SB (mentally active or passive) and the schooling seem to be of particular interest for cognitive performance.

Anthropometric clinical indicators in the assessment of visceral obesity: an update / Indicadores clínicos antropométricos na avaliação da gordura visceral: uma atualização

Introduction: Visceral obesity is associated with an increased risk of metabolic disorders and occurrence of chronic diseases. The quantification of the visceral fat becomes necessary and advantageous in clinical practice, especially through accurate and precise methods in replacement of imaging methods as computed tomography (CT). Objective: To present the use of anthropometric indicators that have been linked to visceral fat. Methods: The selection of items was taken in from Scopus, Scielo, Lilacs, CAPES journals, PubMed/ MEDLINE and Google Scholar, in the period between 2007 and 2014. Anthropometric and clinical indicators as waist circumference (WC), waist- to- height ratio (WHtR), waist-to- thigh ratio (WTR), waist- to- hip ratio (WRH), sagittal abdominal diameter (SAD), abdominal diameter height index (SAD/ Height), abdominal diameter index (ADI), conicity index (CI), visceral adiposity index (VAI) and the lipid accumulation production (LAP) were investigated for their relationship with visceral fat measured by CT. Results: Most indicators have strong correlation (r>0.70) with visceral fat. It was observed that there are few recent studies evaluating this relationship, especially with the indices derived of the WC and the SAD, besides the LAP and the VAI. Most studies investigated the relationship between these indicators with the diseases that are consequent of the visceral obesity. Conclusion: The clinical anthropometric indicators are accurate in estimating visceral obesity, easy to use and has low cost enabling clinical nutritional assessment able to intervene earlier and more effectively in the prevention and/or treatment of this obesity (AU)

Introdução: A obesidade visceral está associada a um risco maior de distúrbios metabólicos e ocorrência de doenças crônicas. A quantificação da gordura visceral torna-se necessária e vantajosa na prática clínica, sobretudo por métodos acurados e precisos em substituição aos métodos por imagem, como a tomografia computadorizada (TC). Objetivo: Descrever a utilização de indicadores clínicos antropométricos que têm sido relacionados à gordura visceral. Métodos: A seleção dos artigos foi feita no Scopus, Scielo, Lilacs, periódicos Capes, Pubmed/Medline e Google Acadêmico, no período entre 2007 e 2014. Indicadores clínicos antropométricos como circunferência da cintura (CC), Razão cintura altura (RCA), Razão cintura coxa (RCCx), Razão Cintura Quadril (RCQ), Diâmetro abdominal sagital (DAS), Diâmetro abdominal altura (DAS/ALT), Índice Diâmetro abdominal (IDA), Índice conicidade (IC), Índice de adiposidade visceral (IAV) e o Produto de acumulação lipídica (PAL) foram investigados quanto sua relação com o tecido adiposo visceral medido pela TC. Resultados: A maioria dos indicadores tem forte correlação (r>0.70) com a gordura visceral. Observou-se que há poucos estudos recentes que avaliaram essa relação, sobretudo com os índices derivados da CC e do DAS, além do PAL e o IAV. A maioria dos estudos investigou a relação entre esses indicadores com as doenças que são consequentes da obesidade visceral. Conclusão: Os indicadores clínicos antropométricos são acurados na estimativa da gordura visceral, fáceis de utilizar e apresentam baixo custo possibilitando uma tomada de decisão na avaliação clínica nutricional capaz de intervir mais precoce e efetivamente na prevenção de risco de doenças (AU)

Nutritional status of institutionalized elderly Brazilians: a study with the mini nutritional assessment / Estado nutricional de ancianos brasileños institucionalizados: un estudio con el mini nutritional assessment

Objective: To assess the nutritional status of elderly living in nursing homes in the city of Salvador, Brazil and associated factors. Methods: Cross-sectional study performed with 359individuals of both sexes, ages equal or over 60 years old, located in Nursing Homes in the urban area of the city of Salvador, Bahia, Brazil. Results: Regarding nutritional status according to Mini Nutritional Assessment (MNA), 66.3% of the evaluated elderly were malnourished and at risk of malnutrition. When comparing sexes, it has been observed that among men the prevalence of this condition (76.6%) was higher than in women (62.4%). It has been observed, as a result of the multivariate analysis, that only the variable functional capacity for Activities of Daily Living (ADL)was statistically significant. There was moderate correlation between MNA and Mini-Mental State Examination(r=0.454; p<0.0001), as well as between MNA and the ADL scale (r=0.569; p<0.0001). There was weak negative correlation between MNA total score and age (r=0.159;p=0.002).Conclusion: Malnutrition and malnutrition risk were conditions of remarkable importance, with almost two thirds of the elderly in this situation. ADL functional capacity must be monitored given their close relationship with the nutritional status of the elderly. An interdisciplinary approach in the context of institutionalization is needed due to the association between nutritional status and variables of different dimensions (AU)

Objective: Evaluar el estado nutricional de los ancianos residentes en Hogares para Ancianos, en la ciudad de Salvador, Brasil y factores asociados. Métodos: Estudio transversal con 359 individuos mayores de 60 años, de ambos sexos y residentes en hogares de ancianos en la zona urbana de la ciudad de Salvador, Bahia, Brasil. Resultados: En cuanto al estado nutricional de acuerdo con Mini Nutritional Assessment (MNA), el 66,3% de los ancianos evaluados estaban desnutridos y en riesgo de desnutrición. La prevalencia de esta afección fue mayor entre los hombres (76,6%) en comparación con las mujeres (62,4%). Se ha observado, como resultado del análisis multivariado, que sólo la capacidad funcional variable para Actividades de la Vida Diaria (AVD) fue estadísticamente significativa. Hubo correlación moderada entre MNA y Mini Examen del Estado Mental (r = 0,454; p <0,0001), así como entre MNA y la escala AVD (r = 0,569; p <0,0001). Hubo correlación débil negativa entre la puntuación total del MNA y la edad (r = 0,159; p = 0,002). Conclusión: La desnutrición y el riesgo de desnutrición fueron de importancia excepcional de las condiciones, porque casi dos tercios de los ancianos estaban en esta situación. La capacidad funcional para AVD debe ser supervisada por su estrecha relación con el estado nutricional de las personas mayores. Un enfoque interdisciplinario en el contexto de la institucionalización es necesario debido a la asociación entre el estado nutricional y variables de diferentes dimensiones (AU)

Anthropometric indicators associated with hypertriglyceridemia in the prediction of visceral fat / Indicadores antropométricos associados a hipertrigliceridemia na predição de gordura visceral

The accumulation of visceral fat is strongly associated with cardiometabolic changes. Alternative methods, such as the association between anthropometric indicators and hypertriglyceridemia, are used as the best estimate for the accumulation of visceral fat, preventing cardiovascular diseases. The aim of this study was to evaluate the association of anthropometric indicators with hypertriglyceridemia in the prediction of visceral fat in men and women. This was a cross-sectional study conducted with 192 individuals, of both genders, submitted to anthropometric evaluation (sagittal abdominal diameter [SAD], waist circumference [WC], and waist-hip ratio [WHR]), serum dosage of triglycerides (TG), and computed tomography scan, in order to measure the visceral adipose tissue (VAT) area. Descriptive analysis, Pearson's Correlation, and multiple linear regression were performed. Anthropometric indicators had high correlation with the VAT area (p=0.000). Regardless of serum TG levels, individuals with high values of anthropometric indicators had excess VAT area (p<0.05). For every centimeter increased in SAD, there was an average increase of 12.46 cm² in the VAT area. The study showed that both SAD and WC were good indicators to explain the variability in the VAT area, independently of changes in TG levels, making it possible to identify individuals with a risk of developing cardiovascular diseases.

O acúmulo de gordura visceral está fortemente associada com alterações cardiometabólicas. Métodos alternativos, como a associação de indicadores antropométricos e hipertrigliceridemia, são usados ​​como uma melhor estimativa para o acúmulo de gordura visceral, prevenindo doenças cardiovasculares. O objetivo foi avaliar a associação entre indicadores antropométricos com a hipertrigliceridemia para predição de gordura visceral em homens e mulheres. Estudo transversal, realizado com 192 indivíduos, de ambos os sexos, que foram submetidos à avaliação antropométrica (Diâmetro Abdominal Sagital -DAS, Circunferência da Cintura -CC e Relação Cintura-quadril -RCQ), dosagem sérica de triglicérides (TG) e tomografia computadorizada, a fim de medir a área do tecido adiposo visceral (ATAV). Análise descritiva, Correlação de Pearson e Regressão Linear Múltipla foram realizados. Indicadores antropométricos apresentaram alta correlação com a ATAV (p=0,000). Independente do nível sérico de TG, os indivíduos com indicadores antropométricos elevados tinham excesso de ATAV (p<0,05). Para cada aumento de um centímetro no DAS, houve um aumento médio de 12,46 cm² de ATAV. O estudo mostrou que ao mesmo tempo, DAS e CC foram os melhores indicadores para explicar a variabilidade na ATAV, independentemente de mudanças no nível de triglicérides, o que possibilitou a identificação de indivíduos com risco de desenvolver doenças cardiovasculares.

Evaluation of the accuracy of anthropometric clinical indicators of visceral fat in adults and elderly.

BACKGROUND: Visceral obesity is associated with higher occurrence of cardiovascular events. There are few studies about the accuracy of anthropometric clinical indicators, using Computed Tomography (CT) as the gold standard. We aimed to determine the accuracy of anthropometric clinical indicators for discrimination of visceral obesity. METHODS: Cross-sectional study with 191 adults and elderly of both sexes. Variables: area of visceral adipose tissue (VAT) identified by CT, Waist-to-Height Ratio (WHtR), Conicity index (C index), Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI). ROC analyzes. RESULTS: There were a strong correlation between adiposity indicators and VAT area. Higher accuracy of C index and WHtR (AUC≥0.81) than the LAP and the VAI was observed. The higher AUC of LAP and VAI were observed among elderly with areas of 0.88 (CI: 0.766-0.944) and 0.83 (CI: 0.705-0.955) in men and 0.80 (CI: 0.672-0.930) and 0.71 (CI: 0.566-0.856) in women, respectively. The cutoffs of C index were 1.30 in elderly, in both sexes, with sensitivity ≥92%, the LAP ranged from 26.4 to 37.4 in men and from 40.6 to 44.0 in women and the VAI was 1.24 to 1.45 (sens≥76.9%) in men and 1.46 to 1.84 in women. CONCLUSION: Both the anthropometric indicators, C Index and WHtR, as well as LAP and VAI had high accuracy in visceral obesity discrimination. So, they are effective in cardiovascular risk assessment and in the follow-up for individual and collective clinical practice.