Adequacy of the "pocket formulas" for measuring total energy expenditure in healthy women compared with the new DRI equation: A doubly labeled water study.

OBJECTIVES: "Pocket formulas" are practical alternatives for calculating an individual's total energy expenditure (TEE). Typically, more sophisticated predictive equations are used, such as the new equations proposed in the Dietary Reference Intakes (DRI). Nevertheless, these new equations necessitate estimating physical activity levels (PALs). The aim of this study was to compare the use of pocket formulas (kcal/kg of body weight) with the new predictive equations for energy expenditure proposed by the DRI (2023) in healthy women and with the doubly labeled water (DLW) method to predict TEE. METHODS: The TEEs of healthy adult women were measured by DLW and calculated using the pocket formulas (× 20, × 25, × 30, and × 35 kcal/kg of body weight) and the new DRI equation. PALs by triaxial accelerometers were also collected. RESULTS: The study included 55 women. For the entire sample, the × 30 pocket formula had the lowest bias (-6%; limits of agreement [LOAs]: -39.8; 27.5; root mean square error: 373.4) and the highest precision (42%). The pocket formulas showed reasonable agreement in the different body mass index categories compared with the results found by the 2023 DRI proposal. For individuals with normal weight, the agreement was × 35 kcal/kg: bias (%) = -4.8; LoA = -41.5; 31.8, with overweight, it was × 30 kcal/kg: bias (%) = -2.2; LoA = -25.1; 20.6, and with obesity, it was × 30 kcal/kg: bias (%) = 4.2; LoA = -21.1; 29.4. CONCLUSION: Pocket formulas provide a reasonable agreement with TEE in healthy, sedentary, or low-active adult women, which may be a more simplistic strategy when there is no PAL data for calculating the DRI equations.

Use of the activPAL® triaxial accelerometer to estimate total energy expenditure in low-income women: differences between body mass index classifications.

Objective: This study aimed to assess the agreement between the total energy expenditure (TEE) estimated by the activPAL® triaxial accelerometers (ACC) and the TEE measured by the doubly labeled water method (DLW), as well as to assess if these values differ between the classifications of body mass index (BMI). Materials and methods: This is a cross-sectional study. Low-income adult women (19-45y) with BMI ≥ 18.5 kg/m2 were included. Accelerometry data (activPAL® ) were collected over 7 consecutive days, which were used to calculate TEE-ACC and compared with DLW data. The Bland-Altman method, concordance correlation coefficient and root mean square error were used to assess agreement between methods. Results: The sample consisted of 55 women with a mean age of 31 ± 5 years. The agreement between TEE-ACC and TEE-DLW showed a bias of -142.5 kcal (-7.1%). Among the BMI classifications, participants with normal weight show a bias of -417.1 kcal (-21.0%), participants with overweight, -87.5 kcal (-3.9%) and participants with obesity, 97.5 kcal (4.3%). Furthermore, the bias between the methods showed a significant and positive correlation with the body weight (r = 0.49; p < 0.01). Conclusion: The TEE-ACC estimates from activPAL® were reasonably accurate when compared to the TEE-DLW, especially in women with overweight and obesity, being much less accurate in individuals with normal weight.

Commentary on "Food addiction, orthorexia nervosa and dietary diversity among Bangladeshi university students: a large online survey during the COVID-19 pandemic".

The food addiction construct is receiving increasing attention from researchers and clinicians worldwide. Given its rise, scientific production on the subject is increasingly abundant. Conducting studies evaluating food addiction in emerging countries is of great importance, given that most scientific production comes from high-income countries. A recent study aimed to explore the prevalences of orthorexia nervosa and food addiction and their associations with dietary diversity in university students in Bangladesh during the COVID-19 pandemic. This correspondence presents questions about using the older version of the modified Yale Food Addiction Scale to assess food addiction. It also highlights issues related to the prevalence of food addiction observed in the study.

Prevalence of food addiction determined by the Yale Food Addiction Scale in Latin America: A systematic review with meta-analysis.

OBJECTIVE: Food addiction (FA) has been extensively investigated worldwide; however, the prevalence of FA in the Latin American population has yet to be established and past work has largely neglected the specificities of this region, that includes the most significant economic disparities in the world. Thus, the objective of this study was to assess the prevalence of FA measured by the Yale Food Addiction Scale in Latin America. METHOD: The search was performed on MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL, and the gray literature. FA prevalence data were collected, and random effects meta-analyses were performed to calculate the overall weighted prevalence, the prevalence by country, and by clinical and non-clinical samples. RESULTS: A total of 10,082 occurrences were identified through database searches, and 23 studies were included (Mexico = 9; Brazil = 7; Chile = 4; Argentina = 1; Peru = 1; Uruguay = 1). The prevalence of FA found in clinical samples was 38% (95% CI: 16%-63%; I2  = 98.67%; 8 studies), while in non-clinical samples, it was 15% (95% CI: 10%-21%; I2  = 98.51%; 15 studies). DISCUSSION: The average prevalence of FA in the Latin American countries included here was in accordance with that reported in other regions worldwide. It is noteworthy that the studies were conducted only in six countries, which are among those with the highest income in the region and do not represent the situation in native populations or those with lower purchasing power. This gap in the data also reflects the effects of economic disparities on the availability of empirical data in the region. PUBLIC SIGNIFICANCE: The prevalence of food addiction in Latin America was similar to that reported in other regions. It was higher among individuals with overweight, whether or not undergoing bariatric surgery, than in non-clinical samples. These findings contribute to aggregate information about this condition that has drawn the attention of clinicians and researchers.

OBJETIVO: La adicción a la comida (FA, por sus siglas en inglés) ha sido ampliamente investigada en todo el mundo; sin embargo, la prevalencia de la FA en la población latinoamericana aún no se ha establecido y el trabajo previo ha descuidado en gran medida las especificidades de esta región, que incluye las disparidades económicas más significativas del mundo. Por lo tanto, el objetivo de este estudio fue evaluar la prevalencia de FA medida por la Escala de Adicción a la Comida de Yale en América Latina. MÉTODO: La búsqueda se realizó en MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL y la literatura gris. Se recopilaron datos de prevalencia de FA y se realizaron metanálisis de efectos aleatorios para calcular la prevalencia ponderada general, la prevalencia por país y por muestras clínicas y no clínicas. RESULTADO: Se identificaron 10 082 casos mediante búsquedas en bases de datos y se incluyeron 23 estudios (México = 9; Brasil = 7; Chile = 4; Argentina = 1; Perú = 1; Uruguay = 1). La prevalencia de FA encontrada en muestras clínicas fue del 38% (IC95%:16%; 63%; I2 = 98,67%; 8 estudios), mientras que en muestras no clínicas, fue del 15% (IC del 95%: 10%; 21%; I2 = 98,51%; 15 estudios). DISCUSIÓN: La prevalencia promedio de FA en los países latinoamericanos incluidos aquí estuvo de acuerdo con la reportada en otras regiones del mundo. Cabe destacar que los estudios se realizaron solamente en seis países, que se encuentran entre los de mayores ingresos de la región y no representan la situación de las poblaciones nativas o de menor poder adquisitivo. Esta brecha en los datos también refleja los efectos de las disparidades económicas en la disponibilidad de datos empíricos en la región.

Social and Racial Disparities in Food Consumption Among Brazilian College Students: a Nationwide Study.

This study aims to assess the association between economic class, race/skin color, and food consumption among Brazilian college students. A cross-sectional web-based survey was conducted with college students from all over Brazil. Demographic data, economic class, self-reported race/skin color, anthropometry, and food consumption markers from the Brazilian Food and Nutrition Surveillance System were collected. The final sample comprised 5843 participants with a mean age of 24.1 (SD: 6.3) years, 4292 (73.5%) were female, and 810 (13.9%) in the highest economic stratum. We observed a progressive decrease in the frequency of fresh fruits and vegetables consumption from higher to lower economic classes (p < 0.01 for both). Contrarily, there was a progressive increase in the frequency of consumption of beans from higher to lower economic classes (p < 0.01). The frequency consumption of vegetables was also associated with race/skin color (p < 0.01), being lower in brown (PR: 0.94; CI 95%: 0.90; 0.98), and black (PR: 0.91; 95% CI: 0.85; 0.98) individuals, compared to white individuals. Brown individuals showed higher frequency consumption of beans (PR: 1.10; 95% CI: 1.05; 1.15) than whites. When compared to individuals of white race/skin color, brown (PR: 1.07; 95% CI: 1.01; 1.13) and black (PR: 1.15; 95% CI: 1.07; 1.23) individuals showed higher frequency consumption of sweetened beverages. Economic class and race/skin color were independent factors associated with the food consumption of Brazilian college students.

Use of the activPAL® triaxial accelerometer to estimate total energy expenditure in low-income women: differences between body mass index classifications

ABSTRACT Objective: This study aimed to assess the agreement between the total energy expenditure (TEE) estimated by the activPAL® triaxial accelerometers (ACC) and the TEE measured by the doubly labeled water method (DLW), as well as to assess if these values differ between the classifications of body mass index (BMI). Materials and methods: This is a cross-sectional study. Low-income adult women (19-45y) with BMI ≥ 18.5 kg/m2 were included. Accelerometry data (activPAL®) were collected over 7 consecutive days, which were used to calculate TEE-ACC and compared with DLW data. The Bland-Altman method, concordance correlation coefficient and root mean square error were used to assess agreement between methods. Results: The sample consisted of 55 women with a mean age of 31 ± 5 years. The agreement between TEE-ACC and TEE-DLW showed a bias of -142.5 kcal (-7.1%). Among the BMI classifications, participants with normal weight show a bias of -417.1 kcal (-21.0%), participants with overweight, -87.5 kcal (-3.9%) and participants with obesity, 97.5 kcal (4.3%). Furthermore, the bias between the methods showed a significant and positive correlation with the body weight (r = 0.49; p < 0.01). Conclusion: The TEE-ACC estimates from activPAL® were reasonably accurate when compared to the TEE-DLW, especially in women with overweight and obesity, being much less accurate in individuals with normal weight.

Effects of dietary polyphenols in the glycemic, renal, inflammatory, and oxidative stress biomarkers in diabetic nephropathy: a systematic review with meta-analysis of randomized controlled trials.

CONTEXT: Polyphenols have antioxidant, anti-inflammatory, and anti-glycation properties. OBJECTIVE: To assess the effects of dietary polyphenols, from food sources or supplements, on the anthropometric, glycemic, renal, inflammatory, and oxidative stress markers in adults with diabetic nephropathy (DN). DATA SOURCES: Systematic searches for randomized clinical trials were performed in MEDLINE, Embase, CENTRAL, Web of Science, LILACS, SciELO, opengrey.eu, and ClinicalTrials.gov databases until December 2021. DATA EXTRACTION: Studies with adults with DN were included. Random-effects meta-analyses were conducted. Risk of bias of the studies and Grading of Recommendations, Assessment, Development, and Evaluation assessment were carried out. DATA ANALYSIS: The searches resulted in 5614 unique occurrences, and 34 full-text articles were retrieved. Of these, 17 studies were included in the qualitative synthesis. Most of the studies used soy protein or milk (n = 5; 0.5-1 g/kg of body weight/d of soy protein, or introduction of 240 mL/d of soy milk) or turmeric/curcumin (n = 5; dose range, 80 to 1500 mg/d) as the intervention. The following outcomes were analyzed: body mass index, glycated hemoglobin (HbA1c), proteinuria, creatinine clearance, glomerular filtration rate (GFR), urinary albumin to creatinine ratio, and levels of fasting blood glucose, insulin, serum urea and creatinine, C-reactive protein, serum tumor necrosis factor-α, and serum malondialdehyde (MDA). The polyphenol intervention significantly decreased HbA1c (n = 7 studies; -0.27% [95%CI, -0.51%, -0.04%]), proteinuria (n = 5 studies; -109.10 [95%CI, -216.57, -1.63] mg/24 h), and MDA (n = 5 studies; z-score: -0.41; 95%CI, -0.71, -0.10), and significantly increased GFR (n = 7 studies; 3.65 [95%CI, 0.15-7.15] mL/min/1.73 m2). Overall, studies showed a high risk of bias, and outcomes showed a low or very-low quality in the Grading of Recommendations, Assessment, Development, and Evaluation assessment. CONCLUSIONS: There is a clinically modest effect of dietary polyphenols intervention in HbA1c, proteinuria, GFR, MDA, and C-reactive protein levels in patients with DN. It is impossible to establish clinical recommendations, because the evidence was of' low or very-low quality and because of the heterogeneity of types and dose regimens used in the studies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. ID245406.

Estimates of resting energy expenditure and total energy expenditure using predictive equations in adults with overweight and obesity: a systematic review with meta-analysis.

CONTEXT: Energy expenditure predictive equations can generate inaccurate estimates for overweight or obese individuals. OBJECTIVE: The objective of this review was to determine which predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) have the lowest bias and the highest precision in adults with overweight and obesity. DATA SOURCES: Searches were performed in January 2022 in MEDLINE, Web of Science, Scopus, CENTRAL, and the gray literature databases. DATA EXTRACTION: Meta-analyses were performed with equations included in more than 1 study. The DerSimonian and Laird random-effects model and the I2 statistic were used to quantify heterogeneity in the quantitative analyses. The Egger test was performed to assess potential publication biases, and metaregressions were conducted to explore the heterogeneity. Findings were presented separated by participants' body mass index classification (overweight and obesity). DATA ANALYSIS: Sixty-one studies were included. The FAO/WHO/UNU (1985) equation, which uses only body weight in its formula, showed the lowest bias in estimating REE (mean difference [MD] = 8.97 kcal; 95% CI = -26.99; 44.94). In the subgroup analysis for individuals with obesity, the Lazzer (2007) equation showed the lowest bias (MD = 4.70 kcal; 95% CI = -95.45; 104.86). The Harris-Benedict equation (1919) showed the highest precision values for individuals with overweight (60.65%) and for individuals with obesity (62.54%). Equations with body composition data showed the highest biases. The equation proposed by the Institute of Medicine (2005) showed the lowest bias (MD = -2.52 kcal; 95% CI = -125.94; 120.90) in estimating the TEE. Most analyses showed high heterogeneity (I2 > 90%). There was no evidence of publication bias. CONCLUSION: For individuals with overweight, the FAO/WHO/UNU (1985) and the Harris-Benedict equations (1919) showed the lowest bias and the highest precision in predicting the REE, respectively. For individuals with obesity, the Harris-Benedict equation (1919) showed the highest precision and the Lazzer equation (2007) showed the lowest bias. More studies are needed on predictive equations to estimate the TEE. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021262969.

Prevalence of food addiction and its association with anxiety, depression, and adherence to social distancing measures in Brazilian university students during the COVID-19 pandemic: a nationwide study.

The study's objective was to determine the prevalence of food addiction (FA) in Brazilian university students and to verify whether there is an association with anxiety, depression, and adherence to the social distancing measures adopted during the COVID-19 pandemic. This is a nationwide cross-sectional study carried out through the application of online questionnaires. Self-reported data on age, sex, economic class, race/skin color, anthropometric data, depression diagnosis, anxiety, modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and adherence to social distancing measures were collected. 5368 participants were included, with a mean age was 24.1 ± 6.3 years, the majority were female (n = 3990; 74.3%), and the mean BMI in our sample was 24.5 ± 5.3 kg/m2. The prevalence of FA was 19.1% (95%CI: 18.0; 20.0%). An association was observed between FA with depression (PR: 1.60; 95%CI: 1.43; 1.78; p < 0.01), and anxiety (3.13; 95%CI: 2.74; 3.58; p < 0.01), but not with adherence to social distancing measures (p = 0.70). In conclusion, there was a higher prevalence of FA in Brazilian university students. Besides, university students with anxiety, depression, overweight, or obesity and females are more prone to FA.Level of evidence Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Association between sitting/lying down, standing, walking time and number of steps per day with the hormonal profile and resting energy expenditure of women with obesity living in a low-income region.

Reducing sedentary behaviour (SB) and increasing physical activity (PA) by sitting less and standing/walking more is advised to prevent chronic diseases. However, the mechanisms underlying this recommendation are not well established, especially in individuals with obesity living in low-income regions. The present study evaluated whether there are associations between PA indicators (PAI - standing time, walking time and the number of steps/d) and SB indicators (SBI - sitting/lying down time) with the hormonal profile and resting energy expenditure (REE) of adult women living in a low-income region. This is a cross-sectional study. We collected data on hormones (insulin resistance, leptin and thyroid axis), body composition (tetrapolar bioimpedance), REE (indirect calorimetry), and PAI and SBI (triaxial accelerometers, ActivPAL). Multivariable linear models adjusting for age and fat-free mass were performed. Fifty-eight women (mean age of 31 years and BMI of 33 kg/m2) were included. The mean sitting/lying down time and standing time were 16·08 and 5·52 h/d, respectively. Sitting/lying down time showed a direct association with free thyroxine (FT4) (ß = 0·56 ng/dl; 95 % CI = -1·10, -0·02). Standing time showed a direct association with FT4 (ß = 0·75 ng/dl; 95 % CI = 0·01; 1·48) and inverse association with free triiodothyronine (ß = -2·83 pg/ml 95 % CI = -5·56, -0·10). There were no associations between PAI and SBI with the REE, insulin resistance, leptin and thyroid-stimulating hormone. Thus, decreased SB is associated with thyroid hormones levels but not with REE, insulin resistance or leptin in women with obesity living in low-income regions.

Racial Differences in Generalized Anxiety Disorder During the COVID-19 Pandemic among Brazilian University Students: a National Survey.

There is evidence that during the COVID-19 pandemic, there was an increase in anxiety and depression rates among college students. However, little is known about how generalized anxiety disorder (GAD) developed among individuals of different race/skin color. This study aimed to determine whether there are racial differences in GAD in Brazilian university students during the COVID-19 pandemic. This is a nationwide cross-sectional study, carried out through the application of online questionnaires to university students from 94 Brazilian universities. Self-reported data on age, sex, economic class, race/skin color, anthropometric data, and adherence to social distancing measures were collected. To determine the GAD, the Generalized Anxiety Disorder 7-item scale was applied. A total of 5879 participants were included, with a mean age of 24.1 ± 6.4 years, and the majority were female (n = 4324, 73.5%), most self-declared to be whites (n = 2945, 50.1%), followed by browns (n = 2185, 37.2%) and blacks (n = 749, 12.7%). The prevalence of GAD among black Brazilian university students (47.3% [95% CI 43.7, 50.8]) was significantly higher than that of browns (38.6% [95% CI 36.6, 40.7]) and whites (44.1% [95% CI 42.3, 45.9]), even after multivariable adjustment by other sociodemographic factors. The findings of the present study suggest a possible racial difference in GAD among Brazilian university students, in which those who declared their race/skin color as black showed a greater risk for GAD than those who declared themselves as white or brown.

Trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period. / Tendência do estado nutricional de gestantes adolescentes beneficiárias do programa de transferência condicionada de renda brasileiro Bolsa Família no período 2008-2018.

This ecological study aimed to analyze the trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period. We evaluated secondary data of pregnant adolescent beneficiaries of the Bolsa Família Program from January 2008 to December 2018, extracted from the public reports of the WEB Food and Nutrition Surveillance System. We accessed the monitoring reports on the consolidated public-access health conditionalities of the Bolsa Família Program, always considering the second validity. An annual variation of -1.2% (95%CI: [-1.6; -0.8] p<0.01) was observed in the prevalence of underweight in Brazil in the studied sample. The prevalence of overweight and obesity in the country had annual variations of 2.9% (95%CI: [2.0; 3.7] p<0.01) and 7.5% (95%CI: [5.7; 9.3] p<0.01), respectively. We conclude by saying, that, in the evaluated period, the prevalence of underweight among pregnant adolescent beneficiaries of the Bolsa Família Program showed a decreasing trend, while the prevalence of overweight and obesity increased throughout Brazil.

Trata-se de um estudo ecológico que objetivou analisar a tendência do estado nutricional de gestantes adolescentes beneficiárias do programa brasileiro de transferência condicionada de renda, Bolsa Família, no período 2008-2018. Foram avaliados dados secundários de gestantes adolescentes beneficiárias do Programa Bolsa Família no período de janeiro de 2008 a dezembro de 2018, extraídos dos relatórios públicos do Sistema de Vigilância Alimentar e Nutricional WEB. Foram consultados os relatórios de acompanhamento das condicionalidades de saúde consolidados de acesso público do Programa Bolsa Família, sempre considerando a 2ª vigência. Observou-se uma variação anual de -1,2% (IC95%: [-1,6; -0,8] p<0,01) na prevalência de baixo peso na amostra estudada. Com relação as prevalências de sobrepeso e obesidade no país, observou-se variações anuais de 2,9% (IC95%: [2,0; 3,7] p<0,01) e 7,5% (IC95%: [5,7; 9,3] p<0,01), respectivamente. Conclui-se que, no período avaliado, a prevalência de baixo peso entre as gestantes adolescentes beneficiárias do Programa Bolsa Família apresentou uma tendência decrescente, ao passo que as prevalências de sobrepeso e obesidade apresentam uma tendência crescente em todo o Brasil.

Association between phase angle and height-to-age index classifications of children under five years of age.

BACKGROUND & AIMS: The phase angle (PA) has been used as an indicator of prognosis and nutritional status because it reflects the integrity of the individuals' cellular function. In contrast to the investigations that assessed acute malnutrition (weight deficit) and PA in children, studies that evaluated the relationship of this indicator with stunting (height deficit) are still scarce and inconclusive. Thus, we aim to investigate whether there are differences in PA according to the classifications of the height-for-age (H/A) index of children under five years of age. METHODS: This is a cross-sectional study carried out in a nutritional recovery center, in households, and in a daycare center in Maceió-Alagoas, Brazil. Anthropometric data were collected, and resistance and reactance were obtained through the use of tetrapolar electrical bioimpedance, from children aged 2-5 years. The PA and the percentage of body fat were calculated. Children were divided into 3 groups: adequate H/A, at-risk of stunting and stunted. Analysis of covariance for the main outcome was performed using age, sex, and the body mass index-to-age as covariates, and the H/A classification as the exposure. RESULTS: The mean children's PA in the adequate H/A group was 3.9° [95% CI 3.6-4.2], while in the group at-risk of stunting and stunted it was 4.5° [95% CI 4.3-4.7] and 4.6° [95% CI 4.4-4.8], respectively, showing statistical difference (p < 0.01). CONCLUSION: In the present sample, stunted children have higher PA values than children with adequate H/A.

Tendência do estado nutricional de gestantes adolescentes beneficiárias do programa de transferência condicionada de renda brasileiro Bolsa Família no período 2008-2018 / Trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period

Resumo Trata-se de um estudo ecológico que objetivou analisar a tendência do estado nutricional de gestantes adolescentes beneficiárias do programa brasileiro de transferência condicionada de renda, Bolsa Família, no período 2008-2018. Foram avaliados dados secundários de gestantes adolescentes beneficiárias do Programa Bolsa Família no período de janeiro de 2008 a dezembro de 2018, extraídos dos relatórios públicos do Sistema de Vigilância Alimentar e Nutricional WEB. Foram consultados os relatórios de acompanhamento das condicionalidades de saúde consolidados de acesso público do Programa Bolsa Família, sempre considerando a 2ª vigência. Observou-se uma variação anual de -1,2% (IC95%: [-1,6; -0,8] p<0,01) na prevalência de baixo peso na amostra estudada. Com relação as prevalências de sobrepeso e obesidade no país, observou-se variações anuais de 2,9% (IC95%: [2,0; 3,7] p<0,01) e 7,5% (IC95%: [5,7; 9,3] p<0,01), respectivamente. Conclui-se que, no período avaliado, a prevalência de baixo peso entre as gestantes adolescentes beneficiárias do Programa Bolsa Família apresentou uma tendência decrescente, ao passo que as prevalências de sobrepeso e obesidade apresentam uma tendência crescente em todo o Brasil.

Abstract This ecological study aimed to analyze the trend of the nutritional status of pregnant adolescent beneficiaries of the Brazilian Bolsa Família conditional cash transfer program in the 2008-2018 period. We evaluated secondary data of pregnant adolescent beneficiaries of the Bolsa Família Program from January 2008 to December 2018, extracted from the public reports of the WEB Food and Nutrition Surveillance System. We accessed the monitoring reports on the consolidated public-access health conditionalities of the Bolsa Família Program, always considering the second validity. An annual variation of -1.2% (95%CI: [-1.6; -0.8] p<0.01) was observed in the prevalence of underweight in Brazil in the studied sample. The prevalence of overweight and obesity in the country had annual variations of 2.9% (95%CI: [2.0; 3.7] p<0.01) and 7.5% (95%CI: [5.7; 9.3] p<0.01), respectively. We conclude by saying, that, in the evaluated period, the prevalence of underweight among pregnant adolescent beneficiaries of the Bolsa Família Program showed a decreasing trend, while the prevalence of overweight and obesity increased throughout Brazil.

Effect of early time-restricted feeding on the metabolic profile of adults with excess weight: A systematic review with meta-analysis.

BACKGROUND & AIMS: Time-restricted feeding (TRF) studies have been summarized in previous systematic reviews, but these were not specific for individuals with excess weight and studies involving early time-restricted feeding (eTRF). This meta-analysis aimed to evaluate the effect of eTRF on the metabolic profile of adults with excess weight. METHODS: Data were extracted from MEDLINE, CENTRAL, LILACS, Web of Science, ClinicalTrials.gov, OpenGrey.eu, Greylit, and by manual search. Randomized controlled trials in which the participants were older than 18 years, with a body mass index greater than 25 kg/m2 and that were allocated in an intervention with eTRF were included. The studies should have assessed any of the following outcomes from the metabolic profile: resting metabolic rate, triacylglycerol, total cholesterol, HDL-cholesterol, and LDL-cholesterol, fasting blood glucose, insulin, HOMA-IR, C-reactive protein, Interleukin-6, cortisol, leptin, Ghrelin, Peptide YY and glucagon-like peptide, hemodynamic parameters, and appetite. The risk of bias was assessed using the Cochrane collaboration tool. Publication bias was examined with a funnel plot and Egger's test. GRADE was used to assess the overall quality of evidence. RESULTS: Ten articles from nine randomized clinical trials, with 264 individuals, were included in qualitative analysis and eight articles with 184 individuals were included in the meta-analysis. There were significant effects on the fasting blood glucose (WMD: -2.75; 95% CI [-4.59; -0.90] mg/dL; p < 0.01; I2 = 88.7%; 7 studies) and HOMA-IR. (WMD: -0.50; 95% CI [-0.82; -0.19]; p < 0.01; I2 = 50.8%; 4 studies). The other outcomes were not significant. Three studies showed a high risk of bias. Seven outcomes were classified as very low quality and one as low quality. There was evidence of publication bias for fasting blood glucose. CONCLUSIONS: Although the eTRF regimen seems to have a beneficial effect on the fasting blood glucose and HOMA-IR of individuals with excess weight, the results of this meta-analysis should be analyzed with caution due to the low-quality evidence.

Association between COVID-19 diagnosis and economic class, race/skin color and social distancing in Brazilian university students / Associação entre o diagnóstico de COVID-19 e a classe econômica, raça/cor da pele e distanciamento social em universitários brasileiros

ABSTRACT: Purpose: To determine the association between diagnosis of COVID-19 and the economic class, race/skin color, and adherence to social distancing in Brazilian university students. Methods: This is a nationwide cross-sectional study carried out with online questionnaires applied to Brazilian university students, at 94 universities in the public and private education network. Self-reported age, sex, economic class data, race/skin color, COVID-19 diagnosis, and adherence to social distancing measures were collected. Results: 5,984 individuals were evaluated. No significant association was found between the diagnosis of COVID-19 and economic class and race/skin color in the multivariable analysis. However, we observed that there were significant associations between the diagnosis of COVID-19 and partial adherence to social distancing, with leaving home only for going to work (PR: 1.35; 95% CI: 1.10­1.66; p < 0.01) and with non-adherence to social distancing (PR: 1.96; 95% CI: 1.29­2.97; p <0.01). Conclusion: The diagnosis of COVID-19 was associated with age, non-adherence and partial adherence to social distancing measures in Brazilian university students, but was not associated with race/skin color and economic class.

Objetivo: Verificar a associação entre o diagnóstico de COVID-19 e a classe econômica, raça/cor da pele e adesão às medidas ao distanciamento social em universitários brasileiros. Métodos: Estudo transversal, de abrangência nacional, realizado com universitários brasileiros. Foram coletados dados autorreferidos de idade, sexo, classe econômica, raça/cor, diagnóstico do COVID-19 e adesão às medidas de distanciamento social. Resultados: 5.984 indivíduos foram avaliados. Não foi encontrada associação significativa entre o diagnóstico de COVID-19, a classe econômica e raça/cor na análise multivariável. Observamos que houve associações significativas entre o diagnóstico de COVID-19 e adesão parcial ao distanciamento social (RP: 1,35; IC 95%: 1.10­1.66; p < 0,01) e com a não adesão ao distanciamento social (RP: 1,96; IC95%: 1.29­2.97; p < 0,01). Conclusão: O diagnóstico de COVID-19 foi associado à idade, não adesão e adesão parcial às medidas de distanciamento social em universitários brasileiros, mas não se associou à raça/cor e classe econômica. (AU)