Assessment of Intuitive Eating and Mindful Eating among Higher Education Students: A Systematic Review.

BACKGROUND: The role of mindful eating (ME) and intuitive eating (IE) in improving eating behavior, diet quality, and health is an area of increasing interest. OBJECTIVE: The objective of this review was to identify the instruments used to assess ME and IE among higher education students and outcomes related to these dimensions. METHODS: This review was carried out according to the PRISMA statement, through systematic searches in PubMed, Web of Science, PsycInfo, and Scopus. The inclusion criteria selected for higher education students, levels of ME and/or IE reported, and observational and clinical studies. The exclusion criteria selected against reviews, qualitative studies, and case studies. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS: A total of 516 initial records were identified, from which 75 were included. Cross-sectional studies were the most common research design (86.7%). Most studies were conducted with samples that were predominantly female (90.7%), White (76.0%), aged 18 to 22 years (88.4%), with BMI < 25 kg/m2 (83.0%), and in the United States (61.3%). The Intuitive Eating Scale (IES), the Mindful Eating Questionnaire (MEQ), and their different versions were the most used instruments. The outcomes most studies included were eating behavior and disorders (77.3%), anthropometric assessments (47.8%), mental health (42.0%), and body image (40.6%). Regarding the quality of studies, 34.7% of studies were assigned a positive, 1.3% a negative, and 64.0% a neutral rate. CONCLUSIONS: IES and MEQ were the most used instruments. RCT and cohort studies are scarce, and future research with a higher level of quality is needed, especially on the topics of food consumption, diet quality, and biochemical markers.

Dietary patterns and cardiometabolic risk factors of a federal public institution staff in the northern region of Brazil / Padrões alimentares e fatores de risco cardiometabólicos em funcionários de uma instituição pública federal na região norte do Brasil

ABSTRACT Objective To identify dietary patterns in an adult population and assess those patterns association with cardiometabolic risk factors. Methods Cross-sectional study conducted with 130 workers of a university in Tocantins, Brazil, aged 20-59 years. Dietary patterns were identified by principal component analysis based on a food frequency questionnaire. Body mass index, waist circumference, blood pressure, fasting glycemia, triacylglycerols, low-density lipoprotein and high-density lipoprotein cholesterol were measured. Multinomial logistic regression was used to assess the association between dietary patterns and cardiometabolic risk factors. Results Three dietary patterns were identified that together explained 78.74% of total variance: healthy, western and fit dietary patterns. In the adjusted model, greater adherence to the healthy pattern was associated with lower fasting glucose values (OR: 0.89; 95%IC: 0.82-0.97; p=0.009) and with higher concentrations of low-density lipoprotein cholesterol (OR: 1.02; 95%IC: 1.00-1.04; p=0.024); the western dietary pattern was associated with higher fasting glucose values (OR: 1.06; 95%IC: 1.00-1.13; p=0.05) and the fit pattern was associated with lower concentrations of low-density lipoprotein cholesterol (OR: 0.98; 95%IC: 0.97-0.99; p=0.048). Conclusion Food was an important risk and protective factor for cardiometabolic changes.

RESUMO Objetivo Identificar padrões alimentares em uma população adulta e avaliar a associação com fatores de risco cardiometabólico. Métodos Estudo transversal realizado com 130 funcionários entre 20 e 59 anos de uma universidade do Tocantins, Brasil. Os padrões alimentares foram identificados por análise de componentes principais com base em um questionário de frequência alimentar. Foram mensurados índice de massa corporal, perímetro da cintura, pressão arterial, glicemia de jejum, triglicerídeos, lipoproteínas de baixa densidade e lipoproteínas de alta densidade. As associações dos padrões com os fatores de risco cardiometabólico foram determinadas por regressão logística multinomial. Resultados Três padrões foram identificados que explicaram 78.74% da variância total: saudável, ocidental e fit. No modelo ajustado, a maior adesão ao padrão saudável foi associada com menores valores de glicemia de jejum (OR: 0.89; 95% IC: 0.82-0.97; p=0.009) e com maiores concentrações de lipoproteína de baixa densidade colesterol (OR: 1.02; 95% IC: 1.00-1.04; p=0.024); o padrão ocidental foi associado com maiores valores de glicemia de jejum (OR: 1.06; 95% IC: 1.00-1.13; p=0.05) e o padrão fit foi associado com menores concentrações de lipoproteína de baixa densidade colesterol (OR: 0.98; 95% IC: 0.97-0.99; p=0.048). Conclusão A alimentação constituiu um importante fator de risco e de proteção para alterações cardiometabólicas.

Equation of height estimation from knee height: Performance in the composition of body adiposity INDICES in older adults.

AIM: To propose an equation to estimate height and evaluate it's performance in the composition of adiposity indicators in community-dwelling older adults in Brazil. METHODS: It is a cross-sectional study with 675 community-dwelling older adults (≥60 anos). Interviews and anthropometric measurements were taken at subjects' homes. Body mass index (BMI), body adiposity index (BAI), waist height ratio (WHR), and conicity index (CI) were calculated. The height estimation equation was obtained by multiple linear regression. Concordance between height and the indicators measured and estimated was evaluated by the intraclass correlation coefficient (ICC) and Cohen's Kappa and Weighted Kappa indexes. Concordance was also evaluated by the Bland and Altman graphical approach. RESULTS: Equations of height estimation composed of knee height, sex, and schooling were proposed and stratified by age group (60-74 years and ≥75 years). In both age groups, almost perfect agreement (ICC ≥ 0.915 and Kappa ≥0.81) was found between height and adiposity indicators estimated and measured. CONCLUSION: The equation proposed is suitable to estimate height of the older adults, and can be a valuable tool for the evaluation of the nutritional status of Brazilian older adults in the community.

Prevalence, diagnostic criteria, and factors associated with sarcopenic obesity in older adults from a low middle income country: A systematic review.

OBJECTIVE: To evaluate the scientific evidences on the prevalence, diagnostic criteria, and factors related to sarcopenic obesity (SO) in Brazilian older adults. METHODS: this systematic review was based on searches of the databases PubMed, Science Direct, Excerpta Medica Database (Embase), Web of Science, Scientific Electronic Library Online (SciELO), and Scopus. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The inclusion criteria were: original articles of observational design that evaluated the presence of sarcopenic obesity in Brazilian older adults (≥60 years). Therefore, studies that investigated only obesity or sarcopenia, animal studies, review studies, congress publications, theses, dissertations, book chapters, editorials, letters to the editor, and newspaper articles were not included. RESULTS: The initial screening identified 549 records. After removing the duplicates, assessing the titles and abstracts, and the complete analysis of the papers, 12 studies were included in the review. The sample size of the studies ranged from 56 to 1373 subjects, most of them selected by convenience sampling (n = 11) and exclusively with women (n = 9). The prevalence of SO varied from 4.4% to 48.4%. No consensus was found on the diagnostic criteria for SO. The main associations identified were between SO and decrease in muscle strength, aerobic fitness, gait speed, and increase in frequency of frailty and cardiometabolic and inflammatory alterations. CONCLUSIONS: Epidemiological studies conducted so far in Brazil are heterogeneous, which limits the possibility of comparison between prevalence and distribution of sarcopenic obesity among older adults. Further studies with representative samples of the population are required to understand the magnitude of SO in this group.

Factors associated with food security in households in the urban area of the state of Tocantins, Northern Brazil. / Fatores associados à insegurança alimentar em domicílios da área urbana do estado do Tocantins, Região Norte do Brasil.

OBJECTIVE: To evaluate the factors associated with food insecurity in families living in the urban area of Tocantins/Brazil. METHODS: This is a population-based cross-sectional study conducted in the urban area of 22 municipalities in the 8 microregions of the state. A semi-structured questionnaire was applied to the head of household to obtain socioeconomic and demographic data, and the Brazilian Food Insecurity Scale (EBIA) was used to assess food insecurity at home. The anthropometric assessment of the residents was made by measuring weight, height/length and waist circumference. Multinomial logistic regression was performed to assess the association of food insecurity with individual/household variables, and Pearson's chi-square test was used to compare whether there was a difference in the prevalence of food insecurity between microregions and between families with and without individuals under 18 years. RESULTS: A total of 596 households were evaluated, of which 63.4% were in a food insecurity situation. The final model of the multivariate analysis showed that low head-of-household schooling, low per capita income, receiving social assistance benefits and lack of clean drinking water in the household were associated with food insecurity (p < 0.05). CONCLUSIONS: The findings of this study reveal the high prevalence of food insecurity in the families studied and their associated factors, showing the need for local actions and public policies to improve health conditions, education and income of the population, and consequently, improve the scenario of food and nutritional insecurity in the state.

OBJETIVO: Avaliar os fatores associados à insegurança alimentar de famílias residentes na zona urbana do Estado do Tocantins, Brasil. MÉTODOS: Trata-se de um estudo transversal, de base populacional, realizado na área urbana de 22 municípios das oito microrregiões do Estado. Foram aplicados um questionário semiestruturado ao chefe de família, para obtenção dos dados socioeconômicos e demográficos, e a Escala Brasileira de Insegurança Alimentar (EBIA), para avaliação da insegurança alimentar no domicílio. A avaliação antropométrica dos moradores foi feita a partir da aferição de peso, estatura/comprimento e perímetro da cintura. Realizou-se regressão logística multinomial, para avaliar a associação da insegurança alimentar com as variáveis individuais/domiciliares, e o teste do χ2 de Pearson foi empregado para comparar se houve diferença da prevalência de insegurança alimentar entre as microrregiões e entre famílias com e sem indivíduos menores de 18 anos. RESULTADOS: No total, foram avaliados 596 domicílios, dos quais 63,4% se encontravam em insegurança alimentar. O modelo final da análise multivariada mostrou que baixa escolaridade do chefe de família, baixa renda per capita, recebimento de benefício de programa socioassistencial e falta de água potável no domicílio foram associados à insegurança alimentar (p < 0,05). CONCLUSÕES: Os achados deste estudo revelam a elevada prevalência de insegurança alimentar nas famílias estudadas e seus fatores associados, mostrando a necessidade de ações e políticas públicas locais para melhoria das condições de saúde, de educação, de renda da população e, consequentemente, do cenário da insegurança alimentar e nutricional no Estado.

Methodologies for assessing the household food availability in the context of food (in)security: a systematic review.

This article aims to identify the methods used to assess household food availability in studies on food and nutritional security and to discuss its methodological aspects. Systematic review elaborated according to the PRISMA method. We searched at PubMed; Scielo and Lilacs databases, and studies that used methods of assessing the availability of food at home were included. In the end, 19 papers composed the review. Food availability was predominantly assessed for a seven days period and from a single data measurement. Other variables were also observed in the studies, such as socio-demographic data and expenditure on food. Among the limitations to assess the food availability at home, we can highlight the difficulty in measuring the food distribution among family members and the lack of information on the variability of this availability. Such assessment can be improved by investigating the strengths and weaknesses of the instruments for greater detail and accuracy of the information. We recommend the development and validation of specific instruments capable of effectively measure the food availability at the household level.

[Household availability of food based on the new classification of food and nutritional (in)security]. / Disponibilidade domiciliar de alimentos a partir da nova classificação de alimentos e (in)segurança alimentar.

The scope of this research was to characterize the household availability of food based on the classification adopted in the new Brazilian food guide and to analyze its relationship with food (in)security. It involved a population-based, cross-sectional study conducted in 95 households in the State of Tocantins. Food (in)security was evaluated by means of the Brazilian Food Insecurity Scale. The household availability of food in the last 30 days was recorded and, subsequently, food was classified as in natura and/or minimally processed, processed and ultra-processed according to the new Brazilian food guide. The prevalence of food insecurity was 55.79%. It was found that the foods of the in natura and ultra-processed groups contributed the most to the household availability of food. There was a positive and significant relationship between the food security and food availability rates: milk, animal fat, canned food and cheese bread. The prevalence of food insecurity was high in this population group. In households with a higher level of food security, the availability of milk, animal fat, canned goods and cheese bread was significantly higher.

O objetivo deste estudo foi caracterizar a disponibilidade domiciliar de alimentos a partir da classificação dos alimentos adotada no novo guia alimentar brasileiro e analisar sua relação com a (in)segurança alimentar. Trata-se de um estudo de base populacional, transversal, realizado em 95 domicílios do Estado do Tocantins. Avaliou-se a (in)segurança alimentar, por meio da Escala Brasileira de Insegurança Alimentar. A disponibilidade domiciliar de alimentos nos últimos 30 dias foi registrada e, posteriormente, classificou-se os alimentos em in natura e/ou minimamente processados, processados e ultraprocessados, conforme o novo guia alimentar brasileiro. A prevalência de insegurança alimentar foi de 55,79%. Verificou-se que os alimentos dos grupos in natura e ultraprocessados foram os que mais contribuíram para a disponibilidade domiciliar de alimentos. Verificou-se relação positiva e significante do grau de segurança alimentar com a disponibilidade dos alimentos: leite, gordura animal, enlatados e pão de queijo. A prevalência de insegurança alimentar foi elevada nessa população. Nos domicílios com maior grau de segurança alimentar, a disponibilidade de leite, gordura animal, enlatados e pão de queijo foi significantemente maior.

Methodologies for assessing the household food availability in the context of food (in)security: a systematic review / Metodologias de avaliação da disponibilidade de alimentos no domicílio no contexto da (in)segurança alimentar: uma revisão sistemática

Abstract This article aims to identify the methods used to assess household food availability in studies on food and nutritional security and to discuss its methodological aspects. Systematic review elaborated according to the PRISMA method. We searched at PubMed; Scielo and Lilacs databases, and studies that used methods of assessing the availability of food at home were included. In the end, 19 papers composed the review. Food availability was predominantly assessed for a seven days period and from a single data measurement. Other variables were also observed in the studies, such as socio-demographic data and expenditure on food. Among the limitations to assess the food availability at home, we can highlight the difficulty in measuring the food distribution among family members and the lack of information on the variability of this availability. Such assessment can be improved by investigating the strengths and weaknesses of the instruments for greater detail and accuracy of the information. We recommend the development and validation of specific instruments capable of effectively measure the food availability at the household level.

Resumo O objetivo deste artigo é identificar métodos empregados para a avaliação da disponibilidade de alimentos no âmbito domiciliar em estudos sobre segurança alimentar e nutricional e discutir seus aspectos metodológicos. Revisão sistemática elaborada segundo o método PRISMA. Realizou-se busca nas bases de dados PubMed, SciELO e Lilacs, tendo sido incluídos estudos que empregaram métodos de avaliação da disponibilidade de alimentos no domicílio. Ao final, 19 artigos compuseram a revisão. A disponibilidade de alimentos foi avaliada predominantemente para um período de sete dias e a partir de única medição dos dados. Outras variáveis também foram observadas nos estudos, como dados sociodemográficos e de despesas com os alimentos. Dentre as limitações para a avaliação da disponibilidade domiciliar de alimentos, destaca-se a dificuldade de mensuração da distribuição de alimentos entre os membros da família e a falta de informação sobre a variabilidade desta disponibilidade. Tal avaliação pode ser melhorada através da investigação de pontos fortes e fracos dos instrumentos para maior detalhamento e precisão das informações. Recomenda-se o desenvolvimento e a validação de instrumentos específicos capazes de mensurar efetivamente a disponibilidade de alimentos em nível domiciliar.

Disponibilidade domiciliar de alimentos a partir da nova classificação de alimentos e (in)segurança alimentar / Household availability of food based on the new classification of food and nutritional (in)security

Resumo O objetivo deste estudo foi caracterizar a disponibilidade domiciliar de alimentos a partir da classificação dos alimentos adotada no novo guia alimentar brasileiro e analisar sua relação com a (in)segurança alimentar. Trata-se de um estudo de base populacional, transversal, realizado em 95 domicílios do Estado do Tocantins. Avaliou-se a (in)segurança alimentar, por meio da Escala Brasileira de Insegurança Alimentar. A disponibilidade domiciliar de alimentos nos últimos 30 dias foi registrada e, posteriormente, classificou-se os alimentos em in natura e/ou minimamente processados, processados e ultraprocessados, conforme o novo guia alimentar brasileiro. A prevalência de insegurança alimentar foi de 55,79%. Verificou-se que os alimentos dos grupos in natura e ultraprocessados foram os que mais contribuíram para a disponibilidade domiciliar de alimentos. Verificou-se relação positiva e significante do grau de segurança alimentar com a disponibilidade dos alimentos: leite, gordura animal, enlatados e pão de queijo. A prevalência de insegurança alimentar foi elevada nessa população. Nos domicílios com maior grau de segurança alimentar, a disponibilidade de leite, gordura animal, enlatados e pão de queijo foi significantemente maior.

Abstract The scope of this research was to characterize the household availability of food based on the classification adopted in the new Brazilian food guide and to analyze its relationship with food (in)security. It involved a population-based, cross-sectional study conducted in 95 households in the State of Tocantins. Food (in)security was evaluated by means of the Brazilian Food Insecurity Scale. The household availability of food in the last 30 days was recorded and, subsequently, food was classified as in natura and/or minimally processed, processed and ultra-processed according to the new Brazilian food guide. The prevalence of food insecurity was 55.79%. It was found that the foods of the in natura and ultra-processed groups contributed the most to the household availability of food. There was a positive and significant relationship between the food security and food availability rates: milk, animal fat, canned food and cheese bread. The prevalence of food insecurity was high in this population group. In households with a higher level of food security, the availability of milk, animal fat, canned goods and cheese bread was significantly higher.

A systematic review of cross-sectional studies on the association of sedentary behavior with cardiometabolic diseases and related biomarkers in South American adults / Revisión sistemática de estudios transversales sobre la asociación de la conducta sedentaria con las enfermedades cardiometabólicas y sus biomarcadores relacionados en adultos sudamericanos

INTRODUCTION: sedentary behavior (SB) has been independently associated with detrimental health outcomes in different regions worldwide. The aim of this systematic review was to examine whether domain-specific SB is associated with cardiometabolic diseases (CMD) and related biomarkers in South American adults. METHODS: nine electronic databases were searched to identify all studies that analyzed the association between SB and CMD -e.g. obesity, diabetes, hypertension, metabolic syndrome (MetS) and clustering of chronic diseases (CCD) - and related biomarkers in South American adults. Two independent reviewers performed the necessary Abstract/full-text screening, data abstraction, and quality assessments. The review protocol was registered in the PROSPERO database (CRD42018099319). RESULTS: from the 1,262 articles identified in the search 262 were reviewed in full and 20 were used in the analysis in accordance to the inclusion criteria. High SB (mainly sitting and TV time) was associated with an increased likelihood of obesity (n = 8), diabetes (n = 6), and CCD (n = 3), as well as high values of BMI (n = 8), WC (n = 7), % BF (n = 4), plasma lipids (n = 4), and glycemia (n = 5). Eleven out of 20 studies were of higher quality. CONCLUSION: long time spent in SB, mainly sitting and TV time, was positively associated with the occurrence of CMD and related biomarkers in South American adults

INTRODUCCIÓN: el comportamiento sedentario (CS) se ha asociado de forma independiente con resultados perjudiciales para la salud en diferentes regiones del mundo. El objetivo de esta revisión sistemática fue examinar si el CS específico de cada dominio se asocia o no a enfermedades cardiometabólicas (ECM) y sus biomarcadores relacionados en adultos sudamericanos. MÉTODOS: se realizaron búsquedas en nueve bases de datos electrónicas para identificar todos los estudios que habían analizado la asociación entre CS y ECM -por ejemplo, obesidad, diabetes, hipertensión, síndrome metabólico y agrupación de enfermedades crónicas (AEC)- y sus biomarcadores relacionados en adultos sudamericanos. Dos revisores independientes realizaron evaluaciones de los resúmenes/textos completos, el resumen de los datos y evaluaciones de calidad. El protocolo de revisión está registrado en la base de datos PROSPERO (CRD42018099319). RESULTADOS: de los 1262 artículos identificados en la búsqueda, 262 se revisaron en su totalidad y 20 se utilizaron en el análisis de acuerdo con los criterios de inclusión. El gran CS diabetes (n = 6) y AEC (n = 3), así como a valores altos de IMC (n = 8), WC (n = 7), % BF (n = 4), lípidos plasmáticos (n = 4) y glucemia (n = 5). Once de los 20 estudios fueron de alta calidad. CONCLUSIÓN: la gran cantidad de tiempo invertido en el CS, principalmente el tiempo sentado y de televisión, se asoció positivamente con la aparición de ECM y sus biomarcadores relacionados en adultos de América del Sur

General and Central Adiposity in Older Adults in Palmas (TO): Prevalence and Associated Factors.

Objectives: To evaluate the prevalence and associated factors with general and central adiposity in older adults in Palmas (TO).Methods: Cross-sectional study with older adults (≥60 years) of both sexes enrolled in the Family Health Strategy program in Palmas (TO). Sociodemographic aspects, health conditions, and functionality were evaluated as independent variables and Body Mass Index (BMI) for general adiposity and Waist Circumference (WC) for central adiposity as dependent variables. Descriptive analysis and hierarchical multiple Poisson regression with robust variance were performed.Results: A total of 449 seniors (50.6% women) from 60 to 92 years of age, average of 68.3 years, were evaluated. The prevalence of general adiposity was 46.8% (95% CI: 42.2%-51.4%) and central adiposity was 78.8% (95% CI: 74.7%-82.3%). The prevalence of both outcomes was significantly higher among women and the participants with a history of hypertension, diabetes, dyslipidemia, and rheumatic diseases and those dependent in activities of daily living (ADL) than among men. Lower frequency of adiposity (general and central) was found with increasing age. After adjustment, the prevalence of both outcomes was significantly higher in women aged 70-79 years and hypertensive.Conclusions: The results of this study confirm the need to establish nutritional status monitoring and direct obesity prevention and control interventions in programs to promote health and quality of life of older adults and those in the stages prior to old age.

A systematic review of cross-sectional studies on the association of sedentary behavior with cardiometabolic diseases and related biomarkers in South American adults.

INTRODUCTION: Introduction: sedentary behavior (SB) has been independently associated with detrimental health outcomes in different regions worldwide. The aim of this systematic review was to examine whether domain-specific SB is associated with cardiometabolic diseases (CMD) and related biomarkers in South American adults. Methods: nine electronic databases were searched to identify all studies that analyzed the association between SB and CMD-e.g. obesity, diabetes, hypertension, metabolic syndrome (MetS) and clustering of chronic diseases (CCD)-and related biomarkers in South American adults. Two independent reviewers performed the necessary abstract/full-text screening, data abstraction, and quality assessments. The review protocol was registered in the PROSPERO database (CRD42018099319). Results: from the 1,262 articles identified in the search 262 were reviewed in full and 20 were used in the analysis in accordance to the inclusion criteria. High SB (mainly sitting and TV time) was associated with an increased likelihood of obesity (n = 8), diabetes (n = 6), and CCD (n = 3), as well as high values of BMI (n = 8), WC (n = 7), % BF (n = 4), plasma lipids (n = 4), and glycemia (n = 5). Eleven out of 20 studies were of higher quality. Conclusion: long time spent in SB, mainly sitting and TV time, was positively associated with the occurrence of CMD and related biomarkers in South American adults.

INTRODUCCIÓN: Introducción: el comportamiento sedentario (CS) se ha asociado de forma independiente con resultados perjudiciales para la salud en diferentes regiones del mundo. El objetivo de esta revisión sistemática fue examinar si el CS específico de cada dominio se asocia o no a enfermedades cardiometabólicas (ECM) y sus biomarcadores relacionados en adultos sudamericanos. Métodos: se realizaron búsquedas en nueve bases de datos electrónicas para identificar todos los estudios que habían analizado la asociación entre CS y ECM ­por ejemplo, obesidad, diabetes, hipertensión, síndrome metabólico y agrupación de enfermedades crónicas (AEC)­ y sus biomarcadores relacionados en adultos sudamericanos. Dos revisores independientes realizaron evaluaciones de los resúmenes/textos completos, el resumen de los datos y evaluaciones de calidad. El protocolo de revisión está registrado en la base de datos PROSPERO (CRD42018099319). Resultados: de los 1262 artículos identificados en la búsqueda, 262 se revisaron en su totalidad y 20 se utilizaron en el análisis de acuerdo con los criterios de inclusión. El gran CS (principalmente, tiempo sentado y de televisión) se asoció a una mayor probabilidad de obesidad (n = 8), diabetes (n = 6) y AEC (n = 3), así como a valores altos de IMC (n = 8), WC (n = 7), % BF (n = 4), lípidos plasmáticos (n = 4) y glucemia (n = 5). Once de los 20 estudios fueron de alta calidad. Conclusión: la gran cantidad de tiempo invertido en el CS, principalmente el tiempo sentado y de televisión, se asoció positivamente con la aparición de ECM y sus biomarcadores relacionados en adultos de América del Sur.

Fatores associados à insegurança alimentar em domicílios da área urbana do estado do Tocantins, Região Norte do Brasil / Factors associated with food security in households in the urban area of the state of Tocantins, Northern Brazil

RESUMO: Objetivo: Avaliar os fatores associados à insegurança alimentar de famílias residentes na zona urbana do Estado do Tocantins, Brasil. Métodos: Trata-se de um estudo transversal, de base populacional, realizado na área urbana de 22 municípios das oito microrregiões do Estado. Foram aplicados um questionário semiestruturado ao chefe de família, para obtenção dos dados socioeconômicos e demográficos, e a Escala Brasileira de Insegurança Alimentar (EBIA), para avaliação da insegurança alimentar no domicílio. A avaliação antropométrica dos moradores foi feita a partir da aferição de peso, estatura/comprimento e perímetro da cintura. Realizou-se regressão logística multinomial, para avaliar a associação da insegurança alimentar com as variáveis individuais/domiciliares, e o teste do χ2 de Pearson foi empregado para comparar se houve diferença da prevalência de insegurança alimentar entre as microrregiões e entre famílias com e sem indivíduos menores de 18 anos. Resultados: No total, foram avaliados 596 domicílios, dos quais 63,4% se encontravam em insegurança alimentar. O modelo final da análise multivariada mostrou que baixa escolaridade do chefe de família, baixa renda per capita, recebimento de benefício de programa socioassistencial e falta de água potável no domicílio foram associados à insegurança alimentar (p < 0,05). Conclusões: Os achados deste estudo revelam a elevada prevalência de insegurança alimentar nas famílias estudadas e seus fatores associados, mostrando a necessidade de ações e políticas públicas locais para melhoria das condições de saúde, de educação, de renda da população e, consequentemente, do cenário da insegurança alimentar e nutricional no Estado.

ABSTRACT: Objective: To evaluate the factors associated with food insecurity in families living in the urban area of Tocantins/Brazil. Methods: This is a population-based cross-sectional study conducted in the urban area of 22 municipalities in the 8 microregions of the state. A semi-structured questionnaire was applied to the head of household to obtain socioeconomic and demographic data, and the Brazilian Food Insecurity Scale (EBIA) was used to assess food insecurity at home. The anthropometric assessment of the residents was made by measuring weight, height/length and waist circumference. Multinomial logistic regression was performed to assess the association of food insecurity with individual/household variables, and Pearson's chi-square test was used to compare whether there was a difference in the prevalence of food insecurity between microregions and between families with and without individuals under 18 years. Results: A total of 596 households were evaluated, of which 63.4% were in a food insecurity situation. The final model of the multivariate analysis showed that low head-of-household schooling, low per capita income, receiving social assistance benefits and lack of clean drinking water in the household were associated with food insecurity (p < 0.05). Conclusions: The findings of this study reveal the high prevalence of food insecurity in the families studied and their associated factors, showing the need for local actions and public policies to improve health conditions, education and income of the population, and consequently, improve the scenario of food and nutritional insecurity in the state.

Food availability and food insecurity in households in the state of Tocantins, Northern Brazil / Disponibilidade de alimentos e insegurança alimentar de domicílios do Estado do Tocantins, Região Norte do Brasil

ABSTRACT Objective To assess the relationship between food availability, food insecurity and socioeconomic and demographic characteristics of households in the urban area of the state of Tocantins. Methods Population-based, cross-sectional study conducted in 594 households in the urban area of 22 municipalities in the state of Tocantins. A survey was carried out in the households, to collect socioeconomic and data, and assess food insecurity using the Brazilian Food Insecurity Scale. Further a food availability questionnaire was applied by the interviewer with the head of the family, who reported on the food and drinks available at home in the last 30 days. The description of the food available in the households resulted in a total of 142 food items that were grouped according to the NOVA classification of foods. demographic Results It was found that 63.3% of households were in a situation of food insecurity. The median caloric availability found was 2,771.4kcal/per capita/day, with the largest caloric contribution coming from fresh and minimally processed foods, regardless of the degree of food insecurity. Food availability was affected by socioeconomic vulnerability and the situation of food insecurity in the families.

RESUMO Objetivo Avaliar a relação entre a disponibilidade alimentar, a situação de insegurança alimentar e características socioeconômicas e demográficas de domicílios da zona urbana do Estado do Tocantins. Métodos Estudo de base populacional, do tipo transversal, realizado em 594 domicílios da área urbana de 22 municípios do Estado do Tocantins. A coleta de dados foi realizada nos domicílios, com levantamento de dados socioeconômicos e demográficos, avaliação da insegurança alimentar por meio da Escala Brasileira de Insegurança Alimentar e avaliação da disponibilidade dos alimentos a partir de um questionário de disponibilidade alimentar aplicado pelo entrevistador ao chefe da família, que informou sobre os alimentos e bebidas disponíveis no domicílio nos últimos 30 dias. A descrição dos alimentos disponíveis nos domicílios resultou em um total de 142 itens alimentares que foram agrupados de acordo com a classificação NOVA de alimentos. Resultados Constatou-se que 63,3% dos domicílios encontravam-se em situação de insegurança alimentar. A disponibilidade calórica mediana encontrada foi de 2.771,4kcal/per capita/dia, sendo a maior contribuição calórica advinda de alimentos in natura e minimamente processados, independente do grau de insegurança alimentar. Conclusão A disponibilidade alimentar foi afetada pela vulnerabilidade socioeconômica e pela situação de insegurança alimentar das famílias.

Atividade sexual, satisfação e qualidade de vida em pessoas idosas / Sexual activity, satisfaction and quality of life in older adults

Objetivou-se analisar a relação entre satisfação sexual e variáveis demográficas, sociais, clínicas e qualidade de vida em idosos. Estudo transversal de base populacional parte do Estudo Saúde, Bem-Estar e Envelhecimento, realizado no município de São Paulo em 2010, com uma amostra de 1.129 idosos. Avaliou-se a satisfação sexual pelo relato da atividade sexual e sua satisfação e a qualidade de vida pelo SF-12. Quanto à satisfação sexual, 45,1% afirmaram estar inativos satisfeitos, 6,2% ativos insatisfeitos, 37,0% ativos satisfeitos e 11,7% inativos insatisfeitos. O componente físico da qualidade de vida foi associado à satisfação sexual e as maiores médias deste componente foram encontradas entre os idosos ativos satisfeitos. Concluiu-se que a prática sexual é de extrema importância para a qualidade de vida do idoso, reforçando a necessidade de implantar ações de educação e proteção em relação à vulnerabilidade da sexualidade dos idosos.

The objective of this study was to analyze the relationship between sexual satisfaction and demographic, social, and clinical variables as well as quality of life in older adults. This is a cross-sectional population-based study conducted as part of the Health, Well-Being, and Aging Study, in the city of São Paulo in 2010, with a sample of 1,129 older adults. Sexual satisfaction was measured by reporting sexual activity, satisfaction and quality of life using the SF-12 survey. Regarding sexual satisfaction, 45.1% reported being inactive and satisfied, 6.2% active and dissatisfied, 37.0% active and satisfied and 11.7% inactive and dissatisfied. The physical component of quality of life was associated with sexual satisfaction and the highest means of this component were found among the older adults who were active and satisfied. It was concluded that sexual practice is extremely important for quality of life in older adults, which reinforces the need to implement education and protection actions in relation to the vulnerability of sexuality in older adults.

Associação de força de preensão palmar e osteoporose avaliada por densitometria óssea (DXA) em idosos quilombolas: um estudo seccional / Association between handgrip strength and osteoporosis assessed by bone densitometry in elderly quilombolas: a sectional study

Objetivo: Verificar a associação de força de preensão palmar e osteoporose em idosos quilombolas. Método: Trata-se de um estudo seccional com 70 participantes (idade 65,58 ± 6.67 anos) de ambos os sexos. A densidade mineral óssea (DMO), massa muscular (MM) e o percentual de gordura foram analisados pela absortometria de raios-x de dupla energia (DXA) e a força de preensão palmar (FPP) por meio do dinamômetro de mão. O ponto de coorte adotado para identificação de osteoporose foi o da Organização Mundial de Saúde (OMS). A identificação do status da sarcopenia foi realizado para caraterização da amostra e para o diagnóstico foi utilizado os critérios propostos pelo European Working Group on Sarcopenia in Older People (EWGSOP). A FPP foi associada positivamente e significativamente com a DMO. Resultados: A osteopenia foi identificada em 42,8% da amostra e a osteoporose em 20%, sem diferença entre as frequências segundo o sexo (p = 0,161). Conclusão: Nos idosos quilombolas a baixa FPP esteve positivamente associada com baixa DMO. Portanto, sugerindo que a FPP pode ser considerada um fator de risco importante de estado ósseo em idosos quilombolas.

Objective: The aim of this study was to verify the association between handgrip strength and osteoporosis in elderly quilombolas. Method: It is a sectional study with 70 participants (aged 65.58 ± 6.67 years) of both sexes. Bone mineral density (BMD), muscle mass and fat percentage were analysed by dual-energy X-ray absorptiometry (DXA) and handgrip strength by a hand dynamometer. Subjects were classified as having osteoporosis according to World Health Organization (WHO) cutoff point. The identification of sarcopenia was performed to characterize the sample and the diagnosis was done according to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Results: Osteopenia was identified in 42.8% of the sample and osteoporosis in 20%, with no difference between sex (p = 0.161). HGS was positively associated with BMD. Osteopenia was identified in 42.8% of the sample and osteoporosis in 20%, with no difference between the frequencies according to sex (p = 0.161). Conclusion: In the elderly quilombolas low HGS was positively associated with low BMD. Therefore, suggesting that HGS may be considered an important risk factor for bone state in this population.

Anthropometric patterns of adiposity, hypertension and diabetes mellitus in older adults of Viçosa, Brazil: A population-based study.

AIM: To identify anthropometric patterns of adiposity and estimate their association with hypertension and diabetes mellitus (DM) in older adults. METHODS: A cross-sectional study with 537 older adults aged ≥60 years was carried out. Weight, height, and waist, hip and calf circumference were measured. The following indices were calculated: a body shape index, body roundness index, conicity index, body adiposity index, body mass index, waist-to-height ratio, waist-to-calf ratio, waist-to-hip ratio and waist-to-hip-to-height ratio. The anthropometric patterns of adiposity were obtained by factor analysis of principal components, and their association with hypertension and DM was identified by multiple Poisson regression with robust variance. RESULTS: Two anthropometric patterns of adiposity were identified. Pattern 1 and 2 explained approximately 53% and 33% of the total variance, respectively, in both sexes. Pattern 1 indicated of global adiposity, and weight, body mass index and hip circumference were the variables most strongly correlated with this pattern in both sexes. Pattern 2 represented the body fat distribution, being a body shape index the most important variable in this factor. After adjustment by confounding factors, only the pattern 2 remained significantly associated with DM in women. CONCLUSIONS: Only the anthropometric pattern of adiposity central was associated with DM in older women. Geriatr Gerontol Int 2018; 18: 584-591.

EFFECT OF EICOSAPENTAENOIC ACID AND DOCOSAHEXAENOIC ACID SUPPLEMENTATIONS TO CONTROL COGNITIVE DECLINE IN DEMENTIA AND ALZHEIMER'S DISEASE: A SYSTEMATIC REVIEW.

INTRODUCTION: there is a lack of consensus on the benefits of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementations on cognition in dementia and/or Alzheimer's disease (AD) elderly. OBJECTIVE: this study presents a systematic review of the results of randomized clinical trials about this topic. The adopted search criteria were randomized clinical trials involving elderly over 65 years of age with no limit to the year of publication of the study. RESULTS: we identified 139 articles, and from the eligible ones a reverse search was conducted. The quality of the trials was assessed using the Jadad scale. Of the four selected studies, three were related to mild to moderate AD elderly, of both genders. Mini Mental State Examination, Alzheimer's Disease Assessment Scale Cognitive, and Clinical Dementia Rate were the main tests used to assess cognitive performance. CONCLUSION: EPA and/or DHA supplementations did not affect scores obtained on the cognitive tests. However, supplementation with EPA and/or DHA improved verbal fluency and attention in patients who had only very mild dementia or AD or presented APOEε4 negative genotype. In case of advanced AD elderly patients, EPA and/or DHA supplementations did not reduce cognitive decline rates.

Introducción: no existe consenso sobre los benefícios de la suplementación con ácido eicosapentaenoico (EPA) y ácido docosahexaenoico (DHA) sobre la cognición de las personas mayores con demencia y/o Alzheimer. Objetivo: esta revisión sistemática muestra los resultados de ensayos clínicos randomizados al respecto. Métodos: se realizó una búsqueda de ensayos clínicos randomizados llevados a cabo en personas mayores de 65 años, sin estabelecer límites en cuanto al año de publicación. Resultados: se identificaron 139 artículos y a partir de los artículos candidatos se llevó a cabo una búsqueda inversa. La calidad de los ensayos clínicos aleatorios se evaluó mediante la escala de Jadad. De los cuatro estudios seleccionados, tres valoraban ancianos, con diagnóstico de enfermedad de Alzheimer de leve a moderada, en ambos sexos. Mini Examen del Estado Mental, Enfermedad de Alzheimer, Escala de Evaluación Cognitiva y Tasa Clínica de Demencia fueron los principales test utilizados para estudiar el rendimiento cognitivo. Conclusión: la suplementación de EPA y/o DHA no afectó las puntuaciones en las pruebas cognitivas. Sin embargo, la suplementación con EPA y/o DHA mejoró la cognición en los dominios de fluidez y de atención verbales en pacientes que únicamente presentaban demencia leve o enfermedad de Alzheimer o el genotipo APOEε4 negativo. En los pacientes ancianos con enfermedad de Alzheimer avanzada, la suplementación con EPA y/o DHA no redujo las tasas de deterioro cognitivo.

ANTHROPOMETRIC DIFFERENCES RELATED TO GENDERS AND AGE IN THE ELDERLY.

INTRODUCTION: anthropometry facilitates the evaluation of the risks associated with reduced lean body mass, as well as of excess adiposity. However, very little is known regarding the anthropometric standards among the elderly and the differences observed between the genders and among the various age groups Objective: to compare indicators and indices anthropometrics of the elderly by gender and age group. METHODS: a cross-sectional study was undertaken using a representative probability sample, involving 621 elderly. We evaluated the weight, height, circumferences (waist, hip, calf and arm); body mass index, body adiposity index, waist-hip ratio and waist-stature ratio. RESULTS: women were found to have a higher mean body mass index, waist-stature ratio, body adiposity index and arm circumference (p < 0.001), whereas men had higher values for weight, height and waist-hip ratio (p < 0.001). The average arm and calf circumference, however, did not differ between the genders (p > 0.05). Weight, and calf and arm circumferences were observed to be lower in the older age groups (p < 0.001) and the same was true for the body mass index and height only in men (p < 0.05). The waist circumference, waist-hip ratio, body adiposity index and waist-stature ratio did not differ among the age groups (p > 0.05). CONCLUSION: the total and peripheral body mass, for the men, in particular, was lower among the older subjects. Central adiposity did not differ among the age groups in both the genders.

Introducción: la antropometría facilita la evaluación de los riesgos asociados con la masa corporal magra reducida, así como con el exceso de adiposidad. Sin embargo, se conoce muy poco acerca de las diferencias antropométricas observadas entre los géneros y entre los grupos de edad en los ancianos. Objetivo: comparar indicadores e índices antropométricos de los ancianos por género y grupo de edad. Métodos: estudio transversal, con una muestra de 621 ancianos. Se evaluó el peso, la talla, circunferencias (cintura, cadera, pantorrilla y brazo), índice de masa corporal, índice de adiposidad corporal, relación cintura-cadera y cintura-talla. Resultados: se encontró que las mujeres tienen un promedio mayor de índice de masa corporal, relación cintura- talla, índice de adiposidad corporal y circunferencia del brazo (p < 0,001); mientras que los hombres presentaron mayores valores para el peso, la talla y la relación cintura-cadera (p < 0,001). Las circunferencias de brazo y pantorrilla, sin embargo, no fueron diferentes entre los géneros (p > 0,05). Se observaron peso y circunferencias de pantorrilla y brazo menores en los grupos de mayor edad (p < 0,001) y lo mismo sucedió para el índice de masa corporal y la talla solo en los hombres (p < 0,05). La circunferencia de cintura, índice de adiposidad corporal, relación cintura-cadera y cintura-talla no fue diferente entre los grupos de edad (p > 0,05). Conclusión: la masa corporal total y periférica, para los hombres, en particular, fue menor entre los sujetos de mayor edad. La adiposidad central no fue diferente entre los grupos de edad en ambos géneros.

Effect of eicosapentaenoic acid and docosahexaenoic acid supplementations to control cognitive decline in dementia and Alzheimer’s disease: a systematic review / Efecto de la suplementación del ácido eicosapentaenoico y ácido docosahexaenoico para controlar el deterioro cognitivo en la demencia y enfermedad de alzheimer: una revisión sistemática

Introduction: there is a lack of consensus on the benefits of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementations on cognition in dementia and/or Alzheimer’s disease (AD) elderly. Objective: this study presents a systematic review of the results of randomized clinical trials about this topic. The adopted search criteria were randomized clinical trials involving elderly over 65 years of age with no limit to the year of publication of the study. Results: we identified 139 articles, and from the eligible ones a reverse search was conducted. The quality of the trials was assessed using the Jadad scale. Of the four selected studies, three were related to mild to moderate AD elderly, of both genders. Mini Mental State Examination, Alzheimer’s Disease Assessment Scale Cognitive, and Clinical Dementia Rate were the main tests used to assess cognitive performance. Conclusion: EPA and/or DHA supplementations did not affect scores obtained on the cognitive tests. However, supplementation with EPA and/or DHA improved verbal fluency and attention in patients who had only very mild dementia or AD or presented APOEε4 negative genotype. In case of advanced AD elderly patients, EPA and/or DHA supplementations did not reduce cognitive decline rates (AU)

Introducción: no existe consenso sobre los beneficios de la suplementación con ácido eicosapentaenoico (EPA) y ácido docosahexaenoico (DHA) sobre la cognición de las personas mayores con demencia y/o Alzheimer. Objetivo: esta revisión sistemática muestra los resultados de ensayos clínicos randomizados al respecto. Métodos: se realizó una búsqueda de ensayos clínicos randomizados llevados a cabo en personas mayores de 65 años, sin estabelecer límites en cuanto al año de publicación. Resultados: se identificaron 139 artículos y a partir de los artículos candidatos se llevó a cabo una búsqueda inversa. La calidad de los ensayos clínicos aleatorios se evaluó mediante la escala de Jadad. De los cuatro estudios seleccionados, tres valoraban ancianos, con diagnóstico de enfermedad de Alzheimer de leve a moderada, en ambos sexos. Mini Examen del Estado Mental, Enfermedad de Alzheimer, Escala de Evaluación Cognitiva y Tasa Clí- nica de Demencia fueron los principales test utilizados para estudiar el rendimiento cognitivo. Conclusión: la suplementación de EPA y/o DHA no afectó las puntuaciones en las pruebas cognitivas. Sin embargo, la suplementación con EPA y/o DHA mejoró la cognición en los dominios de fluidez y de atención verbales en pacientes que únicamente presentaban demencia leve o enfermedad de Alzheimer o el genotipo APOEε4 negativo. En los pacientes ancianos con enfermedad de Alzheimer avanzada, la suplementación con EPA y/o DHA no redujo las tasas de deterioro cognitivo (AU)