Child feeding indexes measuring adherence to New Zealand nutrition guidelines: Development and assessment.

New Zealand (NZ) lacks nationally representative or generalisable information on the dietary intakes of pre-schoolers. We used Growing Up in New Zealand cohort data to i) develop child feeding indexes (CFIs) based on National Food and Nutrition Guidelines for 2- and 4.5-year-olds; ii) describe the cohort adherence to the guidelines at 2 (n = 6046) and 4.5 years (n = 5889) and; iii) assess the CFIs' convergent construct validity, by exploring associations with maternal sociodemographic and health behaviours and with child body mass index for age (BMI/age) and the waist-to-height ratio at 4.5 years. The CFIs scores ranged from 0 to 11, with 11 representing full adherence to the guidelines. Associations were tested using multiple linear regressions and Poisson regressions with robust variance (risk ratios [RR], 95% confidence intervals, 95% CI). The CFIs mean scores (SD) at 2 and 4.5 years were, respectively, 6.13 (1.21) and 6.22 (1.26) points. Maternal characteristics explained, respectively, 27.2% and 31.9% of the variation in the CFIs scores at 2 and 4.5 years. In the adjusted model at the 4.5-year interview, in relation to girls ranked in the 5th quintile, those in the 2nd (RR, 95% CI: 1.48; 1.03; 1.24) and 4th (1.53; 1.05; 2.23) quintiles of the CFI were more likely to have BMI/age > +2z (World Health Organization growth standards) at 4.5 years. At 2 and 4.5 years, most children fell short of meeting national guidelines. The associations between the CFIs scores at both time points with maternal characteristics and with children's body size at 4.5 years were in the expected directions, confirming the CFIs' convergent construct validity among NZ pre-schoolers.

'Candidatus Mycoplasma haematohydrochoerus', a novel hemoplasma species in capybaras (Hydrochoerus hydrochaeris) from Brazil.

Three different species of hemoplasmas have been described in rodents, Mycoplasma coccoides, 'Candidatus Mycoplasma haemomuris' and 'Candidatus Mycoplasma haemosphiggurus'. Additionally, potentially novel hemoplasma species have been detected in wild rodents from Brazil, including capybaras (Hydrochoerus hydrochaeris). Capybaras are the largest rodent in the world and are well adapted to live within close proximity to humans, which increases the risk to spread of zoonotic pathogens. Herein, we investigate the occurrence and genetic diversity of hemoplasmas infecting free-ranging capybaras from southern Brazil. Blood samples and ticks from 17 capybaras were collected. Packed cell volume and total plasma protein were measured, DNA was extracted, and further screened by species-specific and pan-hemoplasma PCR assays targeting the 16S rRNA gene of hemoplasmas. Sixteen out of 17 (94.12%; 95% CI: 73.02-98.95%) were anemic. Only one young female was hypoproteinemic. All capybaras were infested by adults and nymphs of Amblyomma dubitatum ticks. Using the PCR assay targeting the 16S rRNA gene of M. coccoides, 13/17 (76.47%; 95% CI: 52.74-90.44%) capybaras were positive for hemoplasmas. When DNA samples were tested by the pan-hemoplasma PCR, 16/17 (94.12%; 95% CI: 73.02-98.95%) animals were positive. One out of 11 (9.09%) adult ticks salivary glands tested positive for hemoplasma by the pan-hemoplasma PCR assay. Sequencing and phylogenetic analysis of the 16S and 23S rRNA gene fragments confirmed that animals were infected by a novel hemotropic Mycoplasma sp. previously reported in capybaras from Brazil. Additionally, sequencing and phylogenetic analysis of the 23S rRNA gene from three hemoplasma-positive capybaras samples from a previous study performed in midwestern Brazil also confirm our findings. Based on phylogenetic and Neighbor-Net network analysis of the 16S rRNA and 23S rRNA genes, the name 'Candidatus Mycoplasma haematohydrochoerus' is proposed for this novel organism.

2 + 2 (+ 2) = 4: A new approach for appendicular muscle mass assessment by ultrasound.

OBJECTIVE: The aim of this study was to develop new appendicular lean mass (ALM) prediction models based on ultrasound and anthropometric measurements. METHODS: This was a cross-sectional assessment of a subsample from a population-based study (COMO VAI?), conducted with community-dwelling individuals ≥60 y of age living in a southern Brazilian city. ALM was measured by dual-energy x-ray absorptiometry (DXA). Muscle thickness (MT) from supine participants was assessed by ultrasound on the anterior aspect of both upper and lower limbs. Such measures, along with anthropometric data, were used to develop prediction models (multivariable linear regression) through the backward stepwise method. RESULTS: The study included 190 participants composed mainly of women, white, and middle-class individuals. The best ALM predictive performance was achieved by a model based on two "lengths" (height and arm length), two circumferences (dominant arm and thigh), and two ultrasound-measured MTs (dominant arm and thigh): R2 = 0.90, limits of agreement: ±2.36 kg. Closely satisfactory results were also achieved by an "abbreviated" model composed by the two aforementioned "lengths" and MTs (R2 = 0.89, limits of agreement: ±2.51 kg). ALM estimates from both equations were unbiased and similar to DXA measurements (P = 0.13 and 0.09, respectively). Bootstrap analysis favorably suggested the validity of the models. CONCLUSIONS: Based on two ultrasound assessments and a few anthropometric measurements, the developed equations produced accurate and unbiased ALM estimates in the sample. Hence: 2 MTs + 2 lengths (+ 2 circumferences) = 4 limbs' muscle mass. Such models might represent promising alternatives for muscle assessment among older individuals.

Think Globally, Act Locally: The Importance of Population-Specific Bioelectrical Impedance Analysis Prediction Equations for Muscle Mass Assessment.

BACKGROUND: Bioelectrical impedance analysis (BIA) is a convenient muscle assessment method, but its accuracy highly depends on population-specific aspects of the adopted equation. We aimed to develop appendicular lean mass (ALM) prediction models for older South Americans and to compare their performances to those of reference equations in the same sample. METHODS: Cross-sectional evaluation of 192 community-dwelling Brazilian subjects ≥60 years old from the COMO VAI? STUDY: Using measurements from single-frequency and multifrequency devices (BIASF and BIAMF, respectively), new ALM prediction equations were developed (reference method: dual-energy x-ray absorptiometry [DXA]). Validity was assessed by bootstrapping. Four previously established equations were also tested, and the performances were compared using Bland-Altman analysis. RESULTS: Stepwise variable selection produced the following equations: ALMSF-BIA = (2.08 × sex) + (0.04 × weight) + (0.24 × RI50 ) + (0.07 × Xc50 ) - 0.16; ALMMF-BIA = (1.85 × sex) + (0.03 × weight) + (0.31 × RI50 ) + (0.04 × Xc50 ) + (0.01 × Z5 ) - 8.16, where ALM is estimated in kg; female sex = 0 and male sex = 1; weight is measured in kg; RI50 is the resistance index at 50 kHz measured in cm2 /Ω); Xc50 is the reactance at 50 kHz measured in Ω; and Z5 is impedance at 5 kHz measured in Ω. The equations explained, respectively, 89% and 90% of the variability of ALMDXA in our sample, and their estimates were not significantly different from DXA measurements. Bland-Altman analysis revealed accurate and unbiased performances for both models, with similar limits of agreement (BIASF : ±2.58 kg; BIAMF : ±2.48 kg), and their validity was considered adequate by the bootstrap method. The reference equations, however, systematically overestimated ALM in our sample. CONCLUSION: The proposed equations might represent practical options to estimate ALM in older noninstitutionalized South Americans. Further external validation, though, is required to verify the reproducibility of our findings.

Antenatal care and caesarean sections: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

BACKGROUND: Antenatal care and correctly indicated caesarean section can positively impact on health outcomes of the mother and newborn. Our objective was to describe how coverage and inequalities for these interventions changed from 1982 to 2015 in Pelotas, Brazil. METHODS: Using perinatal data from the 1982, 1993, 2004 and 2015 Pelotas birth cohorts, we assessed antenatal care coverage and caesarean section rates over time. Antenatal care indicators included the median number of visits, the prevalence of mothers attending at least six visits and the proportion who started antenatal care in the first trimester of pregnancy and attended at least six visits. We described these outcomes according to income quintiles and maternal skin colour, to identify inequalities. We described overall, private sector and public sector caesarean section rates. Differences in prevalence were tested using chi-square testing and median differences using Kruskal-Wallis testing. RESULTS: From 1982 to 2015, the median number of antenatal care visits and the prevalence of mothers attending at least six visits increased in all income quintiles and skin colour groups. Inequalities were reduced, but not eliminated. The overall proportion of caesarean births increased from 27.6% in 1982 to 65.1% in 2015, when 93.9% of the births in the private sector were by caesarean section. Absolute income-related inequalities in caesarean sections increased over time. CONCLUSIONS: Special attention should be given to the antenatal care of poor and Black women in order to reduce inequalities. The explosive increase in caesarean sections requires radical changes in delivery care policies, in order to reverse the current trend.