Baixa ingestão de proteínas está associada à mortalidade em idosos brasileiros / Low protein intake is associated with mortality in Brazilian older adults

Resumo Objetivo Estimar a associação entre baixa ingestão de proteínas e mortalidade em pessoas idosas. Métodos Estudo prospectivo realizado com 621 pessoas idosas da cidade de Viçosa (Minas Gerais), município de médio porte no Brasil. A ingestão de proteínas foi avaliada na linha de base (2009) pelo recordatório de ingestão habitual e foi utilizada a classificação de ingestão de proteínas proposta pela Sociedade Brasileira de Nutrição Parenteral e Enteral. Os dados de mortalidade foram coletados no período de acompanhamento (2009 a 2018) através do Sistema de Informações sobre Mortalidade. Modelos de regressão de Cox foram aplicados para estimar a associação independente entre ingestão total de proteínas e mortalidade, e estimativas de hazard ratio e seus respectivos intervalos de confiança de 95% foram calculados. Resultados Entre os 621 participantes do estudo, 52,7% eram do sexo feminino e a prevalência de baixa ingestão proteica foi de 60,9%. Ao longo dos 9 anos de acompanhamento ocorreram 154 óbitos (23,3%). No modelo ajustado, pessoas idosas com baixa ingestão de proteínas apresentaram maior risco de morte [HR: 1,72; IC 95%: 1,05 - 2.82]. Conclusão A baixa ingestão de proteínas pode aumentar o risco de morte em pessoas idosas.

Abstract Objective To estimate the association between low protein intake and mortality in older adults. Methods Prospective study carried out with 621 older adults in a medium-sized city (Viçosa, Minas Gerais) in Brazil. Protein intake was assessed at baseline (2009) by the usual intake recall and the protein intake classification was used as proposed by the Brazilian Society of Parenteral and Enteral Nutrition. Mortality data were collected in the follow-up period (2009 to 2018) from the Mortality Information System. Cox regression models were applied to estimate the independent association between total protein intake and mortality, and Hazard Ratio estimates and their respective 95% confidence intervals were calculated. Results Among the 621 participants in the study, 52.7% were female, and the prevalence of low protein intake was 60.9%. Over the 9 years of follow-up, there were 154 deaths (23,3%). In the adjust models, older adults with low protein intake showed increased risk of death [HR: 1.72; 95% CI: 1.05 - 2.82]. Conclusion Low protein intake may increase the risk of death in the older adults.

Obesogenic neighborhood environment is associated with body fat and low-grade inflammation in Brazilian children: could the mother's BMI be a mediating factor?

OBJECTIVE: To evaluate the direct and indirect associations of obesogenic and leptogenic neighborhood environments with body fat, and pro- and anti-inflammatory adipokines in Brazilian children. DESIGN: Cross-sectional study. The body fat distribution was assessed using dual-energy X-ray absorptiometry (DXA). Concentrations of leptin and adiponectin were measured. Four hundred meters (0·25 miles) road network buffer was the neighborhood unit used to assess the environmental characteristics around households. Obesogenic and leptogenic environments were the latent variables obtained from the observed characteristics. The mother's BMI, ultra-processed food consumption, and physical activity before and after school, were tested as mediating variables. A hybrid model of structural equations was used to test the direct and indirect associations of obesogenic and leptogenic environments with body fat, leptin and adiponectin concentrations. SETTING: Urban area of Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Children aged 8- and 9-years (n 367). RESULTS: Obesogenic environment was directly associated with the mother's BMI (ß: 0·24, P = 0·02) and the child's body fat (ß: 0·19, P = 0·02). The mother's BMI and body fat mediated the association of the obesogenic environment with leptin concentrations (ß: 0·05, P = 0·02). CONCLUSIONS: Obesogenic neighborhood environment was directly associated with body fat and mother's BMI, and indirectly associated with leptin concentrations in Brazilian children, mediated by the mother's BMI and body fat.

Iodine Intake and its Interindividual Variability in Brazilian Pregnant Women: EMDI Brazil Study.

Data on pregnant women's iodine intake are limited in Brazil. The aim of the study was to evaluate the contribution of foods, food groups, and food subgroups to the Brazilian pregnant women's iodine intake, and identify which food items explain the interindividual variability of their intake. A cross-sectional study with food consumption data of 2247 pregnant women from 24-h recalls was developed. Food items were classified according to the FAO/WHO GIFT classification, and their contribution to iodine intake and interindividual variability was assessed by the proportion of means method and linear regression, respectively. The mean usual iodine intake was 163.1 mcg (95% CI: 162.9-163.2). The food groups "spices and condiments," "cereals and their products," and "milk and milk products"; and the food subgroups "herbs and spices," "wheat and wheat-based products," "milk: fresh and processed," "dough-based sweets," and "eggs: fresh and processed" contributed to at least 80% of the iodine intake. Of these, only the food subgroups "milk," "dough-based sweets," and "eggs" did not explain the higher proportion (> 80%) of the interindividual variability. The contribution of "salt," "white French bread," "fluid whole milk," and "rice" to the iodine intake and its interindividual variability is highlighted. This study confirms the importance of "salt" as a dietary source of iodine and that few food groups and subgroups explained the difference in the iodine intake among pregnant women. Despite that, Brazilian staple foods, such as "rice," "beans," "eggs," "milk," and "bread" were identified as important for iodine intake and could be included in nutritional guidelines targeted to Brazilian pregnant women.

Higher atherogenic risk in schoolchildren is associated with MTMR9 rs2293855 gene polymorphism and genetic score.

Childhood dyslipidaemia is associated with the occurrence of cardiovascular diseases in adulthood, so evaluating whether an individual has a genetic predisposition to this pathology is of great importance for early action of prevention and treatment. This study aimed to evaluate the association between the FTO (rs9939609), MC4R (rs17782313) and MTMR9 (rs2293855) polymorphisms, the obesity-related genetic risk score and atherogenic risk in Brazilian children. This is a cross-sectional study conducted in 544 children aged 4-9 years in the city of Viçosa, Minas Gerais state, Brazil. The single nucleotide polymorphisms rs9939609, rs17782313 and rs2293855, were identified by the system TaqMan SNP genotyping and the obesity-related genetic risk score was determined. The lipid profile (serum total cholesterol [TC], high density lipoprotein [HDL] cholesterol, low density lipoprotein [LDL] cholesterol, triglycerides) was analysed and the atherogenic indices (Castelli I and II indices), atherogenic coefficient (AC), lipoprotein combined index (LCI) and plasma atherogenic index (PAI) were calculated. A semi-structured questionnaire was applied, obtaining data on the sociodemographic, economic and lifestyle characteristics of the children. Weight and height measurements were performed in all children, and body composition was evaluated by Dual-Energy X-ray Absorptiometry (DXA). 55.5% of the sample had dyslipidaemia, while 28.5% of the sample had at least one polymorphism and 2.2% had three polymorphisms. Children with the AG/AA genotypes in the rs2293855 polymorphism had lower HDL cholesterol levels and higher TC/HDL cholesterol, LDL/HDL cholesterol ratios and AC. Those with one or more polymorphisms (rs9939609, rs17782313 and rs2293855) in the genetic risk score had lower HDL cholesterol levels and higher TC/HDL cholesterol ratios, AC, LCI and PAI. In conclusion, the risk allele of the rs2293855 polymorphism and a higher obesity-related genetic risk score were positively associated with higher atherogenic risk in Brazilian children.

Information on medication abortion provided by family planning clinics in California.

OBJECTIVES: To assess access to abortion pills offered by clinics providing state-funded family planning services in California. METHODS: We attempted to make two scripted calls to a 20% random sample of family planning clinics in California, stratified by county, as "secret shoppers" in 2020 and 2021. RESULTS: Clinic staff responded to 407 calls. Only 50 respondents (12%) reported their clinic offered abortion pills and 23 respondents (6%) accurately indicated to callers that abortion pills were available free to low-income individuals in California. Most (68%) clinics that did not offer abortion pills could not direct callers to a clinic that did offer abortion pills. CONCLUSIONS: Efforts are needed to increase the number of clinics providing medication abortion services in California. Clinic staff need training to provide accurate information about medication abortion.

Characteristics of the obesogenic environment around schools are associated with body fat and low-grade inflammation in Brazilian children.

OBJECTIVE: To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children. DESIGN: Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry. Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4) and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents and crime were evaluated. The neighbourhood unit was the 400 m (0·25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using generalised estimating equations. SETTING: Urban schools (n 24), Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Children aged 8 and 9 years (n 378). RESULTS: A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (ß: 0·12; 95 % CI 0·06, 0·18 and ß: -0·10; 95 % CI -0·16, -0·04, respectively) and android body fat (ß: 0·28; 95 % CI 0·13, 0·43 and ß: -0·18; 95 % CI -0·32, -0·04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4. CONCLUSIONS: Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.

Higher serum uric acid is associated with body fat, retinol-binding protein 4, and antioxidative status in Brazilian children.

OBJECTIVE: The aim of this study was to evaluate the association of serum uric acid (SUA) with adiposity, adipokines, and anti- and oxidative markers in Brazilian children. METHODS: This was a cross-sectional investigation with 378 children ages 8 to 9 y in Viçosa, Minas Gerais, Brazil. Information on sociodemographic and lifestyle characteristics was obtained via questionnaires, and body fat was determined by dual energy x-ray absorptiometry. We compared the distributions of adiposity (total and central), adipokines (adiponectin, chemerin, leptin, and retinol-binding protein 4 [RBP4]), anti- and oxidative markers (plasma ferric reducing antioxidant power [FRAP], superoxide dismutase [SOD], and malondialdehyde [MDA]) by SUA categories using linear regression. RESULTS: SUA was positively associated with total and central fat. Every standard deviation (SD) of SUA was related, respectively, to a 3.4 (95% confidence interval [CI], 2.4-4.4), 4 (95% CI, 2.8-5.1), 4.2 (95% CI, 2.9-5.5), and 3.5 (95% CI, 2.4-4.6) units higher of total, truncal, android, and gynoid fat. We found a positive association of SUA with RBP4 and FRAP, and a negative association with MDA. Every SD of SUA was related, respectively, to 0.1 (95% CI, 0.01-0.1) and 7.8 (95% CI, 5.5-10.1) units higher of RBP4 and FRAP; and to -0.3 (95% CI, -0.5 to -0.1) units lower of MDA. CONCLUSIONS: SUA was positively associated with adiposity, RBP4, and antioxidative status in Brazilian children.

Community food environment and childhood obesity in a medium-sized Brazilian city: An approach to school and neighborhood environments.

OBJECTIVE: We aimed to analyze the relationship of community food environments with childhood obesity in a medium-sized Brazilian city. METHODS: This is a cross-sectional study with 366 schoolchildren aged 8 and 9 years. Children's body mass index (BMI), waist circumference and concentrations of total cholesterol (TC), high cholesterol density lipoprotein (HDL-c), low cholesterol density lipoprotein (LDL-c) and triglycerides (TG) were measured. The parent's nutritional status was assessed by calculating the BMI. All food stores within a 200- and 400-m radius buffers of schools and households were evaluated. The food stores were classified as healthy, unhealthy, and mixed according to the predominance of foods commercialized. Binary logistic regression models were proposed for each category. RESULTS: Over seventy percent (70.2%) of the food stores were categorized as "unhealthy". The prevalence of obesity was 15.6%. In the 200-m buffer around schools, there was an inverse and direct association between obesity and the presence of healthy food stores and unhealthy food stores, respectively. Around the households, there was an inverse association between the presence of healthy food stores and obesity in both buffers. CONCLUSION: The community food environment may be protective or potentiating childhood obesity, depending on the access and types of food sold.

Role of diet quality in bone health in children and adolescents: a systematic review.

CONTEXT: Poor diet quality and unhealthy dietary patterns have been linked to poor bone health, yet few studies have investigated the role of diet quality in bone health in pediatric populations. OBJECTIVE: This systematic review aims to assess the available evidence on the association between diet quality and bone health markers in children and adolescents. DATA SOURCES: The PubMed, Scopus, and Virtual Health Library databases were searched electronically from October to November 2022, without any restrictions on date or language. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist was used to assess the quality of the studies. DATA EXTRACTION: Published observational studies in children and adolescents (ages 2 to 19 years) that investigated the association between diet quality and bone health were eligible for inclusion. Two researchers independently analyzed and selected all articles using the Rayyan app. Initially, 965 papers were identified. A total of 12 observational studies qualified, including 8 cross-sectional and 4 longitudinal studies. The sample comprised 7130 individuals aged 3 to 17.9 years, representing both sexes. Bone health was evaluated by measures of bone mineral density and bone mineral content. DATA ANALYSIS: Seven studies (58.3%) showed significant associations between diet quality and bone health markers, all of which evaluated diet quality by identifying dietary patterns. Diet quality as evaluated by all dietary indexes was not associated with bone health markers. CONCLUSIONS: Adherence to a healthy diet may benefit bone health in children and adolescents. These findings emphasize the importance of developing effective public health policies that encourage healthy eating habits from childhood to preserve bone health. Longitudinal research using a specific tool to assess diet quality in relation to bone health is warranted. Future studies should also measure bone-regulating hormones and markers of bone turnover. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022368610.

Associations of adiposity and adipokine concentrations with anti- and oxidative markers in Brazilian children.

OBJECTIVE: The aim of this study was to evaluate the association of body fat, anti- and inflammatory adipokines with anti- and oxidative markers. METHODS: We conducted a cross-sectional study with 378 schoolchildren ages 8 to 9 y in Viçosa, Minas Gerais, Brazil. We obtained information on sociodemographic and lifestyle characteristics via questionnaires, measured height and weight, and estimated body fat by dual energy x-ray absorptiometry. Blood sample was collected to analyze the adipokines (adiponectin, leptin, chemerin, and retinol-binding protein 4) by enzyme-linked immunosorbent assay based on the sandwich principle; and anti- and oxidant markers (plasma ferric reducing antioxidant power [FRAP], superoxide dismutase [SOD], and malondialdehyde [MDA]) by enzymatic methods. Concentrations of anti- and oxidant markers were compared by percent body fat quartiles and adipokine concentrations terciles using of linear regression adjusted for potential confounders. RESULTS: Total and central body fat were positively associated with FRAP. Every 1 standard deviation (SD) of total fat was associated with 4.8 higher FRAP (95% confidence interval [CI], 2.7-7). Additionally, every 1 SD of truncal, android, and gynoid fat were associated with, respectively, 5, 4.6, and 4.6 higher FRAP (95% CI, 2.9-7.1; 2.6-6.7; and 2.4-6.8, respectively). However, adiponectin was inversely associated with FRAP; every adiponectin SD was related to -2.2 lower FRAP (95% CI, -3.9 to -0.5). Chemerin was positively associated with SOD [5.4 (95% CI, 1.9-8.8) SOD units per chemerin SD]. CONCLUSIONS: The body fat measures and adiposity-related inflammation (chemerin) were positively associated with antioxidative markers in children, whereas the adiponectin (anti-inflammatory marker) was inversely associated with FRAP (antioxidative marker).

Socioeconomic status, screen time, and time spent at school, and children's food consumption. / Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças.

The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças / Socioeconomic status, screen time, and time spent at school, and children's food consumption

Resumo Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Abstract The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Obesogenic environment around schools is associated with atherogenic risk in Brazilian children.

INTRODUCTION: Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status. METHODS: In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations. RESULTS: "Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR = 0.63; p < 0.001). CONCLUSION: We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.

Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management.

OBJECTIVES: To analyze soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factors (PlGF) concentrations and their ratio in pregnant and postpartum women with suspected COVID-19, and further investigate conditions associated with an increased ratio (sFlt-1/PlGF > 38), including preeclampsia (PE) and severe acute respiratory syndrome (SARS). STUDY DESIGN: The present study is a secondary analysis of a prospective cohort. Blood samples were collected at time of COVID-19 investigation and the serum measurements of sFlt-1 and PlGF were performed. Clinical background, SARS-CoV-2 infection characteristics, maternal and perinatal outcomes were further analyzed. MAIN OUTCOME MEASURES: Serum measurements of sFlt-1 and PlGF; obstetrics and clinical outcomes. RESULTS: A total of 97 SARS-CoV-2 unvaccinated women with suspected infection were considered, 76 were COVID-19 positive cases and 21 COVID-19 negative. Among COVID-19 positive cases, 09 presented with SARS and 11 were diagnosed with PE, of which 6 had SARS-CoV-2 infection in first and second trimester (04 with sFlt-1/PlGF ≥ 38) and 05 with PE and COVID-19 diagnosed at the same time, during third trimester (03 with sFlt-1/PlGF ≥ 38). Five presented with PE with severe features. sFlt-1/PlGF ratio was significantly higher in the COVID-19 positive/PE positive group compared to COVID-19 positive/PE negative group (p-value = 0.005), with no increase in cases complicated by SARS. CONCLUSIONS: sFlt-1/PlGF ratio could be a useful tool for differential diagnosis and adequate counseling among cases of COVID-19 and PE, especially if severe disease. COVID-19 early in pregnancy could potentially be a risk factor for PE later during gestation.

Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index.

OBJECTIVE: We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). METHODS: A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. RESULTS: The neighborhood obesogenic environment had a significant total association (Standardized Coefficient = 0.172, p = .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient = 0.066, p = .049). CONCLUSIONS: Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.

Interaction effect between breakfast skipping and sedentary behavior in the dietary inflammatory potential of Brazilian school-age children.

OBJECTIVES: Missed nutrients from skipped meals affect diet quality. However, the extent to which breakfast skipping affects the inflammatory potential of a diet, as indicated by Children's Dietary Inflammatory Index (C-DII) score, remains unknown. We aimed to evaluate the association between breakfast skipping and C-DII score, and investigate the presence of interaction with sociodemographic factors and sedentary behavior. METHODS: This representative cross-sectional study enrolled 378 children ages 8 and 9 y from Viçosa, Minas Gerais, Brazil in 2015. We collected sociodemographic data (sex, age, race, and household per-capita income) and screen time using a semistructured questionnaire. Dietary intake and breakfast skipping were evaluated by three 24-h dietary recalls from which energy-adjusted C-DII scores were calculated. We performed linear regression models to test the associations and possible interactions. RESULTS: The prevalence of breakfast skipping and sedentary behavior were 20.1% and 47.6%, respectively. The mean ± standard deviation of the C-DII scores was 0.60 ± 0.94, and ranged from -2.16 (most anti-inflammatory diet) to 2.75 (most proinflammatory diet). Breakfast skipping was associated with a higher intake of lipids, monounsaturated fat, and polyunsaturated fat, as well as lower carbohydrate, calcium, and magnesium intake (P < 0.05). After adjustment, breakfast skippers had higher C-DII scores (ß = 0.33; 95% confidence interval, 0.12-0.54). This association was more pronounced in children with sedentary behavior (ß = 0.53; 95% confidence interval, 0.24-0.82). CONCLUSIONS: Breakfast skipping was associated with a more proinflammatory diet in school-age children, and there was significant interaction with sedentary behavior. Early childhood interventions encouraging the habit of eating a breakfast and engaging in physical activity may help reduce the dietary inflammatory potential and prevent related cardiometabolic disorders.

Retail food outlets and metabolic syndrome: a systematic review of longitudinal studies.

CONTEXT: The community food environment covers the type, quantity, density, location, and access to retail food outlets, and its influence on eating behavior, obesity, and metabolic syndrome has been investigated. OBJECTIVE: To evaluate the evidence on longitudinal associations between objectively measured retail food outlets and metabolic syndrome components in children, adolescents, and adults. DATA EXTRACTION: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality and risk of bias were assessed with the Newcastle-Ottawa Scale. DATA SOURCES: The Scopus, Embase, Web of Science, Scielo, PubMed, MEDLINE, and Lilacs databases were searched without any restriction on publication dates. DATA ANALYSIS: Of the 18 longitudinal studies included, significant associations were reported in 9 between retail food outlets and metabolic syndrome components in adults (6 positive associations, 2 negative, and 1 both positive and negative), and in 3 studies of children and adolescents (2 negative associations and 1 both positive and negative). Six studies with adults found no association. CONCLUSION: Limited evidence was found for longitudinal associations between retail food outlets and metabolic syndrome components. In future studies, researchers should consider the use of standardized retail food outlet measurements and accurate analysis to better understand the influence of the community food environment on metabolic syndrome. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no: CRD42020177137.

Prevalence of dyslipidemias and food consumption: a population-based study. / Prevalência de dislipidemias e consumo alimentar: um estudo de base populacional.

This study aimed to assess the prevalence of dyslipidemia and its association with an adequate intake of carbohydrates, saturated, monounsaturated, trans, and omega-3 fats among adults living in Viçosa, Minas Gerais, Brazil. This is a cross-sectional study with 884 adults aged 20 to 59 years. Sociodemographic, food intake, anthropometric, and biochemical data were collected. Associations between study variables were investigated by the chi-square test. There was a high prevalence of dyslipidemia in the study population (64.25%), with most individuals having abnormal levels of at least one serum lipid component. Inadequate intakes of saturated, trans, and monounsaturated fats and carbohydrates were predominant. It is noteworthy that omega-3 intake levels were adequate in most individuals. Eutrophic adults showed a higher prevalence of excessive intake of saturated and trans fats. It was found that 38.7% of individuals with low levels of High Density Lipoprotein cholesterol (HDL-c) had an excessive intake of saturated fat. Most individuals with high triglyceride levels or high triglyceride/HDL-c ratios had an insufficient intake of monounsaturated fat. Further studies are needed to evaluate other factors that may influence dietary patterns.

O presente artigo objetivou estimar a prevalência de dislipidemias e sua associação e adequação da ingestão de gorduras saturadas, monoinsaturadas, trans, ômega-3 e carboidratos, em adultos de Viçosa-MG. Trata-se de um estudo transversal com 884 adultos com idades entre 20 e 59 anos. Foram coletados dados sociodemográficos, de consumo alimentar, antropométricos e bioquímicos da população. As associações entre as variáveis foram verificadas utilizando-se o teste qui-quadrado. Verificou-se elevada prevalência de dislipidemias na população (64,25%), com pelo menos um dos lipídeos séricos alterados. Houve predomínio de inadequação na ingestão de gorduras saturadas, trans, monoinsaturadas e carboidratos. Ressalta-se que a ingestão de ômega-3 esteve adequado para a maioria dos indivíduos. Adultos eutróficos apresentaram maiores prevalências de ingestão excessiva de gorduras saturadas e trans. Observou-se que 38,7% dos indivíduos com HDL-c reduzido apresentaram ingestão acima do recomendado de gordura saturada. A maioria dos indivíduos com triglicerídeos e razão TG/HDL-c elevada possuíam ingestão insatisfatória de gordura monoinsaturada. Faz-se necessária a avaliação de outros fatores que podem influenciar o padrão alimentar.

Prevalência de dislipidemias e consumo alimentar: um estudo de base populacional / Prevalence of dyslipidemias and food consumption: a population-based study

Resumo O presente artigo objetivou estimar a prevalência de dislipidemias e sua associação e adequação da ingestão de gorduras saturadas, monoinsaturadas, trans, ômega-3 e carboidratos, em adultos de Viçosa-MG. Trata-se de um estudo transversal com 884 adultos com idades entre 20 e 59 anos. Foram coletados dados sociodemográficos, de consumo alimentar, antropométricos e bioquímicos da população. As associações entre as variáveis foram verificadas utilizando-se o teste qui-quadrado. Verificou-se elevada prevalência de dislipidemias na população (64,25%), com pelo menos um dos lipídeos séricos alterados. Houve predomínio de inadequação na ingestão de gorduras saturadas, trans, monoinsaturadas e carboidratos. Ressalta-se que a ingestão de ômega-3 esteve adequado para a maioria dos indivíduos. Adultos eutróficos apresentaram maiores prevalências de ingestão excessiva de gorduras saturadas e trans. Observou-se que 38,7% dos indivíduos com HDL-c reduzido apresentaram ingestão acima do recomendado de gordura saturada. A maioria dos indivíduos com triglicerídeos e razão TG/HDL-c elevada possuíam ingestão insatisfatória de gordura monoinsaturada. Faz-se necessária a avaliação de outros fatores que podem influenciar o padrão alimentar.

Abstract This study aimed to assess the prevalence of dyslipidemia and its association with an adequate intake of carbohydrates, saturated, monounsaturated, trans, and omega-3 fats among adults living in Viçosa, Minas Gerais, Brazil. This is a cross-sectional study with 884 adults aged 20 to 59 years. Sociodemographic, food intake, anthropometric, and biochemical data were collected. Associations between study variables were investigated by the chi-square test. There was a high prevalence of dyslipidemia in the study population (64.25%), with most individuals having abnormal levels of at least one serum lipid component. Inadequate intakes of saturated, trans, and monounsaturated fats and carbohydrates were predominant. It is noteworthy that omega-3 intake levels were adequate in most individuals. Eutrophic adults showed a higher prevalence of excessive intake of saturated and trans fats. It was found that 38.7% of individuals with low levels of High Density Lipoprotein cholesterol (HDL-c) had an excessive intake of saturated fat. Most individuals with high triglyceride levels or high triglyceride/HDL-c ratios had an insufficient intake of monounsaturated fat. Further studies are needed to evaluate other factors that may influence dietary patterns.