Dietary and nutrient intake among participants of a Brazilian health promotion programme: a cross-sectional study.

OBJECTIVE: Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde - PAS). DESIGN: A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis. SETTING: Belo Horizonte - Brazil. PARTICIPANTS: 3372 adults (≥20 years). RESULTS: Users in the third tertile of PAS (24·4-61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1-24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0-10 months). CONCLUSIONS: Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.

Influence of parental perceived environment on physical activity, TV viewing, active play and Body Mass Index among Portuguese children: A mediation analysis.

OBJECTIVES: The environment is believed to be key in obesity prevention, yet it is unclear how factors in the neighborhood influence weight-related behaviors. The present study aimed to investigate the influence of parental perceived environment on physical activity (PA), television (TV) time, active play and Body Mass Index (BMI) z score, and the mediating role of these weight-related behaviors on the relationship between neighborhood characteristics and children's BMI. METHODS: Data of 8472 Portuguese preschool (aged 3-6, n = 3819) and school-aged children (aged 7-11 years, n = 4653) were collected during 2016/2017. Structural equation modeling was used to estimate the associations between parents perceived neighborhood characteristics (latent variables: unsafety and built/physical environment) and child's BMI z score, PA and TV time. RESULTS: Among preschoolers, the latent variables of the perceived environment were not associated with the BMI, TV time, extracurricular PA, and active play. Among schoolchildren, the unsafety environment was positively associated with both the BMI (SC = 0.050, P = .008) and the time spent watching TV (SC = 0.052, P = .031) and negatively associated with extracurricular PA (SC = -0.125, P < .001). The latent variable Favorable Built Environment for PA (ie, environmental facilitating elements) was positively associated with active play (SC = 0.041, P = .031). Moreover, the TV time was a marginally significant mediator of the relationship between the perceived unsafe environment and the BMI of school-aged children (B = 0.002, P = .096). CONCLUSIONS: In conclusion, changes in the environment to targeting parental perception of neighborhood safety could have positive effects on the promotion of healthy weight and the adoption of a healthy lifestyle in school-aged children.

A higher number of school meals is associated with a less-processed diet / Maior número de refeições nas escolas está associado a uma alimentação menos processada

Abstract Objective: To compare the participation of food groups - fresh and minimally processed, processed, and ultra-processed - in the diet of students (n = 1357) from Belo Horizonte, MG, Brazil, in accordance with the number of school meals consumed daily. Methods: Four groups were defined: children that did not consume school meals and children that consumed one, two, or three school meals daily. Food groups participation, in g/1000 kcal, was obtained using two 24-hour recalls. Three linear regression models were analyzed, in which the consumption of each of the food groups was the dependent variable, the number of school meals was the independent variable, and sociodemographic data (gender, age, health vulnerability) and overweight condition were the control variables. Results: Children that consumed 2 or 3 school meals daily showed, respectively, 7.3% and 10.5% higher ingestion of fresh and minimally processed food in comparison to children that did not consume school meals. Moreover, ultra-processed food participation was 18.0% lower among students that consumed two school meals and 26.0% lower among children that consumed three meals daily, in comparison to students that did not consume school meals. Conclusion: The study showed a possible dose-response effect in children's daily diets with two or three school meals and highlighted the relevance of the prolonged stay at school for healthy eating promotion in children.

Resumo Objetivo: Comparar a participação dos alimentos in natura e minimamente processados, processados e ultraprocessados na alimentação de 1.357 escolares de Belo Horizonte (MG) de acordo com o número de refeições escolares consumidas diariamente. Métodos: Foram definidos quatro grupos de estudo: crianças que não consumiam a alimentação escolar e crianças que consumiam uma, duas ou três refeições escolares diariamente. A participação na dieta dos grupos de alimentos, em g/1.000 kcal, foi obtida a partir de dois recordatórios alimentares de 24 horas. Foram analisados três modelos de regressão linear, nos quais o consumo de cada um dos três grupos de alimentos constituiu a variável dependente, o número de refeições escolares consumidas diariamente constituiu a variável independente e os dados sociodemográficos (sexo, idade, índice de vulnerabilidade à saúde) e de excesso de peso constituíram-se as variáveis de ajuste. Resultados: Verificou-se que as crianças que consumiam duas e três refeições escolares diariamente apresentaram, respectivamente, 7,3% e 10,5% maior ingestão de alimentos in natura e minimamente processados quando comparadas com as crianças que não consumiam a alimentação escolar. Além disso, a participação de ultraprocessados foi 18,0% menor na alimentação das crianças que consumiam duas refeições escolares e 26,0% menor entre as que consumiam três refeições escolares diariamente, em comparação com aquelas que não consumiam a alimentação escolar. Conclusão: O estudo apontou possível efeito dose-resposta na proteção da alimentação dos estudantes a partir do consumo de duas refeições escolares diárias, destacando a relevância da permanência da criança em período integral na escola para a promoção da alimentação saudável.

Ultra-processed food product brands on Facebook pages: highly accessed by Brazilians through their marketing techniques.

OBJECTIVE: To analyse the content and extent of marketing of ultra-processed food products (UPP) and their brand pages on Facebook, which are highly accessed by Brazilians. DESIGN: Descriptive. SETTING: Sixteen UPP brand pages on Facebook were selected from 250 pages that were the most liked by Brazilians in October 2015. SUBJECTS: We analysed the frequency of 'likes' and members 'talking about' each one of the pages, in addition to fifteen marketing techniques used in the previous year (September 2014 to October 2015). The number of posts, likes, 'shares' and 'commentaries', and the mean number of likes, shares and commentaries per post, were collected for one month, from 23 September to 23 October 2015. RESULTS: The two most liked pages were: Coke® (93 673 979 likes) and McDonald's® (59 749 819 likes). Regarding the number of people talking about the pages, McDonald's led with 555 891 commentaries, followed by Coke (287 274), Burger King® (246 148) and Kibon® (244 523). All pages used marketing techniques, which included photos, user conversations, presence of brand elements and links. Videos were observed on 93·8 % of the pages; promotions on 68·8 %; and celebrities on 62·5 %. In one month, Garoto®, Outback® and Coke were brands that published more than one post per day. Kibon achieved the highest ratio of likes per post (285 845·50) and Burger King had the highest mean shares per post (10 083·93), including commentaries per post (7958·13). CONCLUSIONS: UPP marketing is extensively used on Facebook pages and is highly accessed by Brazilians, with UPP companies employing a diversity of marketing strategies.

A higher number of school meals is associated with a less-processed diet.

OBJECTIVE: To compare the participation of food groups - fresh and minimally processed, processed, and ultra-processed - in the diet of students (n=1357) from Belo Horizonte, MG, Brazil, in accordance with the number of school meals consumed daily. METHODS: Four groups were defined: children that did not consume school meals and children that consumed one, two, or three school meals daily. Food groups participation, in g/1000kcal, was obtained using two 24-hour recalls. Three linear regression models were analyzed, in which the consumption of each of the food groups was the dependent variable, the number of school meals was the independent variable, and sociodemographic data (gender, age, health vulnerability) and overweight condition were the control variables. RESULTS: Children that consumed 2 or 3 school meals daily showed, respectively, 7.3% and 10.5% higher ingestion of fresh and minimally processed food in comparison to children that did not consume school meals. Moreover, ultra-processed food participation was 18.0% lower among students that consumed two school meals and 26.0% lower among children that consumed three meals daily, in comparison to students that did not consume school meals. CONCLUSION: The study showed a possible dose-response effect in children's daily diets with two or three school meals and highlighted the relevance of the prolonged stay at school for healthy eating promotion in children.

Irish coffee: Effects of alcohol and caffeine on object discrimination in zebrafish.

Many studies regarding the effects of drugs investigate the acute and chronic use of alcohol, but only a few address the effects of caffeine and alcohol combined to the performance of the zebrafish in cognitive tasks. The zebrafish is an important model for studying the effects of drugs on learning, because it has large genetic similarities to humans and the non-invasive administration of the substances favors translational bias of research. In this study, we observed the effects of alcohol and caffeine on zebrafish cognition through an object discrimination test. We noticed that animals subjected to acute alcohol dose and those under alcohol or caffeine withdrawal did not show discrimination. When fish were treated with associated alcohol and caffeine, those chronically treated with alcohol and subjected to moderate acute dose of caffeine showed learning of the task. Our results reinforce the harmful effects of the alcohol use on cognitive tasks, and suggest that continued use of high doses of caffeine cause cognitive impairment during withdrawal of the substance. However, the acute use of caffeine appears to reverse the harmful effects of alcohol withdrawal, allowing discriminative performance equivalent to control fish. Finally, we reiterate the use of zebrafish as a model for drug effects screening and search for active compounds that modulate the alcohol and caffeine effects.

Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years / Deficiência de ferro e anemia estão associadas com baixos níveis de retinol em crianças de 1 a 5 anos

OBJECTIVE: To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. METHODS: This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n = 692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. RESULTS: The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p < 0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p < 0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r = 0.597; p < 0.001) and hemoglobin vs. retinol serum (r = 0.770; p < 0.001). CONCLUSIONS: Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency. .

OBJETIVO: Analisar a ocorrência de anemia e de deficiência de ferro em crianças de 1 a 5 anos e a associação destes desfechos com a deficiência de retinol. MÉTODOS: Trata-se de um estudo observacional analítico do tipo transversal, realizado no município de Vitória - ES, entre abril e agosto de 2008, com crianças (n = 692) saudáveis de 1 a 5 anos, residentes em áreas de abrangência de Unidades Básicas de Saúde. Foram avaliados dados sociodemográficos, econômicos, dietéticos (ingestão de energia, proteína, ferro e vitamina A), antropométricos (índice de massa corporal-por-idade e estatura-por-idade) e bioquímicos (níveis séricos de ferritina, hemoglobina e retinol). RESULTADOS: Detectou-se anemia, deficiência de ferro e deficiência de retinol em 15,7%, 28,1% e 24,7% das crianças, respectivamente. A análise univariada evidenciou maior ocorrência de anemia (RP: 4,62; IC 95%: 3,36; 6,34, p < 0.001) e de deficiência de ferro (RP: 4,51; IC 95%: 3,30; 6,17, p < 0.001) entre crianças que apresentavam deficiência de retinol. As mesmas relações se mantiveram após o ajuste pelas variáveis socioeconômicas, demográficas, dietéticas e antropométricas. Houve relação positiva entre os valores de ferritina sérica vs. retinol (r = 0,597; p < 0,001) e hemoglobina vs. retinol (r = 0,770; p < 0,001). CONCLUSÕES: A anemia e a deficiência de ferro mostraram-se associadas com baixos níveis de retinol em crianças de 1 a 5 anos, e houve correlação positiva dos níveis de retinol com os de ferritina sérica e hemoglobina. Isto torna importante iniciativas que estimulem o desenvolvimento de novos tratamentos e a ampliação de pesquisas em relação à deficiência ...

Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years.

OBJECTIVE: To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. METHODS: This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n=692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. RESULTS: The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p<0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p<0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r=0.597; p<0.001) and hemoglobin vs. retinol serum (r=0.770; p<0.001). CONCLUSIONS: Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency.

ß-Actin-binding complementarity-determining region 2 of variable heavy chain from monoclonal antibody C7 induces apoptosis in several human tumor cells and is protective against metastatic melanoma.

Complementarity-determining regions (CDRs) from monoclonal antibodies tested as synthetic peptides display anti-infective and antitumor activities, independent of the specificity of the native antibody. Previously, we have shown that the synthetic peptide C7H2, based on the heavy chain CDR 2 from monoclonal antibody C7, a mAb directed to a mannoprotein of Candida albicans, significantly reduced B16F10 melanoma growth and lung colony formation by triggering tumor apoptosis. The mechanism, however, by which C7H2 induced apoptosis in tumor cells remained unknown. Here, we demonstrate that C7H2 interacts with components of the tumor cells cytoskeleton, being rapidly internalized after binding to the tumor cell surface. Mass spectrometry analysis and in vitro validation revealed that ß-actin is the receptor of C7H2 in the tumor cells. C7H2 induces ß-actin polymerization and F-actin stabilization, linked with abundant generation of superoxide anions and apoptosis. Major phenotypes following peptide binding were chromatin condensation, DNA fragmentation, annexin V binding, lamin disruption, caspase 8 and 3 activation, and organelle alterations. Finally, we evaluated the cytotoxic efficacy of C7H2 in a panel of human tumor cell lines. All tumor cell lines studied were equally susceptible to C7H2 in vitro. The C7H2 amide without further derivatization significantly reduced lung metastasis of mice endovenously challenged with B16F10-Nex2 melanoma cells. No significant cytotoxicity was observed toward nontumorigenic cell lines on short incubation in vitro or in naïve mice injected with a high dose of the peptide. We believe that C7H2 is a promising peptide to be developed as an anticancer drug.

Notificação imprecisa da ingestão energética na dieta de adolescentes / Misreporting of dietary energy intake in adolescents

OBJETIVOS: Examinar a prevalência da sub e supernotificação da ingestão energética em adolescentes e seus fatores associados. MÉTODOS: Estudo transversal com 96 adolescentes na pós-puberdade (47 com peso normal e 49 obesos), com idade média de 16,6±1,3 anos. Peso e altura foram medidos e o índice de massa corporal foi calculado. A composição corporal foi avaliada através de absorciometria por raios X de dupla energia. A ingestão de alimentos foi avaliada por meio de um registro alimentar de 3 dias. Realizou-se uma avaliação bioquímica (níveis séricos de colesterol total, LDL, HDL, glicose plasmática e insulina). Os subnotificadores relataram uma ingestão energética < 1,35 x taxa metabólica basal (TMB), enquanto os supernotificadores relataram uma ingestão energética > 2,4 x TMB. RESULTADOS: Notificação imprecisa (sub ou supernotificação) da ingestão energética foi identificada em 65,6 por cento dos adolescentes (64,6 e 1 por cento de sub e supernotificação, respectivamente). Os adolescentes obesos apresentaram 5.0 vezes mais chances de subnotificar a ingestão energética (IC95 por cento 2,0-12,7) do que os participantes com peso normal. Os subnotificadores apresentaram taxas mais altas de ingestão insuficiente de carboidratos (19,3 versus 12,1 por cento, p = 0,046) e de lipídios (11,3 versus 0 por cento, p < 0,001) do que os notificadores plausíveis. A ingestão de colesterol também foi mais baixa entre os subnotificadores (p = 0,017). Não houve diferenças significativas na composição corporal e nos parâmetros bioquímicos em relação à notificação imprecisa. CONCLUSÕES: Os resultados obtidos demonstraram alta porcentagem de notificação imprecisa da ingestão energética entre adolescentes, principalmente entre os obesos, o que sugere que os valores de consumo de nutrientes ajustado para o consumo de energia deveriam ser empregados na análise de risco da relação dieta-doença a fim de contribuir para a redução de erros associados à notificação imprecisa.

OBJECTIVES: To examine the prevalence of under and overreporting of energy intake in adolescents and their associated factors. METHODS: Cross-sectional study with 96 postpubertal adolescents (47 normal-weight and 49 obese), mean age of 16.6±1.3 years. Weight and height were measured, and body mass index was calculated. Body composition was assessed by dual energy X-ray absorptiometry. Dietary intake was evaluated by a 3-day dietary record. Biochemical assessment was performed (serum total cholesterol, LDL-cholesterol, HDL-cholesterol, plasma glucose, and insulin). Underreporters reported energy intake < 1.35 x basal metabolic rate (BMR), whereas overreporters reported energy intake > 2.4 x BMR. RESULTS: Energy intake misreporting (under or overreporting) was identified in 65.6 percent of adolescents (64.6 and 1 percent of under and overreporting, respectively). Obese adolescents were 5.0 times more likely to underreport energy intake (95 percentCI 2.0-12.7) than normal-weight participants. Underreporters showed higher rates of insufficient intake of carbohydrate (19.3 vs. 12.1 percent, p = 0.046) and lipids (11.3 vs. 0 percent, p < 0.001) than plausible reporters. Cholesterol intake was also lower in underreporters (p = 0.017). There were no significant differences in body composition and biochemical parameters in relation to misreporting. CONCLUSIONS: The results obtained demonstrated a high percentage of misreporting of energy intake among adolescents, especially among obese subjects, which suggests that energy-adjusted nutrient intake values should be employed in diet-disease risk analysis in order to contribute to a reduction in errors associated with misreporting.

Misreporting of dietary energy intake in adolescents.

OBJECTIVES: To examine the prevalence of under and overreporting of energy intake in adolescents and their associated factors. METHODS: Cross-sectional study with 96 postpubertal adolescents (47 normal-weight and 49 obese), mean age of 16.6±1.3 years. Weight and height were measured, and body mass index was calculated. Body composition was assessed by dual energy X-ray absorptiometry. Dietary intake was evaluated by a 3-day dietary record. Biochemical assessment was performed (serum total cholesterol, LDL-cholesterol, HDL-cholesterol, plasma glucose, and insulin). Underreporters reported energy intake < 1.35 x basal metabolic rate (BMR), whereas overreporters reported energy intake > 2.4 x BMR. RESULTS: Energy intake misreporting (under or overreporting) was identified in 65.6% of adolescents (64.6 and 1% of under and overreporting, respectively). Obese adolescents were 5.0 times more likely to underreport energy intake (95%CI 2.0-12.7) than normal-weight participants. Underreporters showed higher rates of insufficient intake of carbohydrate (19.3 vs. 12.1%, p = 0.046) and lipids (11.3 vs. 0%, p < 0.001) than plausible reporters. Cholesterol intake was also lower in underreporters (p = 0.017). There were no significant differences in body composition and biochemical parameters in relation to misreporting. CONCLUSIONS: The results obtained demonstrated a high percentage of misreporting of energy intake among adolescents, especially among obese subjects, which suggests that energy-adjusted nutrient intake values should be employed in diet-disease risk analysis in order to contribute to a reduction in errors associated with misreporting.

Densidade mineral óssea, composição corporal e ingestão alimentar de adolescentes modelos de passarela / Bone mineral density, body composition, and food intake of adolescent runway models

OBJETIVO: Avaliar a densidade mineral óssea (DMO) e relacioná-la com a ingestão alimentar e composição corporal de adolescentes modelos de passarela. MÉTODOS: Estudo transversal avaliando 33 modelos e 33 não modelos de 15 a 18 anos pareadas por idade e índice de massa corporal (IMC). A densidade mineral óssea da coluna (L1-L4) foi avaliada por meio da técnica da absorciometria de feixe duplo de energia (Lunar® DPX Alpha), e a composição corporal, pela técnica de pletismografia. A ingestão alimentar foi avaliada por meio do registro alimentar de 3 dias. RESULTADOS: A média de idade das adolescentes foi de 16,75±1,04 anos, sendo que 24 por cento apresentaram IMC abaixo dos valores ideais para a idade. Não houve diferença de DMO entre modelos (1,108±0,080 g/cm2) e não modelos (1,096±0,102 g/cm2) (p > 0,05), sendo identificada uma porcentagem de 6 por cento de baixa DMO para a idade. Observou-se que a média de ingestão de energia foi menor entre as modelos em comparação às adolescentes não modelos (1.480,93±582,95 versus 1.973,00±557,63 kcal) (p > 0,05) e que a maioria das adolescentes de ambos os grupos apresentou consumo inadequado de micronutrientes, ressaltando-se a baixa ingestão de cálcio. Verificou-se correlação significativa da DMO apenas com a massa magra (kg) (modelos r = 0,362 e não modelos r = 0,618; p < 0,05). CONCLUSÃO: Apesar de não ter sido encontrada associação entre a DMO, o IMC e a ingestão de nutrientes importantes no processo de mineralização óssea, as inadequações na ingestão alimentar podem influenciar negativamente a aquisição de massa óssea, que se encontra potencializada neste estágio de vida.

OBJECTIVE: To evaluate the bone mineral density (BMD) and to relate it to the food intake and body composition of adolescent runway models. METHODS: Cross-sectional study evaluating 33 models and 33 non-models aged from 15 to 18 years, paired by age and body mass index (BMI). BMD of spine (L1-L4) was evaluated using the dual-energy X-ray absorptiometry technique (Lunar® DPX Alpha), and body composition was assessed by means of plethysmography. Food intake was evaluated by a 3-day-food record. RESULTS: The subjects mean age was 16.75±1.04 years, and 24 percent had BMI below ideal value for their age. BMD values (g/cm2) were similar between models (1.108±0.080) and non-models (1.096±0.102) (p > 0.05), and 6 percent of the participants had low BMD for age. We found that the mean energy intake was lower among models as compared to non-models (1,480.93±582.95 vs. 1,973.00±557.63 kcal) (p < 0.05) and that most of the adolescents in both groups presented an inadequate consumption of micronutrients, with emphasis to the low calcium intakes. There was only significant correlation between BMD and lean body mass (kg) (r = 0.362 for models and r = 0.618 for non-models) (p < 0.05). CONCLUSION: Although no association was found between BMD, BMI, and intake of nutrients which are important for the bone mineralization process, inadequacies of food intake have an adverse influence on the acquisition of bone mass, which is more effective at this stage of life.

Bone mineral density, body composition, and food intake of adolescent runway models.

OBJECTIVE: To evaluate the bone mineral density (BMD) and to relate it to the food intake and body composition of adolescent runway models. METHODS: Cross-sectional study evaluating 33 models and 33 non-models aged from 15 to 18 years, paired by age and body mass index (BMI). BMD of spine (L1-L4) was evaluated using the dual-energy X-ray absorptiometry technique (Lunar DPX Alpha), and body composition was assessed by means of plethysmography. Food intake was evaluated by a 3-day-food record. RESULTS: The subjects' mean age was 16.75+/-1.04 years, and 24% had BMI below ideal value for their age. BMD values (g/cm2) were similar between models (1.108+/-0.080) and non-models (1.096+/-0.102) (p > 0.05), and 6% of the participants had low BMD for age. We found that the mean energy intake was lower among models as compared to non-models (1,480.93+/-582.95 vs. 1,973.00+/-557.63 kcal) (p < 0.05) and that most of the adolescents in both groups presented an inadequate consumption of micronutrients, with emphasis to the low calcium intakes. There was only significant correlation between BMD and lean body mass (kg) (r = 0.362 for models and r = 0.618 for non-models) (p < 0.05). CONCLUSION: Although no association was found between BMD, BMI, and intake of nutrients which are important for the bone mineralization process, inadequacies of food intake have an adverse influence on the acquisition of bone mass, which is more effective at this stage of life.

[Association among weight loss, bone mass, body composition and dietary intake of post-pubertal obese adolescents]. / Associação entre a perda de peso, a massa óssea, a composição corporal e o consumo alimentar de adolescentes obesos pós-púberes.

OBJECTIVE: To verify the effects of weight loss on bone mass of obese adolescents submitted to a nutritional intervention based on a hypocaloric diet and nutritional advice over a nine-month-period. METHODS: Anthropometry, body composition, BMD and dietary intake were evaluated. RESULTS: Fifty-five adolescents, 78.2% females, within an average age of 16.6 (1.4) years old participated in the study. Sixteen participants who completed the study did not lose weight. The group that adhered to the nutritional intervention had a mean weight loss of 6.2 (4.6)% baseline. There was a significant increase in total BMD and bone mineral content (BMC) in those adolescents who did not lose weight, while increased BMC and bone area were verified in participants who lost weight, mainly when associated with body composition alterations while changing weight. CONCLUSION: The increment in bone mineral density, even throughout weight loss, has showed no negative effect on bone mass and has also emphasized the importance of nutritional improvement in total bone mass during adolescence.

Associação entre a perda de peso, a massa óssea, a composição corporal e o consumo alimentar de adolescentes obesos pós-púberes / Association among weight loss, bone mass, body composition and dietary intake of post-pubertal obese adolescents

OBJETIVO: Verificar os efeitos da perda de peso na densidade mineral óssea (DMO) de adolescentes obesos submetidos a intervenção com base em dieta hipocalórica e orientações durante nove meses. MÉTODOS: Realizaram-se avaliações da antropometria, da composição corporal, da DMO e do consumo alimentar. RESULTADOS: Participaram do estudo 55 adolescentes, 78,2 por cento meninas, com média de 16,6 (1,4) anos. Destes, 44,4 por cento não apresentaram redução do peso. O grupo que respondeu à intervenção apresentou média de perda de peso de 6,2 por cento (4,6) do peso inicial. Houve aumento significativo da DMO e conteúdo mineral ósseo (CMO) entre os adolescentes não-respondedores e aumento do CMO e área óssea entre os respondedores, associados, principalmente, com as alterações da composição corporal com o ganho ou a perda de peso. CONCLUSÃO: O aumento da massa óssea mesmo com a perda de peso demonstrou que o emagrecimento não ter efeito negativo do emagrecimento e denota provável contribuição da melhora dos hábitos alimentares na aquisição óssea de adolescentes.

OBJECTIVE: To verify the effects of weight loss on bone mass of obese adolescents submitted to a nutritional intervention based on a hypocaloric diet and nutritional advice over a nine-month-period. METHODS: Anthropometry, body composition, BMD and dietary intake were evaluated. RESULTS: Fifty-five adolescents, 78.2 percent females, within an average age of 16.6 (1.4) years old participated in the study. Sixteen participants who completed the study did not lose weight. The group that adhered to the nutritional intervention had a mean weight loss of 6.2 (4.6) percent baseline. There was a significant increase in total BMD and bone mineral content (BMC) in those adolescents who did not lose weight, while increased BMC and bone area were verified in participants who lost weight, mainly when associated with body composition alterations while changing weight. CONCLUSION: The increment in bone mineral density, even throughout weight loss, has showed no negative effect on bone mass and has also emphasized the importance of nutritional improvement in total bone mass during adolescence.

Tratamento multidisciplinar reduz o tecido adiposo visceral, leptina, grelina e a prevalência de esteatose hepática não alcoólica (NAFLD) em adolescentes obesos / Multidisciplinary treatment reduces visceral adiposity tissue, leptin, ghrelin and the prevalence of non-alcoholic fat liver disease (NAFLD) in obese adolescents

O objetivo do presente estudo foi avaliar as alterações promovidas, por intervenção multidisciplinar, nas concentrações plasmáticas de grelina e leptina, adiposidade visceral e prevalência de esteatose hepática não alcoólica (NAFLD), em adolescentes obesos. Foram avaliados 28 adolescentes obesos, 16 meninas (IMC 34,58 ± 3,86kg/m²) e 12 meninos (IMC 37,08 ± 3,17kg/m²), com idade entre 15 e 19 anos, quanto à concentração de leptina, grelina, insulina, assim como a adiposidade visceral e o diagnóstico de NAFLD pelo método de ultra-sonografia. Os resultados demonstraram redução significante na concentração circulante de grelina e leptina e na adiposidade visceral (p < 0,01). Houve ainda redução percentual na prevalência de NAFLD, sendo este um resultado relevante, visto que esta doença pode progredir para cirrose, tanto em crianças quanto em adolescentes obesos. Este tipo de tratamento demonstrou ser eficiente na melhora do perfil metabólico e hormonal, contribuindo para o controle da obesidade e suas co-morbidades em adolescentes obesos.

The aim of this study was to assess the changes promoted by a multidisciplinary therapy in ghrelin and leptin concentrations, visceral adiposity and non-alcoholic fat liver disease-NAFLD, in obese adolescents. A total of 28 obese adolescents, 16 girls (BMI 34.58 ± 3,86 wt/ht²) and 12 boys (BMI 37.08 ± 3.17 wt/ht²), aged between 15 and 19 years old, was evaluated to leptin, ghrelin and insulin concentrations, visceral adiposity and NAFLD through ultrasonography. The results showed a significant decrease in ghrelin, leptin concentrations and visceral adiposity (p < 0.01). Moreover, a decrease in the NAFLD prevalence was observed. It is an important result, since this disease can progress to cirrhosis, not only in children but also in obese adolescents. This kind of treatment can be efficient to improve metabolic and hormonal profile, as well as, to control obesity and related co-morbidities in obese adolescents.

El objetivo del presente trabajo ha sido evaluar las alteraciones promovidas por la intervención multidisciplinar, en las concentra- ciones plasmáticas de grelina y leptina, adiposidad visceral y prevalencia de esteatosis hepática no alcohólica - NAFLD, en adolescentes obesos. 28 adolescentes obesos, 16 chicas (IMC 34,58 ± 3,86 kg/m²) y 12 chicos (IMC 37,08 ± 3,17 kg/m²), con edades entre 15 y 19 años, fueron evaluados respecto a la concentración de leptina, grelina, insulina, así como a la adiposidad visceral y el diagnóstico de NAFLD por el método de ultrasonografía. Los resultados demostraron una reducción significante en la concentra- ción circulante de grelina y leptina y en la adiposidad visceral (p < 0,01). Hubo aún una reducción porcentual en la prevalencia de NAFLD, siendo este un resultado relevante, ya que esta enfermedad puede progresar hasta la cirrosis, tanto en niños como en adolescentes obesos. Este tipo de tratamiento demostró ser eficiente en la mejora del perfil metabólico y hormonal, contribuyendo para el control de la obesidad y su comorbilidad en adolescentes obesos.