Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis.

Food insecurity is a public health problem as it affects a wide array of individuals in the population. It can be characterized by food deprivation, lack of essential nutrition, lack of dietary education, lack of adequate storage conditions, poor absorption, and poor overall nutrition. The relationship between food insecurity and micronutrient deficiency requires more effort to deepen and discuss the relationship. This systematic review aimed to evaluate the association between food insecurity and micronutrient deficiency in adults. The research was conducted according to PRISMA using the Medline/Pubmed, Lilacs/BVS, Embase, Web of Science, and Cinahl databases. Studies carried out with male and female adults were included, which investigated the correlation or association between food insecurity and the nutritional status of micronutrients. There were no publication year, country, or language restrictions. A total of 1148 articles were found, and 18 of these were included, carried out mainly on the American continent and with women. The most evaluated micronutrients were iron and vitamin A. Food insecurity was associated with nutrient deficiency in 89% (n = 16) of the studies. As a result of the meta-analysis, it was observed that there is a greater chance of anemia and low levels of ferritin among food insecure individuals. It is concluded that food insecurity is associated with micronutrient deficiency. Understanding these problems allows the creation of public policies capable of contributing to changes. Protocol registration: This review was registered on the PROSPERO-International Prospective Register of Systematic Reviews database-CRD42021257443.

Correlation Between Drinking Water and Iodine Status: a Systematic Review and Meta-analysis.

Iodine is a micronutrient essential for maintaining normal body functioning, and the consumption depends on the distribution in the environment, and insufficient or excessive intake results in thyroid dysfunction. The purpose of this review was to evaluate the correlation between iodine concentration in drinking water and the iodine status of the population. The systematic review was conducted following the PRISMA guidelines and was registered at the International Prospective Register of Ongoing Systematic Reviews (CRD42019128308). A literature search was conducted using MEDLINE/PUBMED (National Library of Medicine), LILACS (Latin-American and Caribbean Literature on Health Sciences), and Cochrane Library, June 2021. The quality of the studies was assessed by a checklist for cross-sectional studies developed by Joanna Briggs Institute. The initial search identified 121 articles, out of which ten were included in this systematic review, and five were included in the meta-analysis. Among the articles listed, six adopted cutoff points to classify the iodine content in the drinking water. The study identified median iodine concentration in drinking water from 2.2 to 617.8 µg/L and the correlation between iodine concentration in drinking water and urinary iodine concentration was 0.92, according to meta-analysis. Furthermore, the iodine status was correlated to the iodine content in water. The determination of a cutoff point can contribute to the implementation of iodine consumption control measures.

Factors Associated with Anemia among Adults and the Elderly Family Farmers.

The majority of studies on anemia are focused on children and women of reproductive age. Although the disease is a widespread public health problem, studies that include the rural population are scarce. This study determined the prevalence of anemia and associated factors in adults and the elderly living in the rural area of a municipality in Minas Gerais. Twelve rural communities were included. During home visits, hemoglobin levels were measured using a hemoglobinometer to check for the presence or absence of anemia. Additionally, anthropometric data and food insecurity data based on the Brazilian Food Insecurity Scale (EBIA) were collected. A questionnaire about socioeconomic, demographic, and housing conditions was applied. Analyses were performed using the Stata software version 13.0. Spearman correlation and regression analysis logistics were performed (p < 0.05) on 124 families (n = 297 farmers). The prevalence of anemia was 41.1%, being higher among women (55.7%). Additionally, 40.1% of the farmers were food insecure; 52.7% and 80.5% presented excess weight and cardiovascular risk, respectively. Poverty was a reality for 39.7% of individuals. A positive correlation between hemoglobin levels and per capita income was found as well as a negative correlation with EBIA scores and cardiovascular risk. Multivariate analysis showed that individuals experiencing food insecurity, the elderly, and those who do not own a property, were more likely to be anemic. Farmers with per capita income above 1/2 minimum wage were less likely to have anemia. The prevalence of anemia in the group studied was higher than previous studies. The disease is associated with factors that also predispose to food insecurity. The improvement of the determinants of insecurity can contribute to the fight against anemia.

Implications of iodine deficiency by gestational trimester: a systematic review.

As pregnant women are susceptible to changes in iodine, which can cause miscarriage, goiter, thyroid nodules, hypothyroidism, in addition to fetal neurological impairment or development. The aim of this study was to verify the implications of the iodine alteration in each gestational trimester and its consequences of physiological justification. The review was based on PRISMA. Searching for articles that took place in March 2020 without delimiting data. As bases consulted were the Clinical Trials, Cochrane Library, Lilacs and Medline (PubMed). The descriptors were combined as follows: "pregnancy" AND "iodine deficiency". Articles that addressed iodine deficiency and its implications were included. The selection followed the steps of reading the titles, abstracts and full articles. To assess the methodological quality of the studies, the STROBE Instruction instrument was used. The research resulted in 1,266 studies and 11 were included. In assessing methodological quality, the lowest score was and the maximum 20. According to studies, the fourth most affected by iodine loss are the second and third, it is possible to increase the volume and pneumatic nodules, subclinical hypothyroidism, pre-eclampsia, among others. The damages caused by iodine deficiency in the first or second trimester are still reversible, therefore, they need to be diagnosed early, to guarantee an iodic homeostasis and prevent damage to the health of the mother-child binomial.

Association between food insecurity and cardiometabolic risk in adults and the elderly: A systematic review.

BACKGROUND: Food insecurity is a public health concern that affects health and quality of life, but its association with cardiometabolic risk is not well established. Thus, this systematic review evaluated the association between food insecurity and cardiometabolic risk factors in adults and the elderly. METHODS: Search was conducted according to the PRISMA protocol using Scielo, LILACS and PubMed databases. We included original articles published in Portuguese, English, and Spanish, which assessed the association between food insecurity and cardiometabolic risk factors in adults and the elderly. The search identified 877 articles but only 11 were included in the review. RESULTS: Food insecurity was directly associated with cardiometabolic risk (excess weight, hypertension, dyslipidemias, diabetes, and stress) after adjusting for interfering factors. A limitation of the cross-sectional study design is that the cause-effect relation between food insecurity and cardiometabolic risk cannot be established. CONCLUSIONS: We conclude that food insecurity has a direct relationship with cardiometabolic risk factors, especially excess weight, hypertension, and dyslipidemias. The identification of food insecurity as health problems can contribute to the implementation of efficient public policies for the prevention and control of chronic diseases. PROTOCOL REGISTRATION: This review was registered on PROSPERO-International Prospective Register of Systematic Reviews - CRD4201911549.

Implications of iodine deficiency by gestational trimester: a systematic review

ABSTRACT As pregnant women are susceptible to changes in iodine, which can cause miscarriage, goiter, thyroid nodules, hypothyroidism, in addition to fetal neurological impairment or development. The aim of this study was to verify the implications of the iodine alteration in each gestational trimester and its consequences of physiological justification. The review was based on PRISMA. Searching for articles that took place in March 2020 without delimiting data. As bases consulted were the Clinical Trials, Cochrane Library, Lilacs and Medline (PubMed). The descriptors were combined as follows: "pregnancy" AND "iodine deficiency". Articles that addressed iodine deficiency and its implications were included. The selection followed the steps of reading the titles, abstracts and full articles. To assess the methodological quality of the studies, the STROBE Instruction instrument was used. The research resulted in 1,266 studies and 11 were included. In assessing methodological quality, the lowest score was and the maximum 20. According to studies, the fourth most affected by iodine loss are the second and third, it is possible to increase the volume and pneumatic nodules, subclinical hypothyroidism, pre-eclampsia, among others. The damages caused by iodine deficiency in the first or second trimester are still reversible, therefore, they need to be diagnosed early, to guarantee an iodic homeostasis and prevent damage to the health of the mother-child binomial.

[Evaluation indicators of Food and Nutritional Insecurity and associated factors: systematic review]. / Indicadores de avaliação da Insegurança Alimentar e Nutricional e fatores associados: revisão sistemática.

The scope of this paper was to systematically investigate the indicators used in the evaluation of food and nutritional insecurity and associated factors in Brazilian studies. After selection in the databases using search terms and reverse search, 89 articles were included. The majority of the articles evaluated food and nutritional insecurity according to the indicator of perception, using the Brazilian Scale of Food Insecurity (83.1%), the American Scale (5.62%) and isolated questions (2.25%). The other articles evaluated the presence of malnutrition among children (1.12%), expenditure on food (1.12%), adult-equivalent dietary intake (1.12%), protocols (2.25%), and prediction models (2.25%). Food and nutritional insecurity (measured by the different indicators) was associated with socioeconomic and demographic factors, health and lifestyle conditions, food consumption and nutritional status, based on families, specific age groups, beneficiaries of government programs, among others, as sample units. The majority of the studies merely evaluated the food dimension of the insecurity, thereby increasing the difficulty in evaluating this complex situation.

Objetivou-se investigar sistematicamente os indicadores utilizados na avaliação da insegurança alimentar e nutricional e os fatores associados, em estudos brasileiros. Após seleção nas bases de dados e busca reversa, utilizando os termos de busca, incluiu-se 89 artigos. A maioria destes avaliou a insegurança segundo indicador de percepção, utilizando Escala Brasileira de Insegurança Alimentar (83,1%), Escala Americana (5,62%) e perguntas isoladas (2,25%). Os demais avaliaram pela presença de desnutrição em crianças (1,12%), gastos com alimentação (1,12%), consumo alimentar de adulto equivalente (1,12%), protocolos (2,25%) e modelos de predição (2,25%). A insegurança alimentar e nutricional, mensurada pelos distintos indicadores, associou-se a fatores socioeconômicos e demográficos, condições de saúde e estilo de vida, consumo alimentar e estado nutricional, tendo como unidade amostral famílias, grupos etários específicos, beneficiários de programas governamentais, entre outros. A maioria dos estudos avaliou apenas a dimensão alimentar da insegurança, reforçando a dificuldade de avaliação desta complexa situação.

Cytokines and body adiposity in young female undergraduate students.

INTRODUCTION: Objective: to identify cytokines and to associate them with several indexes of total and central adiposity in young female undergraduate students. Methods: 58 young female sophomore students, aged 18 to 25 years, from a Brazilian public university were evaluated. Both anthropometric measures (weight, height, waist circumference and hip circumference) and body composition were assessed through DXA, and the values of android, gynoid and truncal fat mass were obtained. Cytokines (IL-8, IL-1ß, IL-6, IL-10 e TNF-α) were analyzed, and Body Mass Index (BMI), Body Adiposity Index (BAI), Visceral Adiposity Index (VAI), Conicity Index (CCI), Waist-Hip Index (WHR), Waist-to-Height Ratio (WHtR), Fat Mass Distribution Index 1 (FMI1) and Fat Mass Distribution Index 2 (FMI2) were calculated. Eventually, a linear regression was carried out to determine the regression coefficient and confidence interval (CI), having the predictor variables (cytokines) adjusted according to age and family history of obesity. The statistical significance of α = 5% was applied. Results: a correlation between adiposity indexes and cytokines (CCI, WHR and IL-12; CCI, WHR, FMI1, FMI2 and TNF-α) was identified. When it comes to the regression models, cytokines increase was related to CCI, WHR, FMI1 and FMI2 increase. Conclusion: pro-inflammatory cytokines were associated with an increase in adipose indexes. Therefore, these indexes became a feasible strategy for clinical practice in order to identify propensity to inflammatory disorders.

INTRODUCCIÓN: Objetivo: identificar citoquinas y asociarlas con los distintos índices de adiposidad total y central en estudiantes universitarias jóvenes. Métodos: se evaluaron 58 jóvenes estudiantes, de 18 a 25 años de edad, de segundo curso de carrera de una universidad pública brasileña. Se analizaron mediante densitometría (DEXA) tanto las medidas antropométricas (peso, talla, perímetro de la cintura y perímetro de la cadera) como la composición corporal, obteniéndose los valores de masa grasa androide, ginoide y troncal. Se analizaron las citoquinas (IL-8, IL-1ß, IL-6, IL-10 y TNF-α) y se calcularon el índice de masa corporal (IMC), el índice de adiposidad corporal (IAC), el índice de adiposidad visceral (IAV), el índice de conicidad (CCI), el índice cintura-cadera (WHR), la ratio cintura-talla (WHtR), el índice de distribución de la masa grasa 1 (FMI1) y el índice de distribución de la masa grasa 2 (FMI2). Finalmente se realizó una regresión lineal para determinar el coeficiente de regresión y el intervalo de confianza (IC), ajustando las variables predictivas (citoquinas) a la edad y los antecedentes familiares de obesidad. Se aplicó una significación estadística de α = 5%. Resultados: se detectó una correlación entre índices adiposos y citoquinas (CCI, WHR e IL-12; CCI, WHR, FMI1, FMI2 and TNF-α). Conforme a los modelos de regresión, el aumento de las citoquinas se relacionó con el aumento de CCI, WHR, FMI1 y FMI2. Conclusión: las citoquinas proinflamatorias se asociaron al aumento de los índices adiposos. Por tanto, los índices se convierten en una estrategia factible para detectar la propensión hacia los trastornos inflamatorios en la práctica clínica.

[Food and nutritional insecurity in families in the Brazilian rural environment: a systematic review]. / Insegurança alimentar e nutricional em famílias do meio rural brasileiro: revisão sistemática.

This review sought to analyze food and nutritional insecurity in the Brazilian rural environment, and the measurement instruments used to assess this situation. A systematic review was conducted in the SciELO, PubMed and CAPES databases, using the search terms: 'food security' and 'rural,' Subsequently, a reverse search was performed in the 12 articles selected. The inclusion criteria were: original articles related to food and nutritional (in)security in the Brazilian rural population. Twelve studies were included. Most of them used the Escala Brasileira de Insegurança Alimentar - EBIA (Brazilian Scale for Food Insecurity) and socioeconomic questionnaires to assess food insecurity (FI), an association being found between them. Five studies addressed the nutritional aspect by anthropometry but found no association with FI. Food consumption was assessed by four studies and an association was detected. The results show a high prevalence of FI in rural areas in relation to the population analyzed in the Pesquisa Nacional por Amostra de Domicílio - PNAD (National Household Sample Survey) in the years 2009 and 2013, as well as a high prevalence of severe FI. The conclusion reached is that the rural environment is vulnerable, mainly regarding food and nutritional issues and the associated socioeconomic determinants.

Esta revisão objetivou analisar a insegurança alimentar e nutricional no meio rural brasileiro, bem como os instrumentos de mensuração utilizados na avaliação dessa situação. Realizou-se revisão sistemática nas bases de dados SciELO, Pubmed e o portal de periódicos da CAPES, usando os termos de busca: 'segurança alimentar' e 'rural'. Posteriormente foi realizada busca reversa dentro dos artigos selecionados. Os critérios de inclusão foram: artigos originais, relacionados à (in) segurança alimentar e nutricional na população rural brasileira. Foram incluídos 12 estudos. A maioria utilizou a Escala Brasileira de Insegurança Alimentar-EBIA e questionários socioeconômicos para avaliar a insegurança alimentar (IA), sendo encontrada associação entre eles. Cinco estudos abordaram o aspecto nutricional pela antropometria, porém não encontraram associação com a IA. O consumo alimentar foi avaliado por quatro estudos e foi observada associação. Os resultados mostram alta prevalência de IA no meio rural em relação à população analisada na Pesquisa Nacional por Amostra de Domicílio-PNAD nos anos de 2009 e 2013, assim como alta prevalência de IA grave. Conclui-se que o meio rural se apresenta em vulnerabilidade, principalmente quanto à questão alimentar e nutricional e aos determinantes socioeconômicos atrelados.

Insegurança alimentar e nutricional em famílias do meio rural brasileiro: revisão sistemática / Food and nutritional insecurity in families in the Brazilian rural environment: a systematic review

Resumo Esta revisão objetivou analisar a insegurança alimentar e nutricional no meio rural brasileiro, bem como os instrumentos de mensuração utilizados na avaliação dessa situação. Realizou-se revisão sistemática nas bases de dados SciELO, Pubmed e o portal de periódicos da CAPES, usando os termos de busca: 'segurança alimentar' e 'rural'. Posteriormente foi realizada busca reversa dentro dos artigos selecionados. Os critérios de inclusão foram: artigos originais, relacionados à (in) segurança alimentar e nutricional na população rural brasileira. Foram incluídos 12 estudos. A maioria utilizou a Escala Brasileira de Insegurança Alimentar-EBIA e questionários socioeconômicos para avaliar a insegurança alimentar (IA), sendo encontrada associação entre eles. Cinco estudos abordaram o aspecto nutricional pela antropometria, porém não encontraram associação com a IA. O consumo alimentar foi avaliado por quatro estudos e foi observada associação. Os resultados mostram alta prevalência de IA no meio rural em relação à população analisada na Pesquisa Nacional por Amostra de Domicílio-PNAD nos anos de 2009 e 2013, assim como alta prevalência de IA grave. Conclui-se que o meio rural se apresenta em vulnerabilidade, principalmente quanto à questão alimentar e nutricional e aos determinantes socioeconômicos atrelados.

Abstract This review sought to analyze food and nutritional insecurity in the Brazilian rural environment, and the measurement instruments used to assess this situation. A systematic review was conducted in the SciELO, PubMed and CAPES databases, using the search terms: 'food security' and 'rural,' Subsequently, a reverse search was performed in the 12 articles selected. The inclusion criteria were: original articles related to food and nutritional (in)security in the Brazilian rural population. Twelve studies were included. Most of them used the Escala Brasileira de Insegurança Alimentar - EBIA (Brazilian Scale for Food Insecurity) and socioeconomic questionnaires to assess food insecurity (FI), an association being found between them. Five studies addressed the nutritional aspect by anthropometry but found no association with FI. Food consumption was assessed by four studies and an association was detected. The results show a high prevalence of FI in rural areas in relation to the population analyzed in the Pesquisa Nacional por Amostra de Domicílio - PNAD (National Household Sample Survey) in the years 2009 and 2013, as well as a high prevalence of severe FI. The conclusion reached is that the rural environment is vulnerable, mainly regarding food and nutritional issues and the associated socioeconomic determinants.

Uso do extrato de folhas de Mangifera indica L. e da mangiferina na lesão aterosclerótica em camundongos ApoE-/- / Use of Mangifera indica L. leaves extract and mangiferin on the atherosclerotic lesion in ApoE-/- mice

As folhas de Mangifera indica L são importantes como fonte de compostos fenólicos, especialmente mangiferina, que apresentam propriedades antidiabética, hipolipemiante, antioxidante e anti-inflamatória. O estudo teve como objetivo avaliar os efeitos do extrato etanólico de folhas de M. indica e da mangiferina isolada sobre a lesão aterosclerótica em camundongos ApoE-/-. Métodos: Camundongos ApoE-/- com 15 semanas de idade foram divididos aleatoriamente em 4 grupos de acordo com o tratamento, por gavagem, durante 56 dias: controle (veículo, dimetil sulfóxido); E200 (200 mg/kg/dia de extrato da folha de M. indica), E400 (400 mg/kg/dia de extrato da folha de M. indica); M40 (40 mg/kg/dia de mangiferina). Parâmetros sanguíneos foram dosados utilizando-se kits enzimáticos e as lesões ateroscleróticas foram avaliadas pelo método en face. Resultados: O extrato seco apresentou 17% de mangiferina. Os níveis sanguíneos de colesterol total, frações HDLc e LDLc e triacilgliceróis, bem como o percentual de deposição lipídica no arco aórtico e aorta torácica não diferiram significativamente entre os grupos (p>0,05). Conclusão: A administração do extrato de folhas de M. indica e da mangiferina em camundongos ApoE-/- não afetou a lipidemia e não diminuiu as lesões ateroscleróticas pré-existentes.

Mangifera indica L leaf are an important source of phenolic compounds, especially mangiferin, that exhibits antidiabetic, hypolipidemic, anti-oxidant and anti-inflammatory activities. This study aimed to evaluate the effects of mangiferin and ethanolic extract of M. indica leaf on atherosclerotic lesions in mice ApoE-/-. Methods: Fifteenweek- old ApoE-/- mice were randomly divided into 4 groups according to the treatment giving by gavage during 56 days: control - vehicle (dimethyl sulfoxide); E200 - 200 mg/kg/day M. indica leaf extract; E400 - 400 mg/kg/day M. indica leaf extract, M40 - 40 mg/kg/day mangiferin. Administrations of vehicle, extracts and mangiferin were performed every day by gavage during 8 weeks. Blood parameters were measured using enzymatic kits and atherosclerotic lesions were evaluated by en face method. Results: The dired extract showed 17% of mangiferin. Total cholesterol, HDLc, LDLc and triglycerides blood levels, as well as the percentage of lipid deposition in the aortic arch and thoracic aorta were not significantly different between the groups (p> 0.05). Conclusion: The administration of M. indica leaf extract and mangiferin in ApoE-/- mice did not affect serum lipids and did not decreased pre-existing atherosclerotic lesions