Income and education level trajectories and changes in the daily consumption of vegetables after thirteen years of follow-up: the Pró-Saúde Study.

OBJECTIVE: This study aimed to examine whether education level and income trajectories influence vegetable consumption changes over 13 years among civil servants at different campuses of a university in the state of Rio de Janeiro, Brazil. METHODS: Vegetable intake frequency (daily and non-daily consumption), income (per capita), and education level (maintenance of low schooling/ upward mobility/maintenance of high schooling) were assessed at baseline (1999) and in the fourth wave (2011-12) of the Pró-Saúde (Pro-Health) cohort study. A total of 2,381 participants were analyzed. The association between educational and income trajectories and variation in vegetable consumption was assessed via crude and age-adjusted generalized linear models, stratified by sex. RESULTS: Men in upward educational mobility showed a 0.5% increase in vegetable consumption (p=0.01), while women in this group demonstrated a 2.5% increase (p=0.05). Adjusted models showed that women who reduced their income had a lower likelihood of consuming vegetables (odds ratio [OR] 0.93; 95% confidence interval [CI] 0.89-0.97). CONCLUSIONS: The findings highlight the influence of social inequalities on vegetable consumption in adults.

Does the use of universal adhesive systems improve the durability of the bond strength of orthodontic brackets to enamel?

Background: Universal adhesive systems used for restorative clinical procedures are like orthodontics and may be a viable option. This study evaluated the effectiveness of universal adhesive systems in enhancing the durability of the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets to enamel. Material and Methods: 100 bovine incisors were divided into five groups (n=20), according to the applied adhesive systems: Primer Transbond XT; Ambar; Ambar Universal; Single Bond Universal; Adper Single Bond 2. Bracket from each tooth were submitted to SBS test after 24 hours, and 12 months later. The amount of remaining adhesive was evaluated through ARI. Results: After 24 hours, there was no difference in BS between the control and the other groups (p>0.05). However, there were difference between TOTALETCHING1 group and the Ambar Universal (p=0.015) and Single Bond Universal groups (p=0.011). After 12 months, Primer Transbond XT, Ambar, Ambar Universal and Adper Single Bond 2 showed no differences in the SBS (p>0.05). Nonetheless, Single Bond Universal presented superior result when compared to Primer Transbond XT (p=0.046) and Ambar (p=0.011) groups. The SBS of all groups reduced significantly after 12 months (p<0.05). There was no difference between ARI scores in each individually assessed group (p>0.05), for both periods. Following 24 hours, a difference was observed between the groups (p=0.043), fact that didn't occur after 12 months (p=0.109). Conclusions: Adhesive systems, such as Ambar Universal and Single Bond Universal are efficient in bonding orthodontic brackets to enamel when associated with Transbond XT adhesive paste. Key words:Bond strength; Primer Transbond XT, orthodontic brackets, adhesive systems.

Treatment of childhood obesity based on the reduction of ultra-processed foods plus energy restriction: A randomised controlled trial based on the Brazilian guidelines.

Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = -0.27 kg/m2) compared to the CG (Δ = + 0.53 kg/m2) (p = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. Clinical Trial Registration: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.

Evolution of adolescents' dietary patterns in Northeast Brazil from 2008 to 2018.

OBJECTIVE: To evaluate the evolution of the dietary patterns of adolescents in the northeast region of Brazil. METHODS: Secondary analysis of data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Surveys), collected by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2008-2009 and 2017-2018. A total of 3,095 adolescents were evaluated in 2008-2009 and 3,015 in 2017-2018. Food consumption was assessed using two dietary records in 2008-2009 and two 24-hour recalls in 2017-2018, applied on non-consecutive days. Based on these data, principal components factor analysis (PCFA) was performed, followed by orthogonal rotation of the varimax type, to derive dietary patterns, stratified by sex. The results were described as means or percentage frequencies, with their respective 95% confidence intervals. RESULTS: Three main dietary patterns were identified among adolescents from the northeast region of Brazil. Among boys, in 2008-2009, the patterns were called snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and mixed, in this order of representativeness of the group's eating habits. Among female adolescents, in 2008-2009, the patterns were snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and processed meats. CONCLUSION: The dietary patterns identified in 2008-2009 and 2017-2018 were similar in both genders; however, the snacks pattern, which explained most of the data variability in 2008-2009, was replaced by the traditional Brazilian.

A choice architecture intervention targeting school meals and water frequency intake: A school-based randomized trial.

Our aim was to evaluate the impact of choice architecture on school meals and water intake frequency. We conducted a school-based randomized trial in seven elementary municipal public schools (control = 3; intervention = 4) in Rio de Janeiro, Brazil. The interventions group received the following modifications: (1) banner of the daily school meal menu and two superheroes, (2) waterproof tablecloths, (3) posters on healthy eating habits, (4) displays with playful names, (5) new containers for fruits, and (6) colored footprints for one month. Changes in school meals and daily water frequency consumption were evaluated through intention-to-treat analyses, using generalized estimating equations models for repeated measures, considering the classes' cluster effect. Data from 974 students in the fifth and sixth elementary school grades were analyzed (control = 356; intervention = 618). At baseline, 47.1% of students were female, with a mean age of 12 years (SD = 1.4), 39.2% reported daily consumption of school meals, and 45.7% consumed water from the school drinking fountain three or more times a day. We observed an increase in the odds of daily water intake in the intervention group compared to the control (OR = 1.4 95% CI = 1.1-1.9), no changes in the school meals (OR = 1.2 95% CI = 0.9; 1.6). Low-complexity strategies based on choice architecture applied in the school environment can be promising in increasing water intake frequency among elementary students in public schools. TRIAL REGISTRATION: This study was registered on the Clinicaltrials.gov platform under the number NCT03136016. Access: https://clinicaltrials.gov/ct2/show/NCT03136016.

Ultra-processed foods, adiposity and risk of head and neck cancer and oesophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study: a mediation analysis.

PURPOSE: To investigate the role of adiposity in the associations between ultra-processed food (UPF) consumption and head and neck cancer (HNC) and oesophageal adenocarcinoma (OAC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Our study included 450,111 EPIC participants. We used Cox regressions to investigate the associations between the consumption of UPFs and HNC and OAC risk. A mediation analysis was performed to assess the role of body mass index (BMI) and waist-to-hip ratio (WHR) in these associations. In sensitivity analyses, we investigated accidental death as a negative control outcome. RESULTS: During a mean follow-up of 14.13 ± 3.98 years, 910 and 215 participants developed HNC and OAC, respectively. A 10% g/d higher consumption of UPFs was associated with an increased risk of HNC (hazard ratio [HR] = 1.23, 95% confidence interval [CI] 1.14-1.34) and OAC (HR = 1.24, 95% CI 1.05-1.47). WHR mediated 5% (95% CI 3-10%) of the association between the consumption of UPFs and HNC risk, while BMI and WHR, respectively, mediated 13% (95% CI 6-53%) and 15% (95% CI 8-72%) of the association between the consumption of UPFs and OAC risk. UPF consumption was positively associated with accidental death in the negative control analysis. CONCLUSIONS: We reaffirmed that higher UPF consumption is associated with greater risk of HNC and OAC in EPIC. The proportion mediated via adiposity was small. Further research is required to investigate other mechanisms that may be at play (if there is indeed any causal effect of UPF consumption on these cancers).

Income and education level trajectories and changes in the daily consumption of vegetables after thirteen years of follow-up: the Pró-Saúde Study / Trajetórias de renda e nível de educação e mudanças no consumo diário de vegetais após treze anos de acompanhamento: Estudo Pró-Saúde

ABSTRACT Objective: This study aimed to examine whether education level and income trajectories influence vegetable consumption changes over 13 years among civil servants at different campuses of a university in the state of Rio de Janeiro, Brazil. Methods: Vegetable intake frequency (daily and non-daily consumption), income (per capita), and education level (maintenance of low schooling/ upward mobility/maintenance of high schooling) were assessed at baseline (1999) and in the fourth wave (2011-12) of the Pró-Saúde (Pro-Health) cohort study. A total of 2,381 participants were analyzed. The association between educational and income trajectories and variation in vegetable consumption was assessed via crude and age-adjusted generalized linear models, stratified by sex. Results: Men in upward educational mobility showed a 0.5% increase in vegetable consumption (p=0.01), while women in this group demonstrated a 2.5% increase (p=0.05). Adjusted models showed that women who reduced their income had a lower likelihood of consuming vegetables (odds ratio [OR] 0.93; 95% confidence interval [CI] 0.89-0.97). Conclusions: The findings highlight the influence of social inequalities on vegetable consumption in adults.

RESUMO Objetivo: O objetivo deste estudo foi avaliar se as trajetórias do nível de educação e de renda influenciam na mudança do consumo de vegetais ao longo de 13 anos entre funcionários públicos de diferentes campi de uma universidade do Rio de Janeiro, Brasil. Métodos: A frequência de consumo de vegetais (consumo diário e não diário), a renda (per capita) e o nível de educação (manutenção da baixa escolaridade/mobilidade ascendente/ manutenção da alta escolaridade) foram avaliados no início (1999) e na quarta onda (2011-12) do estudo de coorte Pró-Saúde. Foram analisados 2.381 participantes, e a associação entre as trajetórias de escolaridade e renda e a variação no consumo de vegetais foi avaliada via modelos lineares generalizados brutos e ajustados por idade e variação da escolaridade e estratificados por sexo. Resultados: Homens em mobilidade educacional ascendente apresentaram aumento de 0,5% no consumo de vegetais (p=0,01), enquanto mulheres nesse grupo demonstraram aumento de 2,5% (p=0,05). Modelos ajustados mostraram que mulheres que reduziram sua renda apresentaram menor probabilidade de consumir vegetais (odds ratio [OR] 0,93; intervalo de confiança [IC] 95% 0,89-0,97). Conclusão: Os achados destacam a influência das desigualdades sociais no consumo de vegetais em adultos.

How reverse planning and the use o digital devices revolutionize implantology? ­ Case report / Como o planejamento reverso e o uso de ferramentas digitais revolucionam a implantodontia? ­ Relato de caso

Objectives: The aim of the study was to demonstrate how digital devices can be applied in the field of implant dentistry. By integrating data from computed tomography, panoramic radiography, and intraoral scanning into software, it is feasible to perform virtual planning of prosthetic rehabilitation and implant placement predictably. The adoption of reverse planning increases the chances of treatment success. Material and Methods: In this case report, oral rehabilitation of the area of tooth 36 was conducted through implant placement. The implant was installed based on the virtual planning done in the software, followed by the production of a rigid static guide and guided surgery. Results: It was noted that there is a learning curve associated with the use of these technologies, requiring professionals to have theoretical and practical knowledge of digital devices. By using software and surgical guides obtained through 3D printing, it was possible to achieve high precision and preserve vital structures such as blood vessels and nerves, resulting in aesthetic and functional satisfaction for the patient. Conclusion: The use of digital devices in implant dentistry offers speed and predictability in treatment.(AU)

Objetivos: O objetivo do estudo foi evidenciar como as ferramentas digitais podem ser aplicadas na área da implantodontia. Ao integrar dados de tomografia computadorizada, radiografia panorâmica e escaneamento intraoral em um software, é viável realizar o planejamento virtual da reabilitação protética e implante de forma previsível. A adoção do planejamento reverso aumenta as probabilidades de sucesso do tratamento. Material e Métodos: Neste relato de caso, a reabilitação oral da área do dente 36 foi conduzida por meio da instalação de um implante. O implante foi instalado com base no planejamento virtual realizado no software, seguido pela produção de um guia estático rígido e cirurgia guiada. Resultados: Notou-se que há uma curva de aprendizado associada ao uso dessas tecnologias, exigindo que os profissionais possuam conhecimento teórico e prático dos dispositivos digitais. Ao utilizar softwares e guias cirúrgicos personalizados obtidos por impressão 3D, foi possível alcançar alta precisão e preservar estruturas vitais como vasos sanguíneos e nervos, resultando em satisfação estética e funcional para o paciente. Conclusão: O emprego de ferramentas digitais na implantodontia oferece rapidez e previsibilidade no tratamento.(AU)

Percepções de escolares e merendeiras sobre alimentação escolar: uma análise por grupos focais / Perceptions of schoolchildren and lunch ladies about school meals: a focus groups analysis

Resumo Introdução: O Programa Nacional de Alimentação Escolar (PNAE) destaca-se por ser um dos maiores programas do mundo de alimentação escolar, contemplando o Direito Humano à Alimentação Adequada a estudantes brasileiros. Entretanto, alguns estudos têm observado baixa aceitabilidade e adesão à alimentação escolar. Objetivo: Analisar a percepção de merendeiras e escolares acerca da aceitabilidade e adesão à alimentação escolar. Metodologia: Pesquisa qualitativa realizada através de grupos focais com merendeiras de três escolas e escolares do sexto ao nono ano de escola pública de Sumidouro, Rio de Janeiro, Brasil. Os grupos focais foram realizados utilizando-se roteiros semiestruturados e gravados em áudio e vídeo, posteriormente transcritos e analisados por Análise de Conteúdo. Resultados: Foram identificados seis temas: autoconhecimento, adesão, aceitabilidade, preparo e distribuição da alimentação escolar, cardápio e ambiente. Conclusão: O emprego de esforços na melhoria da infraestrutura e aspecto do ambiente alimentar, com a aquisição de utensílios adequados, alteração no modelo de serviço de distribuição e no modo de preparo das refeições, resultando em cardápios variados, são estratégias que podem contribuir para melhorar a adesão e aceitabilidade à alimentação escolar. Essas mudanças favorecem a promoção de saúde no espaço escolar, com foco em políticas públicas saudáveis.

Abstract Introduction: National School Feeding Program (PNAE) stands out for being one of the largest school feeding programs in the world, contemplating the Human Right to Adequate Food for Brazilian students. However, some research works have observed low acceptability and adherence to school meals. Objective: To analyze the perception of school lunch ladies and students about acceptability and adherence to school meals. Methodology: Qualitative research carried out through focus groups with lunch ladies from three schools and students from the sixth to the ninth grade of a public school in Sumidouro, Rio de Janeiro state, Brazil. The focus groups were carried out using semi-structured scripts and recorded in audio and video, later transcribed and analyzed by Content Analysis. Results: Six themes were identified: self-knowledge, adherence, acceptability, preparation and distribution of school meals, menu and environment. Conclusion: The use of efforts to improve the infrastructure and aspect of the food environment, with the acquisition of adequate utensils, change in the distribution service model and in the way of preparing meals, resulting in varied menus, are strategies that can contribute to improve adherence and acceptability to school meals. These changes favor the promotion of health in the school environment, focusing on healthy public policies.

Evolution of adolescents' dietary patterns in Northeast Brazil from 2008 to 2018

ABSTRACT OBJECTIVE To evaluate the evolution of the dietary patterns of adolescents in the northeast region of Brazil. METHODS Secondary analysis of data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Surveys), collected by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2008-2009 and 2017-2018. A total of 3,095 adolescents were evaluated in 2008-2009 and 3,015 in 2017-2018. Food consumption was assessed using two dietary records in 2008-2009 and two 24-hour recalls in 2017-2018, applied on non-consecutive days. Based on these data, principal components factor analysis (PCFA) was performed, followed by orthogonal rotation of the varimax type, to derive dietary patterns, stratified by sex. The results were described as means or percentage frequencies, with their respective 95% confidence intervals. RESULTS Three main dietary patterns were identified among adolescents from the northeast region of Brazil. Among boys, in 2008-2009, the patterns were called snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and mixed, in this order of representativeness of the group's eating habits. Among female adolescents, in 2008-2009, the patterns were snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and processed meats. CONCLUSION The dietary patterns identified in 2008-2009 and 2017-2018 were similar in both genders; however, the snacks pattern, which explained most of the data variability in 2008-2009, was replaced by the traditional Brazilian.

Blood pressure variation and ultra-processed food consumption in children with obesity.

To investigate the influence of ultra-processed food (UPF) consumption on systolic (SBP) and diastolic (DBP) blood pressure in children with obesity, using dietary and urinary markers. We conducted a secondary analysis of a randomized clinical trial involving children with obesity, aged 7 to 12 years. Over a period of six months, the children and their guardians attended monthly individual consultations and educational activities aimed at promoting a reduction in UPF consumption. During each visit, measurements of blood pressure, body weight, height, and 24-h dietary recall were recorded. Additionally, spot urine samples were collected at baseline, and at the second and fifth-month follow-ups. A total of 96 children were included in the analysis. Energy intake, UPF intake and blood pressure showed a quadratic pattern of change, with a decrease in the first two months and an increase thereafter. There was an association between UPF consumption and DBP. The intake of UPF was correlated with the urinary sodium-to-potassium (Na/K) ratio (r = 0.29; p = 0.008) and the dietary Na/K ratio (r = 0.40; p < 0.001). For every 100 g increase in UPF, DBP increased by 0.28 mmHg (p-value = 0.01). After further adjustment for changes in body mass index (BMI), and physical activity, the increase in DBP was 0.22 mmHg.    Conclusion: Our findings indicate that reducing UPF consumption may have an impact on blood pressure in children with obesity. Additional adjustment for BMI and physical activity did not influence the results. Therefore, reducing UPF consumption can be considered as a strategy against hypertension. What is Known: • Ultra-processed food consumption is associated with an increased risk of cardiovascular disease; however, this evidence is still limited in children. • Intake of calories from ultra-processed food in relation to the total calories is increasing worldwide. What is New: • Ultra-processed food consumption has an effect on the diastolic blood pressure, independent of changes in weight. • The intake of ultra-processed food was correlated to the dietary sodium-to-potassium ratio (r = 0.40; p < 0.001).

Adherence to school meals and co-occurrence of the healthy and unhealthy food markers among Brazilian adolescents.

The aim of this study was to analyze the association between adherence to school meals and the co-occurrence of the regular consumption of healthy and unhealthy eating markers among Brazilian adolescents. Data from 67,881 adolescents in Brazilian public schools who participated in the 2015 National School Health Survey, were used. From the 7-day FFQ, the dependent variable was constructed, co-occurrence of regular consumption (≥ 5x/week) of healthy and unhealthy food markers, which was categorized as regular consumption of none, one or two, or three eating markers. We performed an ordinal logistic regression with adjustment for sociodemographic, eating habits outside of school, and school characteristics variables. The prevalence of the co-occurrence of the regular consumption of three healthy eating markers was 14.5%, and that of three unhealthy markers was 4.9%. High adherence to school meals (every day) was positively associated with regular consumption of healthy eating markers and inversely associated with regular consumption of unhealthy eating markers. The school meals provided by PNAE contribute to the promotion of healthy eating habits among Brazilian adolescents.

A multicomponent family intervention, combined with salt reduction for children with obesity: a factorial randomized study protocol.

BACKGROUND: Clinical trials to treat childhood obesity show modest results, weight regain and high dropout rates. Children with obesity often live in families with habits that contribute to unhealthy weight gain. This study will test whether a family intervention with a Brazilian-adapted Planetary Healthy Diet (PHD) and reduced portion sizes, along with increased physical activity and reduced sedentary behavior, can reduce excessive weight gain. The protocol promotes the intake of in natura products and water and reduces ultra-processed foods, sugar, and sodium. It encourages family lifestyle changes and physical activities, with randomized allocation to experimental and control groups. The responsible family member will be evaluated during follow-up. The control group will receive a print of the Brazilian dietary guideline. METHODS: A factorial crossover design will also allocate families to receive reduced sodium salt plus anti-inflammatory herbs and a placebo salt. Both the control and intervention groups will be randomly assigned to the sequence of both salts. The approach aims to reduce body weight expectations and evaluate salt's impact on blood pressure. It includes a 1-month intervention, 1-month washout, and 1-month intervention with monthly clinic visits and teleservice by health professionals. The primary outcomes will be the variation in the Body Mass Index (BMI) of the children. BMI and the variation in the blood pressure of the pair (child/mother or father) as well as waist circumference (WC) and waist-to-height ratio (WHtR) will also be measured. DISCUSSION: The project will test the effectiveness of the use of the recommendations of the PHD, physical activity and a salt-reduced sodium. The results of the present study will allow the refinement of interventions aimed at the treatment of childhood obesity and may help develop guidelines for the treatment of obesity in Brazilian children. TRIAL REGISTRATION: The study is registered in the Brazilian Registry of Clinical Trials (RBR-10 mm62vs). Registered 10 February 2023.

Adherence to school meals and co-occurrence of the healthy and unhealthy food markers among Brazilian adolescents / Adesão à alimentação escolar e coocorrência dos marcadores de alimentação saudável e não saudável entre adolescentes brasileiros

Abstract The aim of this study was to analyze the association between adherence to school meals and the co-occurrence of the regular consumption of healthy and unhealthy eating markers among Brazilian adolescents. Data from 67,881 adolescents in Brazilian public schools who participated in the 2015 National School Health Survey, were used. From the 7-day FFQ, the dependent variable was constructed, co-occurrence of regular consumption (≥ 5x/week) of healthy and unhealthy food markers, which was categorized as regular consumption of none, one or two, or three eating markers. We performed an ordinal logistic regression with adjustment for sociodemographic, eating habits outside of school, and school characteristics variables. The prevalence of the co-occurrence of the regular consumption of three healthy eating markers was 14.5%, and that of three unhealthy markers was 4.9%. High adherence to school meals (every day) was positively associated with regular consumption of healthy eating markers and inversely associated with regular consumption of unhealthy eating markers. The school meals provided by PNAE contribute to the promotion of healthy eating habits among Brazilian adolescents.

Resumo Este estudo tem como objetivo analisar a associação entre a adesão à alimentação escolar e a coocorrência do consumo regular de marcadores de alimentação saudável e não saudável entre adolescentes brasileiros. Foram avaliados 67.881 adolescentes de escolas públicas brasileiras participantes da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015. A partir do QFA de sete dias, construiu-se a variável dependente, coocorrência do consumo regular (≥ 5x/semana) de marcadores de alimentação saudável e não saudável, que foi categorizada em consumo regular de nenhum; um ou dois; ou três marcadores de alimentação. Realizou-se regressão logística ordinal com ajuste para variáveis sociodemográficas, hábitos alimentares fora da escola e características da escola. A prevalência da coocorrência do consumo regular de três marcadores de alimentação saudável foi de 14,5%, e de três marcadores de alimentação não saudável foi de 4,9%. A alta adesão à alimentação escolar (todos os dias) foi positivamente associada ao consumo regular de marcadores de alimentação saudável e inversamente associada ao consumo regular de marcadores de alimentação não saudável. A alimentação escolar fornecida pelo PNAE contribui para a promoção de hábitos alimentares saudáveis entre os adolescentes brasileiros.

Dietary patterns, obesity markers and leukocyte telomere length among Brazilian civil servants: cross-sectional results from the Pro-Saude study.

OBJECTIVE: Dietary patterns express the combination and variety of foods in the diet. The partial least squares method allows extracting dietary patterns related to a specific health outcome. Few studies have evaluated obesity-related dietary patterns associated with telomeres length. This study aims to identify dietary patterns explaining obesity markers and to assess their association with leukocyte telomere length (LTL), a biological marker of the ageing process. DESIGN: Cross-sectional study. SETTING: University campuses in the state of Rio de Janeiro, Brazil. PARTICIPANTS: 478 participants of a civil servants' cohort study with data on food consumption, obesity measurements (total body fat, visceral fat, BMI, leptin and adiponectin) and blood samples. RESULTS: Three dietary patterns were extracted: (1) fast food and meat; (2) healthy and (3) traditional pattern, which included rice and beans, the staple foods most consumed in Brazil. All three dietary patterns explained 23·2 % of food consumption variation and 10·7 % of the obesity-related variables. The fast food and meat pattern were the first factor extracted, explaining 11-13 % variation of the obesity-related response variables (BMI, total body fat and visceral fat), leptin and adiponectin showed the lowest percentage (4·5-0·1 %). The healthy pattern mostly explained leptin and adiponectin variations (10·7 and 3·3 %, respectively). The traditional pattern was associated with LTL (ß = 0·0117; 95 % CI 0·0001, 0·0233) after adjustment for the other patterns, age, sex, exercise practice, income and energy intake. CONCLUSION: Leukocyte telomere length was longer among participants eating a traditional dietary pattern that combines fruit, vegetables and beans.

Association of the retail food environment, BMI, dietary patterns, and socioeconomic position in urban areas of Mexico.

The retail food environment is a key modifiable driver of food choice and the risk of non-communicable diseases (NCDs). This study aimed to assess the relationship between the density of food retailers, body mass index (BMI), dietary patterns, and socioeconomic position in Mexico. Cross-sectional dietary data, BMI and socioeconomic characteristics of adult participants came from the nationally representative 2012 National Health and Nutrition Survey in Mexico. Geographical and food outlet data were obtained from official statistics. Densities of food outlets per census tract area (CTA) were calculated. Dietary patterns were determined using exploratory factor analysis and principal component analysis. The association of food environment variables, socioeconomic position, BMI, and dietary patterns was assessed using two-level multilevel linear regression models. Three dietary patterns were identified-the healthy, the unhealthy and the carbohydrates-and-drinks dietary pattern. Lower availability of fruit and vegetable stores was associated with an unhealthier dietary pattern whilst a higher restaurant density was associated with a carbohydrates-and-drinks pattern. A graded and inverse association was observed for fruit and vegetable store density and socioeconomic position (SEP)-lower-income populations had a reduced availability of fruit and vegetable stores, compared with higher-income populations. A higher density of convenience stores was associated with a higher BMI when adjusting for unhealthy dietary patterns. Upper-income households were more likely to consume healthy dietary patterns and middle-upper-income households were less likely to consume unhealthy dietary patterns when exposed to high densities of fruit and vegetable stores. When exposed to a high concentration of convenience stores, lower and upper-lower-income households were more likely to consume unhealthy dietary patterns. Food environment and sociodemographic conditions within neighbourhoods may affect dietary behaviours. Food environment interventions and policies which improve access to healthy foods and restrict access to unhealthy foods may facilitate healthier diets and contribute to the prevention of NCDs.

3D-printed microgels supplemented with dentin matrix molecules as a novel biomaterial for direct pulp capping.

OBJECTIVES: To develop a 3D-printed, microparticulate hydrogel supplemented with dentin matrix molecules (DMM) as a novel regenerative strategy for dental pulp capping. MATERIALS AND METHODS: Gelatin methacryloyl microgels (7% w/v) mixed with varying concentrations of DMM were printed using a digital light projection 3D printer and lyophilized for 2 days. The release profile of the DMM-loaded microgels was measured using a bicinchoninic acid assay. Next, dental pulp exposure defects were created in maxillary first molars of Wistar rats. The exposures were randomly capped with (1) inert material - negative control, (2) microgels, (3) microgels + DMM 500 µg/ml, (4) microgels + DMM 1000 µg/ml, (5) microgels + platelet-derived growth factor (PDGF 10 ng/ml), or (6) MTA (n = 15/group). After 4 weeks, animals were euthanized, and treated molars were harvested and then processed to evaluate hard tissue deposition, pulp tissue organization, and blood vessel density. RESULTS: All the specimens from groups treated with microgel + 500 µg/ml, microgel + 1000 µg/ml, microgel + PDGF, and MTA showed the formation of organized pulp tissue, tertiary dentin, newly formed tubular and atubular dentin, and new blood vessel formation. Dentin bridge formation was greater and pulp necrosis was less in the microgel + DMM groups compared to MTA. CONCLUSIONS: The 3D-printed photocurable microgels doped with DMM exhibited favorable cellular and inflammatory pulp responses, and significantly more tertiary dentin deposition. CLINICAL RELEVANCE: 3D-printed microgel with DMM is a promising biomaterial for dentin and dental pulp regeneration in pulp capping procedures.