Pesticide contamination of lactating mothers' milk in Latin America: a systematic review.

OBJECTIVE: To identify the prevalence of contamination by pesticides and their metabolites in the milk of lactating mothers in Latin America. METHODS: In this systematic review, the PubMed, LILACS, Embase, and Scopus databases were searched up to January 2022 to identify observational studies. The Mendeley software was used to manage these references. The risk of bias assessment was evaluated according to the checklist for prevalence studies and writing design, by the Prisma guidelines. RESULTS: This study retrieved 1835 references and analyzed 49 studies. 69.38% of the analyzed studies found a 100% prevalence of breast milk contamination by pesticides among their sample. Main pesticides include dichlorodiphenyltrichloroethane (DDT) and its isomers (75.51%), followed by the metabolite dichlorodiphenyldichloroethylene (DDE) (69.38%) and hexachlorocyclohexane (HCH) (46.93%). This study categorized most (65.30%) studies as having a low risk of bias. CONCLUSIONS: This review shows a high prevalence of pesticide contamination in the breast milk of Latin American women. Further investigations should be carried out to assess contamination levels in breast milk and the possible effects of these substances on maternal and child health.

Post-partum weight retention in Northeastern Brazilian women: a prospective NISAMI cohort study.

BACKGROUND: Weight retention during the post-partum period is associated with excessive weight gain. OBJECTIVES: To investigate factors associated with maternal weight retention at six months post-partum (PPWR). DESIGN AND SETTING: A prospective cohort study was conducted with 127 women monitored using prenatal services. METHODS: The outcome variable was represented by post-partum maternal weight retention and calculated as the difference between the mother's weight at sixth month post-partum and her pregestational weight. RESULTS: The mean age of the pregnant women was 26.7 ± 5.25 years old, and the post-partum maternal weight retention was 46.5%. The proximal determinants showed a direct association with PPWR after adjusting for the distal and intermediate variables: excessive gestational weight gain (odds ratio [OR]:3.34; confidence interval [CI]:1.16-9.59), greater adhesion to dietary intake pattern 2 (composed of red meats and derivatives, eggs, industrialized foods, and coffee) (OR:2.70; CI:1.16-6.32), and the absence of exclusive maternal breastfeeding in the first month (OR:3.40; CI:1.27-9.12), as well as primiparity (OR:2.36; CI:1.00-5.55), an intermediate determinant. Insufficient weight gain in pregnancy was inversely associated with the outcome (OR:0.35; CI:0.31-0.93). CONCLUSIONS: Among the hierarchical determinants, proximal factors were interrelated with maternal weight retention, indicating that excessive total weight gain, an inadequate dietary intake pattern, and the absence of exclusive maternal breastfeeding in the first month of life work as dampeners of the return to pre-gestational weight. Prepartum and post-partum care interventions can contribute to reducing excess weight in women.

Validation and calibration of the Food Consumption Frequency Questionnaire for pregnant women

ABSTRACT BACKGROUND: Few food frequency questionnaires (FFQ) have been validated for pregnant women, particularly those in small- and medium-sized cities in different regions of Brazil. OBJECTIVES: To validate and calibrate a semiquantitative FFQ for pregnant women. DESIGN AND SETTING: The study was validated with a sample of 50 pregnant women (≥ 18 years) enrolled in Brazilian prenatal services. METHODS: An FFQ and a 24-hour recall were used to evaluate dietary intake. Dietary variables were tested for normality and log-converted when asymmetrical. Pearson's Correlation Coefficient was used to validate the questionnaire. Linear regression was applied to extract calibration factors. All variables underlying the consumption analysis were adjusted for energy. RESULTS: The mean age of the pregnant women was 26 years ± 6.2 years; 58% were in their first trimester, and 30% were identified as overweight/obese. The Pearson correlation analysis results indicated that the FFQ overestimated energy and nutrient intake, whose coefficients ranged from −0.15 (monounsaturated fat) to 0.50 (carbohydrate). Adjusting for energy reduced the mean values of intake coefficients, which now ranged from −0.33 (sodium) to 0.96 (folate). The calibration analysis results indicated variation in the coefficients from −0.23 (sodium) to 1.00 (folate). Calibration produced satisfactory coefficients for the FFQ compared with the reference standard for energy, macronutrients, monounsaturated fat, cholesterol, vitamins B12/C, folate, sodium, iron, and calcium. CONCLUSIONS: After validating and calibrating tests, we observed that the FFQ was adequately accurate for assessing the food consumption of the pregnant women in this study.

Validation and calibration of the Food Consumption Frequency Questionnaire for pregnant women.

BACKGROUND: Few food frequency questionnaires (FFQ) have been validated for pregnant women, particularly those in small- and medium-sized cities in different regions of Brazil. OBJECTIVES: To validate and calibrate a semiquantitative FFQ for pregnant women. DESIGN AND SETTING: The study was validated with a sample of 50 pregnant women (≥ 18 years) enrolled in Brazilian prenatal services. METHODS: An FFQ and a 24-hour recall were used to evaluate dietary intake. Dietary variables were tested for normality and log-converted when asymmetrical. Pearson's Correlation Coefficient was used to validate the questionnaire. Linear regression was applied to extract calibration factors. All variables underlying the consumption analysis were adjusted for energy. RESULTS: The mean age of the pregnant women was 26 years ± 6.2 years; 58% were in their first trimester, and 30% were identified as overweight/obese. The Pearson correlation analysis results indicated that the FFQ overestimated energy and nutrient intake, whose coefficients ranged from -0.15 (monounsaturated fat) to 0.50 (carbohydrate). Adjusting for energy reduced the mean values of intake coefficients, which now ranged from -0.33 (sodium) to 0.96 (folate). The calibration analysis results indicated variation in the coefficients from -0.23 (sodium) to 1.00 (folate). Calibration produced satisfactory coefficients for the FFQ compared with the reference standard for energy, macronutrients, monounsaturated fat, cholesterol, vitamins B12/C, folate, sodium, iron, and calcium. CONCLUSIONS: After validating and calibrating tests, we observed that the FFQ was adequately accurate for assessing the food consumption of the pregnant women in this study.

Assistência pré-natal e amamentação exclusiva na atenção primária à saúde em um município do Sudoeste da Bahia / Prenatal care and exclusive breastfeeding in primary health care in a municipality in the Southwest of Bahia

Introdução: o aleitamento materno exclusivo deve ser promovido e fortalecido em todas as esferas públicas, especialmente na Atenção Primária à Saúde (APS), que tem o pré-natal como elemento importante para assistência e acompanhamento da mulher durante a gestação. Objetivo: identificar a associação entre assistência pré-natal e amamentação exclusiva em crianças menores de seis meses acompanhadas na APS em um município do Sudoeste da Bahia. Metodologia: estudo transversal, envolvendo 75 mães/crianças de zero a seis meses cadastradas no programa de Crescimento e Desenvolvimento do serviço de saúde do município de Jequié, Bahia, no período de março a agosto de 2018. Empregou-se o Teste de Qui-Quadrado de Pearson, para avaliar associação entre variáveis da assistência pré-natal e amamentação exclusiva. Resultados: a prevalência de aleitamento materno exclusivo registrado neste estudo foi de 36%.Observou-se que,mães com mais de seis consultas de pré-natal durante a gestação apresentaram maior prevalência de amamentação exclusiva (55,2%; p=0,019). A variável orientações sobre amamentação exclusiva no pré-natal não foi estatisticamente associada ao desfecho (0,457), porém descritivamente identificou-se que as mães que tiveram orientações durante o pré-natal apresentaram tendência de amamentar exclusivamente (56,7%; p= 0,457). Conclusão: a assistência pré-natal pode ser considerada elemento protetor na prática da amamentação exclusiva, e por isso a promoção e apoio ao aleitamento materno deve ser fortalecida na APS.

Introduction: exclusive breastfeeding should be promoted and strengthened in all public spheres, especially in Primary Health Care (PHC), which has prenatal care as an important element for the assistance and monitoring of women during pregnancy. Objective:to identify the link between prenatal care and exclusive breastfeeding in children younger than six months followed up in the PHC in a municipality in the Southwest of Bahia. Methodology: cross-sectional study, with 75 mothers/children aged zero to six months enrolled in the Growth and Development program of the health service in the municipality of Jequié, Bahia, from March to August 2018. Pearson's Chi-Square Test was used to assess the association between prenatal care variables and exclusive breastfeeding. Results: the prevalence of exclusive breastfeeding recorded in this study was 36%. It was observed that mothers with more than six prenatal consultations during pregnancy had a higher prevalence of exclusive breastfeeding (55.2%; p=0.019). The variable guidance on exclusive breastfeeding during prenatal care was not statistically associated with the outcome (0.457), however it was descriptively identified that mothers who received guidance during prenatal care tended to breastfeed exclusively (56.7%; p= 0.457 ). Conclusion:prenatal care can be considered a protective element in the practice of exclusive breastfeeding, and therefore the promotion and support of breastfeeding should be strengthened in PHC.

Associação entre estado nutricional, indicadores socioeconômicos e quesito raça/cor em gestantes do Recôncavo da Bahia, Brasil / Association between nutritional status, socioeconomic indicators and race/color question in pregnant women in the Recôncavo da Bahia, Brazil

O estado nutricional gestacional adequado constitui-se como elemento essencial para a saúde materna e fetal. Este estudo teve como objetivo identificar a associação entre determinantes sociais, quesito raça/cor e estado nutricional, em gestantes do Recôncavo da Bahia, Brasil. Trata-se de um estudo ecológico, com dados extraídos do Sistema de Vigilância Alimentar e Nutricional no ano de 2020, referente ao estado nutricional de gestantes adultas e adolescentes dos 19 municípios do Recôncavo da Bahia. Foi utilizada a regressão quantílica para a análise do desfecho do estado nutricional de gestantes, variável exposição principal, raça/cor autorreferida e covariáveis Coeficiente de Gini (CG) e Índice de Desenvolvimento Humano (IDHM). Foram acompanhadas 4.061 gestantes (14,35% eram adolescentes) com predominância daquelas que se autodeclararam pretas ou pardas (62,34%). Houve prevalência de excesso de peso em 53,36% das gestantes. Identificou-se associação positiva do excesso de peso com a raça/cor preta ou parda e inversamente ao CG. Este estudo revelou que o estado nutricional de gestantes é influenciado pela raça/cor preta e/ou parda e pelo CG. Tais resultados podem contribuir para o planejamento de programas e/ou projetos que incluam ações de alimentação e nutrição e visam o acompanhamento nutricional de gestantes, principalmente dos grupos socialmente vulnerabilizados. (AU)

Adequate gestational nutritional status is an essential element for maternal and fetal health. The objective of this study was to identify the association between social determinants, race/color and nutritional status in pregnant women from Recôncavo da Bahia, Brazil. This ecological study, utilized data extracted from the 2020 Food and Nutrition Surveillance System, focusing on the nutritional status of adults and adolescents pregnant women across the 19 municipalities in the Recôncavo da Bahia. Quantile Regression was employed to analyze the nutritional status of pregnant women, considering the main exposure variable as self-reported race/color and covariates such as the Gini Coefficient and Human Development Index. In 2020, a total of 4,061 pregnant women were followed, with 14.35% being adolescents. The majority of pregnant women self-identified as black or brown (62.34%). The prevalence of overweight among pregnant women was 53.36%. The analysis revealed a positive association between overweight and black or brown race/color, while an inverse association was observed with the Gini Coefficient. These findings have implications for planning programs and projects that encompass food and nutrition interventions aimed at monitoring and improving the nutritional status of pregnant women, particularly those belonging to socially vulnerable groups. (AU)

Associação entre estado nutricional, indicadores socioeconômicos e quesito raça/cor em gestantes do Recôncavo da Bahia, Brasil / Association between nutritional status, socioeconomic indicators and race/color question in pregnant women in the Recôncavo da Bahia, Brazil

O estado nutricional gestacional adequado constitui-se como elemento essencial para a saúde materna e fetal. Este estudo teve como objetivo identificar a associação entre determinantes sociais, quesito raça/cor e estado nutricional, em gestantes do Recôncavo da Bahia, Brasil. Trata-se de um estudo ecológico, com dados extraídos do Sistema de Vigilância Alimentar e Nutricional no ano de 2020, referente ao estado nutricional de gestantes adultas e adolescentes dos 19 municípios do Recôncavo da Bahia. Foi utilizada a regressão quantílica para a análise do desfecho do estado nutricional de gestantes, variável exposição principal, raça/cor autorreferida e covariáveis Coeficiente de Gini (CG) e Índice de Desenvolvimento Humano (IDHM). Foram acompanhadas 4.061 gestantes (14,35% eram adolescentes) com predominância daquelas que se autodeclararam pretas ou pardas (62,34%). Houve prevalência de excesso de peso em 53,36% das gestantes. Identificou-se associação positiva do excesso de peso com a raça/cor preta ou parda e inversamente ao CG. Este estudo revelou que o estado nutricional de gestantes é influenciado pela raça/cor preta e/ou parda e pelo CG. Tais resultados podem contribuir para o planejamento de programas e/ou projetos que incluam ações de alimentação e nutrição e visam o acompanhamento nutricional de gestantes, principalmente dos grupos socialmente vulnerabilizados.

Adequate gestational nutritional status is an essential element for maternal and fetal health. The objective of this study was to identify the association between social determinants, race/color and nutritional status in pregnant women from Recôncavo da Bahia, Brazil. This ecological study, utilized data extracted from the 2020 Food and Nutrition Surveillance System, focusing on the nutritional status of adults and adolescents pregnant women across the 19 municipalities in the Recôncavo da Bahia. Quantile Regression was employed to analyze the nutritional status of pregnant women, considering the main exposure variable as self-reported race/color and covariates such as the Gini Coefficient and Human Development Index. In 2020, a total of 4,061 pregnant women were followed, with 14.35% being adolescents. The majority of pregnant women self-identified as black or brown (62.34%). The prevalence of overweight among pregnant women was 53.36%. The analysis revealed a positive association between overweight and black or brown race/color, while an inverse association was observed with the Gini Coefficient. These findings have implications for planning programs and projects that encompass food and nutrition interventions aimed at monitoring and improving the nutritional status of pregnant women, particularly those belonging to socially vulnerable groups.

Public policy interventions for preventing and treating obesity: scoping review.

CONTEXT: Obesity is a multicausal social problem and a pandemic, and it presents a public health challenge in many countries. Hence, public health interventions have been used in an endeavour to prevent and/or control increased obesity among populations. OBJECTIVE: This review study aimed to provide an overview of the academic literature and to analyze the strategies involved in the main public policies focused on preventing and controlling obesity in a number of countries. DATA SOURCES: MEDLINE/PubMed, Web of Science, and LILACS databases were searched. DATA EXTRACTION: Original studies were included for which the core objective was related to real-life public policy interventions for obesity. DATA ANALYSIS: The studies were organized according to their characteristics, and the qualitative analysis was based on the categorization proposed by the author Poulain. The review included 41 studies and identified 15 types of interventions focused on obesity; the largest proportion of actions were developed in school and city environments and were geared toward behavioral change, supported by direct or indirect government action. It was observed that many strategies focused on environmental line through regulatory and legislative measures, and health promotion geared toward the individual was based on the dissemination of information as a means for behavioral change. A smaller focus was given to individual care and treatment, and participative actions in the community. CONCLUSION: The design of public health strategies applicable to obesity as proposed by Poulain provides a valid model for evaluating interventions. The behavioral approach involving guidance through health education toward a healthy lifestyle prevails in public policies, indicating a movement toward accountability of individuals. However, it is necessary to deepen the debate on the social structures that determine obesity (and which limit possibilities of choice), aligned with cultural change regarding its occurrence, and to employ care strategies based on scientific evidence and which focus on the needs of the subjects.

Vitamin D deficiency aggravates COVID-19: discussion of the evidence.

We discuss the quality of the article evidence on the association between vitamin D deficiency and COVID-19, as well as updating the statistics in response to the letter to the editor regarding the same paper. Our review included 22 studies with data available in 23 articles. Using crude OR data, we observed that the chance of hospitalization was 2.16 (CI 95% = 1.42 - 2.89;) for vitamin-deficient individuals compared to non-deficient ones. However, when using the adjusted OR, it was possible to obtain a chance of 1.78 (CI 95% = 1.36-2.20). For the outcome vitamin D deficiency and death in patients with COVID-19 infection the crude association value was 1.38 (OR =1.38; CI 95% = 1.08 - 1.68) and the adjusted OR with the two studies was 1.08 (CI 95% = 0.82- 1.34). This new analyzes don't substantially alter our results. Vitamin D remains associated with severity COVID-19.

Fatores associados à introdução alimentar precoce em um município baiano / Factors associated with early food introduction in a municipality of baiano

Introdução: a introdução alimentar precoce é uma prática frequente no Brasil, envolta por diversos fatores de ordem social, cultural, econômica, familiar, emocional, bem como relacionados às condições de vida e assistência à saúde. Objetivo: identificar os principais fatores que se associam a introdução precoce de alimentos em crianças de zero a seis meses de vida, atendidas na Atenção Primária à Saúde de um município do Sudoeste da Bahia. Metodologia: estudo transversal, realizado com 75 mães e crianças atendidas na rede de saúde de Jequié, Bahia, no período de março a agosto de 2018. Empregou-se Regressão de Poisson com variância Robusta para avaliar a associação. Resultados: a prevalência da introdução alimentar precoce na população em estudo foi de 64%, sendo o leite de vaca, água/chá e fórmula infantil os alimentos mais prevalentes. Observou-se que a variável uso de chupeta (RP=1,21; IC95%= 1,02-1,43) apresentou associação positiva com a introdução alimentar precoce, enquanto que as variáveis uso de mamadeira (RP= 0,08; IC95%= 0,02-0,28) e orientações sobre amamentação (RP= 0,77; IC95%= 0,63-0,95) apresentaram associação negativa e inversa com o desfecho estudado. Conclusão: apesar da superioridade do leite materno sobre outras formas de nutrir as crianças menores de seis meses, os resultados deste estudo revelaram elevada prevalência de introdução alimentar precoce na população estudada e sua associação com o uso de chupetas. Sugere-se que ações de promoção e proteção da amamentação exclusiva aconteçam desde o pré-natal, evidenciando também os riscos da introdução alimentar precocemente.

Introduction: the early introduction of food is a frequent practice in Brazil, involved by several factors of social, cultural, economic, family, emotional, as well as related to living conditions and health care. Objective: to identify the main factors associated with the early introduction of food in children from zero to six months of life, attended in primary health care in a municipality in southwestern Bahia. Methodology: cross-sectional study, conducted with 75 mothers and children assisted in the health network of Jequié, Bahia, in the period from March to August 2018. Poisson Regression with Robust variance was employed to evaluate the association. Results: the prevalence of early food introduction in the study population was 64%, with cow's milk, water/tea and infant formula being the most prevalent foods. It was observed that the variable pacifier use (PR = 1.21; 95%CI = 1.02-1.43) showed a positive association with early feeding, while the variables bottle use (PR = 0.08; 95%CI = 0.02-0.28) and breastfeeding orientation (PR = 0.77; 95%CI = 0.63-0.95) showed a negative and inverse association with the studied outcome. Conclusion: despite the superiority of breast milk over other forms of feeding children under six months of age, the results of this study revealed a high prevalence of early introduction of food in the studied population and its association with the use of pacifiers. It is suggested that actions to promote and protect exclusive breastfeeding take place since the prenatal period, also highlighting the risks of introducing food early.

Influence of conditional cash transfer program on prenatal care and nutrition during pregnancy: NISAMI cohort study.

BACKGROUND: There are few studies on the influence of a cash transfer program on nutritional outcomes from pregnancy. OBJECTIVES: To analyze how a Brazilian conditional cash transfer program (Bolsa Familia Program, BFP) was associated with changes in body mass index (BMI) and food consumption among pregnant women. DESIGN AND SETTING: Cohort study on 250 pregnant women (≥ 18 years of age) in Brazilian prenatal services. METHODS: A food frequency questionnaire was used to evaluate dietary intake. Weight was measured in each gestational trimester. Generalized estimation equations and structural equation modeling were used for statistical analyses. Correlations were analyzed using standardized coefficients (SCs). RESULTS: Women benefitting from the BFP were of greater age and had lower education. The BFP exerted a direct negative effect on the pregnant women's consumption choices regarding refined grains, regional foods, vegetable oil, sausages, salted meats and snacks (SC = -0.10) and on maternal BMI (SC = -0.12). Among the intermediate variables, we observed that the time elapsed since pregnancy and the month of prenatal onset had direct negative effects; and that the number of visits to doctors, family income and number of years of education had direct positive effects. CONCLUSIONS: Beneficiaries were less likely to increase their BMI outside of the recommended standards and had a greater tendency to receive prenatal care. Participation in the BFP had a direct negative effect on adherence to unhealthy diets.

Influence of conditional cash transfer program on prenatal care and nutrition during pregnancy: NISAMI cohort study

ABSTRACT BACKGROUND: There are few studies on the influence of a cash transfer program on nutritional outcomes from pregnancy. OBJECTIVES: To analyze how a Brazilian conditional cash transfer program (Bolsa Familia Program, BFP) was associated with changes in body mass index (BMI) and food consumption among pregnant women. DESIGN AND SETTING: Cohort study on 250 pregnant women (≥ 18 years of age) in Brazilian prenatal services. METHODS: A food frequency questionnaire was used to evaluate dietary intake. Weight was measured in each gestational trimester. Generalized estimation equations and structural equation modeling were used for statistical analyses. Correlations were analyzed using standardized coefficients (SCs). RESULTS: Women benefitting from the BFP were of greater age and had lower education. The BFP exerted a direct negative effect on the pregnant women's consumption choices regarding refined grains, regional foods, vegetable oil, sausages, salted meats and snacks (SC = -0.10) and on maternal BMI (SC = -0.12). Among the intermediate variables, we observed that the time elapsed since pregnancy and the month of prenatal onset had direct negative effects; and that the number of visits to doctors, family income and number of years of education had direct positive effects. CONCLUSIONS: Beneficiaries were less likely to increase their BMI outside of the recommended standards and had a greater tendency to receive prenatal care. Participation in the BFP had a direct negative effect on adherence to unhealthy diets.

Investigation of maternal polymorphisms in genes related to glucose homeostasis and the influence on birth weight: a cohort study

Abstract Objectives: To contribute to a better understanding of the maternal genetic mechanisms that influence obstetric outcomes and that are involved in maternal and child health, this study aimed to evaluate the association between maternal genetic variants and the offspring birth weight by analyzing single-nucleotide polymorphisms (SNPs) in genes related to glucose homeostasis. Methods: Three polymorphisms were analyzed (GCK rs1799884, TCF7L2 rs7903146 and LEPR rs1137101) in 250 pregnant women who participated in a Brazilian prospective cohort study. Genotyping was performed by Real-Time Polymerase Chain Reaction (qPCR) using pre-designed TaqMan® SNP genotyping assays. Vitamin D dosage was performed by chemiluminescence. Variance, Pearson's chi-square test and multiple linear regression were used for the statistical analysis. Results: It was possible to verify a significant association between birth weight and maternal GCK rs1799884 when obstetric outcomes, clinical and anthropometric characteristics were taken into consideration. The children of homozygous women for the minor allele GCK rs1799884 presented lower birth weight (β = -335.25, 95% CI = -669.39; -1.17, p = 0.04). Furthermore, a direct link between a leptin receptor variant and gestational duration was found (p = 0.037). Conclusion: The variant GCK rs1799884 (mm) was associated with a reduction in newborn weight in the miscegenated Brazilian population.

Bolsa Familia Program and Perinatal Outcomes: NISAMI Cohort.

This study aimed to assess the impact of the Bolsa Familia Program on perinatal outcomes of pregnant women. A cohort study was conducted with pregnant women supported by prenatal services at 17 Family Health Units in Bahia, Brazil. A previously tested structured questionnaire, which has sociodemographic, economic, prenatal care, lifestyle, and nutritional variables, has been used to collect data. The outcomes included premature birth and low birth weight. A hierarchical conceptual model was constructed, and logistic regression analysis was performed. From a total of 1173 pregnant women, the identified average age was 25.44 years and 34.10% had pre-gestational overweight. The non-beneficiary pregnant women presented a 1.54 (95% CI = 0.46-5.09) times higher chance of giving birth to children with low weight and a 1.03 (95% CI = 95% CI = 0.53-2.00) times chance of premature birth when compared to the beneficiary group. In the multilevel model, some variables were statistically significant, such as age between 18 and 24 years (p = 0.003), age greater than or equal to 35 years (p = 0.025), family income (p = 0.008), employment status (p = 0.010), and maternal height (p = 0.009). The Bolsa Familia Program, as an integrated strategy of social inclusion and economic development, is suggested to exert a protective effect on the health of mother-concept binomial.

Evaluation of fecal microbiota and its correlation with inflammatory, hormonal, and nutritional profiles in women.

The present study evaluated the gut microbiota profiles of 40 women and correlated them with their nutritional, inflammatory, and hormonal profiles. Stool and blood samples were collected, and anthropometric measurements were obtained from 20 women diagnosed with obesity ("case" group) and 20 women with weight in the normal range ("control" group). Bacteria belonging to two phyla, Firmicutes and Bacteroidetes, one class, Mollicutes, and four genera were evaluated by real-time polymerase chain reaction. Levels of 18 inflammatory cytokines were measured using the Luminex assay, and ghrelin and leptin levels were measured using enzymatic immunoadsorption assay. Mollicutes proportion differed significantly between the case and control groups, and a significant positive association was detected between the presence of Mollicutes and obesity. Statistically significant differences were observed between the proportions of Firmicutes and Bacteroidetes in the two groups, with a higher proportion of Firmicutes/Bacteroidetes ratio among the gut microbiota of women in the case group compared to those of the control group. Higher counts of Escherichia coli and Clostridium spp. were observed in the control group than in the case group, whereas higher counts of Lactobacillus spp. and Bacteroides spp. were detected in the case group than in the control group. There was a positive correlation between interleukin-6 (IL-6) and interferon-γ (IFN-γ) levels and the anthropometric variables and a negative correlation between IL-10 and these variables. Leptin and ghrelin concentrations differed significantly between the two groups and showed positive and negative correlation with obesity predictors, respectively. Therefore, gut microbiota was associated with obesity in women from this study group. Moreover, this microbiota was associated with inflammatory profiles and alterations in ghrelin and leptin levels.

FADS1 and FADS2 Gene Polymorphisms Modulate the Relationship of Omega-3 and Omega-6 Fatty Acid Plasma Concentrations in Gestational Weight Gain: A NISAMI Cohort Study.

The polymorphisms of fatty acid desaturase genes FADS1 and FADS2 have been associated with an increase in weight gain. We investigated FADS1 and FADS2 gene polymorphisms and the relation between ω-3 and ω-6 fatty acid plasma concentrations and gestational weight gain. A prospective cohort study of 199 pregnant women was followed in Santo Antônio de Jesus, Brazil. Plasma levels of polyunsaturated fatty acids (PUFAs) were measured at baseline and gestational weight gain during the first, second, and third trimesters. Fatty acid recognition was carried out with the aid of gas chromatography. Single nucleotide polymorphisms (SNPs) were genotyped using real-time PCR. Statistical analyses included Structural Equation Modelling. A direct effect of FADS1 and FADS2 gene polymorphisms on gestational weight was observed; however, only the SNP rs174575 (FADS2) showed a significant positive direct effect on weight over the course of the pregnancy (0.106; p = 0.016). In terms of the influence of SNPs on plasma levels of PUFAs, it was found that SNP rs174561 (FADS1) and SNP rs174575 (FADS2) showed direct adverse effects on plasma concentrations of ω-3 (eicosapentaenoic acid and alpha-linoleic acid), and only SNP rs174575 had positive direct effects on plasma levels of ARA and the ARA/LA (arachidonic acid/linoleic acid) ratio, ω-6 products, while the SNP rs3834458 (FADS2) had an adverse effect on plasma concentrations of EPA, leading to its increase. Pregnant women who were heterozygous and homozygous for the minor allele of the SNP rs3834458 (FADS2), on the other hand, showed larger concentrations of series ω-3 substrates, which indicates a protective factor for women's health.

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI.

The objective of this study was to evaluate the socioeconomic and nutritional assistance factors of pregnant women who are beneficiaries of the Bolsa Família Program and were attended at a prenatal service in the city of Recôncavo da Bahia. A cohort study was conducted with 250 pregnant women from the prenatal service in 16 Family Health Units from August 2013 to December 2014. A structured and previously tested questionnaire was used to collect data. Socioeconomic and nutritional variables were used. It was identified that the average age was 28.3 years, of these, 85.2% studied until high school, 72.4% of pregnant women reported having income less than or equal to two minimum wages, with a mean of 1,036.3 and 26.8% reported receiving the benefit. It was observed that 40% had a pre-gestational Body Mass Index of overweight, 38% presented adequate weight gain for Gestational Age; 90.57% performed more than 7 consultations and 75.6% reported that they made use of alcoholic beverages or stopped in the gestation. The Bolsa Família Program as an integrated strategy for social inclusion and economic development seems to have a protective effect on the nutritional health of pregnant women in the municipality.

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI / Aspectos socioeconômicos e nutricionais de gestantes do Programa Bolsa Família: coorte NISAMI

Abstract The objective of this study was to evaluate the socioeconomic and nutritional assistance factors of pregnant women who are beneficiaries of the Bolsa Família Program and were attended at a prenatal service in the city of Recôncavo da Bahia. A cohort study was conducted with 250 pregnant women from the prenatal service in 16 Family Health Units from August 2013 to December 2014. A structured and previously tested questionnaire was used to collect data. Socioeconomic and nutritional variables were used. It was identified that the average age was 28.3 years, of these, 85.2% studied until high school, 72.4% of pregnant women reported having income less than or equal to two minimum wages, with a mean of 1,036.3 and 26.8% reported receiving the benefit. It was observed that 40% had a pre-gestational Body Mass Index of overweight, 38% presented adequate weight gain for Gestational Age; 90.57% performed more than 7 consultations and 75.6% reported that they made use of alcoholic beverages or stopped in the gestation. The Bolsa Família Program as an integrated strategy for social inclusion and economic development seems to have a protective effect on the nutritional health of pregnant women in the municipality.

Resumo Objetivou-se avaliar os fatores socioeconômicos e de assistência nutricional de gestantes beneficiárias do Programa Bolsa Família que foram atendidas em serviço de pré-natal em município do Recôncavo da Bahia. Estudo transversal realizado com 250 gestantes do serviço de pré-natal em 16 Unidades de Saúde da Família, de agosto de 2013 a dezembro de 2014. Para a coleta de dados, utilizou-se questionário fechado envolvendo informações socioeconômicas, antropométricas e de saúde da gestante. Identificou-se que a média de idade das gestantes foi de 28,3 anos, das quais 85,2% estudaram até o ensino médio, 72,4% das gestantes afirmaram possuir renda menor ou igual a dois salários mínimos, com uma média de 1.036,3 reais, e 26,8% declararam receber o benefício. Observou-se que 40% encontravam-se com Índice de Massa Corporal pré-gestacional de excesso de peso, 38% apresentaram um ganho de peso adequado para Idade Gestacional; 90,57% realizaram mais de 7 consultas, e 75,6% relataram que fizeram uso de bebida alcoólica ou pararam na gestação. O Programa Bolsa Família, enquanto uma estratégia integrada de inclusão social e de desenvolvimento econômico, parece exercer efeito protetor na saúde nutricional das gestantes do município.

Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis.

There is still limited evidence regarding the influence of vitamin D in people with COVID-19. In this systematic review and meta-analysis, we analyze the association between vitamin D deficiency and COVID-19 severity, via an analysis of the prevalence of vitamin D deficiency and insufficiency in people with the disease. Five online databases-Embase, PubMed, Scopus, Web of Science, ScienceDirect and pre-print Medrevix were searched. The inclusion criteria were observational studies measuring serum vitamin D in adult and elderly subjects with COVID-19. The main outcome was the prevalence of vitamin D deficiency in severe cases of COVID-19. We carried out a meta-analysis with random effect measures. We identified 1542 articles and selected 27. Vitamin D deficiency was not associated with a higher chance of infection by COVID-19 (OR = 1.35; 95% CI = 0.80-1.88), but we identified that severe cases of COVID-19 present 64% (OR = 1.64; 95% CI = 1.30-2.09) more vitamin D deficiency compared with mild cases. A vitamin D concentration insufficiency increased hospitalization (OR = 1.81, 95% CI = 1.41-2.21) and mortality from COVID-19 (OR = 1.82, 95% CI = 1.06-2.58). We observed a positive association between vitamin D deficiency and the severity of the disease.