Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.

Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study.

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.

Analysis of scientific production aligned with the Food and Nutrition Security Strategy of Portuguese-Speaking African Institutions: a systematic scoping review / Análise da produção científica alinhada com a Estratégia de Segurança Alimentar e Nutricional das Instituições Africanas de Língua Portuguesa: uma revisão sistemática de escopo

ABSTRACT This systematic scoping review aimed to map and characterize the scientific production of researchers from Portuguese-speaking African institutions that align with the Food and Nutrition Security Strategy of the Community of Portuguese-Speaking Countries. The literature search was conducted using six electronic databases (PubMed, EMBASE, Virtual Health Library, Scientific Electronic Library Online, Scopus, and Web of Science), with no restrictions on the year of publication nor language. Through the search strategy, 10,061 records were identified, of which 502 documents and 654 researchers were selected by Food and Nutrition Security specialists along three axes: 1) Policy governance; 2) Access to food; 3) Availability of food. Institutional researchers from Mozambique (66.9%), Guinea-Bissau (15.9%), and Angola (11.4%) presented the most publications and international collaborations. Researchers from Cape Verde, Sao Tome and Principe, and Equatorial Guinea institutions added only 5.8% of the total production. A greater number of publications (61%) was related to axis two of the Food and Nutrition Security Strategy of the Community of Portuguese-Speaking Countries. The most studied themes were sustainable development, child malnutrition, and agricultural production for the first, second, and third axis, respectively. In general, scientific publications have shown limitations in their approaches due to the challenge imposed by the complexity of the food system. However, there has been a quantitative evolution in publications in the last decade, with a greater participation of researchers from Portuguese-speaking African institutions.

RESUMO Esta revisão sistemática de escopo teve como objetivo mapear e caracterizar a produção científica de pesquisadores de instituições africanas de língua portuguesa que se alinham com a Estratégia de Segurança Alimentar e Nutricional da Comunidade dos Países de Língua Portuguesa. A busca das literaturas foi realizada em seis bases de dados eletrônicas (PubMed, EMBASE, Biblioteca Virtual em Saúde, Scientific Electronic Library Online, Scopus e Web of Science), sem restrição quanto ao ano de publicação e ao idioma. Por meio da estratégia de busca, foram identificados 10.061 registros, dos quais 502 documentos e 654 pesquisadores foram selecionados por especialistas em Segurança Alimentar e Nutricional em três eixos: 1) Governança de políticas; 2) Acesso à alimentação; 3) Disponibilidade de alimentos. Pesquisadores de intuições de Moçambique (66,9%), Guiné-Bissau (15,9%) e Angola (11,4%) foram os que apresentaram o maior número de publicações e colaborações internacionais. No entanto, os pesquisadores das instituições de Cabo Verde, São Tomé e Príncipe e Guiné Equatorial somaram apenas 5,8% da produção total. Foi observado maior número de publicações (61%) relacionadas com o eixo dois da Estratégia de Segurança Alimentar e Nutricional da Comunidade dos Países de Língua Portuguesa. As temáticas mais estudadas foram desenvolvimento sustentável, desnutrição infantil e produção agrícola para o primeiro, segundo e terceiro eixo, respectivamente. De forma geral, as publicações científicas mostraram limitações em suas abordagens frente ao desafio imposto pela complexidade do sistema alimentar. Todavia, foi houve uma evolução quantitativa nas publicações na última década; além disso, maior participação de pesquisadores de instituições africanas de língua portuguesa pode ser vislumbrada.

[Food environment and excess weight in schoolchildren: a South American systematic reviewAmbiente alimentario y exceso de peso en la población escolar: revisión sistemática en América del Sur]. / Ambiente alimentar e excesso de peso em escolares: uma revisão sistemática sul-americana.

Objective: To identify and compile the findings of observational studies analyzing the relationship of factors from the school food environment and individual factors related to food consumption in school with excess weight in schoolchildren from South America in the period from 2011 to 2021. Method: The literature review involved a search performed in five databases (PubMed, Web of Science, SciELO, Scopus, and LILACS) and in Google Scholar, as well as a consultation with specialists. Studies were selected if they had an observational design, included schoolchildren aged 5 to 19 years, were performed in South America, and used objective measures such as body mass index (World Health Organization and/or International Obesity Task Force) to assess weight in association with school food environment factors and individual school consumption factors. The protocol was registered in PROSPERO (CRD42020212383). Results: Of 906 identified records, 13 cross-sectional studies (one from Argentina, one from Ecuador, and 11 from Brazil) were included in the review. The prevalence of overweight ranged from 7.5% to 32.5%, and of obesity, from 1.7% to 28.0%. School environment factors from the policy and physical domains (such as unsatisfactory food and nutrition education and unavailability of school-prepared meals) were associated with increased prevalence of excess weight. Individual factors related to adherence to the school meal program (such as consumption of meals offered by the school instead of bringing a snack from home) were associated with lower prevalence of excess weight. Conclusions: Only a few studies are available in South America with a focus on individual and/or school food environment factors and excess weight in schoolchildren. Since the available evidence is restricted to local or regional contexts, new national-level studies are warranted.

Objetivo: Identificar y recopilar los resultados de estudios observacionales realizados en América del Sur, en los cuales se analizó la relación entre los factores del ambiente alimentario escolar y los factores individuales de consumo de la población escolar con exceso de peso en el período del 2011 al 2021. Métodos: La investigación se realizó en cinco bases de datos (PubMed, Web of Science, SciELO, Scopus y LILACS), en Google Scholar y mediante consulta a expertos. Se seleccionaron estudios observacionales realizados en América del Sur con escolares de 5 a 19 años, en los cuales se emplearon medidas objetivas para evaluar el exceso de peso como el índice de masa corporal (Organización Mundial de la Salud y International Obesity Task Force) en relación con factores del ambiente alimentario escolar y factores individuales de consumo en la escuela. El protocolo se registró en la plataforma PROSPERO (CRD42020212383). Resultados: De los 906 registros identificados, en la revisión se incluyeron 13 estudios transversales (uno de Argentina, uno de Ecuador y 11 de Brasil). Las tasas de prevalencia del sobrepeso fluctuaron entre 7,5% y 32,5% y las de la obesidad, entre 1,7% y 28,0%. Los factores del ambiente alimentario escolar de los dominios político y físico (como educación poco satisfactoria en cuanto a alimentos y nutrición, y la falta de comidas preparadas en la escuela) guardaron relación con mayores tasas de prevalencia del exceso de peso. Los factores individuales referentes a la adhesión al programa de alimentación escolar (como el consumo de la alimentación ofrecida por la escuela en vez de la merienda llevada de la casa) guardaron relación con menores tasas de prevalencia del exceso de peso. Conclusiones: Son escasos los estudios realizados en América del Sur sobre la relación entre los factores del ambiente alimentario escolar y los factores individuales y el exceso de peso de la población escolar. El hecho de que la evidencia se limite a los contextos locales o regionales crea un incentivo para realizar nuevos estudios de alcance nacional.

Lack of validity of free-living physical activity energy expenditure estimated from ActiGraph equations in severely obese women: A doubly labelled water study.

The current study aimed to investigate the validity of three ActiGraph predictive equations that are available to estimate free-living physical activity energy expenditure (PAEE) in women with severe obesity. The study included 20 women with class III obesity (age: 22-38 years). During 14 days of free-living conditions, total energy expenditure was measured using the doubly labelled water method; in addition, participants wore a triaxial accelerometer (model GT3X+) on the hip. The resting metabolic rate was measured by indirect calorimetry. At group level, the Freedson VM3 Combination was found to be more precise (bias = -61 kcal/day) than the Williams Work-Energy (bias = -283 kcal/day) and the Freedson Combination equations (bias = -186 kcal/day) for estimating PAEE. However, the three predictive equations had a wider limit of agreement (Williams Work-Energy [258, -824 kcal/day], Freedson Combination equations [324, -697 kcal/day] and Freedson VM3 Combination [424, -546 kcal/day]), indicating great uncertainty of the estimate. In conclusion, a wide variation was observed in the performance of different ActiGraph equations in estimating free-living PAEE among women with class III obesity. Therefore, our data do not support the use of these equations, and more studies are needed to improve predictive performance in free-living conditions.

Food Availability in Different Food Environments Surrounding Schools in a Vulnerable Urban Area of Santiago, Chile: Exploring Socioeconomic Determinants.

The analysis of the food environment is used to identify areas with gaps in the availability of healthy foods and can be used as a public policy assessment tool. In recent decades, Chile has implemented several strategies and regulations to improve food environments, with encouraging results. Little is known about the scope of these measures in socially vulnerable environments. This study is part of a project that seeks to build an integrated intervention model for healthy school environments in a vulnerable area of Santiago, Chile. The objective of this study was to evaluate the availability of healthy and unhealthy foods around schools and the relationship between it and socioeconomic determinants of the school community in the Chilean context. A cross-sectional study to measure the food environment of informal markets (street food), formal markets (stores), and institutions (schools) was conducted in and around 12 schools (100 m surrounding schools) in a vulnerable urban area of Santiago, Chile. A lack of healthy foods was observed, which was related to some socio-economic determinants and the multidimensional poverty was the most relevant. The diagnosis of food environments around schools can represent an important target for governments to implement policies focused at improving the availability of healthy foods.

Lack of association between 11 gene polymorphisms on weight loss 1 year after Roux-en-y gastric bypass surgery in woman.

BACKGROUND: Although effective, the impact of bariatric surgery on weight loss is variable, and little is known about the influence of single-nucleotide polymorphisms (SNPs). The present study investigated the association of eleven SNPs related to obesity with weight loss 1 year after Roux-Y gastric bypass (RYGB) surgery in female patients. METHODS: This prospective study included 351 women with obesity. The genotypes for eleven SNPs (GHRL-rs26802; GHSR-rs572169; LEP-rs7799039; LEPR-rs1137101; 5HT2C-rs3813929; UCP2-rs659366; UCP3-rs1800849; SH2B1-rs7498665; TAS1R2-rs35874116; TAS1R2-rs9701796; FTO-rs9939609) were determined using a real-time polymerase chain reaction and TaqMan assays. Anthropometric measurements were performed before and 1 year after RYGB surgery. To evaluate the factors that influenced the proportion of weight loss 1 year after surgery, beta regression analysis was used. The models were estimated using the GLIMMIX procedure in SAS statistical software. p < 0.05 was considered statistically significant. RESULTS: The mean ± SD percentage of total body weight loss in 1 year was 64.4 ± 5.8% and the median was 65.0%. When assessing the proportion of weight loss in 1 year after surgery, using univariate analysis (beta regression), no SNPs influenced weight loss. Furthermore, in the multiple analysis, with stepwise process of variable selection, no variable was significant to compose the multiple model. CONCLUSIONS: The 11 SNPs investigated did not influence weight loss 1 year after RYGB surgery in female patients. This result indicates that individual behaviours and other factors might better contribute to the magnitude of loss weight loss in a short period after bariatric surgery.

Genetic polymorphisms are not associated with energy intake 1 year after Roux-en-Y gastric bypass in women.

BACKGROUND: The present study aimed to investigate the influence of food intake on body weight loss (WL) and the association of gene polymorphisms, 1 year after Roux-en-Y gastric bypass (RYGB) surgery. METHODS: In total, 95 obese women (age ranged 20-50 years) in a Brazilian cohort underwent RYGB surgery and completed the study. Anthropometric measurements and food intake were assessed before and 1 year after surgery. Twelve gene polymorphisms (GHRL rs26802; GHSR rs572169; LEP rs7799039; LEPR rs1137101; 5-HT2C rs3813929; UCP2 rs659366; UCP2 rs660339; UCP3 rs1800849; SH2B1 rs7498665; TAS1R2 rs35874116; TAS1R2 rs9701796; and FTO rs9939609) were determined using a real-time polymerase chain reaction and a TaqMan assay. The subjects were divided into quartiles regarding percentage of excess weight loss (%EWL). The effect of genetic variants on energy and macronutrient intake was evaluated by simple logistic regression, followed by multiple logistic regression. RESULTS: Subjects in the first and second quartiles showed a higher initial body mass index. Energy and macronutrient intake before and 1 year after RYGB surgery did not differ between the %EWL quartiles. None of gene polymorphisms investigated showed an association with the estimated energy intake 1 year after surgery. CONCLUSIONS: In conclusion, the estimate energy and food intake did not predict a greater body WL 1 year after RYGB surgery. In addition, the 12 gene polymorphism investigated did not affect the energy intake among female patients.

Perceptions of patients in the waiting line for bariatric surgery: contributions from the experience of an educational process / Percepções de pacientes na fila de espera para cirurgia bariátrica: contribuições a partir da experiência de um processo educativo / Percepciones de pacientes en la fila de espera para cirugía bariátrica: contribuciones a partir de la experiencia de un proceso educativo

The present study is a qualitative research with the objective of analyzing the perceptions of patients in the face of the challenges in the bariatric surgery line through focal groups. All patients were treated with an outpatient protocol, however, they were divided into two groups, one participated in the educational process and the other did not. Four categories of analysis were drawn up and discussed in the light of the current literature. Patients from the educational process were able to express themselves with greater positivity in view of the challenges and they showed better resources for going through the emotional suffering, the worsening of comorbidities and the risk of death. The results show the potential of education in health and of group work in the promotion of self-care and well-being.(AU)

O presente estudo trata-se de uma pesquisa qualitativa com o objetivo de analisar as percepções dos pacientes diante dos desafios na fila da cirurgia bariátrica por meio de grupos focais. Todos os pacientes foram atendidos com protocolo ambulatorial, porém, foram divididos em dois grupos, um participou do processo educativo e o outro não. Quatro categorias de análise foram elaboradas e discutidas à luz da literatura atual. Os pacientes do processo educativo conseguiram se expressar com maior positividade diante dos desafios e apresentaram melhores recursos para atravessar o sofrimento emocional, o agravamento das comorbidades e o risco de morte. Os resultados mostram o potencial da educação em saúde e do trabalho em grupo na promoção do autocuidado e do bem-estar.(AU)

El presente estudio se trata de una investigación cualitativa con el objetivo de analizar las percepciones de los pacientes ante los desafíos en la fila de la cirugía bariátrica por medio de grupos focales. Todos los pacientes fueron atendidos con protocolo ambulatorio, pero se dividieron en dos grupos, uno participó en el proceso educativo y el otro no. Se elaboraron y discutieron cuatro categorías de análisis a la luz de la literatura actual. Los pacientes del proceso educativo consiguieron expresarse con mayor positividad antes los desafíos y presentaron mejores recursos para pasar por el sufrimiento emocional, el agravamiento de las comorbilidades y el riesgo de muerte. Los resultados muestran el potencial de la educación en salud y del trabajo en grupo de la promoción del autocuidado y del bienestar.(AU)

Ambiente alimentar e excesso de peso em escolares: uma revisão sistemática sul-americana / Food environment and excess weight in schoolchildren: a South American systematic review / Ambiente alimentario y exceso de peso en la población escolar: revisión sistemática en América del Sur

RESUMO Objetivo. Identificar e compilar os achados de estudos observacionais que analisaram a relação de fatores do ambiente alimentar escolar e individuais de consumo na escola com excesso de peso em escolares da América do Sul no período de 2011 a 2021. Métodos. A pesquisa foi realizada em cinco bases de dados (PubMed, Web of Science, SciELO, Scopus e LILACS) e no Google Scholar, além de consulta a especialistas. Foram selecionados estudos observacionais com escolares de 5 a 19 anos, realizados na América do Sul, que usaram medidas objetivas para avaliar excesso de peso, como o índice de massa corporal (Organização Mundial da Saúde e/ou International Obesity Task Force), em associação a fatores do ambiente alimentar escolar e individuais de consumo na escola. O protocolo foi registrado na plataforma PROSPERO (CRD42020212383). Resultados. Dos 906 registros identificados, 13 estudos transversais (um da Argentina, um do Equador e 11 do Brasil) foram incluídos na revisão. As prevalências variaram de 7,5% a 32,5% para sobrepeso e 1,7% a 28,0% para obesidade. Fatores do ambiente alimentar escolar, dos domínios político e físico (como educação alimentar e nutricional insatisfatória e indisponibilidade de refeições preparadas na escola) se associaram com maiores prevalências de excesso de peso. Fatores individuais relacionados à adesão ao programa de alimentação escolar (como consumo da alimentação oferecida pela escola ao invés de lanche trazido de casa) se associaram a menores prevalências de excesso de peso. Conclusões. São escassos os estudos sul-americanos enfocando a associação entre fatores do ambiente alimentar escolar e/ou individuais e excesso de peso em escolares. As evidências restritas a contextos locais ou regionais incentivam novos estudos de abrangência nacional.

ABSTRACT Objective. To identify and compile the findings of observational studies analyzing the relationship of factors from the school food environment and individual factors related to food consumption in school with excess weight in schoolchildren from South America in the period from 2011 to 2021. Method. The literature review involved a search performed in five databases (PubMed, Web of Science, SciELO, Scopus, and LILACS) and in Google Scholar, as well as a consultation with specialists. Studies were selected if they had an observational design, included schoolchildren aged 5 to 19 years, were performed in South America, and used objective measures such as body mass index (World Health Organization and/or International Obesity Task Force) to assess weight in association with school food environment factors and individual school consumption factors. The protocol was registered in PROSPERO (CRD42020212383). Results. Of 906 identified records, 13 cross-sectional studies (one from Argentina, one from Ecuador, and 11 from Brazil) were included in the review. The prevalence of overweight ranged from 7.5% to 32.5%, and of obesity, from 1.7% to 28.0%. School environment factors from the policy and physical domains (such as unsatisfactory food and nutrition education and unavailability of school-prepared meals) were associated with increased prevalence of excess weight. Individual factors related to adherence to the school meal program (such as consumption of meals offered by the school instead of bringing a snack from home) were associated with lower prevalence of excess weight. Conclusions. Only a few studies are available in South America with a focus on individual and/or school food environment factors and excess weight in schoolchildren. Since the available evidence is restricted to local or regional contexts, new national-level studies are warranted.

RESUMEN Objetivo. Identificar y recopilar los resultados de estudios observacionales realizados en América del Sur, en los cuales se analizó la relación entre los factores del ambiente alimentario escolar y los factores individuales de consumo de la población escolar con exceso de peso en el período del 2011 al 2021. Métodos. La investigación se realizó en cinco bases de datos (PubMed, Web of Science, SciELO, Scopus y LILACS), en Google Scholar y mediante consulta a expertos. Se seleccionaron estudios observacionales realizados en América del Sur con escolares de 5 a 19 años, en los cuales se emplearon medidas objetivas para evaluar el exceso de peso como el índice de masa corporal (Organización Mundial de la Salud y International Obesity Task Force) en relación con factores del ambiente alimentario escolar y factores individuales de consumo en la escuela. El protocolo se registró en la plataforma PROSPERO (CRD42020212383). Resultados. De los 906 registros identificados, en la revisión se incluyeron 13 estudios transversales (uno de Argentina, uno de Ecuador y 11 de Brasil). Las tasas de prevalencia del sobrepeso fluctuaron entre 7,5% y 32,5% y las de la obesidad, entre 1,7% y 28,0%. Los factores del ambiente alimentario escolar de los dominios político y físico (como educación poco satisfactoria en cuanto a alimentos y nutrición, y la falta de comidas preparadas en la escuela) guardaron relación con mayores tasas de prevalencia del exceso de peso. Los factores individuales referentes a la adhesión al programa de alimentación escolar (como el consumo de la alimentación ofrecida por la escuela en vez de la merienda llevada de la casa) guardaron relación con menores tasas de prevalencia del exceso de peso. Conclusiones. Son escasos los estudios realizados en América del Sur sobre la relación entre los factores del ambiente alimentario escolar y los factores individuales y el exceso de peso de la población escolar. El hecho de que la evidencia se limite a los contextos locales o regionales crea un incentivo para realizar nuevos estudios de alcance nacional.

Weight regain in association with macronutrient diet composition and quality of life in women at least 5 years after bariatric surgery

ABSTRACT Bariatric surgery has been shown to be the best alternative for the control of severe obesity, with improvements in patient quality of life. However, regaining weight due to inadequate nutrition can compromise surgery results. Objective: to investigate the relationship between weight gain and food consumption and quality of life among women at least 5 years after gastric bypass procedure. Methods: Seventy-three women who had bariatric surgery >= 5 years prior were evaluated for food consumption on 3 non-consecutive days and quality of life according to the dimensions of the BAROS tool. Results: Twenty two (29.7%) regained at least 10% of their weight. The group of women with stable weight loss had significantly lower carbohydrate consumption and showed no difference in energy consumption. Self-esteem and willingness to work also had a better score in this group, which contributed to a better quality of life score. Conclusion: From a weight regain below 10% after 5 years of bariatric surgery, the perception of quality of life among women changes. There are reasons for further studies on the effects of the proportion of macronutrients on dietary energy after bariatric surgery, including variations in the surgical technique and metabolic and anatomical variables.

RESUMEN La cirugía bariátrica ha mostrado ser una de las mejores alternativas para el control de la obesidad, aportando a la mejoría en la calidad de vida del paciente. Sin embargo, recuperar peso debido a una nutrición inadecuada puede comprometer los resultados de la cirugía. Objetivo: investigar la relación entre el aumento de peso y el consumo de alimentos y la calidad de vida en mujeres al menos 5 años después del procedimiento de bypass gástrico. Métodos: 73 mujeres con al menos 5 años de cirugía bariátrica fueron evaluadas para el consumo de alimentos durante 3 días no consecutivos y la calidad de vida, según las dimensiones de la herramienta BAROS. Resultados: 22 mujeres (29,7%) recuperaron al menos el 10% de su peso. El grupo de mujeres con pérdida de peso estable tuvo un consumo de carbohidratos significativamente menor y no mostró diferencias en el consumo de energía. La autoestima y la voluntad de trabajar también tuvieron un mejor puntaje en este grupo, lo que contribuyó a un mejor puntaje de calidad de vida. Conclusión: a partir de una recuperación de peso por debajo del 10% después de 5 años de cirugía bariátrica, la percepción de la calidad de vida entre las mujeres cambia y existen razones para más estudios sobre los efectos de la proporción de macronutrientes sobre la energía alimentaria después de la cirugía bariátrica, con potencial influencia de variaciones en la técnica quirúrgica.

A nutritionist approach to psychiatric treatment: Notes from a brief experience

ABSTRACT Objective: This study aims to describe the work of the nutritionist in a psychiatric outpatient clinic of a university hospital, with patients with excess weight due to the use of certain psychiatric medications. Method: Content analysis of the clinical history and brief field notes, as complementary material. The clinical-qualitative method was applied in data collection and analysis. Results: Conversations with patients focused on their relationship with food were more effective in managing excessive weight gain than insistence on individualized and restrictive diets. The role of the family was important to strengthen the bond and favor dietary changes. Efforts to identify the emotions involved in eating, including the pleasures given by emotional, cultural, and social factors were also important. Conclusions: Nutritional care in the psychiatric field should emphasize dialogue related to the eating practices of patients. Strict dietary prescriptions can have the same unproductive effect as traditional biomedical practices if they do not consider subjective aspects of patients.

RESUMEN Objetivo: El objetivo de este estudio fue describir el trabajo del nutricionista en una clínica ambulatoria de psiquiatría de un hospital universitario, en pacientes con exceso de peso debido al uso de ciertos medicamentos psiquiátricos. Método: Análisis del contenido de la historia clínica y de breves notas de campo, como material complementario. Se aplicó el método clínico-cualitativo en la recolección y análisis de los datos. Resultados: El autor principal de este artículo, una nutricionista, indica que las conversaciones con pacientes centradas en su relación con la comida fueron más efectivas para manejar el aumento de peso excesivo do que la insistencia en las dietas individualizadas y restrictivas. El rol de la familia fue importante para fortalecer el vínculo e favorecer los cambios alimentarios. También fueran importantes los esfuerzos para identificar las emociones involucradas en la alimentación, incluidas los placeres dados por factores emocionales, culturales y sociales. Conclusiones: La atención nutricional en el campo psiquiátrico debe enfatizar el diálogo relacionado con las prácticas alimentarias de los pacientes. Las prescripciones estrictamente dietéticas pueden tener el mismo efecto improductivo que las prácticas biomédicas tradicionales si tampoco toman en cuenta los aspectos subjetivos de los pacientes.

Avaliação do conhecimento de acadêmicos da área da saúde sobre queilite actínica, como lesão precursora do câncer bucal / Evaluation of health academics' knowledge of actinic cheilitis as a precursor oral cancer injury

Dentre as doenças mais letais em todo o Brasil, o câncer encontra-se como um dos principais, podendo se desenvolver em diversas áreas. Com relação ao câncer bucal, ele é considerado um dos mais prevalentes. Podendo ser justificado em decorrência do estilo de vida adotado por muitos, como tabagismo, alcoolismo, má alimentação e exposição excessiva ao sol. Produzindo um aumento no número de casos de forma progressiva. Em grande parte dos casos de câncer bucal, há o aparecimento de lesões potencialmente malignas, destacando-se a leucoplasia, eritroplasia e queilite actínica. A queilite actínica, decorrente do excesso de radiação ultravioleta, é uma lesão potencialmente maligna, altamente prevalente em pessoas que estão propensas a esta exposição sendo frequente em áreas cuja atividade econômica está pautada na agricultura, que requer exposição à radiação solar, como o noroeste do Paraná. Portanto, é essencial que todos os profissionais de saúde saibam reconhecer este como sendo um fator causador do câncer bucal e fiquem atentos às mudanças que ocorrem previamente à malignização, principalmente, lesões em lábios, onde a queilite manifesta-se. Logo, é importante que os profissionais saibam reconhecê-la precocemente, devendo ser vislumbrado já durante a universidade. Sendo assim, o objetivo do presente trabalho é avaliar o conhecimento de acadêmicos de diferentes áreas da saúde, sobre sinais e sintomas da queilite actínica, que é uma das lesões cancerizáveis mais importantes e prevalentes... (AU)

Among the most lethal diseases in Brazil, cancer is one of the main and can develop in several areas. Re garding oral cancer, it is considered one of the most prevalent. It can be justified due to the lifestyle adopt ed by many, such as smoking, alcoholism, poor diet and excessive sun exposure. Producing an increase in the number of cases in a progressive way. In most cases of oral cancer, there is the appearance of poten tially malignant lesions, highlighting the leukoplakia and actinic cheilitis. Actinic cheilitis, resulting from excess ultraviolet radiation, is a potentially malignant lesion, highly prevalent in people who are prone to this exposure being frequent in areas whose economic activity is based on agriculture, which requires exposure to solar radiation, such as the northwest Paraná. Therefore, it is essential that all health professionals know how to recognize this as a factor causing oral cancer and be aware of the changes that occur prior to malignancy, especially lip lesions, where cheilitis manifests. Therefore, it is important that profes sionals know how to recognize it early, and should be glimpsed already during the university. Therefore, the objective of this work is to evaluate the knowledge of scholars from different health areas about signs and symptoms of actinic cheilitis which is one of the most important and prevalent cancerizable lesions... (AU)

Oral condition of institutionalized older people: influence on anthropometric indicators, food and nutrient intake

ABSTRACT Objective: To assess whether there are differences between oral problems and food, energy, and nutrient intake and anthropometric indicators of institutionalized older adults. Methods: A total of 150 older people participated in the study. Their nutritional status was determined by anthropometric indicators and food intake. Oral problems were examined by a trained dentist who checked for caries, periodontitis, dry mouth, edentulism, and poorly-fitting partial or complete dentures. The categorical variables were analyzed by the Fisher's Exact Test and the continuous variables were analyzed by the Student's t-test for parametric data and the Mann-Whitney test for nonparametric data (p≤0.05). Results: Older people with oral problems presented lower anthropometric measurements and indices except for biceps skinfold thickness and consumed less energy (p= 0.027), protein (p= 0.012), lipids (0.012), and pan-fried meats (p= 0.001). Conclusion: Anthropometric indicators and the energy, protein and lipid intake were lower in elderly people with oral problems. This work warns about the importance of oral health for the good nutrition of older people and the need to establish strategies to adapt the diet of this population.

RESUMEN Objetivo: Evaluar si existe una diferencia entre los problemas orales y la ingesta de alimentos, energía y nutrientes e indicadores antropométricos de adultos mayores institucionalizados. Métodos: Un total de 150 personas mayores participaron en el estudio. Su estado nutricional se determinó mediante indicadores antropométricos y la ingesta de alimentos. Los problemas orales fueron examinados por un dentista capacitado que verificó la presencia de caries, periodontitis, boca seca, edentulismo y dentaduras postizas parciales o completas mal ajustadas. Las variables categóricas se evaluaron mediante la Prueba Exacta de Fisher y las variables continuas se evaluaron mediante la prueba t de Student para datos paramétricos y la prueba de Mann-Whitney para datos no paramétricos (p≤0.05). Resultados: Las personas mayores con problemas orales presentaron mediciones e índices antropométricos más bajos, excepto el grosor del pliegue cutáneo del bíceps y consumieron menos energía (p= 0.027), proteínas (p= 0.012), lípidos (0.012) y carnes fritas (p= 0.001). Conclusión: Los indicadores antropométricos y el consumo de energía, proteínas y lípidos fueron menores en personas mayores con problemas bucales. Este trabajo advierte sobre la importancia de la salud oral para la buena nutrición de las personas mayores y la necesidad de establecer estrategias para adaptar la dieta de esta población.

Compliance of the Physical Activity Guidelines Accumulated in Bouts ≥10 Min and Nonbouts and Its Association With Body Composition and Physical Function: A Cross-Sectional Study in Brazilian Older Adults.

This study aimed to investigate the association between compliance with the guidelines of moderate to vigorous physical activity (MVPA) accumulated in bouts of ≥10 min or nonbouts with body composition and physical function in older adults. The authors evaluated 230 noninstitutionalized older adults. Body composition was estimated using bioimpedance, and physical function was assessed using four physical tests. Physical activities were monitored for 7 days using an accelerometer. Older adults who were physically active according to MVPA in bouts of ≥10 min were less likely to have low appendicular skeletal muscle mass (odds ratio [OR] = 0.12), excess body fat (OR = 0.30), and abdominal obesity (OR = 0.34) and more likely to have a higher physical function (OR = 5.78). No significant association was observed with MVPA nonbout. Our findings indicate that older adults who accumulate MVPA in bouts of  ≥10 min have better parameters for body composition and physical function.

Nutritional therapy in hospital care of in-patients with Covid-19: evidence, consensus and practice guidelines / Terapia nutricional na atenção hospitalar de pacientes hospitalizados com Covid-19: evidências, consensos e guias de práticas

ABSTRACT Objective The objective of this work was to review papers that deal with nutritional therapy of inpatients with Covid-19 from the beginning of the pandemic. The survey covered the period until the month of September 2020. Methods This is a review of the indexed literature (Scopus, Pubmed and Lilacs), including area consensus. Results The review showed that the initial recommendations were based on generic assumptions and, as specific knowledge was being produced, the recommendations became more targeted. Conclusion In the health crisis generated by Covid-19, in the context of uncertainties related to nutritional care procedures, knowledge and action strategies were generated, coordinated by researchers and health professionals.

RESUMO Objetivo O objetivo deste trabalho foi revisar as publicações que trataram da terapia nutricional do paciente hospitalizado com Covid-19 desde o início da pandemia até o mês de setembro de 2020. Métodos Trata-se de uma revisão dos trabalhos indexados nas bases de dados Scopus, Pubmed e Lilacs, incluindo consensos da área. Resultados A revisão mostrou que as recomendações iniciais pautaram-se em pressupostos genéricos e, conforme o conhecimento específico foi sendo produzido, as recomendações passaram a ser mais direcionadas. Conclusão Na crise sanitária gerada pela Covid-19, no contexto de incertezas relacionadas aos procedimentos de atenção nutricional, foram gerados conhecimentos e estratégias de ação, coordenados por pesquisadores e profissionais de saúde.

Contribuição da condição ocupacional de indivíduos obesos no comportamento alimentar

Introdução: Indivíduos obesos que aguardam a cirurgia bariátrica podem apresentar alterações do comportamento alimentar, como restrição dietética, alimentação emocional, e descontrole alimentar. Esses aspectos são comumente avaliados pelo Questionário Alimentar de Três Fatores (TFEQ-18) e, pressupõe-se, que possam ser influenciados por variáveis sociodemográficas e socioeconômicas, como o desemprego. Objetivo: Verificar se há uma relação dos aspectos do comportamento alimentar, medidos pelo TFEQ-18, com a condição ocupacional de indivíduos obesos. Métodos: A amostra foi composta por 522 indivíduos de ambos os sexos, de 18 a 65 anos, com Índice de Massa Corporal ≥ 40 Kg/m2 ou ≥ 35 Kg/m² com comorbidades, que aguardavam a realização da cirurgia bariátrica no Sistema Único de Saúde. Foram aplicados um questionário sociodemográfico e TFEQ-18, bem como verificado a altura e o peso atual dos pacientes. Foi realizada análise descritiva das variáveis e as características entre os grupos foram medidas por meio do teste t independente para variáveis continuas e teste qui-quadrado para variáveis categóricas. Também foi realizado o teste t para análise dos itens do TFEQ-18 entre os grupos de pacientes de acordo com a situação ocupacional. Resultados: A amostra foi composta por 434 mulheres e 88 homens, com idade média de 39,1±10,7 anos. Desses 522 pacientes avaliados, 267 eram do grupo ativo e 255 do grupo não ativo. A maioria dos pacientes possuíam problemas de saúde, eram sedentários e estavam em união estável ou casados. Apenas a variável idade e estrato socioeconômico apresentaram diferença significativa entre os grupos (p<0,05). A idade foi maior no grupo não ativo, e o estrato socioeconômico foi maior no grupo ativo. Não houve diferença significativa entre os grupos em relação aos fatores do comportamento alimentar. Conclusão: A condição ocupacional não influenciou os aspectos avaliados do comportamento alimentar de pacientes que aguardavam a cirurgia bariátrica pelo sistema público de saúde.

Determinants of food and nutrition actions in primary healthcare clinics in the State of São Paulo, Brazil / Determinantes de las acciones de alimentación y nutrición en las clínicas de atención primaria en el estado de São Paulo, Brasil

The objective of the study was to test the link between the preparation of professionals and the operational conditions of food and nutrition actions in primary healthcare in the state of São Paulo, Brazil. This cross-sectional study involved 220 primary healthcare clinics in 65 municipalities of the state. Of the 1873 participating healthcare professionals, 71.8% reported having provided guidance on food and nutrition to different groups, ranging from 56% for pregnant women to 17% for families. Only 19% of the primary healthcare clinics employed nutritionists. Primary healthcare clinics with fewer than two partnerships with other institutions reported 28% and 41% fewer of food and nutrition actions for adults and for families, respectively. Among the variables applied to evaluate professional preparation and operational conditions, work guidance and community partnerships were important for food and nutrition actions, which remains incipient in primary healthcare.

El objetivo del estudio fue contrastar la asociación entre preparación profesional y condiciones operacionales de actuación con el ofrecimiento de acciones de alimentación y nutrición en la Atención Primaria a la Salud en el Estado de São Paulo, Brasil. Estudio transversal, incluyendo 220 unidades de Atención Primaria a la Salud de 65 municipios del Estado. De los 1873 profesionales de salud participantes, 71,8% relataron haber realizado acciones de alimentación y nutrición, variando de 56% para gestantes a 17% para las familias entre las unidades de salud. Apenas 19% de las unidades de salud contaban con nutricionistas. En unidades de salud con menos de dos convenios hubo prevalencia de 28% y 41% menos de oferta de acciones de alimentación y nutrición para adultos y familias, respectivamente. Entre las variables utilizadas para evaluar la preparación profesional y las condiciones operacionales, la orientación para el trabajo y los convenios en la comunidad fueron determinantes para la oferta de acciones de alimentación y nutrición, aun incipientes en la Atención Primaria a la Salud.

Influence of Energy Balance on the Rate of Weight Loss Throughout One Year of Roux-en-Y Gastric Bypass: a Doubly Labeled Water Study.

OBJECTIVE: To investigate the influence of changes in energy balance and body composition on the rate of weight loss throughout 1 year of Roux-en-Y gastric bypass. METHODS: Variables were collected pre-, 6, and 12 months (M) post-surgery from 18 women (BMI ≥ 40 and ≤ 50 kg m-2, 20 to 45 years). Total energy expenditure (TEEm), fat-free mass (FFM), and fat mass (FM) were measured by doubly labeled water. Self-reported energy intake (EIsr) was obtained from three non-consecutive food diaries. Metabolic adaptation was assessed via deviations from TEE predictive equation, and the calculated energy intake (EIc) via the sum of TEE and change in body stores. RESULTS: BMI significantly decreased (mean ± SD) from 45 ± 2 kg m-2 to 32 ± 3 kg m-2 at 6 M, and to 30 ± 3 kg m-2 at 12 M after surgery. The TEEm reduced significantly at both time points when compared with pre-surgery (6 M: - 612 ± 317 kcal day-1; 12 M: - 447 ± 516 kcal day-1). At 6 M, a metabolic adaptation was observed and the energy balance was - 1151 ± 195 kcal day-1, while at 12 M it was - 332 ± 158 kcal day-1. Changes in the values of TEEm were associated with changes in body weight at 12 M post-surgery. A significant underreporting was observed for EIsr (1057 ± 385 kcal day-1) vs. EIc (2083 ± 309 kcal day-1) at 12 M post-operative. CONCLUSION: The higher rate of weight loss at 6 M post-surgery was a response to energy imbalance, which was caused by high restriction in energy intake even with the presence of metabolic adaptation at this time. The EIsr was not sufficiently accurate to assess the energy consumption of this population. REGISTRATION OF CLINICAL TRIALS (OBSERVATIONAL STUDY): Brazilian Clinical Trials Registry: RBR-8k5jsj. Universal Trial Number: U1111-1206-0858.

Correction to: Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW.

The name of author Michele Novaes Ravelli was misspelled in the original article - it is correct here.