Cultural Consonance in Food Consumption and Nutrient Intake in Southern Brazil.

Culture influences food consumption and nutrient intake. In this paper we present a new approach in research, examining how knowledge and understanding of food is encoded in cultural models. The degree to which individuals match these shared models in their own consumption patterns is then measured, using the concept of cultural consonance. In research conducted in urban Brazil, the configuration of cultural models of food, and the association of cultural consonance in food with nutrient intake, are moderated by socioeconomic status. The theory and method employed here offers a new approach to the study of culture, food, and nutrient intake.

The interaction of cultural consonance and a polymorphism in the 2A serotonin receptor in relation to depression in Brazil: failure to replicate previous findings.

OBJECTIVES: To replicate a previously identified gene-environment interaction between a genetic polymorphism in the serotonin 2A receptor and cultural consonance in family life in relation to depressive symptoms (Dressler et al., 2009). METHODS: A sample of 402 individuals in a sample drawn from four different economic strata in Ribeirão Preto, Brazil was interviewed and genotyped. RESULTS: Cultural consonance in family life has an inverse association with depressive symptoms (beta = -0.439, P < 0.001) and with high depressive symptoms (OR = 2.36, P < 0.001), but the interaction with genotype was not statistically significant. CONCLUSION: The previously identified gene-environment interaction was not replicated. Limitations of the study are discussed. Am. J. Hum. Biol. 28:936-940, 2016. © 2016Wiley Periodicals, Inc.

Culture and the Immune System: Cultural Consonance in Social Support and C-reactive Protein in Urban Brazil.

In this article, we examine the distribution of a marker of immune system stimulation-C-reactive protein-in urban Brazil. Social relationships are associated with immunostimulation, and we argue that cultural dimensions of social support, assessed by cultural consonance, are important in this process. Cultural consonance is the degree to which individuals, in their own beliefs and behaviors, approximate shared cultural models. A measure of cultural consonance in social support, based on a cultural consensus analysis regarding sources and patterns of social support in Brazil, was developed. In a survey of 258 persons, the association of cultural consonance in social support and C-reactive protein was examined, controlling for age, sex, body mass index, low-density lipoprotein cholesterol, depressive symptoms, and a social network index. Lower cultural consonance in social support was associated with higher C-reactive protein. Implications of these results for future research are discussed.

Eating Disorders: Cultural Model and Consensus Regarding Food.

The cultural model of food was applied to 112 adult patients with eating disorders (PG) and 36 healthy adult women (CG) of similar age. The Free List and Ranking of Foods was used to group foods and verify consensus and cultural aspects. Calories, health, and taste were the dimensions used by the participants to group the foods, and strong consensus was achieved in regard to calories and health. There were, however, inter- and intra-group divergences in regard to these ideas, especially in the PG. The CG used distinct criteria, showing a more complex model.

How culture shapes the body: cultural consonance and body mass in urban Brazil.

OBJECTIVES: The aim of this article is to develop a model of how culture shapes the body, based on two studies conducted in urban Brazil. METHODS: Research was conducted in 1991 and 2001 in four socioeconomically distinct neighborhoods. First, cultural domain analyses were conducted with samples of key informants. The cultural domains investigated included lifestyle, social support, family life, national identity, and food. Cultural consensus analysis was used to confirm shared knowledge in each domain and to derive measures of cultural consonance. Cultural consonance assesses how closely an individual matches the cultural consensus model for each domain. Second, body composition, cultural consonance, and related variables were assessed in community surveys. Multiple regression analysis was used to examine the association of cultural consonance and body composition, controlling for standard covariates and competing explanatory variables. RESULTS: In 1991, in a survey of 260 individuals, cultural consonance had a curvilinear association with the body mass index that differed for men and women, controlling for sociodemographic and dietary variables. In 2001, in a survey of 267 individuals, cultural consonance had a linear association with abdominal circumference that differed for men and women, controlling for sociodemographic and dietary variables. In general, as cultural consonance increases, body mass index and abdominal circumference decline, more strongly for women than men. CONCLUSIONS: As individuals, in their own beliefs and behaviors, more closely approximate shared cultural models in socially salient domains, body composition also more closely approximates the cultural prototype of the body.

The I405V and Taq1B polymorphisms of the CETP gene differentially affect sub-clinical carotid atherosclerosis.

BACKGROUND: Cholesteryl ester transfer protein (CETP) plays a major role in lipid metabolism, but studies on the association of CETP polymorphisms with risks of cardiovascular disease are inconsistent. This study investigated whether the CETP gene I405V and Taq1B polymorphisms modified subclinical atherosclerosis in an asymptomatic Brazilian population sample. METHODS: The polymorphisms were analyzed using polymerase chain reaction in 207 adult volunteers. Serum lipid profiles, oxLDL Ab titers, C-reactive protein and tumor necrosis factor-α concentrations and CETP and phospholipid transfer protein (PLTP) activities were determined, and common carotid artery intima-media thickness (cIMT) was measured using ultrasonography. RESULTS: No differences in cIMT were observed between the presence or absence of the minor B2 and V alleles in either polymorphism. However, inverse correlations between mean cIMT and CETP activity in the presence of these polymorphisms were observed, and positive correlations of these polymorphisms with PLTP activity and oxLDL Ab titers were identified. Moreover, logistic multivariate analysis revealed that the presence of the B2 allele was associated with a 5.1-fold (CI 95%, OR: 1.26 - 21.06) increased risk for cIMT, which was equal and above the 66th percentile and positively interacted with age. However, no associations with the V allele or CETP and PLTP activities were observed. CONCLUSIONS: None of the studied parameters, including CETP activity, explained the different relationships between these polymorphisms and cIMT, suggesting that other non-determined factors were affected by the genotypes and related to carotid atherosclerotic disease.

Cultural consonance, a 5HT2A receptor polymorphism, and depressive symptoms: a longitudinal study of gene x culture interaction in urban Brazil.

In this study in urban Brazil we examine, as a predictor of depressive symptoms, the interaction between a single nucleotide polymorphism in the 2A receptor in the serotonin system (-1438G/A) and cultural consonance in family life, a measure of the degree to which an individual perceives her family as corresponding to a widely shared cultural model of the prototypical family. A community sample of 144 adults was followed over a 2-year-period. Cultural consonance in family life was assessed by linking individuals' perceptions of their own families with a shared cultural model of the family derived from cultural consensus analysis. The -1438G/A polymorphism in the 2A serotonin receptor was genotyped using a standard protocol for DNA extracted from leukocytes. Covariates included age, sex, socioeconomic status, and stressful life events. Cultural consonance in family life was prospectively associated with depressive symptoms. In addition, the interaction between genotype and cultural consonance in family life was significant. For individuals with the A/A variant of the -1438G/A polymorphism of the 2A receptor gene, the effect of cultural consonance in family life on depressive symptoms over a 2-year-period was larger (beta = -0.533, P < 0.01) than those effects for individuals with either the G/A (beta = -0.280, P < 0.10) or G/G (beta = -0.272, P < 0.05) variants. These results are consistent with a process in which genotype moderates the effects of culturally meaningful social experience on depressive symptoms.

Intracultural diversity in food knowledge in southern Brazil.

This research explores the social distribution of food knowledge in Ribeirão Preto, a city in the state of São Paulo, Brazil. Through an analysis of the distribution of individual expertise in regard to the cultural model of food along the dimensions of healthfulness, practicality, and prestige, this research demonstrates that knowledge of the cultural model of food is most strongly shared in the upper class of the city. Qualitative and quantitative ethnographic research suggests that the social patterning of health-related food knowledge in Ribeirão Preto may serve to maintain class distinction.

Intestinal bacterial overgrowth after Roux-en-Y gastric bypass.

The aim of the present study was to report the occurrence of serious subnutrition, associated to intestinal bacterial overgrowth, in two patients submitted to bariatric surgery. Two female patients (body mass index, 49 and 50 kg/m(2), respectively) were submitted to Y-en-Roux gastric bypass. The first patient evolved a 52% loss of body weight within 21 months after surgery; the other, a 34% loss of initial body weight within 15 months after surgery, results corresponding, respectively, to 62 and 45 kg weight losses. However, both patients reported asthenia, hair fallout, and edema, and one also reported diarrhea, but none was feverish. Their respective albuminemias were of 24 and 23 g/l. A respiratory hydrogen test suggested bacterial hyperproliferation. Thirty days after ciprofloxacin and tetracyclin treatments, they showed improved albumin levels and nutritional states, both confirmed by results of hydrogen breath tests. Bacterial overgrowth is an important complication that can compromise clinical evolution of patients submitted to intestinal surgery like gastroplasty with Y-Roux anastomosis. In cases of clinical suspicion or a confirmed diagnosis, adequate antibiotics, sometimes requiring to be cyclically repeated, should be administered.

Treatment of gastrogastric fistula after Roux-en-Y gastric bypass: surgery combined with gastroscopy.

A 53-year-old male who had previously undergone an open gastric bypass (Capella-Fobi) developed a gastrogastric fistula during the late postoperative course. Because he regained weight and had a stomal ulcer difficult to control, it was decided to submit him to revisional surgery. At laparotomy, a retrogastric approach plus gastroscopy permitted easy identification and closure of the fistula. The patient is doing well and losing weight after this reoperation.

UCP1 -3826 A>G polymorphism affects weight, fat mass, and risk of type 2 diabetes mellitus in grade III obese patients.

OBJECTIVE: We investigated whether or not the UCP1 -3826 A>G polymorphism is associated with obesity and related metabolic disorders in grade III obese patients. METHODS: 150 obese patients (body mass index ≥35 kg/m(2)) who were candidates for bariatric surgery were studied. Weight (kg), body mass index (kg/m(2)); fat free mass (kg), fat mass (kg), energy intake (kcal), level of physical activity, plasma levels of glucose, total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), triacylglycerols, and the prevalence of comorbidities associated with obesity were collected from medical records. Polymorphism rs1800592 genotyping was performed through allelic discrimination method in real time polymerase chain reaction using the TaqMan predesigned SNP Genotyping Assays kits. The t test was done to determine if genotypes of each polymorphism are associated with anthropometric and body composition variables. Linear regression models were used for age, sex, height, physical activity, and energy intake in weight and body composition variations (P < 0.05). RESULTS: Among these 150 individuals (47.2 ± 10.5 y, 80% women) the distribution of AA, AG, and GG was 41.3%, 45.3%, and 13.4%, respectively. Weight and body fat were lower in individuals who were carriers of a mutated allele G. It was observed that mutated homozygotes (GG) had a lower frequency of type 2 diabetes mellitus compared with those of wild allele (AA+AG). CONCLUSIONS: UCP1 -3826 A>G polymorphism is associated with weight, body fat mass, and risk of type 2 diabetes mellitus in obese individuals candidates for bariatric surgery.

Eating, drinking and being depressed: the social, cultural and psychological context of alcohol consumption and nutrition in a Brazilian community.

Much has been written about the socioeconomic distribution of nutritional status, both in more economically developed, and in developing nations. In general, persons of lower socioeconomic status suffer adverse consequences of poor nutritional status, although these consequences can vary depending on the level of development, i.e. in more developed countries the problem tends to be one of over-nutrition and obesity, while in developing countries the problem tends to be one of under-nutrition and nutritional deficiencies. In this paper, we explore the socioeconomic distribution of dietary intake in a Brazilian city, in an area that in some ways is neither prototypically developed or underdeveloped. The analysis presented here was stimulated by the surprising observation of no socioeconomic differences in total caloric intake in the context of extreme differences in income distribution. Further examination showed that socioeconomic differences in total caloric intake appeared after controlling for alcohol intake. A complete analysis of the data suggests that lower income leads to lower cultural consonance, which in turn leads to higher depression, higher alcohol intake, and higher total caloric intake. In this model, alcohol ingestion can be seen as both a psychological and nutritional adaptive strategy to economic, social and cultural marginality in a highly stratified society.

Identification of a new mutation, S305C, in exon 7 of the low-density lipoprotein receptor gene in a Brazilian family with homozygous familial hypercholesterolemia.

DNA analysis of the low-density lipoprotein receptor gene of a young Brazilian man, suffering from an extreme form of hypercholesterolemia, revealed the presence of two mutations, thereby confirming the diagnosis of homozygous familial hypercholesterolemia (FH). The first mutation was a mutation frequently found in Brazilian patients with FH, termed C660X or FHLebanese. The second mutation, in which a serine residue was replaced by a cysteine at amino acid position 305 (S305C) was a new mutation never described before. S305C was inherited from the proband's mother, who was of Italian descent. The occurrence of LDL receptor gene mutations of Lebanese and Italian origin in Brazil underlines the genetic heterogeneity of the Brazilian population.

Culture, skin color, and arterial blood pressure in Brazil.

Populations of African descent in North and South America have higher mean blood pressures and higher rates of hypertension than populations of European descent or populations in Africa. Within populations of African descent, darker skinned persons have higher blood pressures than lighter skinned persons. Whether examined within or between populations, there is an interaction between skin color and socioeconomic status (SES) in relation to blood pressure, with persons with dark skin color and low SES having the highest blood pressures. This interaction was examined in Brazil using a measure of a cultural dimension of SES called "cultural consonance in lifestyle." This measure was derived using cultural consensus analysis linked with social survey data. It was found that darker skinned Brazilians with lower cultural consonance in lifestyle had adjusted systolic blood pressures 16.2 mm Hg higher than darker skinned Brazilians with higher cultural consonance (P <.01); the corresponding difference in adjusted diastolic blood pressure was 9.7 mm Hg (P <.04). The differences for lighter skinned Brazilians were 6.4 mm Hg (P <.02) and 1.0 mm Hg (not significant), respectively. These results could be due either to an interaction of genetic predisposition and SES, or the result of a socially and culturally-mediated process. Given that cultural consonance in lifestyle measures the ability of the person to live up to cultural norms, and given the existence of racial stratification in Brazil, it is argued that a social and cultural mediation of the relationship is more plausible. Am. J. Hum. Biol. 11:49-59, 1999. Copyright 1999 Wiley-Liss, Inc.

Bioelectrical impedance vector analysis in obese women before and after bariatric surgery: changes in body composition.

OBJECTIVE: Because of the inefficacy of standard methods for the evaluation of body composition of grade III obese individuals, it is difficult to analyze the quality of weight loss after bariatric surgery in these patients. Electrical bioimpedance vector analysis and the RXc graph uses crude resistance (R) and reactance (Xc) values, like components of the Z vector, to monitor variations in body fluid and the nutritional status of obese individuals. Using bioelectrical impedance vector analysis (BIVA) and the RXc graph, the objective of the present study was to evaluate long-term changes in weight and body composition of obese women after Roux-en-Y bariatric surgery. METHODS: A study was conducted on 43 grade III obese women submitted to bariatric surgery. Anthropometric and bioimpedance (800 mA-50 kHz) data were obtained during the preoperative period and 1, 2, 3, and 4 y after surgery. BIVA was performed by plotting resistance and reactance values corrected for body height (R/H and Xc/H, Ohm/m) as bivariates on the RXc graph. BIVA software was used to plot the vectors of the RXc plane. RESULTS: Surgery promoted changes in body composition, with a reduction of fat mass and of fat-free mass. During the postoperative period, the vectors demonstrated migration to the right lower quadrant of the graph, corresponding to the classification of cachexia and water retention. CONCLUSION: Weight loss due to surgery results in an important reduction of fat-free mass characterized by the position of most individuals in the cachexia quadrant throughout the postoperative period.

Protein and amino acid status before and after bariatric surgery: a 12-month follow-up study.

BACKGROUND: Patients with obesity submitted to bariatric surgery present altered ingestion of macronutrient and micronutrient levels and nutrients deficiency. The objective of this study was to evaluate the protein and amino acid nutritional status of obese adults before and after bariatric surgery, with emphasis on plasma free amino acids. METHODS: Thirty obese women were submitted to Roux-en-Y gastric shunt (bariatric surgery). Food and protein intake, anthropometric and bioimpedance data (body composition analysis), and serum total protein, albumin, and plasma amino acids levels were collected before the surgery (preoperative) and 3, 6, and 12 months after the surgical procedure. RESULTS: The mean protein intake was 47±2 g/day. The total weight loss during the study period was 39±8 kg; the fat-free mass decreased 7±5 kg. The amino acid profile showed increased concentrations of most amino acids 3 months after surgery; at 6 months, glutamic acid, serine, arginine, alanine, methionine, valine, phenylalanine, isoleucine, and tyrosine concentrations decreased. The total protein and albumin concentrations dropped along the 12-month follow-up. CONCLUSION: The amino acid profile changes after RYGB are evidence that total protein and albumin levels may not be good indicators of protein profile after the surgery.

Bioavailability of iron measurement in two nutrients multiple solutions by in vitro and in vivo;a comparative methodology between methods.

OBJECTIVES: The bioavailability of dietary iron present in a nutritional formulation may be evaluated by in vitro and in vivo methods since they provide for a cohesive line study and provided in the literature. The aim of this study was to evaluate the bioavailability of iron targeting a comparative analysis of two nutritional supplement formulations (A and B). METHODS: For this study were using in vitro and in vivo methods, both described in the literature for availability of iron in an enteral feeding after ingestion supplement nutrition with much nutrients. RESULTS: The results obtained by in vitro simulation of the human gastrointestinal tract were 0.70 ± 0.02 and 0.80 ± 0.01 % iron availability by formulations A and B. In vivo studies, as measured by the curves of serum iron in humans after ingestion of formulations allowed the calculation of coefficient of variation Δ < 0, indicating that there was a low absorption of iron. The bioavailability of iron as two multi-nutrients solutions obtained by in vitro and in vivo showed that there were comparisons of those methodologies used in this study.

Objetivos: La biodisponibilidad de hierro presente en una formulación nutricional puede ser evaluada por in vitro y in vivo, ya que proporcionan para un estudio de línea cohesiva y proporcionado en la literatura. El objetivo de estudio fue evaluar la biodisponibilidad de hierro con in vitro y in vivo, dirigida a un análisis comparativo de dos formulaciones de suplementos nutricionales (A y B). Métodos: Fueron utilizados dos métodos descritos en la literatura que para evaluar la biodiponibilidad de hierro. Uno que es la simulación de digestión humana y otro por los niveles de hierro sérico después de la ingestión de la formulación en los seres humanos. Resultados: Los resultados obtenidos por la simulación in vitro de la digestión del tracto gastrointestinal humano fueron 0,70 ± 0,02 y 0,80 dialisibilidad 0,01% de hierro, respectivamente, para las formulaciones A y B. Los estudios in vivo, segú n se mide por las curvas de hierro en suero en seres humanos después de la ingestión de las formulaciones mostró coeficiente de variación Δ < 0, lo que indica que había una baja absorción de hierro. La biodisponibilidad de hierro a los dos multi-nutrientes soluciones fueron obtenidos por in vitro y in vivo mostraron que había una comparación de las metodologías utilizadas en soluciones acuosas de muchos nutrientes.

Iron (FeSo4) bioavailability in obese subjects submitted to bariatric surgery.

BACKGROUND: Iron bioavailability in obese subjects after the ingestion of a nutritional supplement was the aim of this work. METHODS: Fourteen persons were studied before and after bariatric surgery after the ingestion of a nutritional formulation containing 25 mg iron, 25 g fiber and 800 mg calcium. RESULTS: The following ferremia values (median and minimum--maximum) were obtained before and after bariatric surgery, respectively: Fasting, 105 (70 - 364) µg/dL and 198 (38 - 617) µg/dL; 1 hour, 103 (63 - 305) µg/dL and 160 (11 - 207) µg/dL; 2 hours, 103 (62 - 150) µg/dL and 141 (10 - 412) µg/dL; 3 hours. 97 (63 - 190) µg/dL and 153 (6 - 270) µg/dL; 4 hours, 91 (58 - 163) µg/dL and 156 (40 - 251) µg/dL (p>0.05), with no association of serum iron levels with time. There was a difference in total triglycerides (95 ± 29 mg/dL and 60 ± 10 mg/dL) which were correlated with a decrease in serum ferritin levels (r = 0,926, p = 0.008), UIBC (r = 0.910, p = 0.01), total cholesterol (r = 0,918, p = 0.01) and LDL-c fraction (r = 0.830, p = 0.04), with an increase in HDL-c fraction (r = 0,807, p = 0.05). CONCLUSION: Iron bioavailability in obese subjects was affected by the ingestion of the nutritional formulation containing calcium and fiber, a fact that may cause these patients to develop iron deficiency.

Objetivo: Obesos sometidos a cirugía bariátrica muestran la utilización de deterioro de hierro. Evaluar la biodisponibilidad del hierro en los obesos por el consumo de suplemento nutricional que contiene múltiples nutrientes antes y después de seis meses de la cirugía bariátrica. Material y Métodos: El estudio incluyó a 14 voluntarios antes y después de la cirugía bariátrica que recibieron formulaciones que contienen múltiples nutrientes y medir las concentraciones séricas de hierro en ayunas y cada 1 hora después de la ingestión de formulaciones, con un total de cuatro horas. Resultados: Ferremia por el consumo de entre dos formulaciones de pre-y post-operatorios fueron: El ayuno 104.50 (70,00-363,00) mg / dl y 198.00 (38.00 a 617.00) mg / dl, 103.00 horas (63,00 a 305,00) mg / dl y 160.00 (11,00- 206,90) mg / dL, 2 horas 102.50 (62.00 a 150.00) mg / dL y 141.30 (10.00 a 412.20) mg / dl, 3 horas 97.00 (63.00 a 190.00) mg mg / dl y 153,00 (6,00 hasta 269,60) / dl , 4 horas 91,00 (58,00 a 163,00) mg / dl y 156.10 (40.00 a 250.50) mg / dl y no hubo asociación estadísticamente significativa entre los dos períodos para los niveles de hierro suero. Los valores de la zona de las curvas en el suero fueron 453,50 ± 202,80 mg / dl / hora, p = 0,000 y 579,00 ± 380,30 mg / dl / hora, p = 0,007 y fue estadísticamente diferente entre los dos períodos. La biodisponibilidad del hierro en soluciones que contienen múltiples nutrientes se vio afectada antes y después de seis meses de la cirugía bariátrica. Conclusión: Se encontró que los niveles se redujeron ferremia con la cirugía, que puede poner en peligro estos pacientes presentaron deficiencia de hierro.

Daily vitamin supplementation and hypovitaminosis after obesity surgery.

OBJECTIVE: The objective of this study was to determine whether constant daily vitamin supplementation would be sufficient to prevent possible vitamin deficiencies in obese patients undergoing bariatric surgery. METHODS: The study was conducted on 58 men and women (mean age 41 ± 10 y) who underwent Roux-en-Y gastric bypass RYGB and were assessed preoperatively and at 3, 6, and 12 mo after surgery. During the postoperative period, the patients received a multivitamin-mineral supplement on a daily basis. RESULTS: Serum ß-carotene and vitamin C were lower starting from the third postoperative month and continued to be low after 12 mo, and vitamin A was decreased by the sixth month and increased by 12 mo. Vitamin B12 levels were stable up to 6 mo but were decreased by 12 mo. Folic acid levels increased from the third month and remained higher throughout follow-up. One year after surgery there were 19% and 21% increases in the number of patients with vitamin A and vitamin C deficiency, respectively, and a 4% decreased of patients with folic acid deficiency. CONCLUSION: Weight loss and improvement in patients' general condition followed surgery, but serum levels of some vitamins were decreased despite the use of a vitamin-mineral supplement. These patients need continuous follow-up and individualized prescription of supplementation after the surgical procedure to prevent and treat vitamin deficiencies.