Total polyphenol intake, polyphenol subtypes and incidence of cardiovascular disease: The SUN cohort study.

BACKGROUND AND AIMS: Polyphenol-rich diets have been associated with reduced risk of cardiovascular disease (CVD). However, few prospective epidemiological studies have examined the relationship between classes of ingested polyphenols and risk of CVD. Our aim was to evaluate the association between polyphenol intake and risk of major cardiovascular events in a prospective Spanish cohort. METHODS AND RESULTS: We included 17,065 university graduates (60.7% women, mean age: 37.2 years, age range: 20-89) followed-up for a mean of 10.1 years. Polyphenol intake was assessed at baseline using a validated semi-quantitative 136-item food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for incident cardiovascular events (myocardial infarction, stroke or cardiovascular death). Cherries, chocolate, coffee, apples, and olives were the major sources of variability in polyphenol intake. Participants with higher flavonoids intake (fifth quintile) had a 47% lower incidence of cardiovascular events compared to those in the lowest quintile (HR: 0.53, 95% CI: 0.29-0.98; P for trend = 0.09) after adjusting for potential confounders. The results were non-significant for other polyphenol types. CONCLUSION: The intake of flavonoids showed an inverse association with risk of cardiovascular events in a prospective cohort of Spanish middle-aged adult university graduates. REGISTRATION NUMBER FOR CLINICAL TRIALS: NCT02669602 in Clinical Trials.

Does access to healthy food vary according to socioeconomic status and to food store type? an ecologic study.

BACKGROUND: The food environment can influence opportunities and barriers to food access. This study aimed to investigate whether access to healthy foods varies according to store types and the socioeconomic status of the users of the public health promotion program in Brazil, known as the Health Academy Program. METHODS: A total of 18 Health Academy Program centers were selected via simple conglomerate sampling. Health Academy Program users living up to 1 km from the food stores were evaluated (n = 2831). Their socioeconomic status was investigated via face-to-face interviews. The food stores were audited through direct observation. Variables included the community nutrition environment (type and location) and consumer nutrition environment (healthy food store index, involving variables such as availability, variety, and advertising of healthy and unhealthy products). Multiple linear regression analysis was performed to examine the association between access to healthy foods, socioeconomic status, and food store type. RESULTS: A total of 336 stores were investigated. The majority were specialty fruit and vegetable markets/stores or open-air food markets. Access to healthy food was only associated with the food store type. An increase of 1% in the availability of specialized fruits and vegetable markets or open-air food markets and supermarket raised healthy food store index values by 0.12 and 0.07, respectively. CONCLUSIONS: Public food supply policies aimed at improving the diet quality of the population and reducing inequality in access should prioritize the implementation of stores of better quality, such as specialty fruit and vegetable markets and open-air food markets.

Characterization of the bacterial microbiota of Biomphalaria glabrata (Say, 1818) (Mollusca: Gastropoda) from Brazil.

UNLABELLED: Roughly 200 000 000 people in 74 countries infected with schistosomes all share the fact that they came in contact freshwater harbouring infected snails. The aim of the study is to characterize the microbiota of wild and laboratory-reared snails of Biomphalaria glabrata from Pernambuco, Brazil. The microbiota of these molluscs was identified biochemically by the VITEK 2 automated microbiological system. Antimicrobial susceptibility testing was carried out by the disc diffusion method with ß-lactam antibiotics, aminoglycosides, quinolones, folate pathway inhibitors, fenicols and tetracyclines. The results showed that all bacteria identified were gram-negative, including 11 bacterial genera: Aeromonas, Citrobacter, Enterobacter, Cupriavidus, Rhizobium, Stenotrophomonas, Pseudomonas, Klebsiella, Acinetobacter, Vibrio and Sphingomonas. Regarding the antimicrobial susceptibility, all the isolates exhibited resistance to amoxicillin and sensitivity to meropenem (beta-lactam antimicrobials). The microbiota of the wild snails consisted predominantly of Enterobacter cloacae, while the laboratory-reared snails predominantly showed Citrobacter freundii and Aeromonas sobria. SIGNIFICANCE AND IMPACT OF THE STUDY: Biomphalaria glabrata is a Brazilian freshwater Planorbidae of great medical relevance as an intermediate host of Schistosoma mansoni. About a month after being infected by one or more miracidia larvae of a compatible schistosome, B. glabrata sheds thousands of cercariae into the water where they seek human skin and, if successful, penetrate to establish infection, eventually taking up residence and maturing in blood vessels of the small intestine. Results obtained from this study aim at targeting novel biological control strategies for schistosomiasis such as paratransgenesis. This is the first study on the microbiota of B. glabrata from Brazil.

Factors associated with the calibration of a food frequency questionnaire for the Bambuí Project, Brazil.

BACKGROUND: The present study aimed to calibrate a food frequency questionnaire (FFQ) using one 24-h recall (R24) associated with foodstuff replicas. METHODS: Calibration was performed by linear regression. Of a probability sample of 150 individuals (>18 years) of the town of Bambui, 98 completed the study. RESULTS: The mean age of the participants was 43.8 years and 63.3% were women. The calibration of the FFQ included sex for the estimation of iron, protein and zinc; and an interaction between sex and R24 was significant for vitamin A and cholesterol models. Age contributed to the vitamin C, polyunsaturated fatty acids, proteins and zinc models, and an interaction between age and R24 was significant for protein and zinc. CONCLUSIONS: Calibration coefficients and many interactions in linear regression models revealed important differences between dietary methods, indicating the complexity encountered when combining two methodologies for estimating food intake.

The Bambui health and aging study: is calibration of dietary intake necessary among older adults?

Accurate measurements of food intake in surveys are difficult to be obtained especially in the older adults. Calibration, using two instruments, has been adopted in order to improve the information. This study was carried out in a random sample of older adults (> or =60) living in a Brazilian town. Food intake was obtained by the semi-quantitative food frequency questionnaire associated with photos (SFFQ-P) and the 24 hours recall (R24) with or without food models. Statistical analysis included tests to compare averages, Pearson's correlation coefficient and multiple linear regression. For all nutrients, the average intake obtained through SFFQ-P was significantly higher compared to the obtained by the R24 (p < or =0.05). SFFQ-P correlated better with R24 with food models, which was chosen as the reference method. In the multiple linear regression, vitamin C, fatty acid, protein and zinc intakes were influenced by age, especially when such nutrients were more concentrated in food not frequently reported. For protein and zinc, the significantly interaction between age with the 24 hours recall may have happened because of a differential selection of food sources as a function of age. This fact is probable related to chewing difficulties, reduction in the income and, a diet simplification associated with less complicated preparations, such as meat. This study reinforces the need for calibration of SFFQ in nutritional surveys among older adults, especially in etiological studies where the exposure assessment has to be accurate. In this case, R24 with food models should be used as a reference method to best estimate the true intake.

Eficiência da pasteurizaçäo sobre a qualidade microbiológica do leite tipo C / Efficiency of pasteurization on the microbiological quality of type C milk

Visando avaliar a eficiência da pasteurizaçäo sobre a qualidade microbiológica do leite tipo C, foram colhidas, em uma usina de beneficiamento da cidade do Recife-PE, Brasil, amostras de leite cru e pasteurizado. Foram 42 amostras submetidas a contagem de microrganismos mesófilos, determinaçäo do número mais provável (NMP) de coliformes totais e fecais e pesquisa de Salmonella. Paralelamente foi realizada a prova de peroxidase do leite. Os resultados da pesquisa de Salmonella revelaram a ausência desta bactéria no produto pasteurizado entretanto, em uma amostra de leite cru foi isolada uma cepa de S. panama. Os resultados evedenciaram, ainda, que os níveis de microrganismos mesófilos, coliformes totais e coliformes fecais, nas amostras de leite cru e pasteurizado, apresentaram, respectivamente, médias aritméticas de 3,9x10 elevado a sétima potência e 5,7x10 elevado ao quadrado UFC/ml; 6,4x10 elevado a quinta e <0,3NMP/ml; e 1,4x10 elevado a quinta e <0,3NMP/ml. Por conseguinte, o processo de pasteurizaçäo do leite reduziu em média 99,99 por cento os grupos de microrganismos estudados. Verificou-se, ainda, que 19 (90,5 por cento) amostras de leite pasteurizado apresentaram resultados negativos para a presença de peroxidase. Tais achados demonstram que os binônomios tempo-temperatura de pasteurizaçäo do leite estäo acima do estabelecido pelos regulamentos brasileiros. Esse procedimento, além de mascarar a qualidade microbiológica do leite pasteurizado, pode alterar suas características físicas, químicas e organolépticas