RESUMEN
It has been suggested that an imbalance in mineral levels is involved in the pathophysiology of migraine. However, only a few studies have investigated the circulating levels of mineral in patients with migraine during the pain-free period (i.e. interictal). This study aimed to investigate whether the interictal plasma levels of minerals of women with migraine differ from those of women without migraine (controls). This is a cross-sectional study involving 67 women, of which 38 were diagnosed with migraine and 29 were controls. The groups were similar in age and body mass index. Plasma levels of magnesium (Mg), copper (Cu), calcium (Ca), zinc (Zn), iron (Fe), and selenium (Se) were measured. Dietary intake was assessed using a 24-hour food recall, and migraine impact was evaluated using the Headache Impact Test, version 6 (HIT-6). The association between migraine disability, and plasma levels and dietary intake of minerals was assessed through correlation and logistic regression analyses. Women with migraine had significantly lower plasma levels of Mg, Ca, Cu, and Zn than controls. In parallel, dietary intake of Mg, Cu, and Fe was significantly lower in patients with migraine. Migraine impact was not associated with plasma levels or dietary intake of minerals. The results suggest that patients with migraine have lower plasma levels of minerals, and dietary intervention to ensure adequate mineral intake should be considered as a therapeutic strategy for migraine.
Asunto(s)
Dieta , Trastornos Migrañosos , Humanos , Femenino , Estudios Transversales , Minerales , Magnesio , Calcio de la Dieta , Ingestión de Alimentos , Cobre/análisisRESUMEN
BACKGROUND: It has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil. METHODS: This cross-sectional and comparative study analyzed preliminary data from the study "Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2", which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study "Birth in Belo Horizonte: labor and birth survey", conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, "Birth in Belo Horizonte: labor and birth survey", data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson's chi-square test, with a confidence level of 95%, and using Stata statistical program. RESULTS: We found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001). CONCLUSION: Our study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic.
Asunto(s)
COVID-19 , Trabajo de Parto , Niño , Recién Nacido , Embarazo , Femenino , Humanos , Estudios Transversales , Pandemias , Brasil/epidemiología , COVID-19/epidemiología , SARS-CoV-2 , Parto Obstétrico , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To evaluate the association between the consumption of NOVA food groups (classification based on the nature, extent and purpose of food processing) and the intake of energy, macro and micronutrients among school children. DESIGN: Cross-sectional study. Food consumption was assessed by two 24-h dietary recalls on non-consecutive days. Energy from each NOVA food groups - ultra-processed foods, unprocessed or minimally processed foods, processed culinary ingredients and processed foods - was estimated. For analysis, the percentage of energy from ultra-processed foods and unprocessed or minimally processed foods were categorised into tertiles and associated with intake of energy, macro and micronutrients using analysis of covariance and linear regression. SETTING: Public schools in Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS: School children aged 8-12 years (n 797; 406 girls; 391 boys). RESULTS: Mean energy intake was 2050·18 ± 966·83 kcal/d, 25·8 % was from ultra-processed foods, 56·7 % from unprocessed or minimally processed foods, 8·9 % from processed culinary ingredients and 8·6 % from processed foods. A higher energy contribution from ultra-processed foods was negatively associated with the intake of protein, fibre, vitamin A, Fe and Zn (P < 0·001) and positively associated with total energy, lipid and Na intake (P < 0·001). Concurrently, a higher energy contribution from unprocessed or minimally processed foods was positively associated with the consumption of protein, fibre, Fe and Zn (P < 0·001) and negatively associated with total energy (P = 0·002), lipid and Na intake (P < 0·001). CONCLUSIONS: In conclusion, higher ultra-processed food consumption presented a negative association with the nutrient intake profile of school children.
Asunto(s)
Ingestión de Energía , Comida Rápida , Masculino , Femenino , Niño , Humanos , Estudios Transversales , Dieta , Ingestión de Alimentos , Manipulación de Alimentos , Micronutrientes , LípidosRESUMEN
BACKGROUND: Dietary patterns can influence maternal and child health outcomes. The study aims to characterize dietary patterns during pregnancy as well as to identify their associations with gestational weight gain (GWG) and anthropometric measurements at birth. METHODS: A minimum sample size of 95 nursing mothers was estimated for this work. Socioeconomic, anthropometric, physical activity, obstetric and food consumption (food frequency questionnaire) data was collected from mothers and their newborns in immediate postpartum (n = 260) at the maternity hospital. Maternal pregestational weight and GWG were self-reported and the neonatal data was obtained from their records. The patterns were derived posteriori by Principal Component Analysis (PCA). Multinomial Logistic Regression and Poisson Regression with Robust Variance were applied. FINDINGS: Four dietary patterns were derived: "pattern 1", characterized by the consumption of meat and eggs, processed meat, vegetables and olive oil; "pattern 2", consisting of sweets, snacks and cookies; "pattern 3", which includes cereals and breads, coffee and tea, and processed fats; and "pattern 4", characterized by soft drinks, tubers and instant noodles. Together, the dietary patterns account for 49.16% of the total variance for food intake. Higher adherence to "pattern 3" was associated with inadequate birth weight (low and excessive birth weight); while greater adherence to "pattern 2" was associated with lower chances of inadequate GWG. CONCLUSION: The dietary patterns presented mixed composition and predominance of ultra-processed foods. They were associated with the investigated outcomes, denoting the importance of strategies to promote healthy eating habits during pregnancy in order to avoid possible complications.
Asunto(s)
Ganancia de Peso Gestacional , Peso al Nacer , Niño , Dieta , Femenino , Humanos , Recién Nacido , Parto , Embarazo , Aumento de PesoRESUMEN
OBJECTIVES: To evaluate the direct and indirect effects of family characteristics and the perceived neighborhood environment on obesity risks among schoolchildren. METHODS: Through phone contact with the child's mothers/guardians, the perceptions about the aspects of the neighborhood that could limit or promote health. Physical activity, socioeconomic data, self-reported weight and height, and ultra-processed consumption of the respondents were evaluated, in addition to the screen time of both mothers and children. A hybrid model of structural equations was used to test the direct and indirect effects of family and environmental variables on childhood obesity. SETTING: Belo Horizonte, Minas Gerais, Brazil. SUBJECTS: A total of 322 children from 9 to 10 years old from municipal schools and their respective mothers/guardians. RESULTS: Childhood obesity was positively associated with obesity among mothers/guardians and with the latent variable "socioeconomic status (SES)." It was observed that the child's guardians positively influenced childhood obesity through their own habits, such as screen time and consumption of ultra-processed products, with obesity of mothers/guardians as mediators of both associations. There were no direct and indirect effects of the latent variables of the perceived environment in childhood obesity. CONCLUSION: Family characteristics are important determinants of childhood obesity and should be considered when designing prevention strategies. Parental perceptions of neighborhood characteristics did not have an influence on childhood obesity.
Asunto(s)
Obesidad Infantil , Índice de Masa Corporal , Niño , Ejercicio Físico , Composición Familiar , Femenino , Promoción de la Salud , Humanos , Características del Vecindario , Obesidad Infantil/epidemiología , Obesidad Infantil/etiología , Características de la ResidenciaRESUMEN
OBJECTIVE: To explore the impact of inadequate sleep and associated factors on the social behaviour and food consumption of children and adolescents. DESIGN: Cross-sectional study. SETTING: Sleep information, social behaviour (Strengths and Difficulties Questionnaire), food consumption, demography, nutritional status, lifestyle, and biochemical tests were investigated. PARTICIPANTS: School children in the 4th grade of the municipal school system of a large Brazilian city. RESULTS: Of a total of 797 schoolchildren, 50·9 % were female, with a median age of 9·7 (9·5-10·0) years old and an energy consumption of 7613·6 (5982·7-9766·2) kJ. It was determined that 31·6 % were overweight, and 76·8 % reported insufficient weekly practice of physical activity. A median of 9·6 (8·9-10·5) h of sleep (lower values on weekdays: 9·3 v. 10·5 h, P < 0·001) was recorded. In addition, 27 % of the individuals who experienced inadequate sleep (<9 h) engaged in longer screen time daily (≥2 h/d) (P = 0·05), had an inadequate bedtime (> 22 h) or adequate wake-up time (5-7 h), studied in the morning (P < 0·001) and never took a shower before school (P < 0·001). Of the entire sample, 9·9 % had poor or very poor sleep quality and a greater probability of sleep talking regularly, had difficulty falling asleep, and engaged in inadequate social behaviour while experiencing these conditions compared with those with positive sleep quality. There was no association between sleep and the other variables investigated. CONCLUSIONS: Sleep impairment contributed to changes in sleep and social behaviour in schoolchildren. The findings of this study may reinforce the importance of developing actions to promote adequate sleep and a healthy lifestyle at school age.
Asunto(s)
Tiempo de Pantalla , Sueño , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Recién Nacido , Estado Nutricional , Conducta SocialRESUMEN
OBJECTIVE: Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city. DESIGN: Cross-sectional study. SETTING: Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS: Totally, 3372 participants. RESULTS: UPF were found to contribute to 27·7 % of the diet's total energy. The highest consumption was associated with higher values for energy intake (1561·8 v. 1331·8 kcal/d; P < 0·01), energy density (1·7 v. 1·4 kcal/g; P < 0·01), total (32·5 v. 27·3 %; P < 0·01) and trans-fats (2·1 v. 1·2 %; P < 0·01) and Na (1001·6 v. 758·9 mg/1000 kcal; P < 0·01) and with lower values for proteins (14·9 v. 19·6 %; P < 0·01), mono-unsaturated fats (16·1 v. 20·1 %; P = 0·02), n-3 (0·9 v. 1·1 %; P < 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P < 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population. CONCLUSIONS: Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.
Asunto(s)
Comida Rápida , Manipulación de Alimentos , Estudios Transversales , Dieta , Ingestión de Energía , Promoción de la Salud , Humanos , Atención Primaria de SaludRESUMEN
BACKGROUND AND OBJECTIVE: Maternal food intake during pregnancy can substantially interfere in the baby's anthropometric measurements at birth. Our objective was to perform a systematic review that investigate the influence of nutrient intake via food during pregnancy on the baby's anthropometric measurements at birth. METHODS: A search was performed without time limits on CINAHL, Embase, PubMed, Scopus and Web of Science databases and manual on studies references. All nutrients and baby's anthropometric measurements at birth were included as descriptors. RESULTS: Thirty articles were included, the majority of prospective cohort studies, with 15.39 (2.36) quality points (maximum value: 22). Thirty-six results of associations were found, of which 17 studies had direct associations between nutrient intake and birth outcomes. Inverse associations were identified in 8 studies and 11 articles showed no significant associations in all analyses. Maternal food intake of vitamin C, calcium and magnesium during pregnancy seems to have a positive influence on the baby's birth weight, while carbohydrates intake have an inverse association with the same outcome. CONCLUSION: It is suggested that vitamin C, calcium, magnesium and carbohydrates influence on baby's birth weight. So, these specific nutrients need more attention to the consumption, in addition to carried out new studies, with robust methodologies for measuring maternal food consumption and considering the several factors that can interfere in this assessment. REGISTRATION: This review has been registered to the PROSPERO (International prospective register of systematic reviews) (ID: CRD42020167889).
Asunto(s)
Ingestión de Alimentos , Vitaminas , Peso al Nacer , Femenino , Humanos , Lactante , Recién Nacido , Embarazo , Estudios ProspectivosRESUMEN
PURPOSE: Orthorexia nervosa has been receiving considerable attention and several tools have been developed to assess it, for instance, the "Düsseldorf Orthorexie Scale" (DOS). Such scale is a validated test to measure orthorexic eating behavior and it has shown good psychometric properties. Therefore, this study aimed to transculturally adapt and validate the Brazilian version of the DOS (DOS-BR). METHODS: DOS-BR was obtained using the back-translation process after two reviews done by a focus group and after running a pilot-test (n = 64). A self-report questionnaire was administered to a sample of Brazilian dietitians and Nutrition college students (n = 486). To examine the factor structure of the DOS-BR, exploratory factor analysis and confirmatory factor analysis were conducted. The ordinal alpha was examined. Test-retest reliability was evaluated in a sub-sample (n = 159). Convergent validity was assessed by conducting correlation analyses between the DOS-BR and other theoretically related tools (EAT-26 and OCI-R) within the sub-sample. RESULTS: A three-factor structure was revealed for the DOS-BR properly fitted (KMO = 0.787). The test showed good internal consistency with an ordinal alpha of 0.795, and it also had excellent test-retest reliability of 0.776. DOS-BR median score was 17 (14-22) in Measurement 1 and 19 (17-22) in Measurement 2. The total score had a positive and moderate correlation with eating disorders symptoms (0.488) and a positive and weak correlation with obsessive-compulsive symptoms (0.224). CONCLUSION: The DOS-BR was culturally and psychometrically adequate for the samples of Brazilian Nutrition-related subjects. The tool is indicated as a reliable alternative to evaluate orthorexia nervosa in Brazilian scenery. LEVEL OF EVIDENCE: Descriptive (cross-sectional) study, Level V.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Nutricionistas , Estudios Transversales , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Humanos , Reproducibilidad de los Resultados , Estudiantes , Encuestas y CuestionariosRESUMEN
BACKGROUND: Given the current worldwide epidemic of obesity, there is a demand for interventions with higher impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of intervention performed according to the stages of change of the transtheoretical model (TTM) for weight management. METHODS: This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education. The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The intervention group (IG, n = 51) received the same orientation as the comparison group (CG, n = 35) plus individual health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance (ANCOVA) used to assess intervention effectiveness. RESULTS: There was a difference between groups of - 1.4 kg (CI95%: - 2.5; - 0.3) in body weight after the intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood glucose results compared to the CG during follow-up. CONCLUSION: The individualized TTM-based intervention, combined with usual care, was an effective strategy in PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify additional strategies is needed to address barriers to weight maintenance among obese low-income women. TRIAL REGISTRATION: The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv, Registration date: 12/12/2017 (retrospectively registered).
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Ciencias Bioconductuales/métodos , Obesidad/terapia , Sobrepeso/terapia , Programas de Reducción de Peso/métodos , Adulto , Anciano , Índice de Masa Corporal , Brasil , Dieta , Ejercicio Físico , Terapia por Ejercicio/métodos , Femenino , Humanos , Persona de Mediana Edad , Obesidad/psicología , Sobrepeso/psicología , Educación del Paciente como Asunto/métodos , Pobreza , Atención Primaria de Salud , Resultado del Tratamiento , Pérdida de Peso , Adulto JovenRESUMEN
Transversal study conducted in a Human Milk Bank to evaluate the factors associated with the use of artificial nipples (pacifier and/or nursing bottle) among Brazilian infants. Analyses were performed using the χ2 test and logistic regression analysis. A total of 6017 nursing mothers were evaluated and the use of artificial nipples was reported by 31.3%. The chance of using artificial nipples was higher among infants whose mothers attended antenatal care in private hospitals [odds ratio (OR): 1.61, 95% confidence interval (CI) 1.21-2.14], born in maternities without the Baby-Friendly Hospital Initiative (BFHI) (OR: 18.38, 95% CI 13.50-25.04) and those with adequate birth weight (OR: 2.83, 95% CI 1.99-4.03). A lower chance of using artificial nipples was observed among infants whose mothers had previous breastfeeding experience (OR: 0.76, 95% CI 0.61-0.95), received guidance on breastfeeding during antenatal care (OR: 0.80, 95% CI 0.65-0.98), practiced exclusive breastfeeding (OR: 0.36, 95% CI 0.28-0.45), breastfeeding on demand (OR: 0.66, 95% CI 0.52-0.85) and residents of inland cities/towns (OR: 0.38, 95% CI 0.20-0.72). The findings highlight the importance of breastfeeding guidance during antenatal care and the role of BFHI in clarifying risks associated with artificial nipple use.
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Lactancia Materna , Cuidado del Lactante/estadística & datos numéricos , Pezones , Chupetes , Adulto , Alimentación con Biberón , Brasil , Salud Infantil , Femenino , Humanos , Lactante , Relaciones Madre-Hijo , Embarazo , Atención PrenatalRESUMEN
BACKGROUND: Previous studies have demonstrated the analgesic effects of ginger in different conditions, but evidence about its efficacy in migraine treatment is scarce. OBJECTIVE: This study aimed to evaluate the potential of ginger to improve acute migraine as an add-on strategy to standard treatment. METHODS: A double-blind placebo-controlled randomized clinical trial in the emergency room of a general hospital was conducted. Patients who sought medical care at the time of migraine attack were enrolled in this study. Only adults with episodic migraine (one to six migraine attacks per month) with or without aura were included. Sixty participants were randomized into two groups in which they received 400 mg of ginger extract (5% active ingredient) or placebo (cellulose), in addition to an intravenous drug (100 mg of ketoprofen) to treat the migraine attack. Patients filled a headache diary before, 0.5 h, 1 h, 1.5 h and 2 h after the medication. Pain severity, functional status, migraine symptoms and treatment satisfaction were also recorded. RESULTS: Patients treated with ginger showed significantly better clinical response after 1 h ( p = 0.04), 1.5 h ( p = 0.01) and 2 h ( p = 0.04). Furthermore, ginger treatment promoted reduction in pain and improvement on functional status at all times assessed. CONCLUSIONS: The addition of ginger to non-steroidal anti-inflammatory drugs may contribute to the treatment of migraine attack. This trial is registered at ClinicalTrials.gov (NCT02568644).
Asunto(s)
Analgésicos/uso terapéutico , Trastornos Migrañosos/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Zingiber officinale , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Método Doble Ciego , Quimioterapia Combinada/métodos , Femenino , Humanos , Cetoprofeno/uso terapéutico , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: Food practices in the early years of life are important to form healthy eating habits; therefore, it is essential for the caregivers of infants to receive appropriate guidance. The present study aimed to investigate the effectiveness of different nutritional interventions on complementary feeding practices in municipal nurseries. DESIGN: Non-randomized controlled intervention study with education professionals and parents of infants (<2 years). Participants were divided into: control group (CG), standard food and nutrition education in writing; and intervention group (IG), the same information as the CG and face-to-face meetings (professionals, 8 h; parents, 5 h). Changes in professionals' knowledge on the subject and alterations in parents' beliefs, attitudes and intentions were assessed using questionnaires before and after the educational activities. SETTING: Ten public nurseries in Nova Lima, Belo Horizonte, Minas Gerais, Brazil, 2015. SUBJECTS: Ninety professionals (fifty in CG; forty in IG) and 169 parents (ninety-seven in CG; seventy-two in IG). RESULTS: After the intervention, there was a significant increase in the mean number of correct responses given by professionals in the IG (12·2 v. 10·7; P=0·001). In addition, there were improvements among the parents of the IG in relation to beliefs (soups and broths do not nourish my child: P=0·012), attitudes (offer meat from the sixth month: P=0·032) and intentions (do not offer soups and broths: P=0·003; offer vegetables: P=0·018; offer meat: P<0·001). CONCLUSIONS: Face-to-face nutritional intervention had a significantly greater effect on the parameters evaluated, indicating the importance of adequate guidance in childcare services to support the introduction of complementary feeding.
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Cuidadores/educación , Dieta Saludable/psicología , Conducta Alimentaria/psicología , Promoción de la Salud/métodos , Padres/educación , Brasil , Lactancia Materna/psicología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Masculino , Casas Cuna , Evaluación de Programas y Proyectos de SaludRESUMEN
The present study aimed to evaluate the dietary quality maintained among 113 overweight [body mass index (BMI) > or =25.0 kg/m2] women aged > or =20 years, who were enrolled in a Brazilian primary healthcare service in 2009. Dietary quality was evaluated using the Healthy Eating Index (HEI)-1995, which was adapted in the Brazilian context. Statistical analysis included linear regression adjusted by self-reporting energy intake. The prevalence of obesity (BMI > or = 30.0 kg/m2), elevated waist-circumference, and excessive body-fat were 85.8%, 98.2%, and 100% respectively. Data on dietary quality indicated an HEI score of 66.6 (11.3), with low mean scores for 'milk and dairy products' (2.6) and 'vegetables' (3.1). The calcium (beta=0.40) and vitamin C (beta=0.27) intake was positively associated with the HEI score. Fat (13 = -0.38) and sodium (beta = -0.21) intake and protein adequacy (beta = -18.17) were inversely associated with the dietary quality. We found that the dietary quality in this study population needs improvement, demonstrating the importance of nutritional counselling within the primary healthcare service.
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Dieta , Sobrepeso/fisiopatología , Atención Primaria de Salud , Salud de la Mujer , Adulto , Composición Corporal , Índice de Masa Corporal , Brasil/epidemiología , Calcio de la Dieta/administración & dosificación , Ingestión de Energía , Femenino , Humanos , Persona de Mediana Edad , Obesidad/epidemiología , Sobrepeso/terapia , Vitamina D/administración & dosificación , Circunferencia de la CinturaRESUMEN
This study aimed to describe the distribution of waist-to-height ratio (WHtR) percentiles and cutoffs for obesity in Brazilian adolescents. A cross-sectional study including adolescents aged 10 to 15 years was conducted in the city of São Paulo, Brazil; anthropometric measurements (weight, height, and waist-circumference) were taken, and WHtRs were calculated and then divided into percentiles derived by using Least Median of Squares (LMS) regression. The receiver operating characteristic (ROC) curve was used in determining cutoffs for obesity (BMI ≥ 97th percentile) and Mann-Whitney and Kruskal-Wallis tests were used for comparing variables. The study included 8,019 adolescents from 43 schools, of whom 54.5% were female, and 74.8% attended public schools. Boys had higher mean WHtR than girls (0.45 ± 0.06 vs 0.44 ± 0.05; p=0.002) and higher WHtR at the 95th percentile (0.56 vs 0.54; p<0.05). The WHtR cutoffs according to the WHO criteria ranged from 0.467 to 0.506 and 0.463 to 0.496 among girls and boys respectively, with high sensitivity (82.8-95%) and specificity (84-95.5%). The WHtR was significantly associated with body adiposity measured by BMI. Its age-specific percentiles and cutoffs may be used as additional surrogate markers of central obesity and its co-morbidities.
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Obesidad Infantil/diagnóstico , Relación Cintura-Estatura , Adolescente , Antropometría , Estatura , Peso Corporal , Brasil , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Curva ROC , Valores de Referencia , Instituciones Académicas , Sensibilidad y Especificidad , Distribución por Sexo , Circunferencia de la CinturaRESUMEN
OBJETIVE: To evaluate the planning, production, distribution, and nutritional adequacy of meals served at city schools. METHODS: This descriptive cross-sectional study was conducted between March 2011 and April 2012 and included a representative sample (n = 42 schools) of extended shift city schools from Belo Horizonte, Minas Gerais, Brazil. Five meals from each school were randomly selected and analyzed by direct weighing. Production indicators and nutritional adequacy were evaluated in contrast to the recommendations of the city food security bureau and the Brazilian National Program of School Meals (PNAE). RESULTS: Seventy-nine percent of the analyzed meals did not meet the recommendations of the city food security bureau. The rate of waste (food left on plates) was acceptable at 4,90%, but the rates of cooked and not served food (7,06%) and counter leftovers (5,30%) were high. Both the city planned meals and the meals served in the schools were nutritionally inadequate in terms of the PNAE, particularly for children aged 11-15 years. There was a relationship between consumption by school staff and the amount of food that was cooked (r = 0.353; P < 0.001) and the rate of cooked and not served food (r = 0.138; P = 0.045). Waste was positively correlated with the rate of counter leftovers (r = 0.145; P = 0.035), and inversely correlated with fiber intake (r = -0.143; P = 0.038). CONCLUSIONS: The results indicate the importance of monitoring the planning, production, and distribution of school meals and of food and nutrition education in order to improve the quality of food and to reduce waste in schools.
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Servicios de Alimentación/organización & administración , Servicios de Alimentación/normas , Necesidades Nutricionales , Instituciones Académicas , Adolescente , Brasil , Niño , Estudios Transversales , Humanos , Política NutricionalRESUMEN
In pregnant women, the Energy-adjusted Dietary Inflammatory Index (E-DII) is adopted to measure the inflammatory potential of the diet, but it does not predict the quality of the diet. Our hypothesis is that a more pro-inflammatory diet during pregnancy is also a poorer quality diet. Thus, the objective of this study is to verify the association of the E-DII with the Diet Quality Index Adapted for Pregnancy (DQI-P) and the nutrient intake from the diet in terms of the second and third gestational trimesters. This is a cross-sectional study that took place in Brazil (2018-2019), with eligible adult women up to 72 hours' postpartum and in good health. Socioeconomic, gestational, anthropometric, and food consumption data were collected, enabling the calculation of E-DII, DQI-P, and nutrient intake. The sample (n = 260) had a median E-DII of 0.04 (-1.30 to 1.90) and DQI-P of 68.82 (18.82-98.22). There was no relevant difference between E-DII tertiles by sociodemographic, gestational, and anthropometric characteristics. The E-DII and the DQI-P showed agreement (55.7%) and inverse correlation (r = -0.53; P < .001). Each 1-unit increase in DQI-P, iron, iodine, magnesium, pyridoxine, and vitamin E decreased the E-DII score (P < .05). An increase of 1 unit in protein, saturated fatty acids, and vitamin C increased the E-DII score (P < .05). Thus, the results suggest that the E-DII can predict diet quality during pregnancy, with the added benefit of measuring the inflammatory potential of the diet.
Asunto(s)
Dieta , Inflamación , Humanos , Femenino , Embarazo , Estudios Transversales , Adulto , Brasil , Adulto Joven , Ingestión de Energía , Fenómenos Fisiologicos Nutricionales MaternosRESUMEN
Based on previous studies, we hypothesized that the dietary inflammatory potential in pregnant women might influence maternal and child health. The objective of this work is to review the literature on the association of Dietary Inflammatory Index (DII) during pregnancy with early and late maternal and child health outcomes. We searched Cochrane, Embase, PubMed, Scopus, Web of Science, and the Virtual Health Library. Observational studies on DII in the gestational period that met the objective of this review were selected. There was a double-blind evaluation of 185 studies, of which 16 were included in narrative synthesis and 9 in meta-analysis. High methodological quality, longitudinal studies (87.5%) and the Food Frequency Questionnaire for DII evaluation (68.8%) prevailed. Outcomes studied were gestational diabetes mellitus (n = 5), gestational age at delivery (n = 7), type of delivery (n = 3), gestational weight gain or pregestational body mass index (n = 11), and anthropometry at birth (n = 8) and of the child up to age 10 years (n = 4). Higher maternal DII was associated with increased risk of small-for-gestational-age babies (odds radio, 1.15; 95% confidence interval, 1.08-1.21; I2, 29%; P = .24) and low birth weight (<2.500 g) (odds ratio, 1.16; 95% confidence interval, 1.06-1.26; I2, 56%; P = .10). The association between higher maternal DII and higher risk of obesity in late childhood is also suggestive. Thus, maternal diet may be a modifiable factor of inflammation in pregnancy associated with health outcomes of the offspring.
Asunto(s)
Diabetes Gestacional , Obesidad , Recién Nacido , Humanos , Niño , Embarazo , Femenino , Peso al Nacer , Obesidad/complicaciones , Dieta , Antropometría , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Objectives: Evaluate the protective factors associated with early initiation of breastfeeding. Methods: Cross-sectional study conducted with Brazilian nursing mothers. Breastfeeding in the first hour of life and difficulty initiating breastfeeding in the birth room were adopted as outcome variables and associated with other maternal and child information. Poisson regression was conducted to synthesize the data. Results: Among 104 nursing mothers evaluated, 56.7% reported breastfeeding in the first hour of life and 43% had difficulty initiating breastfeeding in the birth room. There was a higher prevalence of breastfeeding in the first hour of life among mothers with previous breastfeeding experience (PR = 1.47, 95% CI 1.04-2.07). Difficulty initiating breastfeeding in the birth room was more prevalent among mothers who did not receive breastfeeding guidance during antenatal care (PR = 2.83, 95% CI 1.43-4.32) and those without previous breastfeeding experience (PR = 2.49, 95% CI 1.24-6.45). Conclusion: These findings highlight the importance of adequate professional guidance, especially for primiparous mothers.
RESUMEN
Introduction: Migraine is a common and disabling primary headache, and its pathophysiology is not fully understood. Previous studies have suggested that pain can increase humans' Resting Energy Expenditure (REE). However, no previous study has investigated whether the REE of individuals with migraine differs from the general population. Therefore, this study aims to assess whether the REE of women with migraine differs from that of women without headaches. We also tested the accuracy of REE predictive formulas in the migraine patients. Methods: This cross-sectional study involves 131 adult women aged between 18 and 65 years, 83 with migraine and 48 without (controls). We collected clinical, demographic, and anthropometric data. Migraine severity was measured using the Migraine Disability Test and Headache Impact Test, version 6. The REE was measured by indirect calorimetry, and it was compared with the predicted REE calculated by formulas. Results: Patients with migraine had higher REE when compared to controls (p < 0.01). There was a positive correlation between REE and the patient-reported number of migraine attacks per month (Rho = 0.226; p = 0.044). Mifflin-St Jeor and Henry and Rees were the predictive formulas that have more accuracy in predicting REE in women with migraine. Discussion: Considering the benefits of nutritional interventions on treating migraines, accurately measuring REE can positively impact migraine patient care. This study enhances our understanding of the relationship between pain and energy expenditure. Our results also provide valuable insights for healthcare professionals in selecting the most effective predictive formula to calculate energy expenditure in patients with migraine.