The association of dietary glycaemic index and glycaemic load with gestational weight gain and newborn birth weight.

Diet during pregnancy is related to several maternal and infant health outcomes; however, the relationship between maternal dietary glycaemic index (GI) and glycaemic load (GL) and gestational weight gain (GWG) or newborn birth weight is controversial. The purpose of the present study was to investigate the relationship between maternal dietary GI and GL and GWG and birth weight. A cohort of adult pregnant women with usual obstetric risk was followed in Botucatu, SP, Brazil. Two 24-h dietary recalls were collected in each gestational trimester (<14, 24-27, 31-34 weeks), one in person and the other by telephone. GI and GL were determined using the software Nutrition Data System for Research. GWG was obtained from medical records and evaluated as the weekly GWG between the second and third gestational trimesters. Newborn birth weight z-score in relation to gestational age was evaluated according to Intergrowth-21st Project recommendations. A multiple linear regression model, adjusted for potential confounders, showed a one-point increase in the GI resulted in a mean decrease of 12·9 (95 % CI -21·48, -4·24) g in weekly GWG; GL was not associated with this outcome. The birth weight z-score was not associated with GI (P = 0·763) or GL (P = 0·317). In conclusion, in a cohort of pregnant women considered at usual risk for obstetric complications, maternal dietary GI was negatively associated with weekly GWG in the second and third gestational trimesters. No association was observed between GL and GWG, and neither GI nor GL was associated with birth weight z-score.

Clinical Implementation of a Noninvasive, Multi-Analyte Droplet Digital PCR Test to Screen for Androgen Receptor Alterations.

Alterations of the androgen receptor (AR) are associated with resistance to AR-directed therapy in prostate cancer. Thus, it is crucial to develop robust detection methods for AR alterations as predictive biomarkers to enable applicability in clinical practice. We designed and validated five multiplex droplet digital PCR assays for reliable detection of 12 AR targets including AR amplification, AR splice variant 7, and 10 AR hotspot mutations, as well as AR and KLK3 gene expression from plasma-derived cell-free DNA and cell-free RNA. The assays demonstrated excellent analytical sensitivity and specificity ranging from 95% to 100% (95% CI, 75% to 100%). Intrarun and interrun variation analyses revealed a high level of repeatability and reproducibility. The developed assays were applied further in peripheral blood samples from 77 patients with advanced prostate cancer to assess their feasibility in a real-world scenario. Optimizing the reverse transcription of RNA increased the yield of plasma-derived cell-free RNA by 30-fold. Among 23 patients with castration-resistant prostate cancer, 6 patients (26.1%) had one or a combination of several AR alterations, whereas only 2 of 54 patients (3.7%) in the hormone-sensitive stage showed AR alterations. These findings were consistent with other studies and suggest that implementation of comprehensive AR status detection in clinical practice is feasible and can support the treatment decision-making process.

The tendency of stunting among children under five in the Northern Region of Brazil, according to the Food and Nutrition Surveillance System, 2008-2017.

OBJECTIVE: To analyze the temporal tendency of stunting prevalence among children under five years of age registered in the Food and Nutritional Surveillance System (SISVAN) in the Brazilian Northern Region, from 2008 to 2017. METHODS: Ecological time-series study with data from SISVAN. The annual variation rate for the prevalence of undernutrition, measured by the presence of stunting (low height-for-age index), was estimated for the Northern Region and for each of its states using the Prais-Winsten regression model with and without variable adjustment for SISVAN coverage to explore the relationship between these variables. RESULTS: The Northern Region showed a tendency toward the reduction of chronic child stunting, with an annual variation of -5.30% (95%CI -9.64; -0.77) in the period studied. The states of Acre (-7.19%; 95%CI -12.31; -1.77), Pará (-4.86%; 95%CI -9.44; -0.03), and Tocantins (-6.22%; 95%CI -9.88; -2.41) showed a tendency to reduce the prevalence of stunting, while the other four states showed stability during the period. A strong negative correlation was found between SISVAN coverage and the prevalence of stunting in the states of Acre (beta: -0.725), Amazonas (beta: -0.874), Pará (beta: -0.841), and Tocantins (beta: -0.871), indicating that the increase in system coverage is associated with a reduction of stunting. CONCLUSIONS: There is a tendency toward a reduction in the prevalence of stunting particularly in three states and in the North Region as a whole, from 2008 to 2017. The coverage by the system was associated with a reduction in the prevalence of child stunting in four states.

Frequency of anthropometric implausible values estimated from different methodologies: a systematic review and meta-analysis.

CONTEXT: Poor anthropometric data quality affect the prevalence of malnutrition and could harm public policy planning. OBJECTIVE: This systematic review and meta-analysis was designed to identify different methods to evaluate and clean anthropometric data, and to calculate the frequency of implausible values for weight and height obtained from these methodologies. DATA SOURCES: Studies about anthropometric data quality and/or anthropometric data cleaning were searched for in the MEDLINE, LILACS, SciELO, Embase, Scopus, Web of Science, and Google Scholar databases in October 2020 and updated in January 2023. In addition, references of included studies were searched for the identification of potentially eligible studies. DATA EXTRACTION: Paired researchers selected studies, extracted data, and critically appraised the selected publications. DATA ANALYSIS: Meta-analysis of the frequency of implausible values and 95% confidence interval (CI) was estimated. Heterogeneity (I2) and publication bias were examined by meta-regression and funnel plot, respectively. RESULTS: In the qualitative synthesis, 123 reports from 104 studies were included, and in the quantitative synthesis, 23 studies of weight and 14 studies of height were included. The study reports were published between 1980 and 2022. The frequency of implausible values for weight was 0.55% (95%CI, 0.29-0.91) and for height was 1.20% (95%CI, 0.44-2.33). Heterogeneity was not affected by the methodological quality score of the studies and publication bias was discarded. CONCLUSIONS: Height had twice the frequency of implausible values compared with weight. Using a set of indicators of quality to evaluate anthropometric data is better than using indicators singly. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020208977.

Food and Nutrition Surveillance System (SISVAN) coverage, nutritional status of older adults and its relationship with social inequalities in Brazil, 2008-2019: an ecological time-series study.

OBJECTIVE: to analyze the temporal trend of Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional - SISVAN) coverage and the nutritional status of older adults, and its correlation with indicators of social inequality in Brazil between 2008-2019. METHODS: this was an ecological study using records from SISVAN, related to the population aged 60 years and older; the temporal trend of coverage and the correlation between indicators of social inequality and increment rate of nutritional status were analyzed; slope index of inequality and concentration index were used to measure absolute and relative inequalities. RESULTS: 11,587,933 records were identified; national coverage increased from 0.1% (2008) to 2.9% (2019), with a statistically significant upward trend; a moderate inverse correlation with an annual increment rate of overweight between human development index and gross domestic product per capita, was found. CONCLUSION: there was an increasing trend in SISVAN coverage; the increase in overweight was associated with social inequality.

Temporal trend of Food and Nutrition Surveillance System coverage among children under 5 in the Northern Region of Brazil, 2008-2017. / Tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional entre crianças menores de 5 anos da região Norte do Brasil, 2008-2017.

Objective to analyze the temporal trend of Web Food and Nutrition Surveillance System (SISVAN Web) coverage of children under 5 years old in the Northern Region of Brazil between 2008-2017. Methods this was an ecological time series study with data from SISVAN Web; coverage annual percentage change (APC) was estimated using the Prais-Winsten regression model. Results SISVAN Web coverage in the Northern Region in 2008 and 2017 was 12.2% and 37.9%, respectively, with a rising trend (APC=14.2% - 95%CI 10.9;17.6); the states and health regions showed similar trends; Acre was the state with the highest APC (17.3% - 95%CI 13.6;21.1). Conclusion there was a rising trend in SISVAN Web coverage in the Northern Region as a whole, in all its states and in all its health regions.

The tendency of stunting among children under five in the Northern Region of Brazil, according to the Food and Nutrition Surveillance System, 2008-2017

Abstract Objective: To analyze the temporal tendency of stunting prevalence among children under five years of age registered in the Food and Nutritional Surveillance System (SISVAN) in the Brazilian Northern Region, from 2008 to 2017. Methods: Ecological time-series study with data from SISVAN. The annual variation rate for the prevalence of undernutrition, measured by the presence of stunting (low height-for-age index), was estimated for the Northern Region and for each of its states using the Prais-Winsten regression model with and without variable adjustment for SISVAN coverage to explore the relationship between these variables. Results: The Northern Region showed a tendency toward the reduction of chronic child stunting, with an annual variation of -5.30% (95%CI -9.64; -0.77) in the period studied. The states of Acre (-7.19%; 95%CI -12.31; -1.77), Pará (-4.86%; 95%CI -9.44; -0.03), and Tocantins (-6.22%; 95%CI -9.88; -2.41) showed a tendency to reduce the prevalence of stunting, while the other four states showed stability during the period. A strong negative correlation was found between SISVAN coverage and the prevalence of stunting in the states of Acre (beta: -0.725), Amazonas (beta: -0.874), Pará (beta: -0.841), and Tocantins (beta: -0.871), indicating that the increase in system coverage is associated with a reduction of stunting. Conclusions: There is a tendency toward a reduction in the prevalence of stunting particularly in three states and in the North Region as a whole, from 2008 to 2017. The coverage by the system was associated with a reduction in the prevalence of child stunting in four states.

Temporal trend in the nutritional status of children in a Brazilian metropolis in light of food and nutrition policies / Tendencia temporal en el estado nutricional de los niños en una metrópolis brasileña a la luz de las políticas de alimentación y nutrición

Introduction. Brazil's health system offers insights into addressing the double burden of malnutrition by proper population monitoring, coupled with local policies and national guidelines. Objective. To investigate the recent temporal trends in nutritional status indicators and its coverage of children aged two to five years from Campinas, a metropolis in the state of São Paulo, Brazil. Material and methods. The analysis of time series from 2018 to 2022 were conducted by accessing data from the Brazilian Food and Nutrition Surveillance System (SISVAN) due to regression analysis. Results. The number of children aged two to five in the SISVAN registry rose from 7,300 in 2018 to 11,171 in 2022, forming the study sample. In 2018, 700 were chronically undernourished, 306 underweight, and 977 overweight; by 2022, 530 showed stunting, 457 were underweight, and 1,084 overweight. Stunting prevalence declined from 9.6% (2018) to 4.7% (2022). Underweight dropped slightly from 4.2% to 4.1% over the years and overweight, consistently the highest indicator, ranged from 13.4% (2018) to 9.7% (2022). SISVAN's coverage varied between 16.6% (2018) and 26.1% (2022), the lowest at 12.3% in 2020. The trend for stunting decreased significantly (APV: -15.01; CI95% -22.64; -6.62). Adding SISVAN's coverage variable the model slightly reduced the declining stunting trend (APV: -12.12; CI95% -13.19; -11.04). Conclusions. Coordinated efforts to address nutritional challenges, from adequate population monitoring to the interaction between local policies and national guidelines, have shown positive health outcomes(AU)

Introducción. El sistema de salud de Brasil ofrece conocimientos valiosos para abordar la doble carga de malnutrición mediante el seguimiento adecuado de la población y políticas locales y nacionales. Objetivo. Investigar las tendencias temporales recientes en indicadores nutricionales y cobertura en niños de dos a cinco años en Campinas, São Paulo, Brasil. Materiales y métodos. Se analizaron datos del SISVAN de 2018 a 2022 con regresión temporal. Resultados. Niños de dos a cinco años en el SISVAN pasaron de 7,300 en 2018 a 11,171 en 2022. En 2018, 700 estaban crónicamente desnutridos, 306 con bajo peso y 977 con sobrepeso; en 2022, 530 con retraso en el crecimiento, 457 con bajo peso y 1,084 con sobrepeso. La prevalencia del retraso en el crecimiento bajó de 9,6% a 4,7%. El bajo peso disminuyó levemente del 4,2% al 4,1% y el sobrepeso osciló del 13,4% al 9,7%. La cobertura de SISVAN varió de 16.6% a 26.1%, con un mínimo de 12.3% en 2020. La tendencia del retraso en el crecimiento disminuyó significativamente (APV: -15.01; CI95% -22.64; -6.62). La inclusión de la cobertura de SISVAN redujo levemente esta tendencia (APV: -12.12; CI95% -13.19; -11.04). Conclusiones. Coordinar esfuerzos para abordar los desafíos nutricionales, desde el seguimiento de la población hasta políticas locales y nacionales, ha tenido resultados positivos para la salud(AU)

Cobertura do Sistema de Vigilância Alimentar e Nutricional (SISVAN), estado nutricional de idosos e sua relação com desigualdades sociais no Brasil, 2008-2019: estudo ecológico de série temporal / Cobertura del Sistema de Vigilancia Alimentaria y Nutricional (SISVAN), estado nutricional de los ancianos y su relación con las desigualdades sociales en Brasil, 2008-2019: un estudio de serie temporal ecológica / Food and Nutrition Surveillance System (SISVAN) coverage, nutritional status of older adults and its relationship with social inequalities in Brazil, 2008-2019: an ecological time-series study

Objective: to analyze the temporal trend of Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional - SISVAN) coverage and the nutritional status of older adults, and its correlation with indicators of social inequality in Brazil between 2008-2019. Methods: this was an ecological study using records from SISVAN, related to the population aged 60 years and older; the temporal trend of coverage and the correlation between indicators of social inequality and increment rate of nutritional status were analyzed; slope index of inequality and concentration index were used to measure absolute and relative inequalities. Results: 11,587,933 records were identified; national coverage increased from 0.1% (2008) to 2.9% (2019), with a statistically significant upward trend; a moderate inverse correlation with an annual increment rate of overweight between human development index and gross domestic product per capita, was found. Conclusion: there was an increasing trend in SISVAN coverage; the increase in overweight was associated with social inequality.

Objetivo: analizar la tendencia temporal de cobertura del Sistema de Vigilancia Alimentaria y Nutricional (SISVAN), y el estado nutricional de adultos mayores, correlacionándolos con indicadores de desigualdad social, en el período 2008-2019. Métodos: estudio ecológico mediante registros del SISVAN sobre la población ≥60 años. Se realizaron análisis de correlación entre indicadores de desigualdad social y la tasa de incremento del estado nutricional y análisis de desigualdades absolutas y relativas para obtener el índice de desigualdad angular y el índice de concentración. Resultados: se identificaron 11.587.933 registros. La cobertura nacional evolucionó del 0,1% en 2008 al 2,9% en 2019, con una tendencia ascendente estadísticamente significativa. Se encontró una correlación inversa moderada con la tasa de incremento anual de sobrepeso para IDH y PIB per cápita. Conclusión: hubo una tendencia de crecimiento en la cobertura del SISVAN. El aumento del sobrepeso se asoció con la desigualdad social.

Objetivo: analisar a tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional (SISVAN) e do estado nutricional de idosos, e sua correlação com indicadores de desigualdade social no Brasil, no período 2008-2019. Métodos: estudo ecológico, sobre registros do SISVAN relativos à população na idade de 60 anos ou mais; analisaram-se a tendência temporal da cobertura e a correlação entre indicadores de desigualdade social e taxa de incremento do estado nutricional; os índices angular e de concentração foram utilizados para medir desigualdades absolutas e relativas. Resultados: foram identificados 11.587.933 registros de idosos; a cobertura nacional evoluiu de 0,1% (2008) para 2,9% (2019), com tendência de aumento estatisticamente significativa; foi encontrada correlação inversa moderada com taxa de incremento anual de sobrepeso, para índice de desenvolvimento humano e produto interno bruto per capita. Conclusão: houve tendência de crescimento da cobertura do SISVAN; o aumento de sobrepeso esteve associado à desigualdade social.

Tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional entre crianças menores de 5 anos da região Norte do Brasil, 2008-2017 / Tendencia temporal de la cobertura del Sistema de Vigilancia Alimentaria y Nutricional entre niños menores de 5 años de la Región Norte de Brasil, 2008-2017 / Temporal trend of Food and Nutrition Surveillance System coverage among children under 5 in the Northern Region of Brazil, 2008-2017

Objetivo: analisar a tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional Web (Sisvan Web) em menores de 5 anos de idade da região Norte brasileira, no período de 2008 a 2017. Métodos: estudo ecológico de séries temporais, com dados do Sisvan Web; a variação percentual anual (VPA) da cobertura do sistema foi estimada pelo modelo de regressão de Prais-Winsten. Resultados: na região Norte, as coberturas do SISVAN Web em 2008 e 2017 foram de 12,2% e 37,9%, respectivamente, com tendência crescente (VPA=14,2% - IC95% 10,9;17,6); os estados da região e respectivas regionais de saúde apresentaram tendências semelhantes; o Acre foi o estado que apresentou maior VPA (17,3% - IC95% 13,6;21,1). Conclusão: houve tendência crescente da cobertura do Sisvan Web na região Norte do país, assim como em todos os seus estados e regionais de saúde.

Objetivo: analizar la tendencia temporal de la cobertura del Sistema de Vigilancia Alimentaria y Nutricional (SISVAN Web) en niños menores de 5 años en la Región Norte de Brasil entre 2008-2017. Métodos: estudio ecológico de series temporales con datos del SISVAN Web; el porcentaje de variación anual (PVA) de cobertura se estimó mediante el modelo de regresión de Prais-Winsten. Resultados: en la Región Norte, la cobertura del SISVAN Web en 2008 y 2017 fue de 12,2% y 37,9%, respectivamente, con una tendencia creciente (PVA=14,2% - IC95% 10,9;17,6); los Estados y las Regionales de Salud presentaron resultados similares; Acre fue el Estado con el PVA más alto (17,3% - IC95% 13,6;21,1). Conclusión: hubo una tendencia creciente en la cobertura del SISVAN Web en todos los Estados y Regionales de Salud de la Región Norte entre 2008 y 2017.

Objective: to analyze the temporal trend of Web Food and Nutrition Surveillance System (SISVAN Web) coverage of children under 5 years old in the Northern Region of Brazil between 2008-2017. Methods: this was an ecological time series study with data from SISVAN Web; coverage annual percentage change (APC) was estimated using the Prais-Winsten regression model. Results: SISVAN Web coverage in the Northern Region in 2008 and 2017 was 12.2% and 37.9%, respectively, with a rising trend (APC=14.2% - 95%CI 10.9;17.6); the states and health regions showed similar trends; Acre was the state with the highest APC (17.3% - 95%CI 13.6;21.1). Conclusion: there was a rising trend in SISVAN Web coverage in the Northern Region as a whole, in all its states and in all its health regions.

Aceleração do crescimento entre crianças e adolescentes de populações multiétnicas e suas evidências / Accelerating growth among children and adolescents of multiethnic populations and their evidence

Introdução: Déficits de altura-para-idade (DAI) descrevem falhas no crescimento da criança e estão associados a condições de saúde e socioeconômicas. Evidências sugerem que intervenções durante os primeiros 1000 dias de vida são mais efetivas para reduzir a carga global de DAI. Entretanto, há evidências de recuperação do DAI após este período, fenômeno chamado de catch-up growth (CUG). O CUG descreve um rápido crescimento linear que permite o indivíduo acelerar para e, em condições favoráveis, voltar a sua curva de crescimento pré-doença. Contudo, não há uniformidade na definição operacional de CUG e existem divergências acerca do melhor mensurador do CUG, fator decisivo nas conclusões sobre o tema. Objetivos: Analisar evidências de crescimento acelerado entre crianças e adolescentes de populações multiétnicas utilizando distintas formas de mensuração e caracterizar aspectos epidemiológicos do CUG. Métodos: Utilizaram-se bases de dados de populações multiétnicas. Medidas de altura foram convertidas em escore-z a partir do padrão e referência OMS (2006/07). O CUG foi avaliado pelo escore-z altura-para-idade (HAZ) e pela diferença altura-para-idade (HAD), em centímetros, por meio da variação destes índices e pela canalização do crescimento, utilizando três valores de amplitude de canal (0,67, 0,75 e 0,86 desvio-padrão), assim como pela recuperação do DAI inicial. Os efeitos dos fatores associados ao crescimento sobre o CUG foram estimados em modelos de regressão de Poisson e análise multinível. Entre as variáveis independentes configuraram características socioeconômicas, maternas e da criança e variável contextual indicando o nível de desenvolvimento do país. Resultados: Nas coortes Young Lives e nas Filipinas o HAZ declinou nas idades iniciais e aumentou até o último seguimento. O HAD, contudo, indicou aumento do déficit de altura até o último acompanhamento. Em São Paulo e na Grã-Bretanha ambos índices apresentaram incremento entre os períodos inicial e final, indicando melhoria do estado nutricional. Houve desigualdade de ambos indicadores entre os estratos socioeconômicos. Maiores prevalências de DAI ocorreram nos países menos desenvolvidos, em áreas rurais, em domicílios sem acesso a saneamento e em indivíduos com baixo peso ao nascer, episódios de diarreia na infância e cujas mães possuíam baixa estatura e menor escolaridade; houve relação dose-resposta com o quinto de renda. Houve substancial recuperação do DAI em todos países, com maiores taxas nos mais desenvolvidos. A incidência de CUG a cada cinco anos variou de 7,9% a 15,4% entre 1 e 12 anos de idade e foi 1% nas Filipinas entre 0 e 19 anos. Em todos os estudos, o grupo com DAI inicial obteve as maiores incidências. A maior parte dos indivíduos que se recuperaram do DAI inicial apresentaram crescimento acelerado considerando os três limites de canalização. O número de eventos de CUG durante a trajetória de crescimento foi o principal determinante da ocorrência de CUG final e recuperação do DAI, bem como o grau de DAI inicial e o estrato socioeconômico. Os efeitos randômicos sobre estes desfechos variaram em torno de 9%. Conclusões: Os resultados indicam potencial para o CUG e recuperação do DAI. O uso de distintos mensuradores levou a interpretações divergentes acerca da ocorrência de CUG

Introduction: Height-for-age déficits (stunting) describe failures in child growth and are associated with health and socioeconomic conditions. Evidence suggests that interventions during the first 1000 days of life are more effective in reducing the overall burden of stunting. However, there is evidence of recovery of stunting after this period, a phenomenon called catch-up growth (CUG). CUG describes a rapid linear growth that allows the individual to accelerate to and, under favorable conditions, return to their pre-disease growth curve. However, there is no uniformity in the operational definition of CUG and there are disagreements about the best CUG measurer, a decisive factor in the conclusions about the subject. Objectives: To analyze evidence of accelerated growth among children and adolescents of multiethnic populations using different forms of measurement and to characterize the epidemiological aspects of CUG. Methods: Databases of multiethnic populations were used. Height measurements were converted to z-score from the WHO standard and reference (2006/07). The CUG was evaluated by height-for-age z-score (HAZ) and height-for-age difference (HAD), in centimeters, by variation of these indices and by canalisation of growth, using three values of amplitude (0.67, 0.75 and 0.86 standard deviation), as well as by recovery of the initial stunting. The effects of growth-related factors on CUG were estimated in Poisson regression models and multilevel analysis. Among the independent variables configured socioeconomic, maternal and child characteristics and a contextual variable indicating the level of development of the country. Results: In the Young Lives Cohorts and in the Philippines HAZ declined in the early ages and increased until the last follow-up. HAD, however, indicated an increase in height deficit until the last follow up. In São Paulo and Great Britain, both indexes showed an increase between the initial and final periods, indicating an improvement in nutritional status. There was inequality of both indicators among the socioeconomic strata. Higher prevalence of stunting occurred in less developed countries, in rural areas, in households without access to sanitation, and in individuals with low birth weight, episodes of childhood diarrhea and whose mothers had short stature and lower schooling; there was a dose-response relationship with the income. There was a substantial recovery of stunting in all countries, with higher rates in the most developed. The incidence of CUG every five years ranged from 7.9% to 15.4% between 1 and 12 years of age and was 1% in the Philippines between 0 and 19 years. In all studies, the group with initial stunting had the highest incidence. Most of the individuals who recovered from the initial stunting presented accelerated growth considering the three canalisation limits. The number of CUG events during the growth trajectory was the main determinant of the occurrence of final CUG and recovery of the stunting, as well as the degree of initial stunting and the socioeconomic stratum. The random effects on these outcomes varied around 9%. Conclusions: The results indicate potential for CUG and recovery of stunting. The use of different measurers led to divergent interpretations regarding the occurrence of CUG