Neck circumference as a predictor of cardiometabolic risk and truncal obesity in people living with HIV.

Introduction: Introduction: recent studies have suggested the use of neck circumference as a parameter capable of identifying risks of cardiometabolic complications and the accumulation of truncal fat caused by both antiretroviral therapy and the lifestyle of people with the human immunodeficiency virus (HIV). Objective: to investigate the relationship between neck circumference and anthropometric indicators and to assess cardiometabolic risk and truncal obesity through proposed cut-off points. Methods: cross-sectional study including 233 people with HIV. Demographic, socioeconomic, lifestyle and clinical data were collected using a structured questionnaire. The anthropometric evaluation included: weight, height, body mass index (BMI) measurements; waist (WC), neck (NC), arm and arm muscle circumferences; triceps and subscapular skinfolds and their sum. ROC curves were constructed to determine the accuracy of NC in predicting cardiometabolic risk in people living with HIV. Results: the sample was 57.5 % male, with a mean age of 38.4 years (95 %CI: 37.2-39.7 years). NC showed a positive and significant correlation with all anthropometric variables analyzed (p < 0.05), and a higher correlation strength with WC and BMI. The NC cut-off point selected as a predictor of risk of cardiac metabolic complications and truncal obesity in women was ≥ 32.4 cm, considering both WC and BMI. For men, the NC cut-off points were different when considering WC (≥ 39.6 cm) and BMI (≥ 38.1 cm) as a reference. It is worth noting that NC performed well in ROC curve analysis for men, while in women it was a poor performance. Conclusion: NC proved to be a promising indicator in the assessment of nutrition and health of people living with HIV, especially in men.

Introducción: Introducción: estudios recientes han sugerido el uso de la circunferencia del cuello como parámetro capaz de identificar los riesgos de complicaciones cardiometabólicas y la acumulación de grasa troncal causados tanto por la terapia antirretroviral como por el estilo de vida de las personas con el virus de la inmunodeficiencia humana (VIH). Objetivo: investigar la relación entre la circunferencia del cuello y los indicadores antropométricos y evaluar el riesgo cardiometabólico y la obesidad troncal a través de los puntos de corte propuestos. Métodos: estudio transversal que incluyó a 233 personas con VIH. Se recogieron datos demográficos, socioeconómicos, de estilo de vida y clínicos mediante un cuestionario estructurado. La evaluación antropométrica incluyó: medidas de peso, altura, índice de masa corporal (IMC); circunferencias de cintura (CC), cuello (CN), brazo (CA) y músculo del brazo (MCB); pliegues cutáneos del tríceps y subescapular y su suma. Se construyeron curvas ROC para determinar la precisión de la CN en la predicción del riesgo cardiometabólico en personas que viven con el VIH. Resultados: el 57,5 % de la muestra eran varones, con una edad media de 38,4 años (IC 95 %: 37,2-39,7 años). La CN mostró una correlación positiva y significativa (p < 0,05) con todas las variables antropométricas analizadas, y una mayor fuerza de correlación con la CC y el IMC. El punto de corte de la CN seleccionado como predictor de riesgo de complicaciones metabólicas cardiacas y obesidad troncular en mujeres fue ≥ 32,4 cm, considerando tanto la CC como el IMC. En el caso de los hombres, los puntos de corte de la CN fueron diferentes al considerar como referencia la CC (≥ 39,6 cm) y el IMC (≥ 38,1 cm). Cabe destacar que la CN obtuvo buenos resultados en el análisis de la curva ROC en el caso de los hombres, mientras que en el de las mujeres fue deficiente. Conclusión: la CN demostró ser un indicador prometedor en la evaluación de la nutrición y la salud de las personas que viven con el VIH, especialmente en los hombres.

Lifestyle associated with risk of metabolic syndrome in adults and the elderly.

OBJECTIVES: The aim of this study was to analyze the association between at least one of the risk factors for metabolic syndrome and the lifestyle of adults and elderly individuals in Teresina, Piauí. METHODS: This was a cross-sectional, population-based study, with adults and elderly of both both sexes, living in Teresina, Piauí.. Data were collected using Epicollect 5 software (Imperial College London) in a mobile application (mobile). Pearson's χ2 test was used to assess the association between variables. The prevalence ratio (PR) was calculated, with a 95% confidence interval (95% CI), estimated by Poisson regression, to measure the strength of association between the study variables with the presence of at least one factor of risk for disease. The level of significance adopted was P < 0.05. RESULTS: The main habit as a protective factor for at least one risk factor for metabolic syndrome was the consumption of natural fruit juice once to three times a week (0.93), in addition to the current daily use of tobacco (raw and adjusted; 0.80) and irregularly active and active/very active physical activity level (0.86), which when adjusted increased to 0.89 in the latter activity level. The habit of drinking alcohol frequently/occasionally was 1.08 times more likely and when adjusted increased (1.10). CONCLUSIONS: The presence of at least one risk factor for this disease, according to lifestyle, deserves a warning for the population, as it is capable of harming health, especially at the level of cardiovascular impairment.

[Overweight and abdominal fat in adult population of Teresina, PI]. / Excesso de peso e adiposidade central em adultos de Teresina-PI.

OBJECTIVE: To determine prevalence of overweight and abdominal fat in adult population in the urban area of Teresina-PI. METHODS: Cross-sectional study with probabilistic sample by conglomerates. The study evaluated 464 adults, 20 to 59 years of age living in the urban area of Teresina-PI. Nutritional status was classified by the body mass index (BMI) and abdominal fat accumulation was estimated according to waist circumference. The significance level was set at 5% (p<0.05). RESULTS: Prevalence of overweight and obesity according to nutritional status based on BMI was, respectively, 30.0% and 7.7%. There was an increase in the proportion of overweight and obesity among men with progressively higher family income. Highest rates of obesity were found among individuals 50 to 59 years of age with stable marriages and nonsmokers. No association was found between individual or family income and presence of abdominal fat in the population. CONCLUSION: Prevalence of overweight in the study population follows the Brazilian trend. Proportions of overweight and obesity were higher among men and increased with age. Women and married persons showed a greater tendency for abdominal obesity.

Impact of intermittent fasting on body weight in overweight and obese individuals.

OBJECTIVE: To verify the relationship of intermittent fasting in the bodyweight of overweight and obese individuals through a systematic literature review. METHODS: This is a systematic review based on randomized controlled trials. The articles were consulted in the databases: Science Direct, PubMed e BVS. This review was evaluated through the PRISMA recommendation. RESULTS: After the selection process, four articles were included in this review, comparing intermittent fasting (IF) with calorie restriction diet (CRD) as a control group. In 2 studies using similar protocols, there was no significant reduction in body weight of overweight or obese subjects. In the other two studies using different protocols, weight loss was significant in the IF group compared to the CRD group. CONCLUSIONS: Results did not provide evidence of the effect of intermittent fasting on weight loss in overweight or obese individuals.

[Do children and adolescents who consume ultra-processed foods have a worse lipid profile? A systematic review]. / Crianças e adolescentes que consomem alimentos ultraprocessados possuem pior perfil lipídico? Uma revisão sistemática.

The increase in the input of ultra-processed ingredients in the food of children and adolescents is related to the development of noncommunicable diseases such as dyslipidemia. The scope of this study was to conduct a systematic review of the literature on the relationship of consumption of ultra-processed foods in the lipid profile of children and adolescents. A search in the PubMed, Scopus, Cochrane and LILACS databases was carried out to locate cross-sectional and longitudinal studies, with or without intervention, in apparently healthy children and/or adolescents, who had the intake of ultra-processed food as an exposure variable and the lipid profile as an outcome. After screening, 14 studies were included, of which nine demonstrated that ultra-processed food consumption was related to increased LDL-c, total cholesterol, triglycerides and a reduction in HDL-c. Three studies found no relationship and two demonstrated that the increased intake of ready-to-eat cereals was related to the decrease in total cholesterol and LDL-c. There was a high consumption of ultra-processed foods and positive relation with blood lipids among children and adolescents, which calls attention to interventions, such as nutritional education, with a view to reducing the intake of these foods.

O aumento da participação de alimentos ultraprocessados na alimentação de crianças e adolescentes está relacionado ao desenvolvimento de agravos não transmissíveis, como dislipidemia. Objetivou-se realizar uma revisão sistemática da literatura sobre a relação do consumo de alimentos ultraprocessados e o perfil lipídico de crianças e adolescentes. Realizou-se uma busca nas bases de dados PubMed, Scopus, Cochrane e LILACS por estudos com desenhos transversais e longitudinais, com ou sem intervenção; em crianças e/ou adolescentes aparentemente saudáveis, que tivessem a ingestão de alimento ultraprocessado como variável de exposição e o perfil lipídico como desfecho. Após triagem, 14 estudos foram incluídos, destes, nove demonstraram que o consumo de ultraprocessados estava relacionado com o aumento do LDL-c, colesterol total, triglicerídeos e diminuição do HDL-c. Três estudos não encontraram nenhuma relação e dois demonstraram que a maior ingestão de cereais prontos estava relacionada com a diminuição de colesterol total e LDL-c. Observou-se elevado consumo de alimentos ultraprocessados e relação positiva com lipídios sanguíneos em crianças e adolescentes o que chama atenção para a realização de intervenções, como educação nutricional, com vistas a reduzir a ingestão desses alimentos.

Effect of vitamin D3 supplementation on HIV-infected adults: a systematic reviewVitamin DÓ¡ Supplementation on HIV-Infected Adults: A Systematic Review.

INTRODUCTION: Introduction: much evidence confirms that vitamin D may be associated with an improvement in CD4 cell counts in HIV-infected individuals, where antiretroviral therapy (ART) is used and associated with decreased 25(OH)D levels. Objective: to carry out a systematic review on the effect of vitamin D supplementation on HIV-infected adult patients. Methods: the research was conducted in the databases Science Direct, PubMed, BVS, Scielo Cochrane and Periods, from February to April 2018, with publication limit from 2000 to 2018, without restriction of gender, ethnicity and involving individuals with age older than 18 years. To evaluate the quality of the studies, we used the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and the Jadad scale. Results: the search initially resulted in 198 articles. After the selection process 5 articles were identified as eligible, where they highlight that vitamin D supplementation may be an associated and effective intervention to reduce hypovitaminosis. ART reduces vitamin D3 levels and changes its metabolism, being associated with the risk of mortality. However, adequate levels of 25(OH)D are positively associated with the number of CD4 + cells and the reduction of infection levels. Conclusion: vitamin D supplementation promotes immune recovery. However, the cases analysed were few, insufficient to fully confirm the benefits and recommend supplementation. Therefore, intervention studies are needed to elucidate the role of vitamin D in human protection against HIV infections.

INTRODUCCIÓN: Introducción: muchas evidencias ratifican que la vitamina D puede estar asociada con la mejora de los niveles de células CD4 en individuos infectados por el VIH, tratados con terapia antirretroviral (ART) que se asocia a la disminución de los niveles de 25(OH)D. Objetivo: realizar una revisión sistemática sobre el efecto de la suplementación de vitamina D en pacientes adultos infectados con VIH. Métodos: la investigación fue realizada en las bases de datos Science Direct, PubMed, BVS, Scielo Cochrane y periódicos, de febrero a abril de 2018, con límite de publicación de 2000 a 2018, sin restricción de género, etnicidad y que involucra a individuos con edad mayores de 18 años. Para la evaluación de la calidad de los estudios, se utilizó el protocolo Preferred Reporting Items for Systematic Reviews y Meta-Analyzes (PRISMA) y la escala de Jadad. Resultados: la encuesta inicialmente resultó en 198 artículos. Después del proceso de selección, 5 artículos fueron identificados como elegibles, donde ponen de manifiesto que la suplementación con vitamina D puede ser una intervención asociada y eficaz para reducir la hipovitaminosis. La ART reduce niveles de la vitamina D3 y altera su metabolismo, estando asociada al riesgo de mortalidad. Sin embargo, los niveles adecuados de 25(OH)D están asociados positivamente al número de células CD4 + y la reducción de los niveles de infecciones. Conclusión: la suplementación de vitamina D promueve la recuperación inmunológica. Sin embargo, los casos analizados fueron pocos, insuficientes para confirmar totalmente los beneficios y recomendar la suplementación. Por lo tanto, estudios de intervención son necesarios para elucidar la actuación de la vitamina D en la protección humana contra las infecciones por el VIH.

Effect of vitamin D supplementation on patients with systemic lupus erythematosus: a systematic review.

The objective of this systematic review was to analyze clinical trials carried out for the investigation of the effect of vitamin D supplementation on systemic lupus erythematosus. The research was performed from August to September 2016, without limits regarding year of publication, restriction of gender, age, and ethnicity. For the guiding question, the PICO strategy was employed. To evaluate the quality of the publications the PRISMA protocol and Jadad scale were used. The risk of bias analysis of the clinical trials was performed using the Cochrane collaboration tool. After the process of article selection and removal of duplicates, four articles were identified as eligible. The results of three studies showed a positive effect of supplementation on disease activity reduction and significant improvement in levels of inflammatory markers, fatigue, and endothelial function. Only one study showed no improvement in disease activity after supplementation. Moreover, all studies showed an increase in serum vitamin D levels. The data from this review provide evidence on the benefits of vitamin D supplementation in patients with lupus and vitamin D insufficiency/deficiency. However, it is still necessary to elucidate whether vitamin D acts in the protection against this metabolic disorder, as well as the standardization of the type, dose and time of vitamin D supplementation.

Vitamin B12, bone mineral density and fracture risk in adults: A systematic review.

OBJECTIVE: To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans. METHOD: A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system. RESULTS: A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies. CONCLUSION: A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.

Inter-relação entre direito e alimentação: percepções de consumidores sobre seus direitos / Interrelations between law and food: consumer perceptions of their rights

A concretização do direito à alimentação saudável implica a necessidade de pesquisas acerca de mecanismos que favoreçam a construção de uma cultura apta a reforçar a adoção de atitudes positivas em prol dessa conquista. A presente pesquisa analisou o conhecimento acerca de direitos fundamentais/consumeristas, identificando aspectos relacionados às práticas alimentares cotidianas do consumidor de alimentos em restaurantes de um mercado público. Tratou-se de pesquisa qualitativa, com notas de observação em diário de campo e roteiro de entrevista. Na análise das narrativas, foi produzido o mapa analítico que entrelaçou as falas dos participantes com as categorias mais relevantes: direitos e alimentação; disponibilidade de informações; exigência de informações pelo consumidor; desistência do consumo devido às condições do local. Observou-se que os entrevistados apresentaram desconhecimento sobre os direitos relacionados à alimentação. Tempo, preço, sabor, praticidade e higiene foram valores destacados nas narrativas, porém, não se mostrou compromisso em publicizar dados importantes sobre produtos e serviços oferecidos nos restaurantes. A compreensão dos resultados aponta a necessidade de uma educação em direito à segurança alimentar e nutricional na cadeia de produção e comercialização de alimentos, uma vez que a alimentação precisa ser pensada de modo multidimensional.

The realization of the right to healthy eating implies the need for research on mechanisms that favor the construction of a culture capable of reinforcing the adoption of positive attitudes in favor of this achievement. This research analyzed the knowledge about fundamental rights/consumers, identifying aspects related to the daily eating practices of the food consumer in restaurants in a public market. It is a qualitative research, with observation notes in a field diary and an interview script. In the analysis of the narratives, an analytical map was produced that intertwined the speeches of the participants (3 men and 2 women) with the most relevant categories: rights and food; availability of information; consumer demand for information; consumer demand for information; withdrawal from consumption due to local conditions. It was observed that with regard to knowledge of law related to food, the interviewees showed ignorance. Time, price, flavor, practicality and hygiene were values highlighted in the showed ignorance. Time, price, flavor, practicality and hygiene were values highlighted in the narratives, but there is no commitment to publicize important data about products and showed ignorance. Time, price, flavor, practicality and hygiene were values highlighted in the narratives, but there is no commitment to publicize important data about products and services offered in restaurants. Understanding the results shows the need for education in the right to food and nutrition security in the food production and marketing chain, since food needs to be thought of in a multidimensional way.

Influence of Polymorphism of Vitamin D Receptor (Fok I) on Hypertension

Abstract Evidence suggests that polymorphisms in the gene encoding a vitamin D receptor might affect blood pressure. The objective of this systematic review was to investigate the association between hypertension and vitamin D receptor (Fok I) gene polymorphism. A literature search was performed according to the PRISMA guidelines using the MEDLINE®/PubMed, Scopus, Cochrane Library CENTRAL, SciELO, and LILACS databases. The quality of case-control or cohort studies and studies based on cross-sectional methodology was evaluated using the Newcastle-Ottawa Scale and the protocol of Loney and coauthors [25], respectively. In this systematic literature search, 215 publications were identified, of which 10 were analyzed, including seven case-control studies, two cross-sectional studies, and one cohort study. The association between Fok I polymorphism and hypertension was reported in 60% of the publications and the risk for hypertension was shown to be related to FF and ff genotypes. In addition, Fok I polymorphism was shown to increase plasma renin activity, which plays an important role in regulating blood pressure. However, no association was observed between Fok I polymorphism and serum vitamin D levels. In conclusion, Fok I polymorphism plays an important role in hypertension.

An approach on food choice determinants: a study in the restaurants of a public market in Northeastern Brazil / Abordagem sobre determinantes de escolha alimentar: um estudo nos restaurantes de um mercado público do Nordeste do Brasil

ABSTRACT Objective To identify the main determinants of food consumption among adult users of a public market in a capital of Northeastern Brazil. Methods A total of 198 diners in a public market, constituting a sample comprising 149 males and 49 females over 19 years of age, was interviewed using a pre-tested questionnaires from August 2018 to January 2019. Sociodemographic variables such as gender, age, place of origin, education and income, in addition to the determinants of food choices were evaluated. The analysis was performed using the Wilcoxon test (nonparametric) that compared the means of the dimensions involved in these choices according to gender and income. Results Sensory appeal, price and health were the main determinants of food choices. When compared by gender and income, there were significant differences regarding the attributes reviewed. Conclusion The factors that influenced food choice were: sensory appeal, price and health. Ethical issues were the ones that least interfered with food choice. Thus, such aspects must be taken into account for the development of public policies in the area of collective eating and environmental education. The factors that influenced food choice were: sensory appeal, price and health. Ethical issues were the ones that least interfered with food choice. Thus, such aspects must be taken into account for the development of public policies in the area of collective eating and environmental education.

RESUMO Objetivo Identificar os principais determinantes do consumo alimentar entre adultos usuários de um mercado público de uma capital do nordeste brasileiro. Métodos Foram entrevistados, por intermédio de questionários pré-testados, nos meses de agosto de 2018 até janeiro de 2019, uma amostra de 198 comensais de um mercado público, constituída por 149 indivíduos do sexo masculino e 49 do sexo feminino maiores de 19 anos. Foram avaliadas variáveis sociodemográficas como sexo, idade, local de origem, escolaridade e renda, além dos determinantes das escolhas alimentares. A análise foi feita utilizando o teste de Wilcoxon (não paramétrico), que comparou as médias das dimensões envolvidas nessas escolhas conforme sexo e renda. Resultados Apelo sensorial, preço e saúde foram os principais determinantes das escolhas alimentares. Quando comparados por sexo e renda, houve diferenças significativas quanto aos atributos analisados. Conclusão Os fatores que influenciaram a escolha alimentar foram: apelo sensorial, preço e saúde. Já as questões éticas foram as que menos interferiram na escolha alimentar. Desse modo, tais aspectos devem ser levados em consideração para o desenvolvimento de políticas públicas na área de alimentação coletiva e educação ambiental.

Feelings reported by adolescents after food ingestion: a comparative study / Sentimentos relatados por adolescentes após a ingestão alimentar: um estudo comparativo

INTRODUCTION: Food is closely linked with emotions in a complex relationship. The imaginary and symbolic meaning attributed to food has been little studied and the act of eating needs to be better understood. OBJECTIVE: To analyze the association of adolescents´ feelings to selected foods. METHODS: Cross-sectional study with 995 adolescents from public and private schools in Teresina, PI, Brazil. It was a Supplementary Project to the Brazilian national survey ERICA (Estudo de Riscos Cardiovasculares em Adolescentes). Adolescents had to choose one of the following feelings to selected food: well-being/satisfaction, malaise, no feeling, aversion. For the option aversion, the participant had to indicate if it was related to smell, color, appearance, or taste. Adolescents´ feelings to foods were analyzed by type of school, sex, and age range, using Pearson's chi-square (χ²) or Fisher's exact tests. RESULTS: There was significant differences regarding the type of school for the feeling to chocolate (p=0.015); vegetables (p=0.003); leafy greens (p=0.005); healthy sandwich/natural fruit juice (p≤0.001); high fat red meat (p=0.046); fruit/natural fruit juice (p≤0.001). For sex, there was significant difrerences for healthy sandwich/natural fruit juice (p=0.001); beans and rice (p=0.021) and high fat red meat (p=0.005). There was significant differences between age groups for sandwich, chips, soda and ice cream (p=0.018); pasta (p=0.047) and high fat red meat (p=0.021). Well-being predominated in almost all foods and aversion was poorly reported. CONCLUSION: The results suggest that adolescents' feelings are not directed to specific foods.

INTRODUÇÃO: O alimento está intimamente ligado com as emoções em uma relação complexa. O sentido imaginário e simbólico atribuído à alimentação tem sido pouco estudado e o ato de comer precisa ser melhor compreendido. OBJETIVO: Avaliar a associação de sentimentos dos adolescentes relacionados a alimentos selecionados. MÉTODO: Estudo transversal com 995 adolescentes de escolas públicas e privadas de Teresina, PI, Brasil. Os dados foram provenientes do Projeto Suplementar ao levantamento nacional brasileiro ERICA (Estudo de Riscos Cardiovasculares em Adolescentes). O adolescente teve que escolher um dos seguintes sentimentos para o alimento selecionado: bem-estar/satisfação, desconforto, nenhum sentimento ou aversão. Para a opção aversão, o participante deveria indicar se ela estava relacionada ao cheiro, cor, aparência ou sabor. Os sentimentos dos adolescentes em relação aos alimentos foram analisados ​​por tipo de escola, sexo e faixa etária, por meio do teste qui-quadrado de Pearson (c²) ou teste exato de Fisher. RESULTADOS: Houve diferenças significativas entre os tipos de escola para o sentimento em relação ao chocolate (p=0,015); legumes/verduras (p=0,003); folhosos (p=0,005); sanduiche/suco natural (p≤0,001); carne vermelha gordurosa (p=0,046); fruta/suco natural (p≤0,001). Para o sexo, houve diferença significativa para sanduiche/suco natural (p=0,001); arroz com feijão (p=0,021) e carne vermelha gordurosa (p=0,005). Para a faixa etária, houve diferença significativa para sanduíche, batata frita, refrigerante e sorvete (p=0,018); macarrão (p=0,047) e carne vermelha gordurosa (p=0,021). O bem-estar predominou em quase todos os alimentos e a aversão foi pouco relatada. CONCLUSÃO: Os resultados sugerem que os sentimentos dos adolescentes não estão direcionados a um alimento específico.

Effect of vitamin D3 supplementation on 25 OHD plasma levels in the presence of VDR gene polymorphisms / Efecto de la suplementación con vitamina D3 en los niveles plasmáticos de 25 OHD, en presencia de polimorfismos del gen VDR

The objective of this review was to investigate the effect of vitamin D3 supplementation on serum 25-hydroxyvitamin D concentration in individuals with single-nucleotide polymorphisms in the vitamin D receptor gene. The research was conducted on 241 articles found in the PubMed, Scopus, Science Direct, and Cochrane Library databases between November and December 2018. After article screening, three randomized double-blind placebo-controlled clinical trials were identified as eligible for this review. Participants were Australian, Brazilian, and Chinese individuals, who ingested doses of vitamin D3 ranging from 2000 IU to a megadose of 200,000 IU. The presence of the BB/Bb genotype of the BsmI polymorphism and the FokI G allele caused an increase in the serum concentrations of vitamin D after supplementation. Nonetheless, the few studies on this subject are not unanimous in their results. It is possible that differences among populations, sample sizes, doses, and time of supplementation have an impact on data and outcomes.

El objetivo de esta revisión fue investigar el efecto de la suplementación con vitamina D3 sobre la concentración sérica de 25-hidroxivitamina D en individuos con los polimorfismos de un solo nucleótido en el gen del receptor de la vitamina D. La investigación se realizó en 241 artículos encontrados en las bases de datos PubMed, Scopus, Science Direct y Cochrane Library entre noviembre y diciembre de 2018. Después de la selección del artículo, se identificaron tres ensayos clínicos aleatorios, controlados con placebo, doble ciego, como elegibles para esta revisión. Los participantes fueron australianos, brasileños y chinos, quienes ingirieron dosis de vitamina D3 que iban desde las 2000 UI hasta una megadosis de 200,000 UI. La presencia del genotipo BB / Bb del polimorfismo BsmI y el alelo FokI G causó un aumento en las concentraciones séricas de vitamina D después de la suplementación. No obstante, los pocos estudios sobre este tema no son unánimes en sus resultados. Es posible que las diferencias entre poblaciones, tamaños de muestra, dosis y tiempo de suplementación tengan un impacto en los datos y resultados de la investigación.

Crianças e adolescentes que consomem alimentos ultraprocessados possuem pior perfil lipídico? Uma revisão sistemática / Do children and adolescents who consume ultra-processed foods have a worse lipid profile? A systematic review

Resumo O aumento da participação de alimentos ultraprocessados na alimentação de crianças e adolescentes está relacionado ao desenvolvimento de agravos não transmissíveis, como dislipidemia. Objetivou-se realizar uma revisão sistemática da literatura sobre a relação do consumo de alimentos ultraprocessados e o perfil lipídico de crianças e adolescentes. Realizou-se uma busca nas bases de dados PubMed, Scopus, Cochrane e LILACS por estudos com desenhos transversais e longitudinais, com ou sem intervenção; em crianças e/ou adolescentes aparentemente saudáveis, que tivessem a ingestão de alimento ultraprocessado como variável de exposição e o perfil lipídico como desfecho. Após triagem, 14 estudos foram incluídos, destes, nove demonstraram que o consumo de ultraprocessados estava relacionado com o aumento do LDL-c, colesterol total, triglicerídeos e diminuição do HDL-c. Três estudos não encontraram nenhuma relação e dois demonstraram que a maior ingestão de cereais prontos estava relacionada com a diminuição de colesterol total e LDL-c. Observou-se elevado consumo de alimentos ultraprocessados e relação positiva com lipídios sanguíneos em crianças e adolescentes o que chama atenção para a realização de intervenções, como educação nutricional, com vistas a reduzir a ingestão desses alimentos.

Abstract The increase in the input of ultra-processed ingredients in the food of children and adolescents is related to the development of noncommunicable diseases such as dyslipidemia. The scope of this study was to conduct a systematic review of the literature on the relationship of consumption of ultra-processed foods in the lipid profile of children and adolescents. A search in the PubMed, Scopus, Cochrane and LILACS databases was carried out to locate cross-sectional and longitudinal studies, with or without intervention, in apparently healthy children and/or adolescents, who had the intake of ultra-processed food as an exposure variable and the lipid profile as an outcome. After screening, 14 studies were included, of which nine demonstrated that ultra-processed food consumption was related to increased LDL-c, total cholesterol, triglycerides and a reduction in HDL-c. Three studies found no relationship and two demonstrated that the increased intake of ready-to-eat cereals was related to the decrease in total cholesterol and LDL-c. There was a high consumption of ultra-processed foods and positive relation with blood lipids among children and adolescents, which calls attention to interventions, such as nutritional education, with a view to reducing the intake of these foods.

Alimentos saludables y no saludables en la opinión de adolescentes de las escuelas públicas y privadas en la capital del nordeste brasileño / Opinions on healthy and unhealthy foods among adolescentes from public and private schools in a Northeastern Brazilian capital city

RESUMEN Objetivo. Analizar la opinión de los adolescentes sobre alimentos saludables y no saludables. Estudio transversal con adolescentes de escuelas públicas y privadas. Métodos. La muestra se estratificó en tres etapas: escuela, clase y alumno, resultando en 1507 adolescentes estudiados. Los adolescentes respondieron sobre alimentos saludables y no saludables. Resultados: 995 adolescentes respondieron al cuestionario de forma completa. Los adolescentes concordaron con los beneficios de las frutas para la salud. Hubo discordancia entre las respuestas de los estudiantes de escuelas públicas y privadas sobre los maleficios de los saladitos ultraprocesados y las papas fritas para la salud; estudiantes de la red privada de enseñanza, así como del sexo femenino concordaron que las gaseosas ayudan a engordar y provocan obesidad, mientras que los de la red pública discreparon; adolescentes de escuelas privadas, de sexo femenino y grupo de edad de 15 a 17 años discreparon que carnes rojas y grasas protegen contra enfermedades del corazón. Conclusión: Los adolescentes de las escuelas de la red privada de enseñanza parecen presentar una mejor percepción acerca de los refrescos y carnes y sus maleficios a la salud, como aquellos que presentaron la mayor edad y del sexo femenino.

ABSTRACT Objective: To analyze adolescents' opinion on healthy and unhealthy foods. We conducted a cross-sectional study involving adolescents from public and private schools. Methods: The sample was stratified in three stages: school, class and student, resulting in 1507 surveyed adolescents. The adolescents answered questions on healthy and unhealthy foods. Results: A total of 995 adolescents answered the questionnaire and were considered for analysis. By and large, adolescents agreed on the benefits of fruits for health. There was disagreement between responses of public versus private school students with regard to the health risks of processed salty snacks and French fries; private school students, as well as females, agreed that soft drinks contribute to weight gain and obesity, while those belonging to the public schools disagreed; adolescents from private schools, female and adolescents aged 15 to 17 years disagreed that red and fatty meats protect against heart diseases. Conclusion: Adolescents from private versus public schools, females compared to males, and who were older demonstrated a better understanding of the negative health effects of soft drinks and meat consumption

Análise comparativa dos guias alimentares para a população brasileira e argentina / Comparative analysis of diet guidelines for brazilians and argentines

Vários países já desenvolveram seus guias com objetivos semelhantes, porém, abrangendo suas particularidades. Objetivou-se analisar o Guia Alimentar para a População Brasileira e o Guia Alimentar para a População Argentina, identificando possíveis semelhanças e diferenças entre estes, relacionando-os quanto à estrutura e à promoção de práticas alimentares saudáveis. Trata-se do estudo descritivo que utilizou o Guia Alimentar Brasileiro e Argentino, com levantamento bibliográfico e análise documental quanto às principais diferenças e semelhanças estruturais e de desenvolvimento. Ao comparar os guias alimentares, observou-se maior conteúdo técnico no guia argentino. Enquanto o brasileiro apresenta as informações de forma mais resumida e dinâmica. Ambos chamam a atenção para a importância da promoção de práticas alimentares saudáveis em todas as fases da vida. A melhoria da qualidade e o aprimoramento dos guias alimentares são fundamentais para a qualidade de vida da população. Logo, maiores estudos que abordem o entendimento e o ponto de vista da população sobre o guia alimentar fazem-se necessários.

Several countries have prepared guidelines with similar aims, albeit featuring their peculiarities. Current study analyzes the Food Guidelines for Brazilians and Argentines, identifying possible similarities and differences and relating them to structures and promotion of health food practices. Current descriptive study uses the Brazilian and Argentine Food Guide, bibliographic survey and documental analysis with regard to the main differences and similarities, structures and their development. A comparison of the food guides reveals high technical contents in the Argentine book, whilst the Brazilian guide provides dynamic and short information. The two guides focus on the promotion of healthy food practices in all life stages. Quality improvement in food guides is basic for population´s life quality. Further studies on the understanding and point of view of the population on food guides are required.

Relação dos índices antropométricos e vitamina D com o desempenho funcional em idosos / Relationship of anthropometric indices and vitamin D with functional performance in elderly

A complexidade que abrange o processo do envelhecimento e a saúde do idoso envolve mudanças no estado nutricional, como alterações dos índices antropométricos e das concentrações de vitamina D. Este trabalho teve como objetivo analisar o desempenho funcional dos idosos e sua relação com parâmetros antropométricos e níveis de vitamina D. Trata-se de um estudo transversal e descritivo, realizado com 359 idosos assistidos por equipes da Estratégia Saúde da Família (ESF) do município de Teresina-PI, no período entre fevereiro a junho de 2011. Os idosos foram entrevistados individualmente em visitas domiciliares, utilizando-se um questionário estruturado com questões abertas e fechadas referentes aos dados sociodemográficos. Em seguida, foram submetidos ao exame bioquímico onde se realizou uma venopunção, com uma coleta de 5ml de sangue para posterior dosagens séricas de 25OHD. Logo após, foi realizada a avaliação dos índices antropométricos, por meio de medidas de massa corporal (MC), estimativa da estatura (E), índice de massa corporal (IMC), circunferência do braço e dobra cutânea tricipital. E posteriormente, para a avaliação do desempenho funcional dos idosos foi utilizado o teste Timed Up and Go (TUG). Os resultados demonstraram que o tempo médio de realização do TUG foi 13,8s. Observou-se que massa corporal (12%), altura (6%), área muscular do braço (5%) e vitamina D (29%) foram estatisticamente significativas (p < 0,05) quando comparados entre os sexos. A correlação foi significativa entre associações TUG, idade (p = 0,407, p < 0,001) e altura (p = -0,201, p < 0,001). Foram encontradas correlações significativas entre o TUG, idade (p = 0,413, p < 0,001) e altura (p = -0,259, p < 0,001) para o grupo feminino (n = 220) e correlações significativas entre o TUG, idade (p = 0,507, p < 0,001) para o grupo masculino (n = 139). Conclui-se que dentre os parâmetros antropométricos o IMC e a circunferência abdominal foram associados com o desempenho no teste mostrando que quanto maior o IMC e CA maior o tempo de realização do teste. Os níveis séricos de Vitamina D não foram associados ao desempenho no teste. (AU)

The complexity covering the aging process and the health of the aged involves changes in nutritional status, such as changes in anthropometric indices and vitamin D concentrations. This study aimed to analyze the functional performance of the aged and its relationship with anthropometric parameters and levels of vitamin D. It is a transversal and descriptive study with 359 aged people assisted by teams of the Family Health Strategy (FHS) in the city Teresina-PI in the period from February to June 2011. The aged were interviewed individually during home visits, using a structured questionnaire with open and closed questions relating to sociodemographic data. They were then subjected to biochemical tests were conducted a venipuncture through a collection of 5ml of blood for subsequent serum levels of 25OHD. Soon after, it was carried out the evaluation of anthropometric indices, using body mass (MC), height estimate (E), body mass index (BMI), arm circumference and triceps skinfold thickness. And later, to evaluate the functional performance of the aged was used test Timed Up and Go (TUG). The results showed that the mean duration of the TUG was 13,8s. It was observed that body weight (12%), height (6%), muscle area of the arm (5%) and vitamin D (29%) were statistically significant (p < 0.05) when compared between the sexes. Correlation coefficients were significant associations between TUG, age (p = 0.407, p < 0.001) and time (p = -0.201, p < 0.001). Significant correlations were found between the TUG, age (p = 0.413, p < 0.001) and height (p = -0.259, p < 0.001) for the female group (n = 220) and significant correlations between the TUG, age (p = 0.507, p < 0.001) for the male group (n = 139). It is concluded that among the anthropometric parameters BMI and waist circumference were associated with performance on the test showing that the higher BMI and higher CA the test performance time. Serum levels of vitamin D were not associated with performance on the test. (AU)

The relationship between serum retinol concentrations and subclinical infection in rural Brazilian children / Relação entre as concentrações séricas de retinol e a infecção subclínica em crianças rurais brasileiras

ABSTRACT Objective To evaluate the relationship between serum retinol concentrations and subclinical infection in children from rural settlements. Methods A cross-sectional population-based study was carried out in nine rural settlements in the northeastern region of Brazil, involving 118 children aged 6 to 59 months. The relationship between serum retinol and C-Reactive Protein levels, an important marker of infectious and inflammatory processes, was investigated by multiple linear regression, controlling for demographic, socioeconomic and nutritional variables. Serum retinol and C-Reactive Protein were measured, respectively, by High Performance Liquid Chromatography and immunoturbidimetric assay in automated equipment. Results Vitamin A deficiency (retinol <0.70μmol/L) was identified in 9.3% of the children. C-Reactive Protein was the only predictor of retinol concentrations in the final regression model, causing a 0.728μmol/L reduction in retinol concentrations in the studied children (p=0.008). Conclusion Vitamin A deficiency is a problem of mild/moderate severity and measures to control infectious diseases in this population are fundamental to prevent and/or combat this problem.

RESUMO Objetivo Esta pesquisa teve por objetivo avaliar a relação entre concentrações séricas de retinol e infecção subclínica, em crianças de assentamentos rurais. Métodos Trata-se de estudo transversal, de base populacional, realizado em nove assentamentos rurais na região nordeste do Brasil, envolvendo 118 crianças de 6 a 59 meses de idade. A relação entre retinol sérico e níveis de proteína C-reativa, importante marcador de processos infecciosos e inflamatórios, foi investigada por análise de regressão linear múltipla, controlando-se variáveis demográficas, socioeconômicas e nutricionais. O retinol sérico e a proteína C-reativa foram medidos, respectivamente, por Cromatografia Líquida de Alta Performance e ensaio imunoturbidimétrico em equipamento automatizado. Resultados A deficiência de vitamina A (retinol <0,70μmll/L) foi identificada em 9,3% das crianças. A proteína C-reativa foi o único preditor de concentrações de retinol no modelo de regressão final, causando uma redução de 0,728μmol/L nas concentrações de retinol nas crianças estudadas (p=0,008). Conclusão A pesquisa concluiu que a deficiência de vitamina A é um problema de severidade leve/moderada, sendo fundamental a adoção de medidas para controlar doenças infecciosas nessa população, bem como para prevenir e/ou combater o problema.

Vitamin B12, bone mineral density and fracture risk in adults: A systematic review / Vitamina B12, densidade mineral óssea e risco de fraturas em adultos: uma revisão sistemática

Summary Objective: To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans. Method: A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system. Results: A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies. Conclusion: A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.

Resumo Objetivo: Consolidar as informações disponíveis acerca dos efeitos da vitamina B12 sobre a densidade mineral óssea e o risco de fraturas, com destaque para ensaios clínicos, dados observacionais e longitudinais realizados com humanos. Método: Foi realizada uma revisão sistemática da literatura dos últimos dez anos sobre o papel da vitamina B12 na densidade mineral óssea e no risco de fraturas em populações de todas as idades e para ambos os sexos, com busca de artigos nos bancos de dados eletrônicos: PubMed, Science Direct, Medline e SciELO. Como estratégia de busca de dados incluíram-se os descritores: B12 Vitamin and Bone Mineral Density e B12 Vitamin and Risk of Fractures. A qualidade das evidências dos artigos incluídos foi avaliada pelo sistema GRADE. Resultados: Após a análise dos títulos e dos resumos dos artigos, a estratégia de busca resultou em 25 referências, das quais 17 artigos preencheram os critérios de elegibilidade. Esta revisão fornece evidências de que o papel da vitamina B12 sobre a densidade mineral óssea ou o risco de fraturas ainda precisa ser mais bem elucidado. As controvérsias encontram respaldo na heterogeneidade das metodologias utilizadas para o diagnóstico da vitamina B12 e também na variedade de populações presentes entre os estudos. Conclusão: Ainda não está bem estabelecido o real impacto da deficiência de vitamina B12 na saúde dos ossos e sobre os mecanismos associados ao metabolismo ósseo. É de suma importância a realização de mais estudos esclarecedores, principalmente em grupos vulneráveis como as mulheres pós-menopausa e os idosos, grupos estes bastante afetados pela deficiência dessa vitamina.

Effect of vitamin D supplementation on patients with systemic lupus erythematosus: a systematic review / Efeito da suplementação com vitamina D em pacientes com lúpus eritematoso sistêmico: uma revisão sistemática

Abstract The objective of this systematic review was to analyze clinical trials carried out for the investigation of the effect of vitamin D supplementation on systemic lupus erythematosus. The research was performed from August to September 2016, without limits regarding year of publication, restriction of gender, age, and ethnicity. For the guiding question, the PICO strategy was employed. To evaluate the quality of the publications the PRISMA protocol and Jadad scale were used. The risk of bias analysis of the clinical trials was performed using the Cochrane collaboration tool. After the process of article selection and removal of duplicates, four articles were identified as eligible. The results of three studies showed a positive effect of supplementation on disease activity reduction and significant improvement in levels of inflammatory markers, fatigue, and endothelial function. Only one study showed no improvement in disease activity after supplementation. Moreover, all studies showed an increase in serum vitamin D levels. The data from this review provide evidence on the benefits of vitamin D supplementation in patients with lupus and vitamin D insufficiency/deficiency. However, it is still necessary to elucidate whether vitamin D acts in the protection against this metabolic disorder, as well as the standardization of the type, dose and time of vitamin D supplementation.

Resumo O objetivo desta revisão sistemática foi analisar ensaios clínicos feitos na investigação do efeito da suplementação com vitamina D sobre o lúpus eritematoso sistêmico. A pesquisa foi feita nas bases de dados Scopus, PubMed e Biblioteca Cochrane, de agosto a setembro de 2016, sem limite de ano de publicação, restrição de gênero, idade e etnicidade. Para a questão norteadora foi empregada a estratégia Pico. Para avaliar a qualidade das publicações usaram-se o protocolo Prisma e a escala de Jadad. A análise do risco de viés dos ensaios clínicos ocorreu pela ferramenta de colaboração Cochrane. Após o processo de seleção e remoção de artigos duplicados, quatro artigos foram identificados como elegíveis. Os resultados de três estudos mostraram efeito positivo da suplementação na redução da atividade da doença e melhoria significativa nos níveis de marcadores inflamatórios, fadiga e função endotelial. Em apenas um estudo não houve melhoria na atividade da doença após a suplementação. Ademais, todos os estudos apresentaram aumento dos níveis séricos de vitamina D. Os dados desta revisão fornecem evidências dos benefícios da suplementação com vitamina D sobre o lúpus em pacientes com insuficiência/deficiência. Contudo, ainda é necessário elucidar a atuação do nutriente na proteção contra esse distúrbio metabólico, bem como a padronização do tipo, da dose e do tempo de suplementação com vitamina D.