Effects of cocaine, nicotine, and marijuana exposure in Drosophila Melanogaster development: A systematic review and meta-analysis.

Abuse-related drug usage is a public health issue. Drosophila melanogaster has been used as an animal model to study the biological effects of these psychoactive substances in preclinical studies. Our objective in this review is to evaluate the adverse effects produced by cocaine, nicotine, and marijuana during the development of D. melanogaster. We searched experimental studies in which D. melanogaster was exposed to these three psychoactive drugs in seven online databases up to January 2023. Two reviewers independently extracted the data. Fifty-one studies met eligibility criteria and were included in the data extraction: nicotine (n = 26), cocaine (n = 20), and marijuana (n = 5). Fifteen studies were eligible for meta-analysis. Low doses (∼0.6 mM) of nicotine increased locomotor activity in fruit flies, while high doses (≥3 mM) led to a decrease. Similarly, exposure to cocaine increased locomotor activity, resulting in decreased climbing response in D. melanogaster. Studies with exposure to marijuana did not present a profile for our meta-analysis. However, this drug has been less associated with locomotor changes, but alterations in body weight and fat content and changes in cardiac function. Our analyses have shown that fruit flies exposed to drugs of abuse during different developmental stages, such as larvae and adults, exhibit molecular, morphological, behavioral, and survival changes that are dependent on the dosage. These phenotypes resemble the adverse effects of psychoactive substances in clinical medicine.

Type and timing of ultra-processed foods consumption and its association with dietary intake and physical activity in women with obesity living in poverty.

BACKGROUND: The present study aimed to investigate the type and timing of ultra-processed foods (UPF) consumption and its association with dietary intake (DI) and physical activity (PA) in women with obesity living in poverty. METHODS: A cross-sectional study was employed. Obesity was defined by at least two criteria (body mass index, waist circumference or % fat mass). Poverty was defined as the three lowest classes of the Brazilian Economic Classification Criterion. PA was measured with triaxial accelerometers and DI was assessed with three 24-h dietary recalls. Foods were categorised according to the NOVA classification, with UPF classified into five subgroups, as well as the timing of consumption into six meals. RESULTS: In total, 56 adult women were included. Overall energy intake was 1653.21 (503.22) kcal/day. UPF intake was 21.62% (11.94%) kcal/day, being higher at breakfast (4.91% kcal/day), afternoon snack (5.39% kcal/day) and dinner (5.01% kcal/day). Only UPF subgroup 4 (sandwich biscuits, sweets, or treats) showed a positive association with energy intake (ß = 54.40 [27.6, 81.10] kcal/day) and a negative association with protein intake (ß = -0.31% [-0.48%, -0.14%] kcal/day). UPF consumption in morning (ß = -0.41% [-0.79%, -0.02%] kcal/day) and afternoon (ß = -0.18% [-0.33%, -0.04%] kcal/day) snacks was associated with lower protein intake. Furthermore, lunchtime UPF consumption was positively associated with walking time (ß = 0.16% [0.02%; 0.30%]) and steps/hour (ß = 8.72 [1.50; 15.94] steps/h). CONCLUSIONS: Women with obesity living in poverty consume more UPF during breakfast, afternoon snack and dinner. Physical activity is positively associated with UPF consumption at lunch. UPF, such as sandwich biscuits, sweets or treats, contribute to increasing energy intake and reducing protein intake.

Type 2 diabetes mellitus is associated with food addiction in Brazilian women living in poverty.

Food addiction (FA) has been widely investigated. For the first time, two studies reported its association with type 2 diabetes mellitus (DM2) in the general population and populations with mental disorders and undergoing bariatric surgery. However, the relationship between FA and DM2 needs to be better explored in different social contexts and population groups. Given this, the present study aims to evaluate whether DM2 diagnosis is associated with FA diagnosis in women living in poverty. This is a cross-sectional, population-based study conducted in a Brazilian capital city. FA was assessed by the modified Yale Food Addiction Scale (mYFAS) 2.0, and DM2 diagnosis was assessed by self-reporting of previous medical diagnosis. The association was assessed by multivariable Poisson regression with robust variance estimation adjusted for age, poverty situation, race/skin colour, physical activity and BMI. A total of 1878 women were included, of whom 15·1 % had FA and 3·2 % had a medical diagnosis of DM2. In the multivariable analysis, the medical diagnosis of DM2 was associated with FA (prevalence ratio, PR: 2·18; 95 % CI (1·26, 3·76)). The DM2 diagnosis was also identified to be associated with role interference (PR: 1·93; 95 % CI (1·01, 3·67)) symptom of FA. In conclusion, a positive association between FA and DM2 in women living in poverty was observed, information that adds to the current evidence already available in the literature, pointing to a new line of research and integrated care.

Breastfeeding and factors associated with the neuropsychomotor development of children living in social vulnerability / Aleitamento materno e fatores associados ao desenvolvimento neuropsicomotor de crianças em vulnerabilidade social

Abstract Objective: to determine the association between breastfeeding and associated factors with neuropsychomotor development of children living in social vulnerability. Methods: cross-sectional study within a socially vulnerable community. Households with children aged seven to 72 months, and their biological mothers were included. Sociodemographic, anthropometric and breastfeeding variables were collected using questionnaires, and neuropsychomotor development was assessed using the Denver II screening test. Adjusted prevalence ratios were calculated using multivariable models, oriented by directed acyclic graphs. Results: from the 654 households visited, 224 mother-child binomials were included. The mean age of children was 28 (18.7) months, and 143 (63.8%) of them presented suspected delay in neuropsychomotor development. Mothers presented a median of 8 years of formal schooling and 64 (28.6%) had performed exclusive breastfeeding for 6 months. Exclusive breastfeeding was not associated with neuropsychomotor development (PR=0.92; CI95%=0.84-1.00). A significant association was observed only with years of formal maternal education (PR=0.98; CI95%=0.97-0.99). A mediation analysis did not show any clear mediator between maternal education and neuropsychomotor development. Conclusions: children living in social vulnerability presented a high prevalence of suspected delay in neuropsychomotor development. Maternal education was the only variable associated with such condition.

Resumo Objetivos: determinar a associação entre o aleitamento materno e fatores associados ao desenvolvimento neuropsicomotor de crianças em extrema vulnerabilidade social. Métodos: estudo transversal conduzido em uma comunidade em vulnerabilidade social, envolvendo crianças de sete a 72 meses, e suas mães biológicas. Variáveis sociodemográficas, antropométricas e de amamentação foram coletadas por meio de questionários e o desenvolvimento neuropsicomotor foi avaliado por meio do teste de triagem Denver II. Razões de prevalência ajustadas foram calculadas usando modelos multivariáveis, orientados por grafos acíclicos direcionados. Resultados: dos 654 domicílios visitados, foram incluídos 224 binômios mãe-filho, com média de idade de 28,8 (18,7) meses, em que 143 (63,8%) crianças apresentavam suspeita de atraso no desenvolvimento neuropsicomotor e 64 (28,6%) haviam realizado aleitamento materno exclusivo até o sexto mês. Aleitamento materno exclusivo por 6 meses não se associou ao desenvolvimento neuropsicomotor (RP= 0,91; IC95%=0,83-1,00). Houve associação significativa observada apenas com anos de escolaridade materna formal (RP=0,97; IC95%=0,96-0,99). Análise de mediação não mostrou nenhum mediador entre escolaridade materna e desenvolvimento neuropsicomotor. Conclusões: destaca-se a alta prevalência de crianças com suspeita de atraso no desenvolvimento neuropsicomotor. A escolaridade materna foi a única variável associada à esta condição.

Estimation of the availability of iron in the school meals of Municipal Centers for Early Childhood Education of a capital city in northeastern Brazil.

The final stage of Fe deficiency is Fe deficiency anaemia, with repercussions for human health, especially in children under 5 years of age. Studies conducted in Brazilian public daycare centres show high prevalence of anaemia. The present study aims to evaluate the availability of Fe in the meals of the Municipal Centers of Early Childhood Education in Maceió. The experimental design comprises selection of algorithms, menu evaluation, calculation of the estimates, comparison between the estimates obtained and the recommendations, and analysis of correlation between meal constituents, and of the concordance between the absorbable Fe estimates. Four algorithms were selected and a monthly menu consisting of 22 d. The correlation analysis showed a moderate positive correlation to animal tissue (AT) v. non-heme iron (r = 0·42; P = 0·04), and negative to AT v. Ca (r = -0·54; P = 0·09) and Ca v. phytates (r = -0·46, P = 0·03). Estimates of absorbable Fe ranged from 0·23 to 0·44 mg/d. The amount of Fe available, unlike the total amount of Fe offered, does not meet the nutritional recommendations on most school days. The Bland-Altman analysis indicated that the Monsen and Balinfty and Rickard et al. showed greater agreement. The results confirm the need to adopt strategies to increase the availability of Fe in school meals.

Avaliação da insegurança alimentar no contexto da COVID-19: associação com o auxílio emergencial e recebimento de doação de alimentos na população em vulnerabilidade social de uma capital do Nordeste do Brasil / Assessment of food insecurity in the context of COVID-19: association with emergency aid and collecting food donations among the socially vulnerable population of a capital in Northeastern Brazil

Resumo O estudo objetivou investigar a prevalência de insegurança alimentar no contexto da COVID-19 e sua associação com o programa de transferência de renda Auxílio Emergencial e o recebimento de doação de alimentos na população em vulnerabilidade social. Estudo transversal, realizado com famílias em vulnerabilidade social, oito meses após a confirmação do primeiro caso de COVID-19 no Brasil. Foram incluídas 903 famílias, residentes em 22 aglomerados subnormais de Maceió, em Alagoas. Avaliaram-se características sociodemográficas e foi aplicada a Escala Brasileira de Insegurança Alimentar. A associação da insegurança alimentar com as variáveis estudadas foi realizada por meio de regressão de Poisson com estimativa robusta das variâncias, considerando α = 5%. Do total da amostra, 71,1% estavma em insegurança alimentar, situação que se associou com o recebimento de doação de alimentos (RP = 1,14, IC95%: 1,02; 1,27) e ser beneficiário do Auxílio Emergencial (RP = 1,23, IC95%: 1,01; 1,49). Os resultados mostram que a população em vulnerabilidade social foi fortemente afetada pela insegurança alimentar. Em contrapartida, essa população foi beneficiada por ações que foram implementadas no início da pandemia.

Abstract The scope of this study was to investigate the prevalence of food insecurity in the context of COVID-19 and its association with the emergency aid income-transfer program and the collecting of food donations by the population in a situation of social vulnerability. A cross-sectional study was carried out with socially vulnerable families eight months after confirming the first case of COVID-19 in Brazil. A total of 903 families, living in 22 underprivileged communities of Maceió, in the state of Alagoas, were included. Sociodemographic characteristics were evaluated, and the Brazilian Food Insecurity Scale was applied. The association of food insecurity with the variables studied was performed using Poisson regression with robust variance estimation, considering α = 5%. Of the total sample, 71.1% were food insecure, a situation associated with receiving food donations (PR = 1.14; 95%CI: 1.02; 1.27) and being a beneficiary of emergency aid (PR =1.23; 95%CI: 1.01; 1.49). The results show that the population in a situation of social vulnerability was strongly affected by food insecurity. On the other hand, the population group in question benefited from actions implemented at the outset of the pandemic.

Prevalence of food addiction determined by the Yale Food Addiction Scale in Latin America: A systematic review with meta-analysis.

OBJECTIVE: Food addiction (FA) has been extensively investigated worldwide; however, the prevalence of FA in the Latin American population has yet to be established and past work has largely neglected the specificities of this region, that includes the most significant economic disparities in the world. Thus, the objective of this study was to assess the prevalence of FA measured by the Yale Food Addiction Scale in Latin America. METHOD: The search was performed on MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL, and the gray literature. FA prevalence data were collected, and random effects meta-analyses were performed to calculate the overall weighted prevalence, the prevalence by country, and by clinical and non-clinical samples. RESULTS: A total of 10,082 occurrences were identified through database searches, and 23 studies were included (Mexico = 9; Brazil = 7; Chile = 4; Argentina = 1; Peru = 1; Uruguay = 1). The prevalence of FA found in clinical samples was 38% (95% CI: 16%-63%; I2  = 98.67%; 8 studies), while in non-clinical samples, it was 15% (95% CI: 10%-21%; I2  = 98.51%; 15 studies). DISCUSSION: The average prevalence of FA in the Latin American countries included here was in accordance with that reported in other regions worldwide. It is noteworthy that the studies were conducted only in six countries, which are among those with the highest income in the region and do not represent the situation in native populations or those with lower purchasing power. This gap in the data also reflects the effects of economic disparities on the availability of empirical data in the region. PUBLIC SIGNIFICANCE: The prevalence of food addiction in Latin America was similar to that reported in other regions. It was higher among individuals with overweight, whether or not undergoing bariatric surgery, than in non-clinical samples. These findings contribute to aggregate information about this condition that has drawn the attention of clinicians and researchers.

OBJETIVO: La adicción a la comida (FA, por sus siglas en inglés) ha sido ampliamente investigada en todo el mundo; sin embargo, la prevalencia de la FA en la población latinoamericana aún no se ha establecido y el trabajo previo ha descuidado en gran medida las especificidades de esta región, que incluye las disparidades económicas más significativas del mundo. Por lo tanto, el objetivo de este estudio fue evaluar la prevalencia de FA medida por la Escala de Adicción a la Comida de Yale en América Latina. MÉTODO: La búsqueda se realizó en MEDLINE, ScienceDirect, LILACS, IBECS, SciELO, PsycArticles, CENTRAL y la literatura gris. Se recopilaron datos de prevalencia de FA y se realizaron metanálisis de efectos aleatorios para calcular la prevalencia ponderada general, la prevalencia por país y por muestras clínicas y no clínicas. RESULTADO: Se identificaron 10 082 casos mediante búsquedas en bases de datos y se incluyeron 23 estudios (México = 9; Brasil = 7; Chile = 4; Argentina = 1; Perú = 1; Uruguay = 1). La prevalencia de FA encontrada en muestras clínicas fue del 38% (IC95%:16%; 63%; I2 = 98,67%; 8 estudios), mientras que en muestras no clínicas, fue del 15% (IC del 95%: 10%; 21%; I2 = 98,51%; 15 estudios). DISCUSIÓN: La prevalencia promedio de FA en los países latinoamericanos incluidos aquí estuvo de acuerdo con la reportada en otras regiones del mundo. Cabe destacar que los estudios se realizaron solamente en seis países, que se encuentran entre los de mayores ingresos de la región y no representan la situación de las poblaciones nativas o de menor poder adquisitivo. Esta brecha en los datos también refleja los efectos de las disparidades económicas en la disponibilidad de datos empíricos en la región.

Use of the activPAL® triaxial accelerometer to estimate total energy expenditure in low-income women: differences between body mass index classifications

ABSTRACT Objective: This study aimed to assess the agreement between the total energy expenditure (TEE) estimated by the activPAL® triaxial accelerometers (ACC) and the TEE measured by the doubly labeled water method (DLW), as well as to assess if these values differ between the classifications of body mass index (BMI). Materials and methods: This is a cross-sectional study. Low-income adult women (19-45y) with BMI ≥ 18.5 kg/m2 were included. Accelerometry data (activPAL®) were collected over 7 consecutive days, which were used to calculate TEE-ACC and compared with DLW data. The Bland-Altman method, concordance correlation coefficient and root mean square error were used to assess agreement between methods. Results: The sample consisted of 55 women with a mean age of 31 ± 5 years. The agreement between TEE-ACC and TEE-DLW showed a bias of -142.5 kcal (-7.1%). Among the BMI classifications, participants with normal weight show a bias of -417.1 kcal (-21.0%), participants with overweight, -87.5 kcal (-3.9%) and participants with obesity, 97.5 kcal (4.3%). Furthermore, the bias between the methods showed a significant and positive correlation with the body weight (r = 0.49; p < 0.01). Conclusion: The TEE-ACC estimates from activPAL® were reasonably accurate when compared to the TEE-DLW, especially in women with overweight and obesity, being much less accurate in individuals with normal weight.

Effects of SARS-CoV-2 infection on health and functional capacity in institutionalized older adults / Efectos de la infección por SARS-CoV-2 en la salud y capacidad funcional de personas mayores institucionalizadas / Efeitos da infecção por SARS-CoV-2 na saúde e na capacidade funcional de pessoas idosas institucionalizadas

ABSTRACT Objective: To assess the effect of SARS-CoV-2 infection on the health conditions and functional capacity of older adults living in long-term care units in Maceió City - Alagoas State. Methods: A prospective cohort was conducted with institutionalized older adults of both sexes. Older adults were assessed for clinical conditions (diagnosis of chronic diseases and biochemical tests), functional capacity, and nutritional status. All assessments were repeated on two occasions, maintaining a 6-month interval between them. Results: The sample was composed of 289 older adults. Of the total, 98 (33.9%) were positive for COVID-19 and eight died (2.8%). Men were more likely to have COVID-19 (OR = 3.50; p < 0.01). It was observed that the disease contributed to increasing the frequency of dependent older adults after six months (OR = 1.38; p-interaction < 0.01). It was also observed that after six months of positive diagnosis for COVID-19, there was greater weight loss (p < 0.01), reduced BMI (p < 0.01), increased mean SBP (p = 0.04), and DBP (p = 0.03). Conclusion: Effects of COVID-19 in institutionalized older adults go beyond acute complications and compromise blood pressure control, functional capacity, and favor weight loss.

RESUMEN Objetivo: Evaluar el efecto de la infección por SARS-CoV-2 sobre las condiciones de salud y la capacidad funcional de personas mayores que viven en unidades de cuidados a largo plazo en la ciudad de Maceió - Alagoas. Métodos: Se realizó una cohorte prospectiva con ancianos institucionalizados de ambos sexos. Los ancianos fueron evaluados en cuanto a condiciones clínicas (diagnóstico de enfermedades crónicas y pruebas bioquímicas), capacidad funcional y estado nutricional. Todas las evaluaciones se repitieron en dos ocasiones, manteniendo un intervalo de 6 meses entre ellas. Resultados: La muestra estuvo compuesta por 289 personas mayores. Del total, 98 (33,9%) dieron positivo a la COVID-19 y ocho fallecieron (2,8%). Los hombres tenían más probabilidades de tener COVID-19 (OR = 3,50; p <0,01). Se observó que la enfermedad contribuyó al aumento de la frecuencia de ancianos dependientes después de seis meses (OR = 1,38; interacción p < 0,01). Se observó que la enfermedad contribuyó al aumento de la frecuencia de ancianos dependientes después de seis meses (OR = 1,38; interacción p < 0,01). También se observó que después de seis meses de diagnóstico positivo para COVID-19, hubo mayor pérdida de peso (p < 0,01), reducción del IMC (p < 0,01), aumento de la PAS media (p = 0,04) y la PAD (p = 0,03). Conclusión: Los efectos del COVID-19 en ancianos institucionalizados van más allá de las complicaciones agudas y comprometen el control de la presión arterial, la capacidad funcional, favoreciendo la pérdida de peso.

RESUMO Objetivo: Avaliar o efeito da infecção pelo SARS-CoV-2 nas condições de saúde e capacidade funcional de idosos residentes em unidades de longa permanência na cidade de Maceió - Alagoas. Métodos: Foi realizada uma coorte prospectiva com idosos institucionalizados de ambos os sexos. Os idosos foram avaliados quanto às condições clínicas (diagnóstico de doenças crônicas e exames bioquímicos), capacidade funcional e estado nutricional. Todas as avaliações foram repetidas em duas ocasiões, mantendo um intervalo de 6 meses entre elas. Resultados: A amostra foi composta por 289 idosos. Do total, 98 (33,9%) deram positivo para COVID-19 e oito faleceram (2,8%). Os homens tiveram maior probabilidade de ter COVID-19 (OR = 3,50; p < 0,01). Observou-se que a doença contribuiu para o aumento da frequência de idosos dependentes após seis meses (OR = 1,38; interação de p <0,01). Observou-se também que após seis meses de diagnóstico positivo para COVID-19, houve maior perda de peso (p < 0,01), redução do IMC (p < 0,01), aumento da média da PAS (p = 0,04) e da PAD (p = 0,03). Conclusão: Os efeitos da COVID-19 em idosos institucionalizados vão além das complicações agudas e comprometem o controle da pressão arterial, a capacidade funcional, favorecendo a perda de peso.

Social network of malnourished children and its association with family's food and nutritional security / Rede social de crianças desnutridas e sua relação com a segurança alimentar e nutricional da família

Abstract Objectives: evaluate the relationship between family's food and nutrition insecurity (FNI) and the social network of malnourished children. Methods: cross-sectional study with 92 children, included in the economic class D-E. For the analysis of the children's social network, the mothers answered four simple questions. To investigate the FNI, the Brazilian Scale of Food Insecurity was used. The association between variables was analyzed by Poisson regression with robust analysis of variances. Results: 56.5% of the children had a weak social network (<10 individuals), and the prevalence of FNI was 72.8%. An inverse association was observed between children of the daily social network and FNI family (OR=0.94; CI95%=0.89-0.99], p=0.03). The number of individuals in the children's daily social network was negatively associated with the likelihood of FNI. The mother's educational level was also related to FNI (OR=2.20 [CI95%=1.11-4.34]; p=0.02), being the child up to 2.2 times more likely to be in FNI when the mother has less than four years of study. Conclusion: these results suggest that social network is associated with the FNI of malnourished children. Interventions designed to strengthen instrumental and other forms of support among small social networks can improve the health/nutrition of malnourished children with FNI.

Resumo Objetivos: avaliar a relação entre a insegurança alimentar e nutricional (IAN) da família e a rede social de crianças desnutridas. Métodos: estudo transversal com 92 crianças, inseridas na classe econômica D-E. Para a análise da rede social das crianças, as mães responderam quatro perguntas simples. Para investigar a IAN foi utilizada a Escala Brasileira de Insegurança Alimentar. A associação entre as variáveis foi analisada por regressão de Poisson com análise robusta das variâncias. Resultados: 56,5% das crianças apresentaram rede social fraca (<10 indivíduos), e a prevalência de IAN foi de 72,8%. Foi observada uma associação inversa entre rede social diária das crianças e IAN da família (RP=0,94, [IC95%=0,89-0,99]; p=0,03). O número de indivíduos na rede social diária das crianças se associou negativamente com a probabilidade de IAN. O nível de escolaridade materno também estava relacionado com a IAN (RP=2,20 [IC95%=1,11-4,34]; p=0,02), tendo a criança até 2,2 vezes mais probabilidade de estar em IAN quando a mãe apresenta menos de quatro anos de estudo. Conclusão: esses resultados sugerem que a rede social está associada à IAN de crianças desnutridas. Intervenções destinadas a fortalecer maneiras instrumentais e outras formas de apoio entre pequenas redes sociais podem melhorar a saúde/nutrição de crianças desnutridas com IAN.

Red propolis supplementation does not decrease acute respiratory events in stunted preschool children: A paired nonrandomized clinical trial.

BACKGROUND & AIMS: This study aimed to evaluate the efficacy of "red propolis" supplementation in the frequency of acute respiratory infections incidence in stunted preschool children. We hypothesized that the "red" propolis supplementation is effective in the reduce frequency of acute respiratory complications in stunted children. METHODS: This is a non-randomized, pair-matched clinical trial with 70 children, ranging from 1 to 5 years old, followed for 1 year, which were paired into two groups according to age, sex, and stunting classification. The children were in the day hospital regimen of CREN and received 5 meals/day and an additional 8 ml of honey or honey with "red propolis" in a 3% dilution. The children had access to nutritional, psychological, dental, and physician care. Respiratory complications were recorded in a pre-existing protocol of the institution by the same pediatrician, who was blind for the children's allocation. Anthropometric measurements and biochemical tests such as hemogram, IGF-1, and immunoglobulin E, G, M were conducted. RESULTS: The most prevalent symptoms were coughing, runny nose, nasal congestion and wheezing. The use of "red propolis" did not decrease the frequency of infections between the control and propolis groups, respectively (2 [1-7] vs 3 [1-7], p = 0.10), which was within the estimated by the Pan American Health Organization. There were no differences between groups in anthropometric and biochemical parameters. CONCLUSION: Supplementation with "red propolis" did not reduce the number of infections in stunted children over 1 year. Possibly, the dilution percentage (3%) may have been insufficient to allow effective action. The protocol of published in the Brazilian Registry of Clinical Trials (http://www.ensaiosclinicos.gov.br/rg/RBR-4n7j6h).

Effects of dietary polyphenols in the glycemic, renal, inflammatory, and oxidative stress biomarkers in diabetic nephropathy: a systematic review with meta-analysis of randomized controlled trials.

CONTEXT: Polyphenols have antioxidant, anti-inflammatory, and anti-glycation properties. OBJECTIVE: To assess the effects of dietary polyphenols, from food sources or supplements, on the anthropometric, glycemic, renal, inflammatory, and oxidative stress markers in adults with diabetic nephropathy (DN). DATA SOURCES: Systematic searches for randomized clinical trials were performed in MEDLINE, Embase, CENTRAL, Web of Science, LILACS, SciELO, opengrey.eu, and ClinicalTrials.gov databases until December 2021. DATA EXTRACTION: Studies with adults with DN were included. Random-effects meta-analyses were conducted. Risk of bias of the studies and Grading of Recommendations, Assessment, Development, and Evaluation assessment were carried out. DATA ANALYSIS: The searches resulted in 5614 unique occurrences, and 34 full-text articles were retrieved. Of these, 17 studies were included in the qualitative synthesis. Most of the studies used soy protein or milk (n = 5; 0.5-1 g/kg of body weight/d of soy protein, or introduction of 240 mL/d of soy milk) or turmeric/curcumin (n = 5; dose range, 80 to 1500 mg/d) as the intervention. The following outcomes were analyzed: body mass index, glycated hemoglobin (HbA1c), proteinuria, creatinine clearance, glomerular filtration rate (GFR), urinary albumin to creatinine ratio, and levels of fasting blood glucose, insulin, serum urea and creatinine, C-reactive protein, serum tumor necrosis factor-α, and serum malondialdehyde (MDA). The polyphenol intervention significantly decreased HbA1c (n = 7 studies; -0.27% [95%CI, -0.51%, -0.04%]), proteinuria (n = 5 studies; -109.10 [95%CI, -216.57, -1.63] mg/24 h), and MDA (n = 5 studies; z-score: -0.41; 95%CI, -0.71, -0.10), and significantly increased GFR (n = 7 studies; 3.65 [95%CI, 0.15-7.15] mL/min/1.73 m2). Overall, studies showed a high risk of bias, and outcomes showed a low or very-low quality in the Grading of Recommendations, Assessment, Development, and Evaluation assessment. CONCLUSIONS: There is a clinically modest effect of dietary polyphenols intervention in HbA1c, proteinuria, GFR, MDA, and C-reactive protein levels in patients with DN. It is impossible to establish clinical recommendations, because the evidence was of' low or very-low quality and because of the heterogeneity of types and dose regimens used in the studies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. ID245406.

Lack of Concordance among Nutritional Diagnostic Methods in Newly Diagnosed Colorectal Cancer Patients.

This study aimed to investigate the concordance of different nutritional assessment methods and the prevalence of inadequate nutritional status in newly diagnosed Colorectal cancer (CRC) patients. Cross sectional study was conducted in a public hospital in Alagoas, Brazil. Clinical, nutritional (patient-generated subjective global assessment [PG-SGA], body mass index [BMI], arm circumference [AC], triceps skinfold [TSF], arm muscle circumference [AMC]) and functional (handgrip strength [HGS]) data were collected from July 2017-January 2019. Of the 31 CRC patients with a mean age of 58.97 ± 14.96 years, 48.4% were elderly and 51.6% were female. TSF adequacy (80.8%) and PG-SGA (80.0%) revealed the highest prevalence of malnutrition. BMI identified the same prevalence of malnutrition and excess weight (30.0%). The concordance between PG-SGA and BMI (kappa = 0.086; p = 0.426) was slight, with fair HGS (kappa = 0.268; p = 0.124). PG-SGA and AC (kappa = 0.015; p = 0.99), TSF (kappa = 0.195; p = 0.558) and AMC adequacy (kappa = 0.142; p = 0.380) were poor. PG-SGA can diagnose malnutrition, even in those who are eutrophic/overweight, by other methods. Various methods do not show concordance with PG-SGA, confirming the need for both objective and subjective methods for better diagnosis of CRC patients.

Biomarkers of Inflammation and Redox Imbalance in Umbilical Cord in Pregnancies with and without Preeclampsia and Consequent Perinatal Outcomes.

OBJECTIVE: To compare redox imbalance and inflammation biomarkers in umbilical cords from pregnancies with and without preeclampsia (PE) and to analyse their relationships with perinatal outcomes. METHODS: A controlled cross-sectional study was conducted in Maceió, Alagoas, Brazil, that involved pregnant women with PE and a group of women without the disease, through the application of a standardized questionnaire. After delivery, umbilical cord samples were collected to measure antioxidant defense, products from oxidative damage, and inflammation biomarkers such as myeloperoxidase (MPO), interleukin- (IL-) 6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α). Statistical analyses were performed using Stata version 13.0 software and IBM Statistical Package for the Social Sciences (SPSS) 20.0, adopting a 95% confidence level (α = 0.05), with the chi-square test, the Wilcoxon-Mann-Whitney test, and the multinomial and Poisson regression tests. RESULTS: One hundred PE pregnant women and 50 women without the disease were studied. The umbilical cords from PE pregnancies showed higher levels of reduced glutathione (GSH) (p ≤ 0.001), glutathione peroxidase (GPx) (p = 0.016), and malondialdehyde (MDA) (p = 0.028) and lower levels of IL-6 (p = 0.030) and TNF-α (p ≤ 0.001) than the other group, with some associations among these biomarkers with perinatal outcomes. CONCLUSION: The higher levels of GSH and GPx, in addition to the lower levels of IL-6 and TNF-α, found in the PE umbilical cord, may result from adaptive mechanisms to maintain the oxidative and inflammatory balance; however, despite these changes, the damage to the cell membranes was not minimized, as the MDA level was higher in women with PE than in women without the disease. This implies that a redox imbalance is present, confirming that other physiological and adaptive mechanisms are being activated to preserve foetal health. Therefore, the present work unveils an important role of the umbilical cord in controlling redox imbalance and inflammation in PE pregnancies. Our results reinforce the necessity for continuous research on GSH as a protective compound for the perinatal outcome, especially in PE women.

Immunonutrition in head and neck cancer: Systematic review and metanalysis of its clinical and nutritional effects.

BACKGROUND AND AIMS: A systematic review was conducted to assess the effects of glutamine, arginine and omega-3 supplementation on the tolerance to treatment, nutritional status and immune function of head and neck cancer (HNC) patients undergoing chemoradiotherapy. METHODS: Randomized clinical trials were searched in MEDLINE, EMBASE, CENTRAL, LILACS, ClinicalTrials.gov, OpenGrey and Proquest. Tolerance to treatment, nutritional status, immune function and mortality rate were the primary outcomes investigated. Secondary outcomes comprised functional status, weight loss and body composition. Risk of bias of individual studies and the overall quality of the evidence were assessed using the Cochrane and the GRADE tools, respectively. RESULTS: Nineteen articles met the inclusion criteria and nine were included in the meta-analyses, which assessed mucositis severity, weight loss and handgrip strength. Ten studies were evaluated as high risk of bias. Glutamine supplementation has significantly reduced the risk of grade 2-4 mucositis (RR: 0.76, IC95% [0.63; 0.92], P = 0.006, I2 = 0%; P = 0.792; 4 studies). Omega-3 supplementation did not show statistically significant results on weight loss (SMD: -0.042, 95% CI [-0.322; 0.238], P = 0.769, I2 = 33.4%; P = 0.212; 4 studies). The overall quality of the evidence ranged from low to very low. CONCLUSIONS: These results must be interpreted with caution due to differences between supplementations regimen, lack of methodological rigor in most studies and due to the possible role of glutamine in tumor metabolism. Studies focused on elucidating the contribution of each immunonutrient to HNC patients undergoing chemoradiotherapy deserve further investigation.

Association between iron deficiency anaemia and complementary feeding in children under 2 years assisted by a Conditional Cash Transfer programme.

OBJECTIVE: To evaluate the association between Fe deficiency anaemia (IDA) and complementary feeding in children under 2 years old assisted by the Conditional Cash Transfer programme, Bolsa Família (BFP). DESIGN: Cross-sectional study. Data were obtained through a standardised form, questionnaire to assess the eating habits of children under 2 years of age, capillary Hb (HemoCue®) and the Brazilian Household Food Insecurity Measurement Scale. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels. SETTING: Six municipalities from the State of Alagoas, Brazil. PARTICIPANTS: Children aged 6-24 months assisted by BFP. RESULTS: A total of 1604 children were evaluated, among whom 58·1 % had anaemia. A higher number of food groups consumed (prevalence ratio (PR) = 0·97; 95 % CI 0·95, 0·99; P = 0·009), the consumption of dairy (PR = 0·86; 95 % CI 0·79, 0·84; P = 0·001) and meat (PR = 0·90; 95 % CI 0·83, 0·99; P = 0·030) in addition to bottle feeding (PR = 0·88; 95 % CI 0·82, 0·96; P = 0·004) were associated with a lower prevalence of IDA. CONCLUSIONS: IDA is still a serious public health problem in children under 2 years old assisted by BFP in Alagoas. We highlight the importance of promoting complementary feeding based on a diversified dietary intake, as well strengthening prophylactic supplementation programmes to increase children's adherence in conjunction with the implementation of food and nutrition education to help reduce the prevalence of this condition.

Association between COVID-19 diagnosis and economic class, race/skin color and social distancing in Brazilian university students / Associação entre o diagnóstico de COVID-19 e a classe econômica, raça/cor da pele e distanciamento social em universitários brasileiros

ABSTRACT: Purpose: To determine the association between diagnosis of COVID-19 and the economic class, race/skin color, and adherence to social distancing in Brazilian university students. Methods: This is a nationwide cross-sectional study carried out with online questionnaires applied to Brazilian university students, at 94 universities in the public and private education network. Self-reported age, sex, economic class data, race/skin color, COVID-19 diagnosis, and adherence to social distancing measures were collected. Results: 5,984 individuals were evaluated. No significant association was found between the diagnosis of COVID-19 and economic class and race/skin color in the multivariable analysis. However, we observed that there were significant associations between the diagnosis of COVID-19 and partial adherence to social distancing, with leaving home only for going to work (PR: 1.35; 95% CI: 1.10­1.66; p < 0.01) and with non-adherence to social distancing (PR: 1.96; 95% CI: 1.29­2.97; p <0.01). Conclusion: The diagnosis of COVID-19 was associated with age, non-adherence and partial adherence to social distancing measures in Brazilian university students, but was not associated with race/skin color and economic class.

Objetivo: Verificar a associação entre o diagnóstico de COVID-19 e a classe econômica, raça/cor da pele e adesão às medidas ao distanciamento social em universitários brasileiros. Métodos: Estudo transversal, de abrangência nacional, realizado com universitários brasileiros. Foram coletados dados autorreferidos de idade, sexo, classe econômica, raça/cor, diagnóstico do COVID-19 e adesão às medidas de distanciamento social. Resultados: 5.984 indivíduos foram avaliados. Não foi encontrada associação significativa entre o diagnóstico de COVID-19, a classe econômica e raça/cor na análise multivariável. Observamos que houve associações significativas entre o diagnóstico de COVID-19 e adesão parcial ao distanciamento social (RP: 1,35; IC 95%: 1.10­1.66; p < 0,01) e com a não adesão ao distanciamento social (RP: 1,96; IC95%: 1.29­2.97; p < 0,01). Conclusão: O diagnóstico de COVID-19 foi associado à idade, não adesão e adesão parcial às medidas de distanciamento social em universitários brasileiros, mas não se associou à raça/cor e classe econômica. (AU)