Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services.

Malnutrition in heart failure (HF) is frequent and associated with a worse prognosis. Due to differences in investment and the profile of those assisted, the objective of this study was to evaluate the frequency of malnutrition in hospitalized patients with HF and its association with clinical outcomes in the public and private health systems. Methodology: A cross-sectional study, with 247 volunteers hospitalized with HF in three public hospitals and one private hospital in Aracaju, SE, Brazil. A subjective global nutritional assessment (SGA) and mini nutritional assessment (MNA) were performed. Results: Sample with 72.5% users of the public health system and 75.3% with malnutrition (public = 74.9%; private = 76.5%; p = 0.793). Regardless of the healthcare system, hospital stay (>14 days) was longer (p = 0.020) among those with malnutrition (48.4%) than well-nourished patients (29.5%). Malnutrition in the public system had higher mortality (7.5%; 5.8%; p < 0.001) and hospital transfer rate (21.1%; 0.0%; p < 0.001) than those in the private system. Death after discharge was observed only in the public system (p = 0.039). Conclusion: Malnutrition was frequent in both systems and was associated with longer hospital stays and, in the public hospital, in-hospital death and transfers.

Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study.

INTRODUCTION: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. OBJECTIVE: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. METHODS: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. RESULTS: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. CONCLUSION: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.

Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study / Fatores demográficos, socioeconômicos e de estilo de vida associados ao consumo de bebidas açucaradas: um estudo de base populacional

ABSTRACT: Introduction: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. Objective: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. Methods: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. Results: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. Conclusion: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.

RESUMO: Introdução: A ingestão de bebidas açucaradas varia de acordo com as características da população. Objetivos: Investigar o consumo de bebidas açucaradas e os fatores demográficos, socioeconômicos e de estilo de vida associados ao seu consumo em adolescentes, adultos e idosos residentes em São Paulo. Métodos: Foram utilizados dados do Inquérito de Saúde de São Paulo, estudo transversal de base populacional, incluindo 1.662 indivíduos com 12 anos ou mais. As bebidas açucaradas foram classificadas em seis grupos: refrigerantes, cafés e chás adoçados, leite e produtos lácteos adoçados, sucos de fruta natural adoçados, sucos de fruta artificial adoçados e bebidas açucaradas totais. A associação de cada grupo com variáveis demográficas, socioeconômicas e de estilo de vida foi determinada por meio de modelos de regressão linear. Resultados: A ingestão média de bebidas açucaradas foi 668,4 mL em adolescentes, 502,6 mL em adultos e 358,2 mL em idosos. Refrigerantes e cafés e chás adoçados foram os grupos com a maior contribuição para a ingestão energética. O consumo de bebidas açucaradas foi menor entre as mulheres e maior entre os adolescentes com excesso de peso, entre adultos suficientemente ativos e entre os idosos de menor renda familiar per capita. O consumo de bebidas açucaradas foi elevado, particularmente entre adolescentes. Políticas públicas são necessárias a fim de reduzir o consumo dessas bebidas. Conclusão: Faixa etária, sexo, renda familiar per capita e índice de massa corporal foram associadas ao consumo de bebidas açucaradas.

Dietary BCAA Intake Is Associated with Demographic, Socioeconomic and Lifestyle Factors in Residents of São Paulo, Brazil.

BACKGROUND: Identifying which risk groups have a higher intake of branched chain amino acids (BCAA) is important for the planning of public policies. This study was undertaken to investigate BCAA consumption, the foods contributing to that consumption and their association with demographic, socioeconomic and lifestyle factors. METHODS: Data from the Health Survey of São Paulo, a cross-sectional population-based survey (n = 1662; age range 12-97 years), were used. Dietary intake was measured using 24-h dietary recalls. Baseline characteristics were collected. Associations between BCAA intake and demographic, socioeconomic and lifestyle factors were determined using linear regression. RESULTS: Total BCAA intake was 217.14 mg/kg·day (Leu: 97.16 mg/kg·day; Ile: 56.44 mg/kg·day; Val: 63.54 mg/kg·day). BCAA intake was negatively associated with female sex in adolescents and adult groups, with no white race in adolescents, and with former smoker status in adults. Conversely, BCAA was positively associated with household per capita income in adolescents and adults. No associations were observed in the older adults group. Main food contributors to BCAA were unprocessed red meat, unprocessed poultry, bread and toast, beans and rice. CONCLUSIONS: Adolescents and adults were the most vulnerable to having their BCCA intake influenced by demographic, socioeconomic and lifestyle factors.

Nutritional quality of dietary patterns of children: are there differences inside and outside school? / Qualidade nutricional dos padrões alimentares de crianças: existem diferenças dentro e fora da escola?

Abstract: Objectives: To describe the dietary patterns of children inside and outside school and investigate their associations with sociodemographic factors and nutritional status. Methods: This was a multicenter cross-sectional study in which children of both sexes, aged 1-6 years, attending private and public daycare centers and preschools in Brazil, were evaluated (n = 2979). Demographic, socioeconomic and dietary data (weighed food records and estimated food records) were collected. Dietary patterns were derived by factor analysis from 36 food groups. Results: Four dietary patterns were identified inside school, and three outside. Inside school, the "traditional" pattern was associated to low income and presented high nutritional quality. The "dual" pattern was associated with low income and with high intake of added sugar and glycemic load. The "snack" pattern was associated with children enrolled at private schools and with high intake of added sugar and glycemic load. The "bread and butter" pattern was associated with high intake of added sugar and trans fat. Outside school, the "traditional" pattern was associated with high intake of saturated fat, trans fats, sodium, and total fiber. The "bread and butter" pattern was associated with high intake of trans fats and glycemic load, whereas the "snack" pattern was associated with overweight, private schools, high income, and high intake of trans fats, sodium, and total fiber. Conclusion: There are differences in the nutritional quality of dietary patterns inside and outside school, and heterogeneity in adherence to these patterns were observed across regions and socioeconomic classes.

Resumo: Objetivos: Descrever os padrões alimentares de crianças dentro e fora da escola e investigar a sua associação com fatores sociodemográficos e estado nutricional. Métodos: Estudo multicêntrico transversal, no qual foram avaliadas crianças de 1 a 6 anos de ambos os sexos, atendidas em creches públicas e privadas e pré-escolas no Brasil (n = 2.979). Foram coletados dados demográficos, socioeconômicos e dietéticos. Os padrões alimentares foram derivados por análise fatorial a partir de 36 grupos de alimentos. Resultados: Quatro padrões alimentares foram identificados dentro e três fora da creche. Dentro da creche, o padrão "tradicional" foi associado a menor renda e apresentou melhor qualidade nutricional. O padrão "dual" associou-se a menor renda e maior ingestão de açúcar de adição e carga glicêmica. O padrão "lanches" foi associado a crianças matriculadas em escolas privadas e com maior ingestão de açúcar de adição e carga glicêmica. O padrão "pão com manteiga" associou-se a maior ingestão de açúcar de adição e gordura trans. Fora da creche, o padrão "tradicional" foi associado a maior ingestão de gordura saturada, trans, sódio e fibra. O padrão "pão com manteiga" associou-se a maior ingestão de gordura trans e carga glicêmica, enquanto o padrão "lanches" associou-se às crianças com excesso de peso, de creches privadas, maior renda e com maior ingestão de gordura trans, sódio e fibra. Conclusão: Houve diferença na qualidade nutricional dos padrões dentro e fora da escola e a adesão a esses ocorreu de forma heterogênea nas regiões e classes socioeconômicas.

Nutritional quality of dietary patterns of children: are there differences inside and outside school?

OBJECTIVES: To describe the dietary patterns of children inside and outside school and investigate their associations with sociodemographic factors and nutritional status. METHODS: This was a multicenter cross-sectional study in which children of both sexes, aged 1-6 years, attending private and public daycare centers and preschools in Brazil, were evaluated (n=2979). Demographic, socioeconomic and dietary data (weighed food records and estimated food records) were collected. Dietary patterns were derived by factor analysis from 36 food groups. RESULTS: Four dietary patterns were identified inside school, and three outside. Inside school, the "traditional" pattern was associated to low income and presented high nutritional quality. The "dual" pattern was associated with low income and with high intake of added sugar and glycemic load. The "snack" pattern was associated with children enrolled at private schools and with high intake of added sugar and glycemic load. The "bread and butter" pattern was associated with high intake of added sugar and trans fat. Outside school, the "traditional" pattern was associated with high intake of saturated fat, trans fats, sodium, and total fiber. The "bread and butter" pattern was associated with high intake of trans fats and glycemic load, whereas the "snack" pattern was associated with overweight, private schools, high income, and high intake of trans fats, sodium, and total fiber. CONCLUSION: There are differences in the nutritional quality of dietary patterns inside and outside school, and heterogeneity in adherence to these patterns were observed across regions and socioeconomic classes.