RESUMO
OBJECTIVES: Age at menarche (MA) is a proxy for biological maturation and a parameter of socioeconomic changes. Worldwide, anticipation of menarche is associated with nutritional transition and excess weight. The objective of this study was to evaluate the MA in Amazonian students and its association with nutritional status, ethnicity, and socioeconomic level. METHODS: Cross-sectional study with 1,017 students aged 6 to 17 living in the city of Manaus, Brazil. MA was analyzed by status quo and recall; its association with body mass index (BMI), race, socioeconomic status, and adult height was examined. RESULTS: 559 (51.9%) participants had already experienced menarche. In 91.7%, menarche occurred between 10 and 14 years of age; the mean age at the onset of menarche was 11.9 years. Overweight (11.6 years) and obese (11.4 years) participants reached menarche earlier than those with normal weight (12 years) and lean (12.7 years) participants. The associations between MA and nutritional status showed that overweight and obesity are risk factors for the early occurrence of menarche. MA was not associated with socioeconomic status/parental education or race. However, excess weight was associated with earlier MA in all races and social classes. The adult height was slightly lower in girls with menarche before 12 years old (157.9 vs 159.4 cm). CONCLUSION: Regardless of socioeconomic level or ethnicity, excess weight was associated with earlier menarche in Amazonian students.
Assuntos
Índice de Massa Corporal , Menarca , Estado Nutricional , Fatores Socioeconômicos , Humanos , Menarca/fisiologia , Feminino , Estado Nutricional/fisiologia , Adolescente , Estudos Transversais , Brasil , Criança , Fatores Etários , Estudantes/estatística & dados numéricos , Sobrepeso/epidemiologia , Fatores de RiscoRESUMO
Considera-se gestação de alto risco quando a mulher apresenta comorbidade materna e/ou condição sociobiológica que levam as chances de ocorrer alguma intercorrência na evolução natural da gravidez, como hipertensão arterial, diabetes, anemia, alcoolismo e obesidade. É de grande importância o acompanhamento pré-natal com uma equipe de assistência capaz de identificar os problemas antes mesmo que possam ser agravados. O objetivo deste estudo foi rastrear o perfil clínico e nutricional de mulheres com gestação de alto risco na Estratégia de Saúde da Família de Santa Quitéria- CE. Trata-se de um estudo descritivo, com abordagem quantitativa realizado com 33 gestantes. Para a coleta de dados foi utilizado o cartão da gestante e prontuário, o estado nutricional foi avaliado através do peso pré- gestacional contido no cartão e peso atual através da balança. Para análise estatística, foram usados frequências, percentuais, médias e desvio padrão, verificadas por meio dos testes de Kolmogorov-Smirnov e Levene. Para a comparação de médias entre duas categorias, utilizou-se o teste t de Student para amostras independentes. Os resultados mostraram que a maioria tinha o ensino médio como nível de escolaridade, renda igual ou menor que um salário mínimo, multíparas com um ou mais abortos. Em relação às características do estado clínico patológico, as condições mais prevalentes nas gestantes do presente estudo foram hipertensão arterial sistêmica, pré-eclâmpsia, seguidos de DMG e eritoblastose. Excesso de peso antes e durante a gravidez com ganho ponderal de peso adequado. O que demonstra a necessidade de estratégias para a saúde da mulher. É apropriado acionar sinal de alerta no acompanhamento da saúde da mulher também antes da gestação e não somente no pré-natal para que transcorra bem durante e após o parto. PALAVRAS-CHAVE: Estado nutricional; Gestação de alto risco; Assistência Pré-Natal.
High-risk pregnancy is considered when the woman presents maternal comorbidity and/or sociobiological condition that increase the chances of some complication occurring in the natural evolution of pregnancy, such as arterial hypertension, diabetes, anemia, alcoholism, and obesity; It is of great importance the prenatal follow-up with an assistance team capable of identifying the problems even before they can be aggravated; The objective of this study was to track the clinical and nutritional profile of women with high-risk pregnancy in the Family Health Strategy of Santa Quitéria-CE; This is a descriptive study with a quantitative approach carried out with 33 pregnant women; For data collection the pregnant woman's card and medical records were used, the nutritional status was evaluated through the pre-gestational weight contained in the card and current weight through the scale; For statistical analysis, frequencies, percentages, means and standard deviation were used, verified by means of the Kolmogorov-Smirnov and Levene tests;For comparison of means between two categories, Student's t test for independent samples was used; The results showed that most had high school education, income equal to or less than one minimum wage, multiparous women with one or more abortions; Regarding the characteristics of the pathological medical condition, the most prevalent conditions in the pregnant women of the present study were hypertension, pre- eclampsia, followed by GDM and erythoblastosis; Overweight before and during pregnancy with adequate weight gain; This demonstrates the need for women's health strategies; It is appropriate to trigger warning signals in the monitoring of women's health also before pregnancy and not only in the prenatal period so that it goes well during and after delivery;
Se considera embarazo de alto riesgo cuando la mujer presenta comorbilidad materna y/o condición socio-biológica que conlleva las posibilidades de aparición de alguna complicación en la evolución natural del embarazo, como son la hipertensión, la diabetes, la anemia, el alcoholismo y la obesidad. Es de gran importancia el seguimiento prenatal con un equipo de asistencia capaz de identificar los problemas incluso antes de que puedan agravarse. El objetivo de este estudio fue rastrear el perfil clínico y nutricional de las mujeres con embarazo de alto riesgo en la Estrategia de Salud Familiar de Santa Quitéria-CE. Se trata de un estudio descriptivo con un enfoque cuantitativo realizado con 33 mujeres embarazadas. Para la recopilación de datos se utilizó el cartón de la gestante y el prontuario, el estado nutricional se evaluó a través del peso pregestacional contenido en el cartón y el peso actual a través de la balanza. Para el análisis estadístico se utilizaron frecuencias, porcentajes, medias y desviación estándar, verificados mediante las pruebas de Kolmogorov-Smirnov y Levene. Para la comparación de medias entre dos categorías, se utilizó la prueba t de Student para muestras independientes. Los resultados mostraron que la mayoría tenía estudios secundarios, ingresos iguales o inferiores a un salario mínimo, mujeres multíparas con uno o más abortos. En cuanto a las características del estado clínico patológico, las condiciones más prevalentes en las embarazadas del presente estudio fueron la hipertensión arterial sistémica, la preeclampsia, seguidas de la DMG y la eritoblastosis. Exceso de peso antes y durante el embarazo con un aumento de peso adecuado. Lo que demuestra la necesidad de estrategias de salud para las mujeres. Es conveniente activar la señal de alarma en el seguimiento de la salud de las mujeres también antes del embarazo y no sólo en la atención prenatal para que funcione bien durante y después del parto.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Estratégias de Saúde Nacionais , Perfil de Saúde , Estado Nutricional/fisiologia , Gravidez de Alto Risco , Pré-Eclâmpsia/diagnóstico , Cuidado Pré-Natal/estatística & dados numéricos , Mulheres , Índice de Massa Corporal , Prontuários Médicos/estatística & dados numéricos , Saúde da Mulher , Gestantes , Diabetes Mellitus/diagnóstico , Hipertensão/complicações , Obesidade/complicaçõesRESUMO
Adolescence is a pivotal point in the life course, characterised by transformative physical, cognitive, and emotional growth, an openness to change, and a drive to reshape the social environment. It offers unique opportunities to adopt changes in diet and physical activity that can persist into later life. Yet pre-existing nutritional problems, including micronutrient deficiencies, food insecurity, and poor-quality diets, persist at the same time as adolescents face the rapid emergence of an obesity epidemic. Adolescent growth and nutrition has been largely overlooked in intervention and policy research. Most intervention studies have emphasised micronutrient supplementation, with few taking into account the multiple drivers of adolescent diets. This Series paper highlights that effective interventions and policies will need to cut across sectors; be supported by multifaceted and multilevel policy; and extend across education, health, food systems, social protection, and digital media. Better data standardisation and systems will be essential in coordinating and monitoring these responses. In a context of shifts in planetary ecosystems and commercial drivers, resilient food systems will need to both ensure access to healthy and affordable foods and provide the infrastructure and incentives for continuing physical activity. Intergenerational partnerships with young people will be essential in bringing about transformative change and ensuring that food policies reflect their needs and aspirations.
Assuntos
Desenvolvimento do Adolescente/fisiologia , Saúde do Adolescente , Dieta Saudável , Promoção da Saúde/organização & administração , Política Nutricional , Adolescente , Insegurança Alimentar , Saúde Global , Promoção da Saúde/métodos , Humanos , Desnutrição/epidemiologia , Desnutrição/fisiopatologia , Desnutrição/prevenção & controle , Micronutrientes/deficiência , Estado Nutricional/fisiologia , Sobrepeso/epidemiologia , Sobrepeso/fisiopatologia , Sobrepeso/prevenção & controleRESUMO
BACKGROUND & AIMS: Nutrition may be important for recovery from critical illness. Gastrointestinal dysfunction is a key barrier to nutrition delivery in the Intensive Care Unit (ICU) and metabolic rate is elevated exacerbating nutritional deficits. Whether these factors persist following ICU discharge is unknown. We assessed whether delayed gastric emptying (GE) and impaired glucose absorption persist post-ICU discharge. METHODS: A prospective observational study was conducted in mechanically ventilated adults at 3 time-points: in ICU (V1); on the post-ICU ward (V2); and 3-months after ICU discharge (V3); and compared to age-matched healthy volunteers. On each visit, all participants received a test-meal containing 100 ml of 1 kcal/ml liquid nutrient, labelled with 0.1 g 13C-octanoic acid and 3 g 3-O-Methyl-glucose (3-OMG), and breath and blood samples were collected over 240min to quantify GE (gastric emptying coefficient (GEC)), and glucose absorption (3-OMG concentration; area under the curve (AUC)). Data are mean ± standard error of the mean (SEM) and differences shown with 95% confidence intervals (95%CI). RESULTS: Twenty-six critically ill patients completed V1 (M:F 20:6; 62.0 ± 2.9 y; BMI 29.8 ± 1.2 kg/m2; APACHE II 19.7 ± 1.9), 15 completed V2 and eight completed V3; and were compared to 10 healthy volunteers (M:F 6:4; 60.5 ± 7.5 y; BMI 26.0 ± 1.0 kg/m2). GE was significantly slower on V1 compared to health (GEC difference: -0.96 (95%CI -1.61, -0.31); and compared to V2 (-0.73 (-1.16, -0.31) and V3 (-1.03 (-1.47, -0.59). GE at V2 and V3 were not different to that in health (V2: -0.23 (-0.61, 0.14); V3: 0.10 (-0.27, 0.46)). GEC: V1: 2.64 ± 0.19; V2: 3.37 ± 0.12; V3: 3.67 ± 0.10; health: 3.60 ± 0.13. Glucose absorption (3-OMG AUC0-240) was impaired on V1 compared to V2 (-37.9 (-64.2, -11.6)), and faster on V3 than in health (21.8 (0.14, 43.4) but absorption at V2 and V3 did not differ from health. Intestinal glucose absorption: V1: 63.8 ± 10.4; V2: 101.7 ± 7.0; V3: 111.9 ± 9.7; health: 90.7 ± 3.8. CONCLUSION: This study suggests that delayed GE and impaired intestinal glucose absorption recovers rapidly post-ICU. This requires further confirmation in a larger population. The REINSTATE trial was prospectively registered at www.anzctr.org.au. TRIAL ID: ACTRN12618000370202.
Assuntos
Estado Terminal , Esvaziamento Gástrico/fisiologia , Absorção Intestinal/fisiologia , Estado Nutricional/fisiologia , APACHE , Calorimetria , Estudos de Casos e Controles , Feminino , Glucose/metabolismo , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estudos Prospectivos , Respiração ArtificialRESUMO
RESUMO O objetivo deste estudo é analisar a satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade e verificar quais fatores antropométricos e socioeconômicos estão associados a elas. Trata-se de um estudo transversal, realizado com 307 crianças de escolas públicas de Goiânia. A saúde da criança e os aspectos socioeconômicos da família foram avaliados por meio de um questionário semiestruturado; a imagem corporal foi avaliada por meio da Escala de Silhuetas Brasileiras Para Crianças; e também foram coletados dados antropométricos de peso, estatura, dobras cutâneas e circunferência da cintura. Observou-se homogeneidade do gênero neste estudo, predomínio de meninos (52%) eutróficos (73%). Apesar de se tratar de uma amostra com peso saudável, a insatisfação e a distorção da imagem corporal prevaleceram sobre a maior parte da amostra: a insatisfação esteve presente em 92% das crianças, prevalecendo o desejo por uma menor silhueta, enquanto a distorção esteve presente em 75% da amostra, com predomínio da subestimação da silhueta. No entanto, este estudo encontrou associação da insatisfação com a imagem corporal apenas com IMC (aferido, atual e desejado) e circunferência da cintura; e associação da distorção da imagem corporal apenas com os IMC (aferido e atual).
ABSTRACT The aim of this study is to analyze the satisfaction and distortion of body image in children from 7 to 10 years old and to verify which anthropometric and socioeconomic factors are associated with them. This is a cross-sectional study, carried out with 307 children from public schools in Goiânia. The child's health and the socioeconomic aspects of the family were assessed using a semi-structured questionnaire; body image was assessed using the Brazilian Silhouettes Scale for Children; and anthropometric data on weight, height, skinfolds and waist circumference were also collected. Gender homogeneity was observed in this study, with a predominance of eutrophic(73%) boys (52%). Despite being a sample with a healthy weight, dissatisfaction and distortion of body image prevailed over most of the sample: dissatisfaction was present in 92% of children, the desire for a smaller silhouette prevailing, while distortion was present in 75% of the sample, with a predominance of underestimation of the silhouette. However, this study found dissatisfaction association with body image only with BMI (measured, current and desired) and waist circumference; and association of the distortion of the body image only with the BMI (measured and current).
Assuntos
Humanos , Masculino , Feminino , Criança , Imagem Corporal/psicologia , Criança , Estado Nutricional/fisiologia , Instituições Acadêmicas/organização & administração , Fatores Socioeconômicos , Composição Corporal/fisiologia , Índice de Massa Corporal , Antropometria/instrumentação , Saúde da Criança , Estudos Transversais/métodos , Circunferência da Cintura/fisiologiaRESUMO
INTRODUCTION: Today, improving lifestyles and promoting health are basic needs for human society. The main goal in promoting health is to achieve healthy lifestyle behaviors, and self-efficacy is one of the factors influencing people's lifestyle. Therefore, the impact of educational intervention based on self-efficacy theory on improving lifestyles of the female teachers in Galledar was investigated. METHOD: This study was a semiexperimental study with educational intervention with a control group that was performed on 120 teachers in Galledar. Data collection tools included demographic information questionnaires, health-promoting lifestyle questionnaires, and Sherry's self-efficacy questionnaire. Data were analyzed using SPSS 25 software. RESULT: The mean age and standard deviation of teachers in the control and intervention groups were 33.40 ± 5.68 and 32.83 ± 6.46 years, respectively. Health-promoting lifestyle variables are significant correlation with self-efficacy and overall lifestyle index. Six dimensions which consisted of spiritual growth and self-actualization, health responsibility, interpersonal relationships, stress management, exercise and physical activity, and nutrition showed significant statistical differences before and after educational intervention (P = 0.001). CONCLUSION: Due to the sensitive role of teachers as an effective human force in the development and evolution of society and their students' role modeling, the authorities should formulate policies, regulate educational interventions, and design strategies for promoting self-efficacy beliefs and promoting a healthy lifestyle for all teachers. We suggest that other methods and theories of behavior change be used in future studies to promote a healthy lifestyle.
Assuntos
Professores Escolares/estatística & dados numéricos , Adulto , Exercício Físico/estatística & dados numéricos , Feminino , Promoção da Saúde/estatística & dados numéricos , Estilo de Vida Saudável/fisiologia , Humanos , Relações Interpessoais , Irã (Geográfico) , Estilo de Vida , Estado Nutricional/fisiologia , Autoeficácia , Comportamento Social , Software , Inquéritos e Questionários/estatística & dados numéricosRESUMO
BACKGROUND: Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized as complex, most analyses have focused on social and biomedical determinants, with limited attention on psychological factors affecting care and nurturing in the home. We assessed whether the psychological distress of parents is related to child linear growth and stunting, and documented the associated risk factors, and examined the relationship between parental distress and behavioral and other risk factors for stunting. METHODS: We used data from the Indonesia National Health Survey 2013, including 46,315 children 6-59 months of age. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire (SRQ20), with height-for-age z score (HAZ), stunting, and behavioral and other risk factors for stunting. RESULTS: Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.086 (95% CI -0.17, -0.00), 0.11 (95% CI -0.24, -0.02) and 0.19 (95% CI -0.37, -0.00) HAZ-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ <-1) by 33% (95% CI 1.17,1.50) and 37% (95% CI 1.18,1.60), and the risk of moderate stunting (HAZ <-2) by 25% (95% CI 1.10,1.43) and 28% (95% CI 1.08,1.51]), respectively. Parental stress increased the risk of moderate stunting by 40% (95% CI 1.06,1.85). Amongst specific groups of risk factors, the proportion of HAZ-score lost was associated with socioeconomic factors (30.3%) including, low wealth, low maternal occupational status, low maternal education, rural residence, and low paternal occupational status; physiological factors (15.5%) including low maternal height, low maternal mid-upper arm circumference, being male, low paternal height; behavioral factors (8.9%) including open garbage disposal, paternal smoking, not using iodized salt; and experiencing at least one infectious diseases episode (1.1%). CONCLUSIONS: Maternal, paternal and parental stress were associated with reduced linear growth of children. These findings highlight the complex etiology of stunting and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents must be pursued as part of a comprehensive strategy to enhance child growth and development, i.e. improved caretaker capacity, integrated community development, improved parenting skills, as well as reduced gender discrimination, and domestic violence.
Assuntos
Estatura/fisiologia , Pais/psicologia , Pré-Escolar , Estudos Transversais , Escolaridade , Feminino , Transtornos do Crescimento/psicologia , Inquéritos Epidemiológicos , Humanos , Indonésia , Lactente , Masculino , Estado Nutricional/fisiologia , Prevalência , Angústia Psicológica , Fatores de Risco , População Rural , Fatores SocioeconômicosRESUMO
Population aging has recently been an important issue as the number of elderly people is growing worldwide every year, and the extension of social security costs is financially costly. The increase in the number of elderly people with cognitive decline is a serious problem related to the aging of populations. Therefore, it is necessary to consider not only physical care but also cognitive patterns in the future care of older adults. Since food contains a variety of bioactive substances, dietary patterns may help improve age-related cognitive decline. However, the relationship between cognitive function and individual food components remains ambiguous as no clear efficacy or mechanism has been confirmed. Against this background, this review summarizes previous reports on the biological process of cognitive decline in the elderly and the relationship between individual compounds in foods and cognitive function, as well as the role of individual components of food in cognitive function, in the following order: lipids, carotenoids, vitamins, phenolic compounds, amino acids, peptides, and proteins. Based on the research presented in this review, a proper diet that preserves cognitive function has the potential to improve age-related cognitive decline, Alzheimer's disease, and Parkinson's disease. Hopefully, this review will help to trigger the development of new foods and technologies that improve aging and cognitive functions and extend the healthy life span.
Assuntos
Envelhecimento/fisiologia , Cognição/fisiologia , Dieta/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Estresse OxidativoRESUMO
Introducción: Ingresar a la universidad implica múltiples cambios que repercuten en el estado nutricional y pueden condicionar la aparición de enfermedades crónicas no transmisibles al futuro. Objetivo: Comparar el estado nutricional de las estudiantes de Nutrición y Dietética de México y Colombia mediante mediciones antropométricas y el consumo de alimentos. Material y Métodos: Se efectuó un estudio descriptivo, exploratorio, multidimensional de tipo transversal; con un tamaño de la muestra de 583 estudiantes elegidos aleatoriamente en centros universitarios de Colombia y México. Se aplicó una encuesta que indagó sobre el consumo de alimentos y el estilo de vida de las estudiantes, la toma de datos antropométricos se realizó de manera presencial mediante la técnica The International Society for the Advancement of Kinanthropometry (ISAK). Se emplearon las técnicas estadísticas: test de comparación de proporciones, MANOVA y distribuciones de frecuencias. Resultados: Se presentó mayor carga genética para diabetes mellitus, hipertensión arterial, cáncer y obesidad en las estudiantes mexicanas; quienes reportaron más sobrepeso y enfermedades gastrointestinales. El consumo frecuente de queso entero, huevo, grasas saturadas y poliinsaturadas, azúcares y dulces, y productos fritos fue mayor en las colombianas; mientras que el consumo de queso bajo en grasa, leguminosas y mezclas vegetales, grasas monoinsaturadas, salsas, frutas, verduras y hortalizas, nueces y semillas, enlatados y bebidas alcohólicas, fue superior en las mexicanas. Conclusiones: Se reportan cambios alimenticios desde el ingreso a la carrera, lo cual es un factor protector para el desarrollo de enfermedades crónicas no trasmisibles(AU)
Introduction: Entering the university implies multiple changes that affect the nutritional status and can condition the appearance of chronic non-communicable diseases in the future. Objective: To compare the nutritional status of Nutrition and Dietetics students from Mexico and Colombia through anthropometric measurements and food consumption. Material and Methods: Through the application of a survey, the food consumption and lifestyle of the students were investigated. The anthropometric data collection was carried out using the techniques adopted by The International Society for the Advancement of Kinanthropometry (ISAK). With the data obtained, a descriptive, exploratory, multidimensional and cross-sectional study was carried out. The sample size was 583 students randomly chosen from university centers in Colombia and Mexico. The statistical techniques used included: comparison test for proportions, MANOVA and frequency distributions. Results: There was a higher genetic load for diabetes mellitus, arterial hypertension, cancer and obesity in Mexican students who reported more overweight and gastrointestinal diseases. The frequent consumption of whole cheese, eggs, saturated and polyunsaturated fats, sugars and sweets and fried products was higher in Colombian women while the consumption of low-fat cheese, legumes and vegetable mixtures, monounsaturated fats, sauces, fruits, vegetables, nuts and seeds, canned goods and alcoholic beverages was higher in Mexican women, presenting a significant difference (p <0.05). Conclusions: Dietary changes are reported from the beginning of the studies, which is a protective factor for the development of non-communicable chronic diseases. There must be consistency among knowledge, eating practices and lifestyle to maintain health and achieve greater credibility of the knowledge imparted(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Estudantes/estatística & dados numéricos , Universidades , Dietética , Ciências da Nutrição , Estado Nutricional/fisiologia , Epidemiologia Descritiva , Estudos Transversais , Colômbia , Ingestão de Alimentos/fisiologia , Consumo de Álcool na Faculdade , MéxicoRESUMO
OBJECTIVES: To investigate the impact of public health insurance coverage, specifically the New Cooperative Medical Scheme (NCMS), on childhood nutrition in poor rural households in China, and to identify the mechanisms through which health insurance coverage affects nutritional intake. METHODS: Longitudinal data on 3291 children were taken from four time periods (2004, 2006, 2009, and 2011) from the China Health and Nutrition Survey (CHNS). Panel data analysis was performed with the fixed-effect model and the propensity score matching with difference-in-differences (PSM-DID) approach. RESULTS: The introduction of the NCMS was associated with a decline in calories, fat, and protein intake, and an increase in the intake of carbohydrates. The NCMS had the greatest negative effect on children aged 0 to 5 years, particularly girls. Out-of-pocket medical expenses were identified as the main channel through which the NCMS affected the nutritional intake of children. CONCLUSIONS: The study showed that the NCMS neither significantly improved the nutritional status of children nor enhanced intake of high-quality nutrients among rural poor households. These findings were attributed to the way in which health-seeking behavior was modified in the light of NCMS coverage. Specifically, NCMS coverage tended to increase healthcare utilization, which in turn increased out-of-pocket medical expenditures. This encouraged savings to aid financial risk protection and resulted in less disposable income for food consumption.
Assuntos
Ingestão de Energia/fisiologia , Financiamento Pessoal/estatística & dados numéricos , Estado Nutricional/fisiologia , População Rural/estatística & dados numéricos , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Fatores Etários , Criança , Pré-Escolar , China , Dieta , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Modelos Econométricos , Inquéritos Nutricionais , Pontuação de Propensão , Saúde Pública , Fatores SexuaisRESUMO
INTRODUCTION: Disease-related malnutrition represents an imbalance between the intake and the requirements of energy and nutrients. It produces a series of metabolic and functional changes in the body. There are multiple limitations in the classic parameters for nutrition assessment including body mass index, weight loss, food intake, or standard laboratory parameters such as albumin or lymphocytes. We can establish some points of interest in this new approach to nutrition focused on the assessment of nutritional status by evaluating changes in composition and function using parameters such as PhA and other electrical measurements of bioimpedance, dynamometry, functional tests, muscle ultrasound, or laboratory parameters such as CRP/prealbumin. Each of these parameters has a number of uses and limitations that should be understood when evaluating its ability to diagnose malnutrition as related to disease, its concordance with other tests, and its prognostic value. Emerging nutritional parameters for future use should be sensitive, specific, and interrelated to allow a better understanding of each patient's status at different time points during their disease.
INTRODUCCIÓN: La malnutrición relacionada con la enfermedad representa un disbalance entre el aporte y los requerimientos de energía y nutrientes, que produce una serie de cambios metabólicos y funcionales a nivel corporal. Existen múltiples limitaciones de los parámetros clásicos de valoración nutricional, como el índice de masa corporal, la pérdida de peso, la ingesta o los parámetros analíticos clásicos, como es el caso de la albúmina o los linfocitos. Sugerimos un nuevo enfoque de la nutrición clínica centrado en la valoración del estado nutricional del paciente evaluando los cambios de composición y función con nuevos parámetros como el ángulo de fase y otras medidas eléctricas de la bioimpedanciometría, la ecografía nutricional©, los nuevos parámetros analíticos como el cociente PCR/prealbúmina, la dinamometría o los test funcionales. Cada uno de estos parámetros tiene una serie de utilidades y limitaciones que es importante conocer a la hora de evaluar su capacidad de diagnosticar la desnutrición relacionada con la enfermedad, la concordancia con otros tests y su valor pronóstico. La nueva visión global de la nutrición clínica debería integrar diferentes aspectos de composición y función del organismo para poder establecer un diagnóstico más preciso de la situación nutricional y un plan terapéutico individualizado. Los parámetros nutricionales emergentes deben ser sensibles y específicos, y estar relacionados entre sí, de forma que permitan un mejor conocimiento de la situación particular de cada paciente en los diferentes momentos evolutivos de su proceso patológico.
Assuntos
Desnutrição/diagnóstico , Desnutrição/fisiopatologia , Estado Nutricional/fisiologia , Humanos , Desnutrição/etiologiaRESUMO
OBJECTIVE: This study selects the health indicators of older adults to analyze the impact of tea drinking on health. DESIGN: This is a panel data. SETTING: This study uses data from China Health and Nutrition Survey (CHNS), which covers nine provinces and ten waves, between 1997 and 2015. PARTICIPANTS: a total of 706 old adults are consistently surveyed in six surveys on issues such as health and nutrition. MEASUREMENTS: Health of old adults is assessed by self-reported health (SRH), tea drinking is 0-1 dummy variable, and also analyze with the frequency of tea drinking. This study uses ordered probit model to analyze the influence of tea drinking on SRH. RESULTS: Findings reveal a significant negative correlation between tea drinking and SRH of older adults. It is shows that the significant positive correlation exists between the tea drinking frequency and SRH, but the quadratic term of tea frequency shows the significant negative correlation. It means drinking tea benefits older adults in terms of improved health, but excessive consumption of tea is not healthy for them. The heterogeneity analyses reveal that there are no significant geographic, tea-drinking pattern or gender differences in the conclusion that tea drinking is good for older adults' health. CONCLUSION: In this study, we find correlation between tea drinking and SRH of older adults, and tea drinking is beneficial toward the improvement of SRH, but drinking tea in excess is not good for older adults' health.
Assuntos
Envelhecimento , Inquéritos Nutricionais , Estado Nutricional/fisiologia , Chá , Feminino , Promoção da Saúde , Nível de Saúde , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
Pregnancy and lactation can change the maternal nutrient reserve. Non-invasive, quantitative markers of maternal nutrient intake could enable personalized dietary recommendations that improve health outcomes in mothers and infants. Macular pigment optical density (MPOD) is a candidate marker, as MPOD values generally reflect carotenoid intake. We evaluated the association of MPOD with dietary and breastmilk carotenoids in postpartum women. MPOD measurements and dietary intake of five carotenoids were obtained from 80 mothers in the first three months postpartum. Breastmilk samples from a subset of mothers were analyzed to determine their nutrient composition. The association between MPOD and dietary or breastmilk carotenoids was quantitatively assessed to better understand the availability and mobilization of carotenoids. Our results showed that dietary α-carotene was positively correlated with MPOD. Of the breastmilk carotenoids, 13-cis-lutein and trans-lutein were correlated with MPOD when controlled for the total lutein in breastmilk. Other carotenoids in breastmilk were not associated with MPOD. Maternal MPOD is positively correlated with dietary intake of α-carotene in the early postpartum period, as well as with the breastmilk content of lutein. MPOD may serve as a potential marker for the intake of carotenoids, especially α-carotene, in mothers in the early postpartum period.
Assuntos
Carotenoides/administração & dosagem , Dieta , Lactação/fisiologia , Pigmento Macular/química , Estado Nutricional/fisiologia , Adulto , Carotenoides/análise , Feminino , Humanos , Recém-Nascido , Luteína/análise , Leite Humano/química , Fotometria/métodos , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
Vitamin A supplementation for children 6-59 months old is an important intervention that boosts immune function, especially where children do not consume enough vitamin-A-rich foods. However, the low coverage of vitamin A supplementation is a persistent problem in low- and middle-income countries. We first estimated the percentage of children 6-23 months old receiving the minimum dietary diversity, vitamin-A-rich foods, and vitamin A supplementation, and second, the difference in the percentage receiving vitamin A supplementation between children 6-23 months old and children 24-59 months old using nationally representative cross-sectional household surveys, namely, the Demographic and Health Surveys, conducted from 2010 to 2019 in 51 low- and middle-income countries. Overall, 22% (95% CI: 22, 23) of children received the minimum dietary diversity, 55% (95% CI: 54, 55) received vitamin-A-rich foods, 59% (95% CI: 58, 59) received vitamin A supplementation, and 78% (95% CI: 78, 79) received either vitamin-A-rich foods or supplementation. A wide variation across countries was observed; for example, the percentage of children that received either vitamin-A-rich foods or supplementation ranged from 53% (95% CI: 49, 57) in Guinea to 96% (95% CI: 95, 97) in Burundi. The coverage of vitamin A supplementation should be improved, especially for children 6-23 months old, in most countries, particularly where the consumption of vitamin-A-rich foods is inadequate.
Assuntos
Dieta , Vitamina A/administração & dosagem , Burundi , Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Pré-Escolar , Estudos Transversais , Suplementos Nutricionais , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Lactente , Masculino , Estado Nutricional/fisiologia , Pobreza , População Rural , Fatores Socioeconômicos , População UrbanaAssuntos
Enteropatias/complicações , Enteropatias/terapia , Nutrição Parenteral/efeitos adversos , Nutrição Parenteral/história , Acidose/complicações , Caseínas/administração & dosagem , Caseínas/uso terapêutico , Digestão/fisiologia , Gastroenterologia , História do Século XVII , História do Século XX , Humanos , Hipoglicemia/complicações , Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido Prematuro/metabolismo , Enteropatias/fisiopatologia , Estado Nutricional/fisiologia , Nutrição Parenteral/economia , Preparações FarmacêuticasRESUMO
BACKGROUND: No gold standard of nutritional assessment is established among patients with head and neck cancer (HNC) receiving concurrent chemoradiotherapy (CCRT). This study aimed to evaluate the clinical significance of pre-treatment nutritional status using the Mini Nutritional Assessment-short form (MNA-SF) among HNC patients receiving CCRT. METHODS: A total of 461 consecutive patients with newly diagnosed HNC treated with definitive CCRT at three medical institutes were prospectively enrolled. Nutritional status was assessed using MNA-SF within 7 days before CCRT initiation. Patients were classified as having normal nutrition, at risk of malnutrition, and malnourished groups according to MNA-SF for comparison. RESULTS: The 1-year overall survival rates were 89.8%, 76.8%, and 67.7% in the normal nutrition, at risk of malnutrition, and malnourished groups, respectively. Patients with normal nutrition had significantly lower rates of uncompleted radiotherapy and chemotherapy (4.5% and 4.1%, respectively) compared with patients at risk for malnutrition (14.1% and 11.5%, respectively) and those malnourished (11.1% and 11.1%, respectively). Patients with normal nutrition had significantly lower treatment-related complication rates regarding emergency room visits, hospital admission, and need for tubal feeding than those with at risk of malnutrition and malnourished. Patients with normal nutrition had significantly fewer severe hematologic toxicities (p = 0.044) and severe non-hematologic toxicities (p = 0.012) of CCRT than those malnourished. CONCLUSION: Pre-CCRT nutritional status identifies HNC patients vulnerable to treatment interruption and treatment complications. We suggest that nutritional assessment with MNA-SF should be incorporated in pre-CCRT evaluation for all HNC patients.
Assuntos
Quimiorradioterapia/métodos , Neoplasias de Cabeça e Pescoço/dietoterapia , Avaliação Nutricional , Estado Nutricional/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Sobrevida , Adulto JovemRESUMO
BACKGROUND: Home Parenteral Nutrition (HPN) is a lifesaving clinical care process. However, undetected hazards and vulnerabilities in care transitions from hospital to community care may pose risk to patient's safety. Avoidable complications and adverse events may hinder the benefits of treatment. OBJECTIVE: The analysis carried out aims at framing through Human Factors and Ergonomics (HF/E) the critical issues for patient safety related to clinical care practices for HPN in healthcare organization. METHODS: We present the results of a proactive risk assessment analysis based on the FMEA methodology (Failure Mode and Effects Analysis) carried out in three different areas of the regional health care system of Tuscany, Italy. The clinical risk management and patient safety unit assessed the risk perception of Healthcare Workers (HWs) in regard to patient safety and situational awareness throughout the HPN patient journey. RESULTS: The analysis revealed heterogeneity in the Risk Priority Index (RPI) expressed by HWs. A lower RPI is associated with a HPN process that deploys in continuity between hospital care and community care. A higher RPI is associated with a quality and safety improvement process that is still ongoing. We also observed HWs expressing low RPI in the areas of the region where HPN has a hospital- focused approach and has limited adherence to patient safety requirements. Low RPI for HPN process may relate both to extensively deployed continuity of care and to jeopardized awareness on HPN phases and coordination. The analysis carried out enabled the definition of a common HPN workflow used as reference schema allowing for the definition of a set of recommendations for improving the quality and safety of the care processes. Moreover, the outcome of the proactive risk assessment laid the groundwork for the advancement of the patient safety regional requirements. CONCLUSION: The analysis had the role of promoting the contextualization of the culture of quality and safety within the HPN process resulting in an improved awareness of the criticalities and the role of nutrition units throughout the care process.
Assuntos
Serviços de Saúde Comunitária/tendências , Estado Nutricional/fisiologia , Nutrição Parenteral no Domicílio/tendências , Transferência de Pacientes/tendências , Inquéritos e Questionários , Serviços de Saúde Comunitária/normas , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral no Domicílio/efeitos adversos , Nutrição Parenteral no Domicílio/normas , Transferência de Pacientes/normas , Medição de Risco/normas , Medição de Risco/tendências , Falha de Tratamento , Resultado do TratamentoRESUMO
OBJECTIVE: To analyze variability in newborn (NB) anthropometry among Jujenean NBs as a function of geographic altitude (500 m to ≈4000 masl), maternal anthropometry and other maternal characteristics within the maternal capital framework. MATERIALS AND METHODS: Data obtained from 41,371 mother/child pairs recorded in the Jujuy Perinatal Information System (SIP) between 2009 and 2014, including: NB and maternal weight, length/height and BMI; gestational age (corrected); maternal age, educational level, nutritional status, and marital status; birth interval; and planned pregnancy. Based on the declared place of residence, the prevalence of unsatisfied basic needs (% UBN) was determined and the data was split into two altitudinal groups: highlands (HL, >2500 masl) and lowlands (LL, <2500 masl). ANOVA, Chi-squared and Pearson tests were applied as needed. Statistical associations between the response variables-NB weight, length and BMI-and maternal and environmental variables were tested using a Generalized Additive Mixed Model (GAMM). RESULTS: All NB and maternal anthropometric variables were lower in HL compared to LL; they also presented negative correlations with altitude, except NB length. Apart from gestational age and birth interval, HL and LL presented statistically significant differences in all study variables. GAMM results showed that maternal anthropometry was the main influence on NB weight and length. DISCUSSION: Of all the maternal capital features examined, only maternal anthropometric variables were found to protect offspring against the negative impact of HL environments.
Assuntos
Altitude , Indígenas Sul-Americanos/estatística & dados numéricos , Recém-Nascido/fisiologia , Saúde Materna/estatística & dados numéricos , Estado Nutricional/fisiologia , Adulto , Antropologia Física , Antropometria , Argentina , Peso Corporal/fisiologia , Escolaridade , Idade Gestacional , Humanos , Idade Materna , Mães/estatística & dados numéricos , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: Screening of commercial mineral feeds and mineral licks on the German market containing selenium (Se) in relation to the Se status in equines in Thuringia with different forms of Se supplementation. MATERIAL AND METHODS: Commercially available Se-containing minerals for horses identified by an online research were evaluated for their Se concentration, Se source, flavour carrier and recommended dosage according to the manufacturer's labelling. Furthermore, serum Se status in 8 equine farms was regularly monitored over the period of one year. The sampled horses either received no Se supplement or Se was supplemented by a mineral lick, a mineral feed or supplementary feed. RESULTS: In 29.7 % of the mineral licks, the manufacturers provided a label with information on the maximal daily Se dosage, all of which exceeded the current recommendations of daily Se intake for a 600 kg horse under maintenance conditions. According to the manufacturers' labelled dosage, 67.5 % of the mineral feeds also exceeded the recommended daily Se intake taking the daily Se requirement of a 600 kg horse under maintenance conditions into consideration. The declarations of the feeds, especially in the case of mineral licks, were frequently not in conformity with the Regulation (EC) Nr. 767/2009 on commercial market introduction and use of feed. Concerning the horses' Se status, only horses receiving Se supplementation either via mineral lick with a Se concentration ≥ 20-50 mg/kg or a mineral or supplementary feed exhibited median serum Se concentrations within the reference range. In 2 of 10 horses with access to mineral licks with molasses containing Se concentrations ≥ 45 mg/kg, serum Se concentration exceeded the reference range at at least at one sampling time point. CONCLUSION AND CLINICAL RELEVANCE: Due to difficulties in their dosaging, the use of mineral licks should be only considered in extensively managed farms with limited access to the individual horse. The recommended Se concentration in mineral licks is recommended to lie in the range of 40-50 mg/kg. In order to attain improved control over Se intake, this trace element ought to be provided by individual feeding using either a mineral supplement or a supplementary feed.