Brazil Nut (Bertholletia excelsa H.B.K.) Consumption in Energy-Restricted Intervention Decreases Proinflammatory Markers and Intestinal Permeability of Women with Overweight/Obesity: A Controlled Trial (Brazilian Nuts Study).

BACKGROUND: Obesity is associated with low-grade inflammation and increased intestinal permeability (IP). The Brazil nut (BN) (Bertholletia excelsa H.B.K.) appears to be a promising dietary intervention to control inflammation by enhancing antioxidant defenses. OBJECTIVES: We aimed to assess the effect of daily BN consumption on inflammatory biomarkers and IP in the context of an energy-restricted intervention. Furthermore, we evaluated the correlation between the changes in these inflammatory markers and the changes in serum selenium and IP. METHODS: In this 8-wk nonrandomized controlled trial, 56 women with overweight or obesity were allocated into 2 groups, both following an energy-restricted diet (-500 kcal/d). The control group (CO) consumed a nut-free diet, while the BN group consumed 8 g BN/d, providing 347.2 µg selenium (Se). Inflammatory cytokines were analyzed in plasma and Se in serum. IP was assessed using the lactulose/mannitol test (LM ratio). RESULTS: Forty-six women completed the intervention. Both groups achieved similar energy restriction (CO Δ= -253.7 ± 169.4 kcal/d; BN Δ= -265.8 ± 141.8 kcal/d) and weight loss (CO Δ= -2.5 ± 0.5 kg; BN Δ= -3.5 ± 0.5 kg). The BN group showed lower values of C-reactive protein, tumor necrosis factor, interleukin (IL)1-ß, IL-8, percentage lactulose excretion, and LM ratio than the CO group. Additionally, changes in serum Se concentration were predictive of changes in IL-8 concentration (ß: -0.054; adjusted R2: 0.100; 95% confidence interval [CI]: -0.100; -0.007; P = 0.025), and changes in IL-8 were predictive of changes in the LM ratio (ß: 0.006; adjusted R2: 0.101; 95% CI: 0.001, 0.011; P = 0.024). CONCLUSIONS: Regular intake of BNs can be a promising complementary dietary strategy for controlling low-grade inflammation and improving IP in women with overweight/obesity undergoing energy-restricted treatment. However, the effects of BNs seem to be Se status-dependent. This trial was registered at the Brazilian Registry of Clinical Trials (ReBEC: https://ensaiosclinicos.gov.br/rg/RBR-3ntxrm/.

Effect of carotenoids on gut health and inflammatory status: A systematic review of in vivo animal studies.

Carotenoids have anti-inflammatory and antioxidant properties, being a potential bioactive compound for gut health. The objective of this systematic review was to investigate the effects of carotenoids on gut microbiota, gut barrier, and inflammation in healthy animals. The systematic search from PubMed, Scopus, and Lilacs databases were performed up to March 2023. The final screening included thirty studies, with different animal models (mice, rats, pigs, chicks, drosophila, fish, and shrimp), and different carotenoid sources (ß-carotene, lycopene, astaxanthin, zeaxanthin, lutein, and fucoxanthin). The results suggested that carotenoids seem to act on gut microbiota by promoting beneficial effects on intestinal bacteria related to both inflammation and SCFA production; increase tight junction proteins expression, important for reducing intestinal permeability; increase the mucins expression, important in protecting against pathogens and toxins; improve morphological parameters important for digestion and absorption of nutrients; and reduce pro-inflammatory and increase anti-inflammatory cytokines. However, different carotenoids had distinct effects on gut health. In addition, there was heterogeneity between studies regarding animal model, duration of intervention, and doses used. This is the first systematic review to address the effects of carotenoids on gut health. Further studies are needed to better understand the effects of carotenoids on gut health.

Association between total dietary antioxidant capacity and food groups and incidence of depression in a cohort of Brazilian graduates (CUME Project).

This study aims to evaluate the association between Dietary Total Antioxidant Capacity (dTAC) and Total Antioxidant Capacity of food groups (fgTAC) with the incidence of depression in Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). The sample consisted of 2572 participants without a medical diagnosis of depression at baseline who responded to at least one follow-up questionnaire from the CUME Project. The Ferric Reducing Antioxidant Power assay was used to determine dTAC. Incidence of depression was estimated by self-reported medical diagnosis of depression during the years of cohort follow-up. Cox regression models were used to relate dTAC and fgTAC to the incidence of depression. The mean follow-up time was 2·96 (1·00) years, and 246 cases of depression were observed (32·3/1000 person-years). The mean dTAC was 11·03 (4·84) mmol/d. We found no associations between higher dTAC and lower risk of developing depression after adjusting for possible confounders. The incidence of depression was inversely associated with fgTAC of the beans and lentils group (hazard ratio (HR): 0·61; 95 % CI 0·41, 0·90). The fgTAC of the junk food group was positively associated with higher incidence of depression after all adjustments (HR: 1·57; 95 % CI 1·08, 2·26). Our findings do not support an association between dTAC and the incidence of depression in a highly educated Brazilian population. However, associations of fgTAC show the importance of analysing the food matrix in which these antioxidants are inserted. We highlight the need for more prospective studies with different nationalities to confirm these results.

Consumption of sweetened beverages is associated with the incidence of type 2 diabetes in Brazilian adults (CUME project).

BACKGROUND AND AIM: To evaluate the association between the energy consumption of sweetened beverages (SBs) adjusted for daily energy intake and the incidence of type 2 diabetes. METHODS AND RESULTS: This was a prospective study with 2480 type 2 diabetes mellitus (T2DM)-free Cohort of Universities of Minas Gerais (CUME) participants at baseline and 2-4 years of follow-up. A longitudinal analysis was performed with generalized equation estimation to verify the effect of SB consumption, adjusted for sociodemographic and lifestyle variables, on the incidence of T2DM. The incidence of T2DM was 2.78%. The median calorie intake of daily SB consumption adjusted for energy was 47.7 kcal/day. Participants with the highest consumption of SBs (≥47.7 kcal/day) were 63% (odds ratio [OR] = 1.63; p value-0.049) more likely to acquire T2DM over time compared to the lowest consumption (<47.7 kcal/day). CONCLUSIONS: Higher energy consumption from SBs favored a higher incidence of T2DM among CUME participants. The results reinforce the need for marketing restrictions on these foods and taxation to reduce the consumption of these beverages to prevent T2DM and other chronic noncommunicable diseases.

Food consumption by degree of processing is associated with nocturnal dipping and blood pressure variability: The ELSA-Brasil study.

BACKGROUND AND AIMS: Ambulatory blood pressure monitoring (ABPM) allows the assessment of cardiovascular risk markers that cannot be obtained by casual measurements; however, the evidence on the association between food consumption and blood pressure (BP) assessed by ABPM is scarce. We aimed to evaluate the association between food consumption by degree of processing and ambulatory BP. METHODS AND RESULTS: Cross-sectional analysis (2012-2014) of data from a subsample (n = 815) of ELSA-Brasil cohort participants who performed 24-h ABPM was conducted. Systolic (SBP) and diastolic (DBP) BP means and variability during the 24 h and subperiods (sleep and wake), nocturnal dipping, and morning surge were evaluated. Food consumption was classified according to NOVA. Associations were tested by generalized linear models. The consumption of unprocessed, minimally processed foods, and culinary ingredients (U/MPF&CI) was 63.1% of daily caloric intake, 10.8% of processed (PF), and 24.8% of ultraprocessed (UPF). A negative association was found between U/MPF&CI consumption and extreme dipping (T2: odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.55-0.58; T3: OR = 0.55; 95% CI = 0.54-0.57); and between UPF consumption and nondipping (T2: OR = 0.68, 95% CI = 0.55-0.85) and extreme dipping (T2: OR = 0.63, 95% CI = 0.61-0.65; T3: OR = 0.95, 95% CI = 0.91-0.99). There was a positive association between PF consumption and extreme dipping (T2: OR = 1.22, 95% CI = 1.18-1.27; T3: OR = 1.34, 95% CI = 1.29-1.39) and sleep SBP variability (T3: Coef = 0.56, 95% CI = 0.03-1.10). CONCLUSIONS: The high consumption of PF was associated with greater BP variability and extreme dipping, while the U/MPF&CI and UPF consumption were negatively associated with alterations in nocturnal dipping.

Low polyphenol intake among highly scholarity population: CUME cohort.

In the absence of a recommendation for daily intake of phenolic compounds, to compare the intake of the main dietary polyphenols between populations is a really challenge. This study aimed to estimate the total dietary intake of polyphenols, classes and their food sources among Brazilian graduates and postgraduates. This was a cross-sectional study using baseline data from the Cohort of Universities of Minas Gerais (CUME project). Food consumption was assessed using a quantitative food frequency questionnaire with 144 food items. Polyphenol intake was estimated from the Phenol-Explorer and US Department of Agriculture database, and previous studies that evaluated the phenolic content of specific foods. A total of 4130 individuals of both sexes with a median age of 34 (18-86) years old were finally included. The median intake of total polyphenols adjusted for energy was 753.41 mg/day (interquartile range - IQR=461.80; p<0.001), and the most consumed classes were phenolic acids and flavonoids, with median intakes of 552.30 mg/d (IQR=429.78; p<0.001) and 154.70 mg/day (IQR=108.70; p<0.001), respectively. The main food sources of polyphenols were coffee, peanuts, beans, and fruits. A lower intake of total polyphenols and their classes was observed in a population with similar characteristics to those from developed countries. The results demonstrate the importance of disseminating nutritional information about foods, so that the consumption of natural foods is prioritized. New studies that evaluate the consumption of polyphenols and their impact on human health are recommended to establish a daily recommendation for the consumption of such compounds.

Higher caffeine consumption is associated with insufficient sleep time in Brazilian adults (CUME study).

We aimed to evaluate the association between caffeine intake and sleep time in Brazilian adults. This cross-sectional study was conducted with 6,356 participants from the Cohort of Universities of Minas Gerais (CUME Study). Data was collected through an online self-report questionnaire. Of the total, 31.9% of the participants had insufficient sleep. Women were found to sleep less than men (64.1 vs. 35.9%; p < 0.001), as well as being more likely to consume higher doses of caffeine (55.2%, p < 0.001). Coffee (35.7%), dark chocolate (25.2%), milk chocolate (15.2%), and diet soda (11.0%) were the foods that more contributed to caffeine intake. Individuals in the highest quartile of caffeine intake (87.0 - 572.0 mg/day) had a 19% higher prevalence of insufficient sleep compared with the lowest quartile (PR: 1.19; 95%CI: 1.08 - 1.31). Future studies are needed to investigate the genetic and hormonal factors involved in the interindividual response in this population.

Habitual polyphenol intake of foods according to NOVA classification: implications of ultra-processed foods intake (CUME study).

We aimed to evaluate the intake of dietary total polyphenols and their classes according to NOVA classification among adults of a Brazilian cohort study. This is a cross-sectional study, in which food consumption was assessed using an Food Frequency Questionnaire (FFQ) and polyphenol content (total and their classes) was estimated at Phenol-Explorer for each food category and presented as mean and 95% confidence interval. Adjusted linear regression was used to describe the trend of the association between the quintiles of polyphenols intake (dependent variable) and NOVA group of food consumption (independent variable). The higher consumption of fresh/minimally processed foods is accompanied by a higher intake of total polyphenols and all their classes, while the higher consumption of ultra-processed foods represented the lower intake of total polyphenols and their classes. Fresh foods are the greatest sources of polyphenols, and their daily consumption should be encouraged, while ultra-processed foods are deficient in such bioactive compounds.

Effect of chronic consumption of nuts on oxidative stress: a systematic review of clinical trials.

Nuts consumption has been associated with a protective effect against cardiovascular diseases and oxidative stress-related disorders. We aimed to perform a systematic review with clinical trials to assess the impact of chronic nuts consumption on oxidative stress and the possible mechanisms involved. Studies were identified by searching in three electronic databases: PubMed/MEDLINE, Scopus, and LILACS, and selected following PRISMA guidelines. Two authors perform searching and data extraction. A total of 16 articles were included (12 randomized clinical trials and 4 one or two-arm clinical trials). Nut doses were generally high (> 30 g/d), except for Brazil nuts (5-13 g/d). The follow-up time ranges between four weeks and six months, and the oxidized low-density lipoprotein (ox-LDL) was the most assessed biomarker. Eight articles reported improvement in oxidative stress biomarkers after nuts supplementation. Pathways regulated by selenium (e.g. glutathione peroxidase activity and nuclear factor-E2-related factor 2 (Nrf2) regulation), monounsaturated fatty acids (e.g. reduction of LDL oxidation), and bioactive compounds (e.g. antioxidant activity) were described as mechanisms involved in these beneficial effects. No studies reported harmful effects of nut consumption, even in high doses. The chronic consumption of nuts seemed to be effective to change some oxidative stress biomarkers, however, this topic remains controversial because the benefits depends on nut type, nut dose, and population characteristics.

Brazil and cashew nuts intake improve body composition and endothelial health in women at cardiometabolic risk (Brazilian Nuts Study): a randomized controlled trial.

Several mechanisms have been proposed for the beneficial effect of nuts on health. However, Brazil and cashew nuts remain the least studied. We aim to evaluate the effect of these nuts within an energy-restricted diet on body weight, body composition, cardiometabolic markers, and endothelial function in cardiometabolic risk women. Brazilian nuts study is a randomized controlled parallel 8-week dietary intervention trial. Forty women were randomly allocated to 1) Control group: Energy-restricted diet without nuts, n= 19 or, 2) Brazil and cashew nuts group (BN-Group): Energy-restricted diet containing daily 45 g of nuts (15 g of Brazil nuts + 30g of cashew nuts), n= 21. At the beginning and final intervention, anthropometry, body composition, and blood pressure were measured. Fasting blood sampling was obtained to evaluate lipid profile, glucose homeostasis, and endothelial function markers. After 8-week, plasma selenium concentration increased in BN-group (∆ = + 31.5 ± 7.8 µg/L; p= 0.001). Brazil and cashew nuts intake reduced total body fat (-1.3 ± 0.4 %) parallel to improvement of lean mass percentage in BN-group compared to the control. Besides, the soluble adhesion molecule VCAM-1 decreased (24.03 ± 15.7 pg/mL vs. -22.2 ± 10.3 pg/mL; p= 0.019) after Brazil and cashew nuts intake compared to the control. However, lipid and glucose profile markers, apolipoproteins, and blood pressure remained unchanged after the intervention. Thus, the addition of Brazil and cashew nuts to an energy-restricted diet can be a healthy strategy to improve body composition, selenium status, and endothelial inflammation in cardiometabolic risk women.

Adiposity and insulin resistance mediate the inverse association between legume intake and blood pressure: a cross-sectional analysis in secondary cardiovascular prevention.

This study aimed to evaluate the association between legume intake and blood pressure, as well as the mediating role of cardiometabolic risk factors in patients in secondary cardiovascular prevention. Socio-demographic, anthropometric, clinical and food intake data were collected from the baseline of the multicentre study Brazilian Cardioprotective Nutritional Program Trial - BALANCE (RCT: NCT01620398). The relationships between variables were explored through path analysis. In total, 2247 individuals with a median age of 63·0 (45-91) years, 58·8 % (n 1321) male and 96·5 % (n 2168) with diagnosis of hypertension were included. Negative associations were observed between histidine intake and systolic blood pressure (SBP) (standardised coefficient (SC) = -0·057; P = 0·012) and between legume intake and BMI (SC = -0·061; P = 0·006). BMI was positively associated with triglycerides-glucose (TyG) index (SC = 0·173; P < 0·001), SBP (SC = 0·144; P < 0·001) and diastolic blood pressure (DBP) (SC = 0·177; P < 0·001), and TyG index was positively associated with DBP (SC = 0·079; P = 0·001). A negative indirect effect was observed between the intake of legumes, SBP and DBP, mediated by BMI (SC = -0·009; P = 0·011; SC = -0·011; P = 0·010, respectively). In addition, an indirect negative effect was found between the intake of legumes and the DBP, mediated simultaneously by BMI and TyG index (SC = -0·001; P = 0·037). In conclusion, legume intake presented a negative indirect association with blood pressure, mediated by insulin resistance (TyG) and adiposity (BMI) in individuals of secondary care in cardiology.

Ultra-processed food consumption and dietary, lifestyle and social determinants: a path analysis in Brazilian graduates (CUME project).

OBJECTIVE: To explore the relationship between ultra-processed foods (UPF) consumption and dietary, lifestyle and social determinants using pathway analysis in the baseline of the Cohort of Universities of Minas Gerais (CUME project). DESIGN: Cross-sectional study, in which path analysis was used to estimate direct and indirect effects of dietary practices, sleep, time on the computer and professional status on UPF consumption. SETTING: Data were collected in 2016, through an online questionnaire composed of sociodemographic, anthropometric, lifestyle and dietary practices questions, and a FFQ. PARTICIPANTS: Baseline participants from the CUME Project (n 2826), adults who graduated from Universidade Federal de Viçosa or Universidade Federal de Minas Gerais, Brazil. RESULTS: Being employed (P = 0·024), the time spent on the computer (P = 0·031) and the frequency of fried food intake (P < 0·001) were positively and directly associated with UPF consumption, whereas the sleep duration (P = 0·007) and the number of meals per d (P < 0·001) were negatively and directly associated with UPF consumption. Indirect effects were observed between being employed, mediated by the sleep duration (P = 0·032) and fried food intake (P = 0·005), whereas being a student is mediated by the time on the computer (P = 0·048). CONCLUSION: The time spent on the computer, sleep duration and fried food consumption showed direct effects on UPF consumption. They also acted as mediators on the relationship between professional status and UPF consumption. Besides, the number of meals eaten each day also was directly associated with UPF consumption.

Dietary inflammatory potential, cardiometabolic risk and inflammation in children and adolescents: a systematic review.

The Dietary Inflammatory Index (DII®) is a tool developed for quantifying the dietary inflammatory potential of individuals' diets, with the goal of assessing the effect of diet-associated inflammation on health outcomes. With most studies focusing on adults, little is known about the consequences for health of a more proinflammatory diet early in life. Hence, this study analyzed the available evidence on the association between the DII or the children's C-DII (C-DIITM) and cardiometabolic risk and inflammatory biomarkers in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed at the LILACS, ScienceDirect, Cochrane and PubMed databases, without any restriction regarding the dates of the publications. A total of six observational studies qualified; including three cross-sectional and three longitudinal studies focused on children and adolescents between 3 and 18 years of age representing both sexes. All papers found a positive association between the DII or C-DII with cardiometabolic markers. These included adiposity (i.e., BMI, waist and hip circumference, waist-to-height ratio and fat mass index), and/or to inflammatory biomarkers (interleukins 1, 2 and 6, tumor necrosis factor-alpha, interferon gamma, and soluble vascular cell adhesion molecule-1). In conclusion, findings currently available in the literature indicate that a proinflammatory diet is associated with a higher risk of early development of cardiometabolic and inflammatory changes during childhood. Also, the findings show the applicability of the DII and C-DII in epidemiological studies and underscore the need for strategies to encourage healthy, anti-inflammatory diets to prevent chronical illnesses. Systematic Review Registration Number (PROSPERO: CRD42019123939).

Predictive capacity of triglyceride-glucose (TyG) index for insulin resistance and cardiometabolic risk in children and adolescents: a systematic review.

Insulin resistance (IR) in childhood plays a key role in the development of metabolic changes in adulthood, therefore, it is important to diagnose it early. We aimed to investigate studies that evaluated the TyG index for prediction of IR risk and other cardiometabolic risk factors, as well as, the proposed cutoff points in childhood and adolescence. This is a systematic review elaborated according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The search was performed in Lilacs, PubMed and CAPES Journal Portal, using the terms "TyG index OR triglyceride-glucose index OR triglyceride and glucose index AND children OR adolescent*". Eight articles were included in this review. All were cross-sectional studies with individuals aged ≥2 and ≤20 years old, from the United States, Korea, Mexico, Brazil, and Iran. We concluded that the TyG index was positively associated with other IR prediction methods and appears to be advantageous for predicting IR risk and other cardiometabolic risk factors in children and adolescents (review registration: PROSPERO CRD42018100726).

Can resveratrol modulate sirtuins in obesity and related diseases? A systematic review of randomized controlled trials.

PURPOSE: Human sirtuins can be a powerful therapeutic target in preventing and treating obesity and age-related diseases. Some dietary components can modulate sirtuins' activity, such as resveratrol. This systematic review aimed to assess whether resveratrol (RSV), without other interventions, can stimulate sirtuins in the treatment of excess weight and its comorbidities. METHODS: MEDLINE/Pubmed, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) were used for search eligible articles. Randomized clinical trials assessing RSV supplementation on changes in the sirtuins' gene expression/protein levels was the primary outcome. Other possible changes in cardiometabolic markers were considered the second outcome. Following PRISMA guidelines and using predefined inclusion and exclusion criteria, two reviewers independently and in parallel screened, assessed the studies' quality, and compiled data. Disagreements were resolved by consensus or consulting a third author. RESULTS: This review included seven randomized control trials. Four articles demonstrated a significant increase in SIRT-1 with different RSV dosages and interventions time. The secondary outcomes showed improvements in insulin sensitivity, lipid profile, metabolic flexibility, total antioxidant capacity, energy expenditure changes, and reduction of ectopic accumulation of fat. CONCLUSION: Data from RCTs studies showed that RSV supplementation could stimulate SIRT-1 in humans, and therefore contribute to the treatment of excess weight and its comorbidities. However, more research is needed because it was not possible to confirm this effect truly. [PROSPERO registration number: CRD42020205571].

Acute consumption of a shake containing cashew and Brazil nuts did not affect appetite in overweight subjects: a randomized, cross-over study.

PURPOSE: Evidence from epidemiological and clinical studies suggests that nut consumption provides satiety and may contribute to the management of obesity. However, the effect of acute intake of nuts on appetite responses remains unclear. The objective of this study was to evaluate the acute effect of a shake containing 30 g of cashew nuts (Anacardium occidentale L.) and 15 g of Brazil nuts (Bertholletia excelsa H.B.K) on appetite responses in overweight subjects. METHODS: This was a clinical, randomized, controlled, single-blind, cross-over, pilot study. On two non-consecutive test days, 15 subjects received a shake containing nuts, and a shake absent of nuts matched for energy and macronutrient content. Subjective appetite sensation was evaluated by visual analogue scales (VAS). Food intake was measured by weighing the lunch served at the end of each morning-test, which subjects ate ad libitum. Total energy intake was estimated by food records. This study is registered on the Brazilian Registers of Clinical Trials-ReBEC (protocol: U1111-1203-9891). RESULTS: We observed no significant difference in subjective appetite sensations between the groups. Food intake at lunch, as well as energy intake throughout the day also did not differ between the treatments. CONCLUSION: Our results suggest that the acute intake of a shake containing nuts was not able to enhance satiety, compared to a shake matched for energy and macronutrient content. Further studies are warranted to elucidate the satiety mechanisms of nuts intake.

Dietary intake of specific amino acids and liver status in subjects with nonalcoholic fatty liver disease: fatty liver in obesity (FLiO) study.

PURPOSE: Identification of dietary factors involved in the development and progression of nonalcoholic fatty liver disease (NAFLD) is relevant to the current epidemics of the disease. Dietary amino acids appear to play a key role in the onset and progression of NAFLD. The aim of this study was to analyze potential associations between specific dietary amino acids and variables related to glucose metabolism and hepatic status in adults with overweight/obesity and NAFLD. METHODS: One hundred and twelve individuals from the Fatty Liver in Obesity (FLiO) study were evaluated. Liver assessment was carried out by ultrasonography, magnetic resonance imaging and analysis of biochemical parameters. Dietary amino acid intake (aromatic amino acids (AAA); branched-chain amino acids (BCAA); sulfur amino acids (SAA)) was estimated by means of a validated 137-item food frequency questionnaire. RESULTS: Higher consumption of these amino acids was associated with worse hepatic health. Multiple adjusted regression models confirmed that dietary AAA, BCAA and SAA were positively associated with liver fat content. AAA and BCAA were positively associated with liver iron concentration. Regarding ferritin levels, a positive association was found with BCAA. Dietary intake of these amino acids was positively correlated with glucose metabolism (glycated hemoglobin, triglyceride and glucose index) although the significance disappeared when potential confounders were included in the model. CONCLUSION: These findings suggest that the consumption of specific dietary amino acids might negatively impact on liver status and, to a lesser extent on glucose metabolism in subjects with overweight/obesity and NAFLD. A control of specific dietary amino acid composition should be considered in the management of NAFLD and associated insulin resistance. NCT03183193; June 2017.

Influence of dietary total antioxidant capacity on the association between smoking and hypertension in Brazilian graduates (CUME project).

BACKGROUND AND AIMS: Hypertension (HTN) is a chronic non-communicable disease influenced by non-modifiable risk factors, such as sex and age, as well as modifiable risk factors such as lifestyle, including diet and smoking. Moreover, diet quality among smokers is worse than that of non-smokers, mainly in terms of antioxidant content. Thus, the current study aimed to investigate whether dietary total antioxidant capacity (dTAC) influences the association between smoking and HTN. METHODS AND RESULTS: This cross-sectional study included 4303 graduates (69.35% women) from the Cohort of Minas Gerais Universities (CUME) project. An online food frequency questionnaire was administered to participants, and dTAC was estimated using the ferric reducing antioxidant power method. In the questionnaires, individuals reported smoking status, systolic and diastolic blood pressure values, previous HTN diagnosis, and use of antihypertensive drugs. Logistic regression models were used to estimate the odds ratio and 95% confidence interval between smoking and HTN, stratified by the median dTAC. Current and former smokers had higher dTAC values despite their lower fruit intake. Moreover, coffee was the main contributor to dTAC among them. Smoking was associated with a higher likelihood of HTN, mainly among individuals with a higher dTAC. However, after exclusion of coffee antioxidant capacity, there was an association between only smoking and HTN in individuals with lower dTAC. CONCLUSIONS: The controversial association between higher dTAC and HTN can result from high coffee intake. Higher dTAC without coffee intake may mitigate the association between smoking and HTN in this population.

Food processing and risk of hypertension: Cohort of Universities of Minas Gerais, Brazil (CUME Project).

OBJECTIVE: To analyse the association between food consumption according to the degree of processing and incidence of hypertension in CUME project participants. DESIGN: Longitudinal study in which food consumption was evaluated according to the percentage contribution of daily energetic intake (%/d) of each NOVA classification group (unprocessed/minimally processed foods and culinary preparations (U/MPF&CP); processed foods and ultra-processed foods (UPF)). Hypertension was defined according to American College of Cardiology/American Heart Association (ACC/AHA) criteria. Adjusted relative risks (RR) and their 95% confidence intervals (95 % CI) were estimated by Poisson regression models with robust variances. SETTING: Brazil. PARTICIPANTS: 1221 graduates classified as non-hypertensive at baseline and monitored for 2 years. RESULTS: Daily energetic percentage from each group according to degree of processing was 64·3 (sd 12) % for U/MPF&CP; 9·9 (sd 5·8) % for processed foods and 25·8 (sd 11) % for UPF. Incidence of hypertension was high (152/1000 person-years; n 113, 193/1000 person-years in males and n 257, 138/1000 person-years in females). After adjusting for potential confounders, participants in the upper quintile of daily energetic intake of U/MPF&CP presented a reduced risk of hypertension (RR: 0·72; 95 % CI 0·52, 0·98), while those in the upper quintile of daily energetic intake of UPF presented an increased risk of the outcome (RR: 1·35; 95 % CI 1·01, 1·81). CONCLUSIONS: In this prospective cohort of Brazilian middle-aged adult university graduates, the highest consumptions of U/MPF&CP and UPF were associated with, respectively, reduced and increased risk of hypertension. Additional longitudinal studies are needed to confirm our results.

Dietary inflammatory index scores are associated with atherogenic risk in Brazilian schoolchildren.

OBJECTIVE: To investigate the association between the Children's Dietary Inflammatory Index (C-DIITM) scores and atherogenic risk in Brazilian schoolchildren. DESIGN: A cross-sectional representative study. Three 24-h dietary recalls were performed to evaluate food consumption and to calculate C-DII scores. Blood samples were collected for the lipid profile analysis (serum total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol and triglycerides (TAG)) and to determine atherogenic indexes (Castelli risk indexes I and II, lipoprotein combined index (LCI), and atherogenic index of plasma and atherogenic coefficient (AC)). A semi-structured questionnaire was used to obtain sociodemographic characteristics and screen time. Body fat was assessed by dual-energy X-ray absorptiometry. We compared the distributions of outcomes by C-DII categories using multivariable linear regression. SETTING: Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Three hundred seventy-eight children between the ages of 8 and 9 years. RESULTS: The mean C-DII score was 0·60 ± 0·94, and the prevalence of dyslipidaemia was 70 %. Children with hypercholesterolaemia and hypertriglyceridaemia had higher C-DII scores. The C-DII was directly associated with atherogenic risk. Every 1 sd of C-DII was associated with a 0·07 (0·01, 0·13), 1·94 (0·20, 3·67), 0·06 (0·002, 0·12) and 0·12 (0·02, 0·22) units higher TC:HDL cholesterol ratio, LCI, AC and accumulation of altered dyslipidaemia markers (high TC + high LDL-cholesterol + high TAG + low HDL-cholesterol), respectively. CONCLUSIONS: Dietary inflammatory potential, as estimated by the C-DII, is directly associated with atherogenic risk in Brazilian schoolchildren. This results reinforce the importance of effective nutritional policies to promote healthy eating habits and improve children's lipid profiles.