Scientific research on food environments in Brazil: a scoping review.

OBJECTIVE: To map the scientific research on food environments in Brazil, based on the following questions: How many studies have addressed food environments?; What study designs and methodological approaches were applied?; What is the geographic scope of the studies?; What scenarios and dimensions of food environments were studied?; Which population groups were studied?; How were food environments conceptualised?; What are the main limitations of the studies? DESIGN: Scoping review conducted in four databases, from January 2005 to December 2022, using different food environment-related terms to cover the main types and dimensions proposed in the literature. The studies were independently selected by two authors. A narrative synthesis was used to summarise the findings. SETTING: Brazil. PARTICIPANTS: 130 articles. RESULTS: Scientific research on Brazilian food environments has been increasing. The analytical quantitative approach and the cross-sectional design were the most frequently used. Most articles were published in English. The majority of studies evaluated the community food environment, addressed aspects of the physical dimension, sampled the adult population, had food consumption as an outcome, used primary data, and were carried out in capital cities in the Southeast region. Furthermore, in most articles, no conceptual model was explicitly adopted. CONCLUSIONS: Gaps in literature are related to the need for conducting studies in the Brazilian countryside, the support for the formulation of research questions based on conceptual models, the use of valid and reliable instruments to collect primary data, in addition to the need for a greater number of longitudinal, intervention and qualitative studies.

Association between Ultra-Processed Food Consumption and Excess of Weight in Women with Endometrial Cancer.

Obesity is one of major risk factor for endometrial cancer, which is the eighth most incident cancer among women in Brazil. The present study aimed to assess any possible associations between ultra-processed food (UPF) consumption and clinical or sociodemographic characteristics of women diagnosed with endometrial cancer. This is a cross-sectional study with women newly diagnosed with endometrial cancer (EC). The study was conducted between December 2016 and January 2020, at a reference center for gynecological cancer treatment. The nutritional status was assessed by measuring anthropometric parameters and food consumption by the food frequency questionnaire. Multiple logistic regression was performed for the dependent variables overweight and obesity. The analyses were considered statistically significant when p < 0,05. The study population consisted of 318 women, with a mean age of 59.1 ± 6.9 years. The average daily energy intake was 2365.13 kcal/day, with 70.48% of energy consumption from fresh or minimally processed foods and 16.95% from UPF. Women above the highest tertile of UPF intake (19.27%) were more likely to be obese (OR: 1.95; 95% CI: 1.12; 3.41, p < 0.01). Having a partner and systemic arterial hypertension was associated with the outcome. The high intake of UPF was associated with obesity, which indicates the need for nutritional intervention in this population.

Metabolic profile of patients with endometrial adenocarcinoma and association with tumor grade.

OBJECTIVE: To describe the prevalence of metabolic syndrome and other metabolic indicators in patients with endometrial cancer and its association with tumor grade. METHODS: This is a cross-sectional study of patients with endometrial cancer referred to the Brazilian National Cancer Institute. We collected data on sociodemographic variables, smoking, co-morbidities, physical activity level, menopausal status, and tumor characteristics (histological subtype, stage, and tumor grade). In addition, weight, height, and waist circumference were measured. Laboratory evaluation included lipid profile, fasting blood glucose and insulin, and C-reactive protein. Insulin resistance was estimated by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Characterization of metabolic syndrome and cardiovascular risk profile was performed. Binary logistic regression models were used to test the association between metabolic syndrome and its metabolic parameters, HOMA-IR, and C-reactive protein with tumor grade. RESULTS: We included a total of 313 patients, 245 (78.3%) aged <65 years, 262 (83.7%) with endometrioid adenocarcinoma, 193 (61.7%) early stage, and 201 (64.2%) with lower tumor grade (G1 and G2). Metabolic syndrome, insulin resistance, and low levels of leisure-time physical activity were highly prevalent (90.7%). In binary logistic regression models, an association was observed between HOMA-IR and lower tumor grade (p<0.05), while high-grade tumors were associated with the highest C-reactive protein values (p<0.05). CONCLUSION: The main finding of this study was the association between insulin resistance and low-grade tumors, and the association between high C-reactive protein levels and high-grade tumors.

Efficacy of ω-3 supplementation on nutritional status, skeletal muscle, and chemoradiotherapy toxicity in cervical cancer patients: A randomized, triple-blind, clinical trial conducted in a middle-income country.

OBJECTIVES: Supplementation with ω-3 has been shown to favor the preservation of body weight and skeletal muscle. The aim of this study was to evaluate the efficacy of ω-3 supplementation on nutritional status, skeletal muscle quantity and quality, and toxicity for treatment of women with cervical cancer. METHODS: This was a randomized, triple-blinded, placebo-controlled clinical trial in women diagnosed with cervical cancer who underwent chemoradiotherapy between March 2016 and August 2017. The intervention group received four capsules with ω-3 (2.5 g/d) and the control group (CG) received the same number of identical-looking capsules with olive oil, for 45 d. Nutritional status was measured by anthropometry and Patient-Generated Subjective Global Assessment. Body composition was assessed by computed tomography. The skeletal muscle index was calculated using the range -29 to +150 HU. For skeletal muscle quality, the area comprised between -29 and +29 HU was denominated low-radiodensity skeletal muscle index and the range between +30 and +150 HU high-radiodensity skeletal muscle index, representing the skeletal muscle area with high or low intramuscular fat infiltration, respectively. RESULTS: The study population comprised 40 patients, with an average age 44.53 ± 8.73. The intervention group maintained body weight and showed an improvement in Patient-Generated Subjective Global Assessment score. A significant reduction in skeletal muscle index was observed in both groups. However, in regard to skeletal muscle quality, patients in the intervention group preserved low- and high-radiodensity skeletal muscle index, whereas those in the control group had increased low-radiodensity skeletal muscle index and significantly reduced high-radiodensity skeletal muscle index, reflecting high intramuscular fat infiltration only in the control group. The incidence of chemotherapy toxicity was significantly lower in the intervention group. CONCLUSIONS: The results suggest that ω-3 supplementation is effective in maintaining nutritional status, skeletal muscle quality, and reduced symptoms of chemoradiotherapy among women with cervical cancer.