RELACIÓN ENTRE INGESTA ALIMENTICIA Y ESTRÉS ACADÉMICO, REACCIONES FISICAS, PSICOLÓGICAS Y COMPORTAMENTALES EN ESTUDIANTES DE LA UNIVERSIDAD AUTÓNOMA DE CHIHUAHUA, MÉXICO / RELATIONSHIP BETWEEN FOOD INTAKE AND ACADEMIC STRESS, PHYSICAL, PSYCHOLOGICAL AND BEHAVIORAL REACTIONS IN STUDENTS OF THE AUTONOMOUS UNIVERSITY OF CHIHUAHUA, MÉXICO

l estrés académico puede presentarse en estudiantes sometidos a diversas exigencias y requisitos universitarios, provocando diferentes reacciones de estrés, físicas, psicológicas y comportamentales, reduciendo su calidad de vida y provocando consecuencias como: depresión, tristeza, fatiga y dolores de cabeza, afectando su estado nutricional. Se investigó la relación entre ingesta de alimentos y estrés académico en estudiantes del cuarto semestre de la Licenciatura en Medicina de la Universidad Autónoma de Chihuahua. La población de estudio, dado el carácter piloto de la investigación, se realizó mediante muestreo simple, aleatorio, sin reemplazo, con un diseño mixto, descriptivo, comparativo y transversal, utilizándose el cálculo del tamaño muestral con un intervalo de confianza de 95%, resultando N=117; 51 hombres y 66 mujeres entre 19 y 43 años de la generación 2019, a quienes se les aplicó el inventario SISCO de estrés académico. Se encontró mayor frecuencia en situaciones que provocan preocupación y nerviosismo, sobrecarga de tareas y trabajo, inquietud, problemas de concentración, fatiga crónica y apatía. Las estrategias más utilizadas fueron: desarrollo de planes y ejecución de tareas y capacidad asertiva. El 92.2% (n=108) de la población encuestada manifestó preocupación y nerviosismo, resultando 52,1% (n=61) en mujeres y 40.1% (n=47) en hombres. El 38.5% (n=45) de las mujeres entre 21 y 43 años, muestran una mayor relación entre aumentar o reducir el consumo de alimentos en correspondencia con sentimientos de depresión y tristeza. El estrés académico, suele estar relacionado con diferentes manifestaciones psicológicas, físicas y conductuales, que pueden influir directamente en la población estudiantil, afectando gravemente sus hábitos alimenticios y nutricionales

Academic stress can occur in students subjected to various university demands and requirements, causing different, causing different physical, psychological and behavioral reactions. Reducing quality of life and causing consequences such as: depression, sadness, fatigue and headaches, affecting their nutritional status. The relationship between food intake and academic stress was investigated in students in the fourth semester of the Bachelor of Medicine at the Autonomous University of Chihuahua. The study population, given the pilot nature of the research, was carried out through simple, random sampling, without replacement, with a mixed, descriptive, comparative and transversal design, using the sample size calculation with a 95% confidence interval resulting in N=117; 51 men and 66 women between the ages of 19 and 43, from the 2019 generation, to whom the SISCO inventory of academic stress was applied. A greater frequency was found in situations that cause worry and nervousness, overload of tasks and work, restlessness, concentration problems, chronic fatigue and listlessness. The most used strategies were plan development and execution of tasks and assertive ability. 92.2% (n=108) of the surveyed population expressed concern and nervousness, in 52.1% (n=61) women and 40.1% (n=47) men. The 38.5% (n=45) of women between 21 and 43 years old show a greater relationship between increasing or reducing food consumption in correspondence with feelings of depression and sadness. Academic stress is usually related to different psychological, physical and behavioral manifestations, which can directly influence the student population, seriously affecting their eating and nutritional habits

Bebible nutricional y niveles de glucemia en deportistas del centro de alto rendimiento del Gobierno Autónomo Municipal de La Paz, gestión, 2019 / Nutritional beverage and blood glucose levels in athletes from the high-performance center of the Autonomous Municipal Government of La Paz, 2019

OBJETIVO: determinar los niveles de glucemia basal, antes y después del consumo del bebible nutricional en deportistas del Centro de Alto Rendimiento del Gobierno Autónomo Municipal de La Paz, gestión 2019. MATERIAL Y MÉTODOS: en este estudio cuasi experimental de antes-después, se analizaron los cambios en los niveles de glucemia de 20 deportistas tras la realización de un protocolo de ejercicio de 30 minutos, seguido de la ingesta de un bebible nutricional. Posteriormente se tomaron glucemias en tres momentos: en reposo, inmediatamente post-ejercicio y una hora después de la intervención. El propósito del estudio fue explorar la influencia del bebible nutricional en la regulación glucémica y su potencial efecto. RESULTADOS: el análisis de los niveles de glucemia basal revelaron una distribución equilibrada entre hiperglucemia e hipoglucemia en el 50% de los deportistas. Fue así que durante el ejercicio y antes de la ingesta del bebible, se observaron fluctuaciones en los niveles de glucosa, con un 5% persistiendo en hiperglucemia y un 25% en hipoglucemia. Una hora posterior de la actividad física y del consumo del bebible, se registraron una mejora significativa en los niveles de glucosa, con un 4% de los deportistas presentando hipoglucemia y un 80% alcanzando niveles de normoglucemia. CONCLUSIONES: luego al consumo del bebible nutricional y del tiempo de absorción de los nutrientes, la glucemia del 80% de los participantes fue de normoglucemia. En 270mL aportó 218,1 kcal ­ 13,52 g de proteínas ­ 1,56 g de grasa ­ 38g de hidratos de carbono y 0,73 g de fibra cruda, sin embargo, hace falta ampliar la muestra para afirmar este efecto

OBJECTIVE: to determine basal blood glucose levels before and after consumption of a nutritional beverage in athletes from the High-Performance Center of the Autonomous Municipal Government of La Paz during the year 2019. MATERIAL AND METHODS: in this quasi-experimental before-and-after study, changes in blood glucose levels were analyzed in 20 athletes following a 30-minute exercise protocol, followed by the intake of a nutritional beverage. Subsequently, blood glucose levels were measured at three points of time: at rest, immediately post-exercise, and one hour after the intervention. The study aimed to explore the influence of the nutritional beverage on glycemic regulation and its potential effects. RESULTS: analysis of baseline blood glucose levels revealed a balanced distribution between hyperglycemia and hypoglycemia in 50% of the athletes. Besides, during exercise and before beverage intake, fluctuations in glucose levels were observed, with 5% persisting with hyperglycemia and 25% with hypoglycemia. One hour after physical activity and beverage intake, a significant improvement in glucose levels was recorded in 80% achieving normoglycemia, and 4% of athletes presenting hypoglycemia. CONCLUSIONS: after consuming the nutritional beverage and nutrient absorption time, 80% of participants exhibited normoglycemia. The beverage provided 218.1 Kcal, 13.52 g of protein, 1.56 g of fat, 38 g of carbohydrates, and 0.73 g of crude fiber per 270 mL. However, further sample expansion is needed to confirm this effect.

Asociación de la salud cardiometabólica de preescolares y sus padres con características nutricionales y sociodemográficas familiares / Association of cardiometabolic health of preschoolers and their parents with family sociodemographic characteristics

Introducción: Existe escaso conocimiento sobre la asociación entre marcadores cardiometabólicos en preescolares con características nutricionales y sociodemográficos familiares. Objetivo: Determinar la asociación entre marcadores cardiometabólicos de preescolares y sus padres con las características nutricionales y sociodemográficas familiares. Materiales y Métodos: Estudio de corte transversal, de asociación y correlación entre variables Padre-Hijo/a de carácter multicéntrico, en el cual participaron 140 sujetos (70 preescolares y su respectivo padre o madre). Las variables fueron estado nutricional, composición corporal, fuerza prensil y presión arterial de padres/madres y sus hijos/as preescolares y variables sociodemográficas de las familias. Resultados: Existió diferencia significativa al 5% respecto de la obesidad de los padres con la de los hijos/as, se presentó correlación positiva (0,397) entre las variables "porcentaje de grasa" padres e hijos/as. En relación al "nivel de escolaridad de la madre" hubo diferencia significativa con el "porcentaje de grasa" de los hijos/as (p<0,011). Existió similarmente diferencia significativa (p=0,033) entre la variable "tener hermanos" respecto a la variable "porcentaje de grasa" de los hijos/as. Finalmente se presentó asociación entre "usa Tablet" (dispositivo audiovisual) y "presión arterial" de los hijos/as (p=0,030). La variable "usa Tablet" se asoció significativamente con la "fuerza prensil" de los hijos/as (p=0,044). Conclusiones: Padres obesos con alto porcentaje de grasa tienen hijos/as preescolares con bajo perfil cardiometabólico; las variables nivel educacional inferior de la madre y tener hermanos se asociaron a un mayor porcentaje de grasa en los hijos/as, conjuntamente el uso de Tablet en preescolares mostró mayores niveles de presión arterial y menor fuerza prensil(AU)

Introduction: Little is known about the association between cardiometabolic markers in preschoolers with family nutritional and socio- demographic characteristics. Objective: To determine the association between cardiometabolic markers in preschoolers and their parents with family nutritional and sociodemographic characteristics. Materials and methods: cross-sectional study of association and correlation between parent-child variables, multicenter, 140 subjects participated (70 preschoolers and their respective parents). The variables were nutritional status, body composition, prehensile strength and blood pressure of parents and their preschool children and sociodemographic variables of the families. Results: There was a significant difference at 5% between parents' obesity and children's obesity, with a positive correlation (0.397) between the variable "percentage of fat" parents/children. In relation to the "mother's level of schooling" there was a significant difference with the "percentage of fat" of the children (p<0.011). Similarly, there was a significant difference (p=0.033) between the variable "Having siblings" with respect to the variable "percentage of fat" of the children. Finally, there was an association between "Tablet use" (audiovisual device) and "blood pressure" of the children (p=0.030). The variable "Tablet use" was significantly associated with the "prehensile strength" of the children (p=0.044). Conclusions: Obese parents with a high percentage of fat have preschool children with a low cardiometabolic profile; the variables lower educational level of the mother and having siblings were associated with a higher percentage of fatness in children; together, the use of Tablet in preschoolers showed higher levels of blood pressure and lower prehensile strength(AU)

Aleitamento materno e consumo de ultraprocessados pela ótica da desigualdade racial: um delineamento ecológico / Breastfeeding and consumption of ultra-processed foods from the perspective of racial inequality: an ecological outline / Lactancia materna y consumo de alimentos ultraprocesados desde la perspectiva de la desigualdad racial: un panorama ecológico

Este artigo objetivou avaliar as informações acerca do consumo alimentar e aleitamento materno de crianças do município de Alfenas (MG) e, ainda, verificar fatores relacionados, como cor da pele e faixa etária. Trata-se de um estudo epidemiológico ecológico longitudinal, com coleta de dados pelo Sistema de Vigilância Alimentar e Nutricional Web e análise por meio de proporções e contagens medianas mensais. Admitiu-se um nível de confiança de 95% (p<0,05) para as análises realizadas com apoio do pacote computacional estatístico R. Foram totalizados 2.377 registros para os marcadores de consumo alimentar, apresentando 25% (IC95%: 16,67-36,06) de ausência de aleitamento materno exclusivo e 50% (IC95%: 50,00-66,67) para o consumo de alimentos ultraprocessados. Ainda, os marcadores estavam associados à cor da pele, sendo não branca a com maior risco à saúde, na proporção de 63,9% para a ausência de aleitamento materno exclusivo e de 77,5% para o maior consumo de alimentos ultraprocessados. Os resultados, referentes ao consumo de ultraprocessados e à ausência de aleitamento materno exclusivo para o município de Alfenas (MG), são positivamente superiores às médias nacionais, enfatizando o comportamento alimentar inadequado em relação à questão racial.

This article aimed to evaluate information about the food consumption and breastfeeding of children in the municipality of Alfenas, Minas Gerais, and to verify related factors such as ethnicity and age group. Longitudinal ecological epidemiological study, with data collected by the Web Food and Nutrition Surveillance System (SISVAN Web) and analyzed using proportions and monthly median counts. A confidence level of 95% (p<0.05) was accepted for the analyses carried out with the support of the statistical computational package R. There were 2,377 records for the food consumption markers, with 25% (95%CI: 16.67­36.06) absence of exclusive breastfeeding and 50% (95%CI: 50.00­66.67) consumption of ultra-processed foods. Furthermore, the markers were associated with ethnicity, with non-white ethnicity having the highest health risk, in the proportion of 63.9% for the absence of exclusive breastfeeding and 77.5% for the highest consumption of ultra-processed foods. The results regarding the consumption of ultra-processed foods and the absence of exclusive breastfeeding for the municipality of Alfenas, Minas Gerais, are positively higher than the national averages, emphasizing the inadequate eating behavior in relation to the racial issue.

Este artículo tiene por objetivo evaluar información sobre el consumo de alimentos y la lactancia materna de niños en la ciudad de Alfenas, Minas Gerais (Brasil), así como identificar los factores relacionados, como el color de la piel y el grupo de edad. Se trata de un estudio epidemiológico ecológico longitudinal, con recolección de datos en el Sistema de Vigilancia Alimentaria y Nutricional Web y análisis mediante proporciones y conteos medianos mensuales. Se utilizó un nivel de confianza del 95% en los análisis (p<0,05) realizados con apoyo del paquete computacional estadístico R. Hubo un total de 2.377 registros en los marcadores de consumo de alimentos, con un 25% (IC95%: 16,67-36,06) para ausencia de lactancia materna exclusiva y el 50% (IC95%: 50,00-66,67) para el consumo de alimentos ultraprocesados. Además, los marcadores estuvieron asociados con el color de la piel, en el cual el color de piel no blanco presentó un mayor riesgo para la salud, en la proporción del 63,9% para ausencia de lactancia materna exclusiva y del 77,5% para el mayor consumo de alimentos ultraprocesados. Los resultados sobre el consumo de alimentos ultraprocesados y la ausencia de lactancia materna exclusiva en el municipio de Alfenas son positivamente superiores a los promedios nacionales, destacando la conducta alimentaria inadecuada por cuestiones raciales.

Datos de composición de alimentos en Costa Rica: Fuentes, usos e impacto en políticas públicas / Food Composition Data in Costa Rica: Sources, Uses, and impact on public policies

Introducción: Las bases de datos y las tablas de composición de alimentos (BDCA y TCA, respectivamente) contienen información sobre la composición química-nutricional de los alimentos. Objetivo: Definir las fuentes de los datos de composición de alimentos que se usan en Costa Rica y que impacto tienen a nivel de políticas públicas. Materiales y métodos. Se analizaron las TCA y BDCA disponibles en Costa Rica desde 1960 hasta el 2020. Se encuestaron usuarios de datos de composición de alimentos. Se analizaron los usos de estos datos y algunos alcances a nivel de política pública. Resultados: Se identifica la utilización predominante de datos de la BDCA de Estados Unidos, los datos nacionales son desactualizados en su mayoría y hay pocos datos de análisis directo (químico) de alimentos. Se evidencia la importancia de contar con datos propios, actualizados y representativos de composición de alimentos para la toma de decisiones en salud pública. Conclusiones: Se deben vincular las instituciones generadoras y compiladoras para maximizar los recursos para fortalecer la disponibilidad de datos de composición de alimentos en el país. Se evidencia la necesidad de generar un Sistema Nacional de Datos de Composición de Alimentos que se ajuste a las necesidades identificadas en cuanto a la calidad y presentación de la información(AU)

Introduction: Databases and food composition tables (FCDB and FCT, respectively) provide information about the chemical-nutritional composition of foods. Objective: of this work was to define the sources of food composition data used in Costa Rica and their impact on public policies. Materials and methods: It was analyzed which TCA and FCDB have been available in Costa Rica from 1960 to 2020. Users were surveyed about food composition data. It was analyzed the uses of these data and some of their impacts on public policy. Results: The predominant use of data from the U.S. FCDB is identified, the national data are mostly outdated, and there is little data from direct (chemical) analysis of food. The importance of having our own, up- to-date, and representative data on food composition for public health decision-making is evident. Conclusions: Generating and compiling institutions should be linked to maximize resources to strengthen the availability of food composition data in the country. The need to generate a National Food Composition Data System that meets the identified needs in terms of quality and presentation of information is evident(AU)

Perception and food consumption frequency due to the Covid-19 pandemic among University students in Trujillo City, Perú / Percepción y frecuencia del consumo de alimentos debido a la pandemia del COVID-19 entre estudiantes universitarios de la ciudad de Trujillo, Perú

Introduction: The confinement due to COVID-19 significantly affected people's food consumption, especially university students who had to adapt to virtual education. Objective: To determine the perception and food consumption frequency due to the COVID-19 pandemic among Peruvian students from a private university in Trujillo City, Peru. Materials and method: The research design was non-experimental, descriptive, and cross- sectional. The non-probabilistic sample consisted of 169 students and the instrument used was a virtual survey (Cronbach's alpha = 0.846). Results: It is shown that there is a higher frequency of young people (n = 116) and adolescents (n = 45) who participated in the study, and that the average age was 22.15 ± 3.77 years. Likewise, the Frequency of Consumption dimension, it showed a higher frequency in the "Sometimes" scale, where it is related to whether it exceeded the number of meals per day (34.9%), eating out of control (38.5%), desires to eat unhealthy food (32.0%) and whether it influenced eating (30.8%). Similarly, it was shown that the majority of respondents consumed fruits (68.6%) and vegetables (58.0%) and considered water consumption essential (98.3%). On the other hand, there was a higher frequency regarding the consumption of ultra-processed foods (n = 95, 56.2%). Conclusion: The population of a private university made up mostly of young people and adolescents perceives that there was a change in their diet during the COVID-19 pandemic(AU)

Introducción: El confinamiento por COVID-19 afectó notablemente el consumo de alimentos de las personas, sobre todo de los universitarios quienes tuvieron que adaptarse a una educación virtual. Objetivo: Determinar la percepción y la frecuencia del consumo de alimentos a causa de la pandemia por COVID-19 en estudiantes de una universidad privada de la ciudad de Trujillo (Perú). Materiales y métodos: El diseño de la investigación fue no experimental de tipo descriptivo, y de corte transversal. La muestra no probabilística estuvo conformada por 169 estudiantes y el instrumento utilizado fue una encuesta virtual (Alfa de Cronbach = 0,846). Resultados: Se muestra que hay una mayor frecuencia de jóvenes (n = 116) y adolescentes (n = 45) que participaron en el estudio, y que la edad promedio fue de 22,15 ± 3,77 años. Así mismo, en la dimensión Frecuencia de Consumo, tuvo una mayor frecuencia en la escala "A veces", donde se relaciona a si excedió el número de comidas al día (34,9%), comer fuera de control (38,5%), deseos de comer comida poco saludable (32,0%) y si influenció en la alimentación (30,8%). De la misma manera, se mostró que la mayoría de encuestados consumió frutas (68,6%) y verduras (58,0) y consideró imprescindible el consumo de agua (98,3%), por otro lado, hubo una mayor frecuencia respecto al consumo de alimentos ultraprocesados (n = 95, 56,2%). Conclusiones: La población de una universidad privada conformada mayoritariamente por jóvenes y adolescentes percibe que si hubo un cambio en su alimentación durante la pandemia del COVID-19(AU)

Food consumption and remote working conditions among Brazilian Primary Schools teachers during the COVID-19 pandemic / Consumo de alimentos y condiciones de trabajo remoto en maestros brasileños de básica durante la pandemia de COVID-19

Introduction: Teaching work, which is characterized by being exhausting, with a significant workload, with synchronous and/or asynchronous remote classes. Objective: To describe associations between the working conditions of school teachers at home and their food consumption during the suspension of face-to-face classes. Materials and methods: Cross-sectional study using a self-administered online questionnaire with 15,372 working teachers from Minas Gerais, Brazil. The dependent variables analyzed were the consumption of healthy and unhealthy foods. Independent variables included sociodemographic factors, remote work conditions, understanding of online technologies, computer access, and quality of Internet connection. The Poisson model with robust variance was used to determine the association between working conditions and food consumption. Results: In the analysis of the adjusted multivariate model, there was a significant association between eating habits and the following variables: gender, age, working hours (per week), feelings regarding teachers' work during the pandemic, working hours during the pandemic and quality work internet connection. Our data shows that teachers' remote working conditions are associated with worse food consumption. They also showed that working hours equal to or greater than 40 hours per week, feelings of dissatisfaction with working conditions during the pandemic, increased working hours during the pandemic and poor quality of internet connection were variables correlated with the consumption of unhealthy foods. Conclusions: Remote working conditions during the pandemic influenced primary school teachers' food choices. More studies are needed to delve deeper into issues related to teachers' working conditions and the implications for food choices(AU)

Introducción: La labor docente se caracteriza por ser agotadora, con una importante carga horaria, con clases remotas síncronas y/o asíncronas. Objetivo: Describir la asociación existente entre las condiciones del trabajo remoto de los docentes de la educación básica y el consumo de sus alimentos durante el período de suspensión de las clases presenciales. Métodos: Es un estudio transversal mediante cuestionario en línea autoadministrado con 15.372 docentes activos en Minas Gerais, Brasil. Las variables dependientes analizadas fueron el consumo de los alimentos saludables y de los no saludables. Las variables independientes incluyeron los factores sociodemográficos, las condiciones del trabajo remoto, la comprensión de las tecnologías en línea, el acceso a las computadoras así como la calidad de la conexión a la Internet. Se utilizó el modelo de Poisson con variación robusta para determinar la asociación entre las condiciones del trabajo y el consumo de los alimentos. Resultados: En el análisis del modelo multivariado ajustado hubo una asociación significativa entre los hábitos alimentarios y las siguientes variables: el género, la edad, la jornada laboral semanal, el sentimiento sobre el trabajo durante la pandemia, la jornada laboral durante la pandemia y la calidad de la conexión a la internet. Nuestros datos demuestran que las condiciones del trabajo remoto de los docentes están asociadas con un empeoramiento en el consumo de los alimentos. También mostraron que la jornada laboral igual o superior a unas 40 horas semanales, los sentimientos de insatisfacción con las condiciones laborales, el aumento de la jornada laboral y la mala calidad de la conexión a la Internet durante la pandemia fueron variables correlacionadas con el consumo de alimentos no saludables. Conclusiones: Las condiciones del trabajo remoto durante la pandemia influyeron en las elecciones alimentarias de los docentes de la educación básica. Se necesitan más estudios para profundizar en los aspectos relacionados con las condiciones laborales de los docentes y sus implicaciones en la elección de sus alimentos(AU)

Ingesta de calcio y vitamina D: relación con exceso de peso en población costarricense / Calcium and vitamin D intake, its relationship with weight excess in Costa Rican population

Introducción: La presencia de sobrepeso y obesidad aumentan la morbimortalidad de la población latinoamericana. La deficiencia de micronutrientes como el calcio y la vitamina D se han relacionado con un aumento del riesgo de obesidad. Objetivo: Determinar la relación entre la ingesta de vitamina D y de calcio con los factores de riesgo para obesidad en la población urbana costarricense incluidas en el Estudio ELANS. Materiales y métodos: Se incluyeron 798 participantes costarricenses del Estudio ELANS. Se determinó la distribución del consumo de calcio y vitamina D según las características socioeconómicas, la actividad física y los datos antropométricos. Se compararon los grupos con las pruebas U de Mann ­ Whitney y Kruskal-Wallis. Se realizaron modelos de regresión lineal y logística. Resultados: El consumo de calcio y vitamina D fue inadecuado en más del 98% de los participantes. Las mujeres, las personas con menor nivel socioeconómico, baja actividad física, de menor edad, con exceso de peso y obesidad abdominal presentaron un consumo menor de calcio y de vitamina D. El consumo de calcio y vitamina D es mayor en los grupos que tienen un menor IMC (p= 0,023 para calcio y p= 0,252 para vitamina D). Las personas con menor circunferencia de la cintura tuvieron más consumo de calcio y vitamina D (p= 0,002 para calcio y p= 0,008 para vitamina D). No hubo asociación del consumo en los modelos de regresión. Conclusiones: El consumo de calcio y vitamina D es deficiente en la población urbana costarricense y, presentó una relación inversa con el IMC(AU)

ntroduction: The presence of overweight and obesity increase the morbimortality of people in Latin America. Micronutrient deficiencies, such as calcium and vitamin D, are associated with an increased risk of obesity. Objective: To determine the relationship between vitamin D and calcium intake with risk factors for obesity in the Costa Rican urban population included in the ELANS Study. Materials and methods: For this analysis we used the 798 Costa Rican participants of the study (ELANS). The distribution of calcium and vitamin D intake was determined according to socioeconomic status, physical activity, and anthropometric measures. The Mann ­ Whitney and Kruskal-Wallis U tests were used, as well as linear and logistic regression models were performed. Results: Calcium and vitamin D intake was inadequate in more than 98% of the participants. Women, individuals with a lower socioeconomic level, low physical activity, younger age and those with excess weight and abdominal obesity presented lower consumptionofcalciumandvitamin D. Theconsumption of calcium and vitamin D was greater in the groups that have a lower BMI (p= 0.023 for calcium and p= 0.252 for vitamin D). The smaller the waist circumference, the greater the consumption of calcium and vitamin D (p= 0.002 for calcium and p= 0.008 for vitamin D). No association of the consumption of calcium and vitamin D was found in the regression models. Conclusions: Consumption of calcium and vitamin D is deficient in the Costa Rican urban population, and more prevalent among those with higher BMI. Arch Latinoam Nutr 2024(AU)

Nutritional management of muscle mass loss in patients with Post-COVID-19 Syndrome: a scoping review / Manejo nutricional na perda de massa muscular em pacientes com a Síndrome Pós-COVID-19: uma revisão de escopo

Post-Covid-19 Syndrome (PCS) is a condition that causes persistent symptoms and impacts nutritional status such as loss of muscle mass. The objective of this study was to review and map scientific evidence on nutritional management in the loss of muscle mass in patients with PCS. The scoping review protocol was prepared following the PRISMA-ScR guidelines. Review articles not written in English or those that included only hospitalized patients and pertained to conditions other than PCS were excluded. Data extraction followed the methodology outlined by the Cochrane Review Group. Of the 81 articles initially identified, only five met the inclusion criteria. The selected studies emphasized the importance of recovering muscle mass, higher protein and caloric intake, and physical strength exercises. Consequently, nutritional interventions aimed at mitigating muscle mass loss should prioritize strategies that increase caloric and protein consumption.

A Síndrome Pós-covid-19 (SPC) é uma condição que acarreta sintomas persistentes e impactam o estado nutricional, como a perda de massa. O objetivo deste estudo foi realizar revisão para mapear evidências científicas acerca do manejo nutricional na perda de massa muscular em pacientes com SPC. O protocolo da revisão de escopo foi elaborado de acordo com o PRISMA-ScR. Foram excluídos artigos de revisão que não estivessem em inglês ou português, que incluíssem apenas pacientes hospitalizados e com outras condições que não a SPC. Os dados foram extraídos com base no Cochrane Review Group. 81 artigos foram identificados e a amostra final incluiu cinco estudos. Para a recuperação da massa muscular, maior ingestão proteica, calórica e exercícios físicos de força foram descritos nos estudos. A intervenção nutricional para recuperar a perda de massa muscular deve considerar estratégias que visam o aumento do consumo calórico e proteico.

Clinicodemographic profile and treatment outcomes of patients with upper aerodigestive tract foreign bodies in the Southern Philippines Medical Center: A five-year retrospective review

Objective@#This study aims to describe the clinicodemographic profile of patients with foreign bodies in the upper aerodigestive tract and their treatment outcomes.@*Methods@#Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: Records of 304 patients diagnosed with aerodigestive foreign bodies @*Results@#Three hundred-four (304) patients were included. The median age was 5.26 years in the pediatric age group and 42.53 years in the adult age group, with a male-to female ratio = 1.97:1. Foreign bodies were ingested in 291 (96%) patients while aspiration occurred in 13 (4%). Overall, 211 (69%) of cases involved the pediatric population (<19 years) and 93 (31%) the adult population. The most common foreign bodies reported were coins (63.5%), food (18.1%), and dentures (11.5%). Most esophageal foreign bodies (244/291; 83%) were seen at the cricopharyngeal level in all age groups. The foreign body was removed successfully in 288/291 (98%) of ingestion cases. All 13 cases of foreign body aspiration were successfully removed by bronchoscopy. All patients were discharged improved.@*Conclusion@#Most upper aerodigestive tract foreign bodies involved the pediatric age group. Predisposing conditions were mainly due to accidental ingestion and aspiration while playing in the pediatric population and negligence in eating among adults. Almost all ingestion cases were successfully treated with esophagoscopy, while all aspirations were treated successfully with bronchoscopy. Most intraoperative and postoperative complications who were managed conservatively by observation, although some cases required referral to other surgical departments and were treated surgically. All patients were discharged improved.

Evolution of adolescents' dietary patterns in Northeast Brazil from 2008 to 2018

ABSTRACT OBJECTIVE To evaluate the evolution of the dietary patterns of adolescents in the northeast region of Brazil. METHODS Secondary analysis of data from the Pesquisa de Orçamentos Familiares (POF - Household Budget Surveys), collected by the Brazilian Institute of Geography and Statistics (IBGE) in the years 2008-2009 and 2017-2018. A total of 3,095 adolescents were evaluated in 2008-2009 and 3,015 in 2017-2018. Food consumption was assessed using two dietary records in 2008-2009 and two 24-hour recalls in 2017-2018, applied on non-consecutive days. Based on these data, principal components factor analysis (PCFA) was performed, followed by orthogonal rotation of the varimax type, to derive dietary patterns, stratified by sex. The results were described as means or percentage frequencies, with their respective 95% confidence intervals. RESULTS Three main dietary patterns were identified among adolescents from the northeast region of Brazil. Among boys, in 2008-2009, the patterns were called snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and mixed, in this order of representativeness of the group's eating habits. Among female adolescents, in 2008-2009, the patterns were snacks, traditional Brazilian, and coffee; and in 2017-2018, traditional Brazilian, snacks, and processed meats. CONCLUSION The dietary patterns identified in 2008-2009 and 2017-2018 were similar in both genders; however, the snacks pattern, which explained most of the data variability in 2008-2009, was replaced by the traditional Brazilian.

Marcadores do consumo alimentar do Sistema de Vigilância Alimentar e Nutricional: tendência temporal da cobertura e estratégias para utilização na atenção primária à saúde / Food intake markers of the Food and Nutrition Surveillance System in Primary Health Care: temporal trend of coverage and strategies for utilization in primary health care

Introdução: Ainda que fundamental para acompanhamento e diagnóstico da situação alimentar e nutricional da população brasileira, o Sistema de Vigilância Alimentar e Nutricional (Sisvan) tem sido subutilizado, principalmente com relação aos registros de consumo alimentar. Objetivo: Investigar a tendência temporal da cobertura e estratégias para utilização de marcadores do consumo alimentar do Sistema de Vigilância Alimentar e Nutricional, entre 2015 e 2019, na Atenção Primária à Saúde do Sistema Único de Saúde. Métodos: Trata-se de uma pesquisa de caráter misto. Primeiramente, foi realizado estudo ecológico de séries temporais, para estimar a cobertura populacional e Taxa de Incremento Anual (TIA) do registro de marcadores do consumo alimentar do Sisvan nacionalmente, entre 2015 e 2019, segundo entrada de dados via Estratégia e-SUS APS e Sisvan Web. A TIA da cobertura foi calculada utilizando regressão de Prais-Winsten e sua correlação com IDH, PIB per capita e cobertura da APS foi avaliada. Sequencialmente, para explorar barreiras e facilitadores para utilização dos marcadores do consumo alimentar do Sisvan, elaborou-se um roteiro para grupos focais a partir da análise descritiva de respostas de profissionais da APS a um questionário eletrônico com perguntas objetivas e subjetivas sobre a temática. Conduziram-se 10 grupos focais em plataforma online envolvendo 34 profissionais em cargos de assistência à saúde e de gestão do Sisvan, de todas as macrorregiões brasileiras, cujas transcrições passaram por análise de conteúdo temática de caráter indutiva. O livro de códigos foi aplicado no corpus por dois pesquisadores e discordâncias foram discutidas, com concordância satisfatória (Kappa=0,87). Resultados: Houve aumento significante do registro de marcadores do consumo alimentar no país desde 2015 (TIA: +45,63%), mas a cobertura populacional ainda é incipiente (0,92% da população residente total em 2019), com diferenças relevantes entre grupos etários. As tendências foram consistentemente crescentes para a entrada de dados via e-SUS APS, em detrimento do Sisvan Web. A TIA da cobertura via e-SUS APS esteve positivamente correlacionada com IDH e PIB per capita em alguns recortes etários. A partir dos grupos focais, fatores como estrutura dos formulários, manuseio das plataformas digitais e infraestrutura dos serviços de saúde emergiram como barreiras ou facilitadores potenciais para uso dos marcadores. Dificuldades na interação com usuários, falta de sensibilização dos profissionais e insegurança alimentar e nutricional constituíram barreiras adicionais. Por outro lado, constatou-se que a utilização por qualquer profissional de saúde e as condicionalidades com políticas públicas facilitam a utilização dos marcadores. Os grupos focais mostraram-se espaço de troca de experiências entre profissionais e compartilhamento de estratégias para ampliação do uso dos formulários, incluindo matriciamento, técnicas para condução dos marcadores nos serviços de saúde, apoio profissional para digitação de formulários e ampliação da divulgação dos dados. Conclusões: A cobertura populacional do registro de marcadores do consumo alimentar do Sisvan ainda é baixa, mas o e-SUS APS parece ser uma via relevante para sua expansão. A abordagem de estratégias pode estimular o trabalho de equipes da APS, destacando-se a pertinência do compartilhamento de experiências entre contextos distintos para fortalecer o monitoramento do consumo alimentar no SUS.

Introduction: Although essential for monitoring and diagnosing the food and nutrition situation of the Brazilian population, the Food and Nutrition Surveillance System (Sisvan) has been underutilized, especially with regard to food consumption records. Objective: To investigate the temporal trend of coverage and strategies for the use of food intake markers from the Food and Nutrition Surveillance System, between 2015 and 2019, in Primary Health Care (PHC) of the Unified Health System (SUS). Methods: This is a mixed-methods study. Firstly, an ecological time series study was conducted in order to estimate the population coverage and Annual Percentage Change (APC) of the Sisvan food intake markers registry nationally, between 2015 and 2019, according to data entry via the e-SUS PHC Strategy and Sisvan Web. The APC of coverage was calculated using Prais-Winsten regression and its correlation with HDI, GDP per capita and PHC coverage was evaluated. Sequentially, to explore barriers and facilitators to the use of Sisvan food intake markers, a script was drawn up for focus groups based on the descriptive analysis of responses from PHC professionals to an electronic questionnaire with objective and subjective questions on the subject. Ten focus groups were held on an online platform involving 34 professionals in health care and Sisvan management positions from all Brazilian macro-regions, the transcripts of which were subjected to inductive thematic content analysis. The codebook was applied to the corpus by two researchers and disagreements were discussed, with satisfactory agreement (Kappa=0.87). Results: There has been a significant increase in the recording of food intake markers in the country since 2015 (APC: +45.63%), however population coverage is still incipient (0.92% of the total resident population in 2019), with relevant differences between age groups. The trends were consistently increasing for data entry via e-SUS PHC, to the detriment of Sisvan Web. The APC of coverage via e-SUS PHC was positively correlated with HDI and GDP per capita in some age groups. From the focus groups, factors such as the structure of the forms, handling of the digital platforms and the infrastructure of the health services emerged as potential barriers or facilitators to the use of the markers. Difficulties in interacting with users, lack of sensitivity among professionals and food and nutritional insecurity were additional barriers. On the other hand, it was found that use by any health professional and conditionalities with public policies facilitate the use of the markers. The focus groups proved to be a space for professionals for exchanging experiences and sharing strategies for expanding the use of the forms, including matrix support, techniques for using the markers in health services, professional support for typing up the forms and expanding the dissemination of data. Conclusions: Population coverage of the Sisvan food intake marker registry is still low, but e-SUS PHC seems to be a relevant way of expanding it. The approach of strategies can stimulate the work of PHC teams, highlighting the relevance of sharing experiences between different contexts to strengthen the monitoring of food consumption in the SUS.

Expressão de microRNA no plasma e suas relações com biomarcadores cardiometabólicos e dieta em idosos participantes de estudo de base populacional (ISA Capital) / Plasma microRNA expression and its associations with cardiometabolic biomarkers, and diet in elderly participants of a population-based study (ISA Capital)

Introdução - O desenvolvimento das doenças crônicas não transmissíveis (DCNT) em idosos está relacionado, dentre outros fatores, à desregulação da expressão de microRNAs (miRNAs), a qual pode ser modulada por fatores ambientais, incluindo o padrão alimentar. Objetivo - Avaliar o perfil de expressão plasmática de miRNAs e suas relações com biomarcadores cardiometabólicos e dieta em idosos do estudo de base populacional ISA Capital. Métodos - Estudo transversal, com subamostra de 200 indivíduos idosos participantes do ISA Nutrição. Foi avaliado o perfil de expressão de 21 miRNAs plasmáticos. Os indivíduos foram avaliados quanto às medidas antropométricas e à pressão arterial sistêmica; biomarcadores glicêmicos, do perfil lipídico e inflamatórios; e ao consumo alimentar. Calculou-se o escore de inflamação crônica e de baixo grau (SIS) a partir das concentrações de 10 biomarcadores inflamatórios. A expressão plasmática dos miRNAs circulantes foi analisada a partir do método Fluidigm. Os indivíduos avaliados foram distribuídos em dois grupos de acordo com a presença ou não de síndrome metabólica (SM), e o teste ajustado de Wald foi utilizado para comparar a expressão dos miRNAs entre os grupos. A partir do coeficiente tau-a de Kendall estimou-se as correlações entre a expressão dos miRNAs e variáveis de interesse. O teste de Wilcoxon-Mann-Whitney foi utilizado para determinar as diferenças no SIS em indivíduos de acordo com o sexo e a presença de SM. O teste de correlação de Spearman estimou as correlações entre o SIS, concentrações de leptina, miRNAs e demais variáveis de interesse. Além disso, utilizou-se modelos lineares generalizados (MLGs) para aprofundar as associações encontradas. As análises foram realizadas nos softwares Stata/SE (versão 17.0) e R (versão 4.2.3), considerando nível de significância de 0,05. Resultados - A amostra final deste estudo consistiu em 193 indivíduos (69,1 (0,5) anos), sendo 50,4% do sexo feminino, e 64,7% com SM. A expressão plasmática dos miR-30a e miR-122 foi maior em indivíduos com SM do que naqueles sem SM, e sua expressão se correlacionou à glicemia e insulinemia em jejum, HOMA1-IR, HDL-c, VLDL-c, LDL-c, colesterol não-HDL e triacilgliceróis. Além disso, associações negativas entre cinco miRNAs (miR-15a, miR-16, miR-223, miR-363, miR-532), concentração de leptina e/ou SIS foram observadas. Ainda, o consumo de diversos grupos alimentares influenciou a expressão plasmática dos miRNAs. O consumo diário de 100 g de frutas se relacionou à redução na expressão dos miR-16, miR-30a, miR-126, miR-130b, miR-363, miR-375, miR-486 e miR-532. Contudo, o consumo de carne vermelha se associou ao aumento na expressão plasmática de quatro miRNAs (miR-126, miR-150, miR-223 e miR-376a). Ainda, observou-se que o consumo diário de 100 g de hortaliças se associou a uma chance 7 vezes maior de os indivíduos avaliados não apresentarem SM. Conclusões - O aumento da expressão plasmática dos miR-21, miR-30a e miR-122 sugere maior risco cardiometabólico, ao passo que a redução na expressão dos miR-15a, miR-16, miR-223, miR-363 e miR-532 sugere menor risco cardiometabólico em idosos. Ainda, os resultados encontrados enfatizam a importância da adoção de hábitos alimentares saudáveis na regulação da expressão dos miRNAs e, consequentemente, na redução do risco de desenvolvimento de DCNT.

Introduction: The development of noncommunicable diseases (NCD) in older adults is related, among other factors, to the dysregulation of microRNAs (miRNAs) expression, which can be modulated by environmental factors, including dietary patterns. Objectives: To assess the plasma expression profile of miRNAs and its relationships with cardiometabolic biomarkers and diet of older adults participating in the ISA Capital population-based study. Methods: Cross-sectional study, with a sub-sample of 200 older adults participating in ISA Nutrition. The expression profile of 21 plasma miRNAs was evaluated. Subjects were evaluated for anthropometric measurements and systemic blood pressure; glycemic, lipid and inflammatory biomarkers; and food consumption. Furthermore, the chronic and low-grade inflammation score (SIS) was calculated based on the concentrations of 10 inflammatory biomarkers. The plasma expression of circulating miRNAs was analyzed using the Fluidigm method. The evaluated individuals were distributed into two groups according to the presence or absence of metabolic syndrome (MetS), and the adjusted Wald test was used to compare the expression of miRNAs between the groups. Using Kendall's tau-a coefficient, correlations between miRNAs expression and variables of interest were estimated. The Wilcoxon-Mann-Whitney test was used to determine differences in SIS based on the distribution of individuals according to sex and the presence of MetS. The Spearman correlation test estimated correlations between SIS, leptin concentrations, miRNAs and other variables of interest. Furthermore, generalized linear models were used to deepen the associations found. All analyzes were performed using Stata/SE (version 17.0) and R (version 4.2.3) software, considering a significance level of 0.05. Results: The final sample of this study consisted of 193 individuals, (69.1 (0.5) years), 50.4% of whom were female, and 64.7% with MetS. Plasma expression of miR-30a and miR-122 was higher in individuals with MetS than in those without MetS, and their expression correlated with fasting glycemia and insulinemia, HOMA1-IR, HDL-c, VLDL-c, LDL-c, non-HDL cholesterol and triacylglycerols. Furthermore, negative associations between five miRNAs (miR-15a, miR-16, miR-223, miR-363, miR-532), leptin concentration and/or SIS were observed. In addition, the consumption of different food groups influenced the plasma expression of miRNAs. Daily consumption of 100 g of fruits was related to a reduction in the expression of miR-16, miR-30a, miR-126, miR-130b, miR-363, miR-375, miR-486, miR-532. On the other hand, red meat consumption was associated with an increase in the plasma expression of four miRNAs (miR-126, miR-150, miR-223 and miR-376a). Furthermore, it was observed that the daily consumption of 100 g of vegetables was associated with a 7 times greater chance of the individuals evaluated not having MetS. Conclusions: The increase in the plasma expression of miR-21, miR-30a and miR-122 suggests a greater cardiometabolic risk, while the reduction in the expression of miR-15a, miR-16, miR-223, miR-363 and miR-532 suggests lower cardiometabolic risk in the elderly. Furthermore, the results found emphasize the importance of adopting healthy eating habits in regulating the expression of miRNAs and, consequently, in reducing the risk of developing NCD.

Exploratory analysis of the association between stature, obesity, and food insecurity in adults of the National Dietary Survey 2017-2018 / Análise exploratória da associação entre estatura, obesidade e insegurança alimentar em adultos no Inquérito Nacional de Alimentação 2017-2018

ABSTRACT Objective Evaluate short stature as a possible explanation for obesity, and identify if consumption of energy, protein, carbohydrate, and lipids were associated to higher risk for obesity in Brazilian adults (20-59 y) living in household food insecurity. Methods Cross-sectional study from 2017/2018 Household Budget Survey (N=28,112). Food insecurity was measured with the Brazilian Household Food Insecurity Measurement Scale. Short stature was used as an indicator of malnutrition at the beginning of life, which characterizes metabolic alterations resulting from the presence of food insecurity (cuts off women ≤149cm; men ≤160cm). Body mass index (kg/m2) was estimated from self-reported weight and body height. The average food intake was estimated from a 24-hr recall. The weighted means and standard error of the food security/insecurity categories were assessed according to height, mean energy intake and protein(g), carbohydrate(g) and lipids(g) intake, stratified by gender and nutritional status. Results Both men and women with obesity and food insecurity had significantly lower average height in comparison with those in food security status (p-value <0.01). The prevalence of obesity 1 (BMI 30-34.9kg/m2) increased significantly with the food insecurity among women. There was a trend towards short stature among obese women from families with food insecurity, as well as lower intake of energy. Among both men and women, the lowest intakes of protein and the highest intake of carbohydrates were observed in the underweight group (BMI <18.5kg/m2). Conclusion In women, the risk of obesity may depend on the metabolic background, since who presents food insecurity and develop obesity have low stature and lower energy intake.

RESUMO Objetivo Avaliar a baixa estatura como possível explicação para a obesidade, e identificar se o consumo de energia, proteína, carboidrato e lipídios esteve associado ao maior risco de obesidade em adultos brasileiros (20-59 anos) que vivem em domicílios em insegurança alimentar domiciliar. Métodos Estudo transversal realizado com dados da Pesquisa de Orçamentos Familiares 2017/2018 (N=28.112). A Insegurança alimentar domiciliar foi medida pela Escala Brasileira de Insegurança Alimentar. A baixa estatura (mulheres ≤149cm; homens ≤160cm) foi utilizada como indicador de alterações metabólicas decorrentes da presença de insegurança alimentar. O índice de massa corporal (kg/m2) foi estimado a partir do peso e altura autorreferidos. A média de ingestão alimentar foi estimada a partir do recordatório de 24 horas. As médias ponderadas e o erro padrão das categorias de segurança/insegurança alimentar foram avaliadas segundo estatura, médias de ingestão energéticas e de proteínas(g), carboidratos(g) e lipídios(g), estratificado por sexo e estado nutricional. Resultados Homens e mulheres com obesidade e insegurança alimentar apresentaram a média de estatura significativamente menor em comparação aqueles com segurança alimentar (p-valor <0,01). A prevalência de obesidade 1 (índice de massa corporal 30-34,9Kg/m2) aumentou significativamente com a insegurança alimentar entre as mulheres. Houve tendência de baixa estatura entre mulheres obesas de famílias com insegurança alimentar, bem como menor ingestão de energia. Entre homens e mulheres, a menor ingestão de proteína e a maior ingestão de carboidratos foram observadas no grupo de baixo peso (índice de massa corporal <18,5Kg/m2). Conclusão Nas mulheres, o risco de obesidade pode depender do metabolismo, pois quem apresenta insegurança alimentar e desenvolve obesidade possui baixa estatura e menor ingestão energética.

Dietary inflammatory index and inflammatory markers in Brazilian adolescents

ABSTRACT OBJECTIVE To evaluate the association between the inflammatory potential of the diet measured by the energy-adjusted diet inflammatory index (E-DII) and inflammatory markers in adolescents. METHODS This cross-sectional study was conducted among 518 adolescents aged 18 and 19 years from São Luís, Maranhão, Brazil in 2016. A semiquantitative food frequency questionnaire (FFQ) was used to assess dietary intake from which E-DII scores were calculated to determine the inflammatory potential of the diet. The associations between E-DII and inflammatory markers (hs-CRP, IL-6, IL-4, TNF-α, and IFNγ) were analyzed using multivariable linear regression. The variables included in the adjusted model were identified using the directed acyclic graph. RESULTS The diet of these adolescents was mostly pro-inflammatory; mean E-DII score was 1.71 and ranged from -2.44 to 5.58. Higher E-DII scores were positively associated with higher levels of IFNγ in the adjusted analysis (Adjusted Coef.: 1.19; 95%CI: 0.36-12.04). We observed no associations between E-DII and other inflammatory markers (hs-CRP, IL-6, IL-4, TNF-α). Study results indicate that E-DII is useful in evaluating the inflammatory potential of the diet of Brazilian adolescents. CONCLUSIONS Cross-sectionally E-DII scores were positively associated with IFNγ concentrations. Future research should examine the association between changes in E-DII scores and levels of inflammatory markers longitudinally.

Intervenções regulatórias direcionadas ao ambiente alimentar nas estações de metrô da cidade de São Paulo: ideias da sociedade civil usuária, da sociedade civil organizada e do governo estadual / Regulatory interventions targeting the food environment in subway stations in the city of São Paulo: ideas from user civil society, organized civil society and the state government

Introdução: Os ambientes alimentares estão ganhando atenção nacional e internacional como importantes determinantes do consumo alimentar da população. As estações do metrô são locais onde as oportunidades de compra de alimentos prontos para o consumo vêm aumentando, o que pode oferecer vantagem ao consumidor em relação ao tempo da metrópole. Porém, neste ambiente público, onde diariamente circulam cerca de 4 milhões de pessoas, é priorizada a venda de alimentos não saudáveis a preços baixos, o que pode influenciar de forma negativa a alimentação dos usuários deste serviço público. Objetivo: Identificar e analisar a percepção e as ideias de usuários do sistema de transporte metroviário de São Paulo, de representantes de organizações da sociedade civil e de representantes do governo estadual de São Paulo sobre o ambiente alimentar das estações e sobre possíveis intervenções regulatórias direcionadas ao ambiente alimentar das estações de metrô da cidade de São Paulo. Material e Método: Trata-se de um estudo com abordagem qualitativa que teve como foco as estações de metrô da cidade de São Paulo. A coleta de dados foi realizada com membros de organizações da sociedade civil por meio de entrevistas individuais semiestruturadas (entre o segundo semestre de 2020 e o primeiro semestre de 2021), seguida de grupos focais com usuários do metrô (em 2021) e finalizada por entrevistas individuais semiestruturadas com os representantes de setores do governo (primeiro semestre de 2022). Os materiais das entrevistas individuais e grupos focais - gravações em áudio e anotações - foram transcritos e digitados. Após o mapeamento de tudo que foi obtido no trabalho de campo, foi realizada a análise de conteúdo temática. Resultados e Discussão: Os participantes descreveram problemas que indicam a necessidade de mudanças como: a alta exposição a alimentos ultraprocessados (atrelados com a influência do marketing e preços acessíveis), a falta de opções de alimentos saudáveis e a ausência de políticas de alimentação e nutrição asseguradas pelo Estado no metrô. A partir disso, foram levantadas ideias que, na visão deles, solucionariam os problemas apontados e trariam benefícios a toda população. Entre essas, podem ser destacadas: maior disponibilidade de alimentos saudáveis que também garanta a praticidade no consumo e que seja associada com políticas de abastecimento, regulação do marketing de alimentos não saudáveis e ações educativas sobre alimentação adequada e saudável - a fim de estimular a prática autônoma e voluntária de hábitos alimentares saudáveis. Considerações finais: A construção de ambientes alimentares saudáveis está diretamente ligada às políticas regulatórias que são fundamentais para a proteção da saúde da população. A implementação dessas políticas, que garantem a SAN, envolve a articulação entre diferentes setores e suas ações como agricultura, saúde, educação, meio ambiente, planejamento, entre outros. Através desta pesquisa, foram apontados alguns dos problemas no ambiente alimentar em questão e as possíveis soluções a serem aplicadas, mas dependerá da forma como os dados serão interpretados e acatados pelo Governo do Estado de São Paulo, para que os fatos ganhem notoriedade no processo decisório de definições das intervenções a serem ou não implementadas.

Introduction: Food environments are gaining national and international attention as important determinants of population food consumption. Subway stations are places where opportunities to purchase ready-to-eat foods have been increasing, which can offer an advantage to consumers in terms of metropolis time. However, in this public environment, where around 4 million people circulate daily, the sale of unhealthy foods at low prices is prioritized, which can negatively influence the dietary habits of users of this public service. Objective: Identify and analyze the perception and ideas of users of São Paulos subway transportation system, representatives from civil society organizations and representatives of the state government of São Paulo regarding the food environment of the subway stations and possible regulatory interventions targeting the food environment in subway stations in the city of São Paulo. Material and Method: This is a study with a qualitative approach that focused on the subway stations in the city of São Paulo. The data collection was carried out with members of civil society organizations through semi-structured individual interviews (between the second half of 2020 and the first half of 2021), followed by focus groups with subway users (in 2021), and concluded with semi-structured individual interviews with government sector representatives (first half of 2022). Materials from individual interviews and focus groups - audio recordings and notes - were transcribed and typed. After mapping everything obtained in the fieldwork, thematic content analysis was carried out. Results and Discussion: The participants described problems that indicate the need for changes, such as: high exposure to ultra-processed foods (linked to the influence of marketing and affordable prices), lack of healthy food options and the absence of nutrition and food policies ensured by the State in the subway. From this, ideas were raised that, in their view, would address the identified problems and bring benefits to the entire population. Among these, the following can be highlighted: greater availability of healthy foods that also ensure convenience in consumption and are associated with supply policies, regulation of unhealthy food marketing, and educational actions on proper and healthy nutrition - in order to encourage autonomous and voluntary adoption of healthy eating habits. Final considerations: The construction of healthy food environments is directly linked to regulatory policies that are essential for protecting public health. The implementation of these policies, which guarantee Food and Nutrition Security, involves coordination between different sectors and their actions, such as agriculture, health, education, environment, planning, among others. Through this research, some of the issues in the food environment in question were identified, along with possible solutions to be implemented. However, it will depend on how the data is interpreted and accepted by the São Paulo State Government for the facts to gain prominence in the decision-making process regarding which interventions should or should not be implemented.

Association between screen use at night, food consumption at dinner, and evening snack in schoolchildren aged 7 to 14 years with and without overweight, Florianópolis, Santa Catarina, Brazil / Associação entre o uso de tela no período noturno e consumo alimentar no jantar e lanche da noite em escolares de 7 a 14 anos com e sem sobrepeso, Florianópolis, Santa Catarina, Brasil

ABSTRACT Objective Analyze the association between screen use at night, food consumption at dinner, and evening snack in schoolchildren with and without overweight. Methods Cross-sectional study with a probabilistic sample of 1396 schoolchildren from 7 to 14 years of age from public and private schools of Florianópolis, Santa Catarina, Brazil. Dietary intake and frequency of screen use of the previous day were obtained through the questionnaire Consumo Alimentar e Atividades Físicas de Escolares (Food Consumption and Physical Activities of Schoolchildren). The association between screen use at night (exposure) and consumption of food groups (outcome) according to weight status was assessed using multivariate logistic regression. Results At dinner, schoolchildren without overweight who used screens once had a lower chance of consuming fruits and vegetables (OR: 0.62, p=0.017) compared to those who did not use screens. In addition, those who used screens twice were more likely to consume sweets (OR: 2.01, p=0.002), and screen use three times or more was inversely associated with beans (OR: 0.24, p=0.003) and meat, eggs, and seafood (OR: 0.35, p=0.011) consumption. Overweight schoolchildren who used screens three times or more were more likely to consume ultra-processed foods and pizza/hamburger/hot dogs (OR: 2.51, p=0.009). For the evening snack, it was observed that schoolchildren without overweight who used screens three times or more had a greater chance of consuming ultra-processed foods and pizza/hamburger/hot dogs (OR: 8.26; p=0.016). Conclusion Overweight and non-overweight schoolchildren who used screens were more likely to consume ultra-processed foods. Schoolchildren without overweight and who use screens more often at night are less likely to consume healthy foods.

RESUMO Objetivo Analisar a associação entre o uso de dispositivo de tela no período noturno, o consumo alimentar no jantar e lanche da noite em escolares com e sem sobrepeso. Métodos Estudo transversal com uma amostra probabilística de 1.396 escolares de 7 a 14 anos de idade de escolas públicas e privadas de Florianópolis, Santa Catarina, Brasil. O consumo alimentar e a frequência de uso de dispositivos de telas do dia anterior foram obtidas por meio do questionário Consumo Alimentar e Atividades Físicas de Escolares. A associação entre o uso de dispositivo de tela no período noturno (exposição) e o consumo alimentar (desfecho) foi verificada por meio de regressão logística. Resultados No jantar, os escolares sem sobrepeso que utilizaram dispositivo de tela uma vez tiveram menor chance de consumir frutas, verduras e legumes (OR: 0,62, p=0,017) comparado com aqueles que não usaram dispositivos de telas. Além disso, aqueles que usaram dispositivo de tela duas vezes, tiveram maior chance de consumir doces (OR: 2,01, p=0,002) e a utilização de dispositivo de tela três vezes ou mais foi inversamente associado ao consumo de feijão (OR: 0,24, p=0.003), carnes, ovos e peixes (OR: 0,35, p=0,011). Os escolares com sobrepeso que utilizaram dispositivo de tela três vezes ou mais tiveram maior chance de consumirem ultraprocessados e lanches tipo pizza/hambúrguer/cachorro-quente (OR: 2,51, p=0,009). No lanche da noite, observou-se que os escolares sem sobrepeso que utilizaram dispositivo de tela três vezes ou mais, tiveram maior chance de consumir ultraprocessados e lanches (OR: 8,26; p=0,016). Conclusão Os escolares com e sem sobrepeso que utilizaram dispositivo de tela tiveram mais chances de consumir alimentos ultraprocessados. Os escolares sem sobrepeso que utilizam dispositivo de tela mais vezes a noite possuem menor chance de consumir alimentos saudáveis.

Ultra-processed food consumption during pregnancy and newborn weight / Consumo de alimentos ultraprocessados durante a gestação e peso ao nascer do recém-nascido

Abstract Objectives: to assess the association between pregnant women's consumption of ultra-processed foods and newborn body weight. Methods: prospective study with pregnant women (n=214) selected from all Basic Health Units in the city of Pinhais, Paraná. Socioeconomic, demographic, and health data were collected. Food consumption data were assessed using a 24-hour dietary recall and tabulated with GloboDiet software. Daily relative energy intake of ultra-processed food was estimated and logistic regression analysis was utilized. The infuence of covariates on the association analysis was also explored (e.g., income and education). Results: ultra-processed foods contributed to 26.9% of pregnant women's total energy intake. About 5.7% of newborns were classifed as small-for-gestational-age and 10.7% as large-for-gestational-age. A borderline statistically signifcant association was observed between large-for-gestational-age newborn weight and maternal consumption of ultra-processed foods (OR= 1.027; p=0.048). Additionally, family income was associated with the consumption of ultra-processed foods (OR= 0.144; p=0.008). With each additional 1% consumption of ultra-processed foods, mothers' likelihood of having large-for-gestational-age babies increased by about 2.7%. Conclusions: the study reveals a trend of positive association between the weight of large-for-gestational-age newborns and the consumption of ultra-processed foods by pregnant women, but not for small-for-gestational-age children.

Resumo Objetivos: avaliar a associação entre o consumo de alimentos ultraprocessados por gestantes e o peso de recém-nascidos. Métodos: estudo prospectivo com gestantes (n=214) selecionadas em Unidades Básicas de Saúde em Pinhais, Paraná. Dados socioeconômicos, demográfcos e de saúde foram coletados. Dados de consumo alimentar foram coletados por recordatório de 24-horas físico e entrados no software GloboDiet. O consumo diário relativo de energia proveniente de alimentos ultraprocessados foi estimado e a análise de regressão logística foi utilizada, considerando covariáveis como renda familiar e escolaridade. Resultados: o consumo de alimentos ultraprocessados pelas gestantes representou 26,9% da energia total. Cerca de 5,7% de recém-nascidos foram classifcados como pequenos para idade gestacional (PIG) e 10,7% como grandes para idade gestacional (GIG). Foi observada uma associação estatisticamente signifcativa limítrofe entre o peso dos recém-nascidos GIG e o consumo materno de alimentos ultraprocessados (OR= 1,027; p=0,048). Além disso, a renda familiar esteve associada com o consumo de alimentos ultraprocessados (OR=0,144; p=0,008). A cada 1% adicional de consumo de alimentos ultraprocessados, a probabilidade de as mães terem recém-nascidos GIG aumentou cerca de 2,7%. Conclusões: o estudo revela uma tendência de associação positiva entre o peso de recém-nascidos GIG e o consumo de alimentos ultraprocessados por mulheres grávidas, mas não para crianças PIG.

Efeito da ingestão do suco de uva integral sobre a migração de leucócitos em mulheres com sobrepeso. Participação da delfinidina-3-glicosídeo como potencial modulador do perfil inflamatório e da migração celular / Effect of whole grape juice intake on leukocyte migration in overweight women. Participation of delphinidin-3-glycoside as a potential modulator of inflammatory profile and cell migration

Concentrações aumentadas de tecido adiposo corporal observadas no sobrepeso e obesidade, podem gerar a produção de diversos mediadores inflamatórios com ação direta ou indireta em influenciar a capacidade de proliferação e diferenciação das células hematopoéticas e, consequentemente, a complexa regulação que envolve os processos de migração celular. Sabe-se que o recrutamento contínuo de leucócitos durante vários estágios do processo inflamatório apresenta importante papel na gênese desse processo, participando intensamente na perpetuação da inflamação. Na literatura, vários estudos demostraram acapacidade anti-inflamatória das antocianinas sobre vários órgãos; contudo poucos estudos avaliam a influência das antocianinas sobre a migração celular. As antocianinas pertencem à ampla classe dos flavonoides que estão presentes em uma ampla variedade de frutas, vegetais e bebidas e são os compostos responsáveis pelas cores azul, violeta e vermelha desses alimentos. Sendo assim, pretende-se nesse estudo avaliar o efeito da delfinidina-3-glicosídeo, uma antocianina presente em abundância em diversas frutas com destaque para o suco de uva integral, sobre os processos de migração leucocitária. Para tanto esse trabalho foi dividido em duas etapas: (i) uma realizada em pacientes com sobrepeso que consumiram suco de uva integral e (ii) uma segunda etapa, in vitro, onde foi avaliado o efeito da delfinidina-3-glicosídeo sobre mecanismos envolvidos na modulação dos processos de migração leucocitária. Na etapa inicial com estudos in vivo, foram avaliados parâmetros bioquímicos, hematológicos, bem como a expressão de moléculas de adesão de células polimorfonucleares do sangue periférico e a quantificação de citocinas inflamatórias e alguns genes envolvidos nos processos de inflamação e migração celular. Na primeira etapa, a ingestão de suco de uva não alterou o perfil lipídico/inflamatório ou a contagem de leucócitos, entretanto, reduziu os valores circulantes de sICAM e sVCAM. Na segunda etapa, os resultados in vitro mostraram que a delfinidina reduziu a taxa de migração e a expressão de células CD11/CD18 positivas, reduziu a expressão gênica de ICAM-1 e a fosforilação e expressão gênica de NFkB, reduzindo também a produção de IL-6, IL-8 e CCL2

Increased concentrations of body adipose tissue observed in overweight and obesity may generate the production of several inflammatory mediators that can act directly or indirectly on the hematopoietic cells capacity of proliferation and differentiation and, consequently, the complex regulation that involves the processes of cell migration. It is known that the continuous recruitment of leukocytes during various stages of the inflammatory process plays an important role in the genesis of this process, intensely participating in the perpetuation of inflammation. In the literature, several studies have demonstrated the anti-inflammatory capacity of anthocyanins on various organs; however, few studies have evaluated the influence of anthocyanins on cell migration. Anthocyanins belong to the broad class of flavonoids that are present in a wide variety of fruits, vegetables and beverages and are the compounds responsible for the blue, violet and red colors of these foods. Thus, this study intends to evaluate the effect of delphinidin-3-glycoside, an anthocyanin present in abundance in several fruits, especially whole grape juice, on leukocyte migration processes. Therefore, this study was divided into two stages: (i) one performed in overweight patients who consumed whole grape juice and (ii) a second stage, in vitro, where the effect of delphinidin-3-glycoside on mechanisms involved in the modulation of leukocyte migration processes was evaluated. In the initial stage with in vivo studies, biochemical and hematological parameters were evaluated, as well as the expression of adhesion molecules of polymorphonuclear cells of peripheral blood and the quantification of inflammatory cytokines and some genes involved in the processes of inflammation and cell migration. In the first stage, the intake of grape juice did not alter the lipid/inflammatory profile or the leukocyte count, however, it reduced the circulating values of sICAM and sVCAM. In the second step, in vitro results showed that delphinidine reduced the migration rate and expression of CD11/CD18 positive cells, reduced ICAM-1 gene expression and NFkB phosphorylation and gene expression, and also reduced IL-6, IL-8 and CCL2 production

Índices para avaliar dietas sustentáveis e promotoras de saúde cardiovascular: desenvolvimento, validação e aplicação / Indices for evaluating sustainable and cardiovascular health-promoting diets: development, validation, and application

Introdução: Índices de avaliação da dieta são instrumentos úteis para identificar a qualidade global da dieta e verificar se a adesão às recomendações dietéticas possui efeitos benéficos na saúde. Em 2019, a Comissão EAT-Lancet propôs um modelo de dieta sustentável, enquanto que a American Heart Association (AHA) possui recomendações dietéticas para promoção da saúde cardiovascular. No entanto, não existem índices baseados nestas recomendações. Objetivo: Desenvolver e validar dois índices de avaliação da dieta baseados na dieta sustentável do EAT-Lancet e nas recomendações dietéticas da AHA e sua aplicação na análise de associação com aterosclerose subclínica. Métodos: Foram utilizados dados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil), uma coorte multicêntrica que acompanha 15.105 funcionários de seis instituições públicas de ensino e pesquisa. O consumo alimentar foi avaliado através de um Questionário de Frequência Alimentar (QFA). A aterosclerose subclínica foi avaliada através do escore de calcificação arterial coronariano (CAC) na linha de base (2008-2010) e na segunda onda (2012-2014) e a espessura médio-intimal das carótidas (IMT) na linha de base e na terceira onda (2017-2019). Para o desenvolvimento do Planetary Health Diet Index (PHDI), foram utilizadas as recomendações da Comissão EAT-Lancet e para o desenvolvimento do Cardiovascular Health Diet Index (CHDI), foram utilizadas as recomendações dietéticas da American Heart Association. Após o desenvolvimento dos índices, técnicas de validade e confiabilidade interna foram empregadas. Para avaliar os fatores associados aos índices, foram empregados modelos de regressão linear simples e múltiplos. Modelos de Poisson com variância robusta foram construídos para avaliar a associação entre os índices e a incidência e progressão do CAC, enquanto modelos lineares mistos foram construídos para avaliar os índices e as mudanças no IMT. Resultados: A população apresentou uma média de 60,4 pontos no PHDI (de uma variação possível de 0 - 150 pontos) e de 57,1 pontos no CHDI (de uma variação possível de 0 - 110 pontos). Análises de validade relativa e confiabilidade demonstraram que ambos os índices possuem desempenho satisfatórios, demonstrando boa validade e confiabilidade interna. Observou-se que as mulheres, os idosos, pessoas com maior renda per capita, prática de atividade física moderada e vigorosa apresentaram, em média, maiores pontuações. Ao passo que, os fumantes e as pessoas com sobrepeso e obesidade apresentaram, em média, menores pontuações em ambos os índices. Não foram observadas associações significantes entre o PHDI com CAC e IMT. No entanto, após um período médio de acompanhamento de 8 anos, um aumento de 10 pontos no CHDI foi associado a uma diminuição de 0,0023 mm (IC 95% -0,0045; -0,0002) no IMT. Nenhuma associação foi observada entre o escore CHDI e a incidência e progressão de CAC após um período de acompanhamento de 4 anos. Conclusões: Os resultados demonstram a validade dos índices propostos como ferramentas adequadas para avaliação da dieta. Foi possível observar que a adesão as recomendações de dieta sustentável e promotoras da saúde cardiovascular estão associadas com condições sociodemográficas e de estilo de vida. Além disso, maior adesão à uma dieta cardioprotetora está inversamente associada com um marcador de aterosclerose subclínica.

Introduction: Dietary indices are useful tools to identify the overall dietary quality and to verify whether adherence to dietary recommendations has beneficial effects on health. In 2019, the EAT-Lancet Commission proposed a sustainable diet model, while the American Heart Association (AHA) has dietary recommendations for promoting cardiovascular health. However, there are no indices based on these recommendations. Objective: To develop and validate two dietary indices based on the EAT-Lancet sustainable diet and AHA dietary recommendations and their application in analyzing associations with subclinical atherosclerosis. Methods: Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort following 15,105 employees from six public teaching and research institutions, were used. Dietary intake was assessed through a Food Frequency Questionnaire (FFQ). Subclinical atherosclerosis was assessed through coronary artery calcification score (CAC) at baseline (2008-2010) and the second wave (2012-2014) and carotid intima media thickness (IMT) at baseline and the third wave (2017-2019). For the development of the Planetary Health Diet Index (PHDI), the recommendations of the EAT-Lancet Commission were used, and for the development of the Cardiovascular Health Diet Index (CHDI), the dietary recommendations of the American Heart Association were used. After index development, techniques of validity and internal reliability were employed. To assess factors associated with the indices, simple and multiple linear regression models were used. Poisson models with robust variance were constructed to assess the association between the indices and the incidence and progression of CAC, while mixed linear models were constructed to assess the indices and changes in IMT. Results: The population had a mean score of 60.4 points on the PHDI (out of a possible range of 0-150 points) and 57.1 points on the CHDI (out of a possible range of 0-110 points). Relative validity and reliability analyses demonstrated that both indices performed satisfactorily, showing good internal validity and reliability. It was observed that women, the elderly, individuals with higher per capita income, moderate and vigorous physical activity, on average, had higher scores. Conversely, smokers and overweight and obese individuals, on average, had lower scores on both indices. No significant associations were observed between the PHDI and CAC and IMT. However, after a mean follow-up period of 8 years, a 10-point increase in the CHDI was associated with a decrease of 0.0023 mm (95% CI -0.0045; -0.0002) in IMT. No association was observed between the CHDI score and the incidence and progression of CAC after a 4-year follow-up period. Conclusions: The results demonstrate the validity of the proposed indices as suitable tools for dietary assessment. It was possible to observe that adherence to sustainable diet and cardiovascular health-promoting recommendations is associated with sociodemographic and lifestyle conditions. Additionally, greater adherence to a cardioprotective diet is inversely associated with a marker of subclinical atherosclerosis.