Résumé
Abstract Objectives To verify the association between early-life nutrition and chronic adult diseases. Data Sources Medline, Embase, Cochrane Database, and Lilacs. Summary of finds The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that a mismatch between early-life circumstances and later-life situations may have an impact on chronic diseases. In this review, the authors emphasize the research supporting the impact of early nutrition on the origins of adult height, obesity and metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, and reproductive outcomes. Conclusion Even though this is a new topic and there are still many research questions to be answered, there is strong evidence that both deficiency and excess nutrition in early life can cause epigenetic changes that have effects that last a lifetime and contribute to the development of chronic diseases. Public health efforts to protect adults from getting chronic diseases should focus on nutrition in the first 1000 days of life, from conception to the end of the second year of life.
Résumé
Our aim is to verify the association between dietary patterns during early pregnancy and development of gestational diabetes mellitus (GDM) in a low income Brazilian population. A cohort study followed 841 healthy pregnant women from the 15-20th gestational week until delivery. This study was conducted at the Instituto de Medicina Integral Prof. Fernando Figueira, Brazil. 838 pregnant women during the first half of a healthy pregnancy with a monthly family income below US $ 500.00 were selected. 95 (11.3%) pregnant women developed gestational diabetes mellitus. Three dietary patterns from factor analysis were extracted. The traditional pattern was characterized by dairy products, fruits, vegetable and fish. The mixed pattern included fried food, pizza, juice, manioc flour, red meat and candies. The western pattern was characterized by eggs, white bread, cookies, pasta, pizza, fried food, chicken, candies, chocolate, salty snacks and soft drinks. There were no differences among GDM incidence according to these three dietary patterns. This finding remained after adjustment for maternal age, maternal education, body mass index pre-pregnancy and parity. We concluded that eating patterns studied during early pregnancy were not associated to the development of GDM in this sample of Brazilian pregnant women with low income(AU)
Hábitos dietéticos e diabetes mellitus gestacional em uma população de gestantes de baixa renda no Brasil estudo de coorte. Nosso objetivo foi verificar a associação entre o padrão alimentar no começo da gravidez com o desenvolvimento de diabetes mellitus gestacional (DMG) em um grupo populacional de baixa renda no Brasil. Um estudo de coorte seguiu 841 gestantes saudáveis da 15-20 semana gestacional até o parto. Esse estudo foi realizado no Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Brasil. Oitocentas e trinta e oito gestantes no curso da primeira metade da gestação e com uma renda familiar abaixo de US $ 500.00 foram selecionadas. Noventa e cinco gestantes (11.3%) desenvolveram DMG. Três padrões alimentares distintos foram extraídos através da técnica do fator de análise. O padrão alimentar tradicional foi caracterizado pela ingestão de produtos lácteos, frutas, vegetais e peixes. O padrão alimentar misto incluiu frituras, pizza, sucos, farinha de mandioca, carne vermelha e doces. O padrão alimentar ocidental foi caracterizado por ovos, pão branco, biscoitos, massa, pizza, carne de galinha, doces, chocolate, salgadinhos e refrigerantes. Não foi observado diferença na incidência de DMG entre os três padrões alimentares identificados. Esse achado permaneceu inalterado após o ajuste para a idade e nível de educação maternal, assim como para o IMC antes da gravidez e paridade. Em conclusão, o padrão alimentar materno durante o começo da gravi- dez entre gestantes de baixa renda não parece estar associado com o desenvolvimento de DMG(AU)
Sujets)
Humains , Femelle , Adolescent , Adulte , Diabète gestationnel , Nutrition Prénatale , Maladies métaboliques , Conditions sociales , Comportement alimentaire , Alimentation et nutritionRésumé
Abstract Objectives: to describe preliminary data referred to epileptic seizures and the probability of occurring these epileptic seizures in the infants' first months of life with congenital Zika virus (ZIKV) syndrome. Methods: concurrent cohort study including newborns and infants with congenital Zika virus syndrome attended at the specialized outpatient clinic at IMIP, Recife, Pernambuco, from October 2015 to May 2016. Results: data on 106 infants were analyzed with confirmed or suspected association to ZIKV infection. Forty children (38.7%) presented an epileptic seizure, classified at 43.3% of the cases as being spasms, 22.7% as generalized tonic seizures, 20.5% as partial and 4.5% other types of seizures. The median of days until the first report on the occurrence of epileptic seizure was 192 days of life. Conclusions: children with congenital Zika virus syndrome presented a high incidence of epileptic seizures before the end of the first semester of life, and spasm was the epileptic seizure mostly observed.
Resumo Objetivos: descrever dados preliminares referentes às crises epilépticas e à probabilidade de ocorrência dessas crises nos primeiros meses de vida em crianças com síndrome congênita do Zika vírus (ZIKV). Métodos: estudo de coorte concorrente incluindo recém-nascidos e lactentes com síndrome congênita do Zika vírus, atendidos no ambulatório especializado do IMIP, Recife, Pernambuco durante o período de outubro 2015 a maio 2016. Resultados: foram analisados dados de 106 lactentes com diagnóstico confirmado ou provável associação da infecção pelo ZIKV. Quarenta crianças (38,7%) apresentaram crise epiléptica, classificada em 43,3% dos casos como sendo espasmo, 22,7% como crise generalizada tônica, 20,5% parcial e 4,5% crises epilépticas de outros tipos. A mediana dos dias até o primeiro relato de ocorrência de crise epiléptica foi 192 dias de vida. Conclusões: crianças com síndrome congênita do Zika vírus apresentaram elevada incidência de crises epilépticas de aparecimento precoce, antes do final do primeiro semestre de vida, sendo o espasmo o tipo de crise mais observado.