Nutritional status of iodine in pregnant and non-pregnant adolescents assisted at the Family Health Strategy in Vespasiano, MG / Estado nutricional de iodo em adolescentes gestantes e não gestantes assistidas na ESF em Vespasiano, MG

Abstract Objectives: to evaluate the nutritional status of iodine in pregnant adolescents, taking into account the increase in the demand for iodine during pregnancy and the absence of iodization strategies for this population. Methods: cross-sectional study conducted with 62 pregnant and 71 non-pregnant adolescents assisted in primary care. The nutritional status of iodine was determined by urinary samples. The iodine concentration in the consumed culinary salt was also evaluated. For the comparative analyses of categorical variables, the Chi-square test was used and for the continuous variables, the Kruskal-Wallis test, considering a 95% confidence interval (CI) and significance level of 5%. Results: the mean iodine concentration in household salt was 25.1 mg/kg (CI95%= 11.1-67.5 mg/kg), with higher mean content in culinary salt in the group of pregnant women (p<0.028). Regarding the nutritional status of iodine, 71% of pregnant adolescents were deficient and 29% iodine-sufficient, with significant difference when compared to 38% of deficiency and 62% of sufficiency in the control group (p<0.001). Conclusions: there was an iodic deficiency among pregnant adolescents, even in the face of higher concentrations of iode in household salt, exposing a paradox between higher consumption and lower sufficiency in this group. Thus, it is suggested to consider iodine supplementation during pregnancy, seeking to minimize the effects of this deficiency on maternal and child health.

Resumo Objetivos: avaliar o estado nutricional de iodo em adolescentes gestantes, levando-se em consideração o aumento na demanda de iodo na gestação e a ausência de estratégias de iodização para essa população. Métodos: estudo transversal realizado com 62 adolescentes gestantes e 71 não gestantes assistidas na atenção primária. O estado nutricional de iodo foi determinado pela concentração de iodo em amostras urinárias. O teor de iodo no sal culinário também foi avaliado. Para as análises comparativas das variáveis categóricas utilizou-se o teste de qui-quadrado e para as variáveis contínuas o teste Kruskal-Wallis, considerando intervalo de confiança (IC) de 95% e nível de significância de 5%. Resultados: a média da concentração de iodo no sal domiciliar foi de 25,1 mg/kg (IC95%= 11,1-67,5 mg/kg), com maior teor médio no sal culinário de gestantes (p<0,028). Em relação ao estado nutricional de iodo, 71% das adolescentes gestantes mostraram-se deficientes e 29% iodo-suficientes, com diferença significativa quando comparadas aos 38% de deficiência e 62% de suficiência no grupo controle (p<0,001). Conclusões: observou-se deficiência iódica entre adolescentes gestantes, mesmo diante de maiores concentrações de iodo no sal domiciliar, expondo um paradoxo entre maior consumo e menor suficiência neste grupo. Assim, sugere-se considerar a suplementação de iodo na gestação, buscando-se minimizar os efeitos desta carência sobre a saúde maternoinfantil.

DNA Damage, n-3 Long-Chain PUFA Levels and Proteomic Profile in Brazilian Children and Adolescents.

Fatty acids play a significant role in maintaining cellular and DNA protection and we previously found an inverse relationship between blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and DNA damage. The aim of this study was to explore differences in proteomic profiles, for 117 pro-inflammatory proteins, in two previously defined groups of individuals with different DNA damage and EPA and DHA levels. Healthy children and adolescents (n = 140) aged 9 to 13 years old in an urban area of Brazil were divided by k-means cluster test into two clusters of DNA damage (tail intensity) using the comet assay (cluster 1 = 5.9% ± 1.2 and cluster 2 = 13.8% ± 3.1) in our previous study. The cluster with higher DNA damage and lower levels of DHA (6.2 ± 1.6 mg/dL; 5.4 ± 1.3 mg/dL, p = 0.003) and EPA (0.6 ± 0.2 mg/dL; 0.5 ± 0.1 mg/dL, p < 0.001) presented increased expression of the proteins CDK8-CCNC, PIK3CA-PIK3R1, KYNU, and PRKCB, which are involved in pro-inflammatory pathways. Our findings support the hypothesis that low levels of n-3 long-chain PUFA may have a less protective role against DNA damage through expression of pro-inflammatory proteins, such as CDK8-CCNC, PIK3CA-PIK3R1, KYNU, and PRKCB.

Prevalence of childhood anaemia in Brazil: still a serious health problem: a systematic review and meta-analysis.

OBJECTIVE: To estimate the prevalence of anaemia in Brazilian children up to 83·9 months old. DESIGN: Systematic review and meta-analysis, using databases PubMed, Scopus, SciELO, Lilacs, Google Scholar, Periódicos Capes, Arca, Biblioteca Virtual em Saúde, Microsoft Academic Search and Cochrane Library using search terms: anaemia, prevalence, child and Brazil. PROSPERO Registration number: CRD42020208818. SETTING: Cross-sectional, cohort, case-control and intervention studies published between 2007 and 2020 were searched, excluding those who assessed children with an illness or chronic condition. The main outcome was anaemia prevalence. Random effects models based on the inverse variance method were used to estimate pooled prevalence measures. Sensitivity analyses removed studies with high contribution to overall heterogeneity. PARTICIPANTS: From 6790 first screened, 134 eligible studies were included, totalling 46 978 children aged zero to 83·9 months analysed, with adequate regions representativeness. RESULTS: Pooled prevalence of anaemia was 33 % (95 % CI 30, 35). Sensitivity analyses showed that withdrawal of studies that contributed to high heterogeneity did not influence national average prevalence. CONCLUSIONS: Childhood anaemia is still a serious public health problem in Brazil, exposing 33 % of Brazilian children to the anaemia repercussions. The main limitation of the study is the estimation of national prevalence based on local surveys, but a large number of studies were included, with representation in all regions of the country, giving strength to the results. In Brazil, more public policies are needed to promote supplementation, fortification and access to healthy eating to reduce the high level of anaemia among children.

Antioxidant vitamins in the context of nonalcoholic fatty liver disease in obese children and adolescents / Vitaminas antioxidantes en el contexto de la enfermedad hepatica grasosa no alcoholica en ninos y adolescentes obesos / Vitaminas antioxidantes no contexto da doenca hepatica gordurosa nao alcoolica em criancas e adolescentes obesos

OBJECTIVE: To review the literature on the importance of antioxidant vitamins, analyzed in the context of dietary intake, its plasma levels, and its current use as a supplementation treatment in obese children and adolescents with nonalcoholic fatty liver disease. DATA SOURCES: The articles were identified in Lilacs, Ibecs, SciELO, PubMed/Medline, and Scopus databases. To conduct the survey, the "fatty liver" descriptor was associated to the following words: "children", "antioxidants" and "vitamins". The search was limited to articles written in Portuguese, Spanish and English, with publication date until December, 2012. DATA SYNTHESIS: Six studies were selected. The survey revealed a low dietary intake and low antioxidant vitamins serum levels in this population. The changes in lifestyle, with adequate dietary intake of vitamins, and the increase in physical activity were associated with a significant improvement in liver histology and in laboratory tests. Vitamin supplementation also improved the disease progression markers, as the alanine aminotransferase serum levels and the histological characteristics of lobular inflammation and hepatocellular damage. However, these improvements were not statistically significant in all studies. CONCLUSIONS: There is insufficient evidence to recommend or to refute antioxidant supplementation in patients with simple steatosis or steatohepatitis. The changes in lifestyle seem to be, at the present time, the more advisable therapy. .

OBJETIVO: Revisar la literatura sobre la importancia de las vitaminas antioxidantes, analizadas bajo el contexto del consumo dietético, sus respectivos niveles plasmáticos y su actual utilización como tratamiento de suplementación en niños y adolescentes obesos con enfermedad hepática grasosa no alcohólica. FUENTES DE DATOS: Se identificaron los artículos en las bases de datos Lilacs, Ibecs, SciELO, PubMed/MedLine y Scopus. Para realizar la investigación, se utilizó el descriptor "hígado grasoso", asociado a los términos "niño", "antioxidantes" y "vitaminas". La búsqueda se limitó a los artículos en portugués, español e inglés, con fecha límite de publicación hasta diciembre de 2012. SÍNTESIS DE LOS DATOS: Se seleccionaron seis estudios. La investigación reveló baja ingestión dietética y bajos niveles de concentración sérica de vitaminas antioxidantes en la población estudiada. El cambio en los hábitos de vida, con adecuación del consumo dietético de vitaminas y aumento de la actividad física, se asoció a la mejora significativa en la histología hepática y en los exámenes laboratoriales. La suplementación vitamínica también mejoró los marcadores de progresión de la enfermedad, como los niveles séricos de alanina aminotransferasa y las características histológicas de inflamación lobular y lesión hepatocelular. Sin embargo, esas mejorías no fueron estadísticamente significativas en todos los estudios. CONCLUSIONES: No hay evidencias suficientes para recomendar o rechazar la suplementación con antioxidantes en pacientes con esteatosis simple o esteato-hepatitis. El cambio en el estilo de vida parece ser, en el momento, la terapéutica más aconsejable. .

OBJETIVO: Revisar a literatura sobre a importância das vitaminas antioxidantes, analisadas sob o contexto do consumo dietético, seus respectivos níveis plasmáticos e sua atual utilização como tratamento de suplementação em crianças e adolescentes obesos com doença hepática gordurosa não alcoólica. FONTES DE DADOS: Identificaram-se os artigos nas bases de dados Lilacs, Ibecs, SciELO, PubMed/MedLine e Scopus. Para realizar a pesquisa, utilizou-se o descritor "fígado gorduroso", associado aos termos "crianças", "antioxidantes" e "vitaminas". A busca limitou-se aos artigos em português, espanhol e inglês, com data limite de publicação até dezembro de 2012. SÍNTESE DOS DADOS: Selecionaram-se seis estudos. A pesquisa revelou baixa ingestão dietética e baixos níveis de concentração sérica de vitaminas antioxidantes na população estudada. A mudança nos hábitos de vida, com adequação do consumo dietético de vitaminas e aumento da atividade física, associou-se à melhora significativa na histologia hepática e nos exames laboratoriais. A suplementação vitamínica também melhorou os marcadores de progressão da doença, como os níveis séricos de alanina aminotransferase e as características histológicas de inflamação lobular e lesão hepatocelular. Contudo, essas melhorias não foram estatisticamente significativas em todos os estudos. CONCLUSÕES: Não há evidências suficientes para recomendar ou refutar a suplementação com antioxidantes em pacientes com esteatose simples ou esteato-hepatite. A mudança no estilo de vida parece ser, no momento, a terapêutica mais aconselhável. .

Antioxidant vitamins in the context of nonalcoholic fatty liver disease in obese children and adolescents.

OBJECTIVE: To review the literature on the importance of antioxidant vitamins, analyzed in the context of dietary intake, its plasma levels, and its current use as a supplementation treatment in obese children and adolescents with nonalcoholic fatty liver disease. DATA SOURCES: The articles were identified in Lilacs, Ibecs, SciELO, PubMed/Medline, and Scopus databases. To conduct the survey, the "fatty liver" descriptor was associated to the following words: "children", "antioxidants" and "vitamins". The search was limited to articles written in Portuguese, Spanish and English, with publication date until December, 2012. DATA SYNTHESIS: Six studies were selected. The survey revealed a low dietary intake and low antioxidant vitamins serum levels in this population. The changes in lifestyle, with adequate dietary intake of vitamins, and the increase in physical activity were associated with a significant improvement in liver histology and in laboratory tests. Vitamin supplementation also improved the disease progression markers, as the alanine aminotransferase serum levels and the histological characteristics of lobular inflammation and hepatocellular damage. However, these improvements were not statistically significant in all studies. CONCLUSIONS: There is insufficient evidence to recommend or to refute antioxidant supplementation in patients with simple steatosis or steatohepatitis. The changes in lifestyle seem to be, at the present time, the more advisable therapy.