Disability and costs of IHD attributable to the consumption of trans-fatty acids in Brazil.

OBJECTIVE: To estimate the disability and costs of the Brazilian Unified Health System for IHD attributable to trans-fatty acid (TFA) consumption in 2019. DESIGN: This ecological study used secondary data from the Global Burden of Disease (GBD) Study 2019 to estimate the years lived with disability from IHD attributable to TFA in Brazil in 2019. Data on direct costs (purchasing power parity: 1 Int$ = R$ 2·280) were obtained from the Hospital and Ambulatory Information Systems of the Brazilian Unified Health System. Moreover, the total costs in each state were divided by the resident population in 2019 and multiplied by 10 000 inhabitants. The relationship between the socio-demographic index, disease and economic burden was investigated. SETTING: Brazil and its twenty-seven states. PARTICIPANTS: Adults aged ≥ 25 years of both sexes. RESULTS: IHD attributable to TFA consumption resulted in 11 165 years lived with disability (95 % uncertainty interval 932­18 462) in 2019 in Brazil. A total of Int$ 54 546 227 (95 % uncertainty interval 4 505 792­85 561 810) was spent in the Brazilian Unified Health System in 2019 due to IHD attributable to TFA, with the highest costs of hospitalisations, for males and individuals aged ≥ 50 years or over. The highest costs were observed in Sergipe (Int$ 6508/10 000; 95 % uncertainty interval 576­10 265), followed by the two states from the South. Overall, as the socio-demographic index increases, expenditures increase. CONCLUSIONS: TFA consumption results in a high disease and economic IHD burden in Brazil, reinforcing the need for more effective health policies, such as industrial TFA elimination, following the international agenda.

Co-occurrence of obesogenic behaviors and their implications for mental health during the COVID-19 pandemic: a study with university students.

BACKGROUND: The university years are a critical period for young adults, as they are more exposed to obesogenic behaviors and experience stressful situations that compromise their mental health. This study aims to estimate the prevalence of anxiety and depression symptoms and evaluate the association between the combined occurrence of obesogenic behaviors among university students. METHODS: A cross-sectional study was conducted on students from a public university in Brazil during the COVID-19 pandemic. Data were collected from July to August 2020 using an online questionnaire. The outcome variables (anxiety and depression symptoms) were assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). The co-occurrence of obesogenic behaviors was measured based on irregular consumption of fruits and vegetables, frequent consumption of ultra-processed foods, physical inactivity during leisure time, and sedentary behavior. A Venn diagram was used for the exploratory analysis. To verify the association between the outcome and explanatory variables, a directed acyclic graph model was constructed, and multivariate logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (95%CIs). RESULTS: A total of 1,353 students aged 18-24 years participated in this study. Symptoms of anxiety and depression were present in 46.1% and 54.6% of the participants, respectively. The most prevalent combination of obesogenic behaviors was frequent consumption of ultra-processed foods, physical inactivity during leisure time, and sedentary behavior (17.2%). The greater the number of simultaneous obesogenic behaviors, the higher the chance to present symptoms of anxiety [OR: 2.81 (95%CI: 1.77-4.46)] and depression [OR: 3.46 (95%CI: 2.20-5.43)]. CONCLUSION: These findings reinforce the need to take actions to promote mental health in the university environment in conjunction with programs to promote a healthy lifestyle and improve the physical and mental well-being of students.

Development and validity evidence on the scale of perceived social support for university students (EPSSEU) during the period of social restrictions.

AIM: This study aims to validate a Perceived Social Support Scale for University Students (EPSSEU) during periods of social restrictions, by focusing on family and university support. SUBJECT AND METHODS: This cross-sectional study was conducted with undergraduate students from a public higher education institution. The college students who participated in the study-1353 at baseline and 378 after 6 months-answered a virtual questionnaire containing questions on: sociodemographic and lifestyle data, items proposed for the EPSSEU, Satisfaction with Social Support Scale (ESSS), and Depression, Anxiety and Stress Scale (DASS-21). Exploratory factor analysis, Cronbach's alpha reliability analysis, as well as discriminant, convergent, and known-group validations were performed. RESULTS: The results showed two factors support from: i) the university and ii) friends and family- which explained 61.82% of the variance in the data. The EPSSEU showed good reliability (Cronbach's alpha = 0.796) as well as validity, with higher scores among individuals without depression, anxiety, or stress. CONCLUSION: The EPSSEU shows adequate psychometric qualities and may be a useful instrument for assessing university students' social support in pandemics, social distancing, and remote teaching contexts.

Sedentary behavior is associated with the mental health of university students during the Covid-19 pandemic, and not practicing physical activity accentuates its adverse effects: cross-sectional study.

BACKGROUND: Movement behaviours, such as sedentary behavior (SB) and physical inactivity, have become a public health issue due to their implications for physical and mental health. The literature indicates that the university environment influences the movement behaviors of university students, and the strategies adopted during the pandemic may have favored a decrease in the practice of physical activity and an increase in the time dedicated to SB in this population. We aimed to evaluate the association of SB and moderate to vigorous leisure-time physical activity (MVPA) with presence of symptoms of mental disorders during the COVID-19 pandemic. METHODS: This is a multicenter survey conducted with undergraduate students from eight Brazilian universities between October 2021 and February 2022 using an online questionnaire. The outcome variable was symptoms of anxiety and depression, assessed by the Depression, Anxiety, and Stress Scale-21. SB was assessed by total sitting time, being that individuals with ≥ 9 h/day were classified with high SB. The practice of MVPA was evaluated based on weekly frequency, duration, and type of exercise. Subsequently, the ratio between the time spent in MVPA (minutes/day) and the time spent in SB (hours/day) was calculated, being considered as cutoff point was the practice of 2.5 min of MVPA for each sedentary hour. To assess the association between the outcome and explanatory variables, multivariable logistic regression was performed. RESULTS: A total of 8,650 students participated in the study, with an average age of 23.9 years (SD: ± 6.34). In the multivariate analysis, the odds of anxiety symptoms [OR: 1.37 (95% CI: 1.24-1.50)] and depression [OR: 1.61 (95% CI: 1.47-1.77)] were higher in individuals with ≥ 9 h of SB per day. In the analysis of the relationship between MVPA and SB, not engaging in 2.5 min of MVPA per hour of SB increases the odds of anxiety symptoms [OR: 1.44 (95% CI: 1.31-1.58)] and depression [OR: 1.74 (95% CI: 1.59-1.92)]. CONCLUSION: The results suggest that SB is a risk factor associated with symptoms of anxiety and depression and that not engaging in MVPA exacerbates the negative effects of SB.

The combined consumption of fresh/minimally processed food and ultra-processed food on food insecurity: COVID Inconfidentes, a population-based survey.

OBJECTIVE: To investigate whether the combined consumption of fresh/minimally processed and ultra-processed food is associated with food insecurity (FI) during the COVID-19 pandemic. DESIGN: Cross-sectional observational study was derived from a survey using a population-based search of a complex sample. FI was assessed using the validated Brazilian Food Insecurity Scale. Food consumption was assessed using a qualitative FFQ and the NOVA classification for fresh/minimally processed food and ultra-processed food. A scoring system was used to evaluate combined food consumption according to the extent and purpose of processing, considering the weekly consumption of the two groups (according to the NOVA classification). Higher punctuation reflects worse diet quality (higher consumption of ultra-processed foods and lower consumption of fresh/minimally processed foods). A theoretical causality model was constructed using a directed acyclic graph, and multivariate analysis was performed using Poisson regression to test the association between FI and food consumption. SETTING: Ouro Preto and Mariana, Brazil, between October and December 2020. PARTICIPANTS: An epidemiological household survey was conducted with 1753 individuals selected through a stratified and clustered sampling design in three stages. RESULTS: Those with food consumption scores in the fourth quartile had a 60 % higher prevalence ratio (PR) for FI (PR: 1·60 and 95 % CI: 1·06 - 2·40). Also, the increased consumption of fresh/minimally processed foods and low consumption of ultra-processed foods presented a 45 % lower prevalence ratio of FI (PR: 0·55 and 95 % CI: 0·40 - 0·80). CONCLUSION: These results indicate an inverse association between FI and diet quality.

Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea.

OBJECTIVES: The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D deficiency (VDD) in shift workers. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. RESULTS: Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06-2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09-2.48). After subgroup analyses, similar results were not observed in workers aged 20-29 and 30-39 years. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.

Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects.

BACKGROUND: We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS: Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS: A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION: SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.

Low polyphenol intake among highly scholarity population: CUME cohort.

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

Examining the mental health of the academic community at an institution for higher education during the COVID-19 pandemic.

Due to the COVID-19 pandemic, the Higher Education Institutions had to suspend their on-site activities and adapt to the new scenario. Therefore, the objective of the research was to investigate the effects of the COVID-19 pandemic on the mental health of the academic community of a Brazilian public university. This is a cross-sectional study, at a Brazilian public university, that used the baseline data from a longitudinal study carried out with employees and students. Participants answered a self-administered and confidential questionnaire in online platform, composed of sociodemographic, economic, lifestyles and mental health issues. 1,353 students and 372 employees participated. The prevalence of anxiety disorder symptoms among students and employees was 46.12% and 17.47%, depression 54.62% and 22.85% and stress 47.45% and 22.58%, respectively. The co-occurrence of symptoms was 33.56% among university students and 10.75% among employees. Falling family income, having stopped smoking and negative self-rated health, during the COVID-19 pandemic, may be the reasons for the high prevalence of co-occurrence of anxiety, depression and stress disorders among the academic community.

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

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

Key characteristics including sex, sexual orientation and internet use associated with worse mental health among university students in Brazil and implications.

BACKGROUND: The symptoms of anxiety and depression disorders are multifactorial and can trigger a series of problems especially among university students. The aim of this study was to assess the prevalence and associated factors with anxiety and depression symptoms among first-semester university students at a Federal University in Brazil given the paucity of such data and the first semester is the most stressfultime. METHODS: Cross-sectional study with first-semester university students. The questionnaire included socio-demographic variables, lifestyles, health conditions and the Depression Anxiety Stress Scales. Descriptive analysis was performed, followed by bivariate analysis and Poisson regression analysis. RESULTS: Three hundred and fifty-six students (65.2%) across a range of courses in their first semester participated. The prevalence of anxiety was 42.5% and depression 33.2%. Regarding symptoms of anxiety and depression disorders, a positive association was observed among females, non-heterosexual, non-white skin color, excessive internet use, lack of physical activity, not attending university parties, having psychological counseling, history of anxiety in first- or second-degree relatives, poor self-rated health and use of psychotropic medicines. CONCLUSIONS: Due to the high prevalence of anxiety and depression symptoms, the importance of developing programs to promote mental and physical health of university students is highlighted.

Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.

BACKGROUND: Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. METHODS: This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. RESULTS: Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. CONCLUSION: In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.

COVID-Inconfidentes: how did COVID-19 and work from home influence the prevalence of leisure-time physical inactivity? An analysis of before and during the pandemic.

BACKGROUND: The COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic. METHODS: A population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2). RESULTS: The prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4-71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8-64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6-43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI. CONCLUSIONS: The results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

Family characteristics, perceived environment for physical activity, and childhood obesity: An approach with structural equation models.

OBJECTIVES: To evaluate the direct and indirect effects of family characteristics and the perceived neighborhood environment on obesity risks among schoolchildren. METHODS: Through phone contact with the child's mothers/guardians, the perceptions about the aspects of the neighborhood that could limit or promote health. Physical activity, socioeconomic data, self-reported weight and height, and ultra-processed consumption of the respondents were evaluated, in addition to the screen time of both mothers and children. A hybrid model of structural equations was used to test the direct and indirect effects of family and environmental variables on childhood obesity. SETTING: Belo Horizonte, Minas Gerais, Brazil. SUBJECTS: A total of 322 children from 9 to 10 years old from municipal schools and their respective mothers/guardians. RESULTS: Childhood obesity was positively associated with obesity among mothers/guardians and with the latent variable "socioeconomic status (SES)." It was observed that the child's guardians positively influenced childhood obesity through their own habits, such as screen time and consumption of ultra-processed products, with obesity of mothers/guardians as mediators of both associations. There were no direct and indirect effects of the latent variables of the perceived environment in childhood obesity. CONCLUSION: Family characteristics are important determinants of childhood obesity and should be considered when designing prevention strategies. Parental perceptions of neighborhood characteristics did not have an influence on childhood obesity.

Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study.

Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015-2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11-17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

Are neighborhood characteristics associated with sedentary behavior in adolescents? A systematic review.

Sedentary behavior (SB) has emerged as a potential risk factor for chronic diseases. SB includes activities requiring low energy expenditure (≤1.5 metabolic equivalents) performed in a sitting or reclining posture. Our study aimed to gather evidence on the association between SB outcomes in adolescents (10-19 years) and neighborhood characteristics. This systematic review (PROSPERO registration number: CRD42018076877) examined studies indexed in PubMed Central®, LILACS, ScienceDirect, and SPORTDiscus databases. Sixteen articles were included. Insecurity during daytime hours, crime incidence, physical and social disorders, a higher neighborhood socioeconomic level, and time spent with peers were associated with higher levels of SB. Traffic, availability of a favorable environment for physical activity, and higher residential density were associated with lower levels of SB. Despite great variability in the SB cutoff points and methodology used for evaluating SB and neighborhood characteristics among studies, the evidence suggests that adolescent SB might be influenced by neighborhood characteristics.

The Interaction between Education and Sex with Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Analysis of Two Brazilian Cities.

This cross-sectional study, carried out between October and December 2020 in two Brazilian cities, aimed to evaluate the joint association of education and sex with habitual and episodic excessive alcohol consumption during the COVID-19 pandemic. Habitual alcohol consumption was defined as drinking any quantity of alcohol at least once per week. Excessive episodic alcohol consumption was defined as the consumption of five or more drinks by men or four or more drinks by women at least once in the last 30 days. Adjusted multivariate logistic regression models were used to analyze associations of education and sex with alcohol consumption. Education was not associated with habitual alcohol consumption and excessive episodic alcohol consumption. However, when evaluating the joint effect between education and sex, it can be seen that men with low education were more likely to habitually consume (OR: 5.85; CI95:2.74-14.84) and abuse alcohol (OR: 4.45; IC95:1.54-12.82) and women with high education were more likely to have habitual (OR: 2.16; IC95:1.18-3.95) and abusive alcohol consumption (OR: 2.00; IC95:1.16-3.43). These findings highlight the modifying effect of sex on the relationship between education and alcohol consumption, such that education influenced alcohol consumption differently between sexes during the pandemic.

Anxiety Symptoms Influence Food Consumption Differently Depending on Nutritional Status During the COVID-19 Pandemic: A Longitudinal Study with University Students.

BACKGROUND: Anxiety symptoms are factors that directly affect eating habits, but this interference can be heterogeneous depending on the nutritional status of the individuals. OBJECTIVES: To analyze whether the presence of anxiety symptoms at the beginning of the pandemic influenced the change in food consumption according to its purpose and extent of processing during a one-year follow-up and whether this association occurs equally with excess weight and without excess weight university students. METHODS: This longitudinal study was carried out with 583 university students from a public Higher Education Institution (HEI) in Brazil. The Generalized Estimating Equation (GEE) was used to verify whether anxiety symptoms were associated with changes in food consumption over time. RESULTS: The results showed that previous moderate/severe anxiety symptoms were associated with an increased frequency of consumption of both fresh or minimally processed foods (ß: 0.2 95%CI: 0.1; 0.7 p = 0.013) and ultra-processed foods (ß: 5.6 95%CI: 1.8; 17.7 p = 0.003), but with different magnitudes. In university students who were not excess weight, previous moderate/severe anxiety symptoms were associated with a reduction in the frequency of consumption of fresh or minimally processed foods (ß: -2.0 95%CI: -3.5; -0.5 p = 0.008), while in those who were excess weight, there was an increase in consumption of ultra-processed foods (ß: 4.5 95%CI: 2.2; 6.8 p < 0.001). CONCLUSION: This study confirms the influence of anxiety symptoms on food consumption according to the extent and purpose of processing. In addition, these results emphasize the role of psychological distress in the university population, and that this factor can affect excess weight and without excess weight individuals differently.

Vitamin D deficiency and VDR gene polymorphism FokI (rs2228570) are associated with diabetes mellitus in adults: COVID-inconfidentes study.

BACKGROUND: Diabetes mellitus is a chronic and multifactorial condition, including environmental risk factors such as lifestyle habits and genetic conditions. OBJECTIVE: We aimed to evaluate the association of VDR gene polymorphism (rs2228570) FokI and vitamin D levels with diabetes in adults. METHODS: Cross-sectional population-based study in adults, conducted from October to December 2020 in two Brazilian cities. The outcome variable was diabetes, defined as glycated hemoglobin ≥ 6.5% or self-report medical diagnosis or use of oral hypoglycemic drugs. Vitamin D (25-hydroxyvitamin D) was measured by indirect electrochemiluminescence, and classified as deficiency when 25(OH)D < 20 ng/mL. All participants were genotyped for VDR FokI polymorphism by qPCR and classified as homozygous mutant (ff or GG), heterozygous (Ff or AG), or homozygous wild (FF or AA). A combined analysis between the FokI polymorphism and vitamin D levels with diabetes was also examined. A directed acyclic graph (DAG) was used to select minimal and sufficient adjustment for confounding variables by the backdoor criterion. RESULTS: The prevalence of DM was 9.4% and vitamin D deficiency (VDD) was 19.9%. The genotype distribution of FokI polymorphism was 9.9% FF, 44.8% Ff, and 45.3% ff. It was possible to verify a positive association between vitamin D deficiency and DM (OR = 2.19; 95% CI: 1.06-4.50). Individuals with the altered allele (ff) had a 1.78 higher prevalence of DM (OR: 1.78; 95% CI; 1.10-2.87). Combined analyses, individuals with vitamin D deficiency and one or two copies of the altered FokI allele had a higher prevalence of DM (Ff + ff: OR: 1.67; 95% CI; 1.07-2.61; ff: OR: 3.60; 95% CI; 1.40-9.25). CONCLUSION: Our data suggest that vitamin D deficiency and FokI polymorphism are associated with DM.

Interaction between Fokl polymorphism and vitamin D deficiency in the symptoms of mental disorders in adults: a population-based study.

Mental disorders are intricate and multifaceted and encompass social, economic, environmental, and biological factors. This study aimed to explore the potential association between vitamin D deficiency and anxiety and depression symptoms in adults, considering the role of the vitamin D receptor gene polymorphism FokI (rs2228570). This was a population-based cross-sectional study with stratified and cluster sampling, evaluating anxiety symptoms (AS) and depression symptoms (DS) in 1637 adults. Vitamin D levels were measured using electrochemiluminescence and were considered deficient when < 20 ng/mL in a healthy population or < 30 ng/mL in at-risk groups. Genotyping was performed using real-time polymerase chain reaction with TaqMan probes. The prevalence rates of AS, DS, and vitamin D deficiency were 23.5%, 15.8%, and 30.9%, respectively. No direct association was observed between vitamin D deficiency and AS or DS. However, interaction analysis revealed a combined effect of vitamin D deficiency and FokI for DS but not for AS. Individuals with vitamin deficiency and one or two copies of the altered allele of the FokI exhibited a higher prevalence of DS than individuals homozygous for the wild-type allele and vitamin D sufficiency. The interaction between vitamin D deficiency and the FokI polymorphism was associated with DS.