Association of nutritional status with urinary iodine deficiency in Brazilian pregant women / Associação do estado nutricional com deficiência urinária de iodo em gestantes brasileiras

Abstract Objectives: to investigate the association of nutritional status with urinary iodine deficiency in pregnant women attending the Basic Health Units in the city of São Luís - Maranhão. Methods: cross-sectional study carried out with 261 pregnant women. Urine samples were collected for analysis of determination of urinary iodine. Iodine deficiency was considered as <150 µg/L and adequate as ≥150 µg/L. Weight and height measurements were taken at the time of collection and investigation of pre-pregnancy weight calculate BMI). Continuous variables were presented as mean, standard deviation, median, 25th and 75th percentiles, and categorical variables as simple and relative frequencies and percentages. Multivariate analyses investigate the association between pre-pregnancy and current BMI and UIC (urinary iodine concentration). Results: the mean pre-pregnancy BMI was 24.3 ± 4.5 kg/m2, and the current BMI was 27.2 ± 6.5 kg/m2. The median UIC was 181.3 µg/L (113.2-271.7), and 40.6% of the sample showed iodine deficiency. The increase in pre-pregnancy and current BMI was associated with a reduction in the prevalence of iodine deficiency in pregnant women (PR = 0.94; (CI95% = 0.88; 0.99) and PR = 0.95; (CI95% = 0.88 - 0.99), respectively). Conclusion: high BMI is positively associated with UIC and provides a reduction in iodine deficiency prevalence in pregnant women.

Resumo Objetivos: investigar a associação do estado nutricional com deficiência de iodo urinário em gestantes atendidas em Unidades Básicas de Saúde do município de São Luís - MA. Métodos: estudo transversal, realizado com 261 gestantes. Foram coletadas amostras de urina para análise de determinação do iodo urinário, considerou-se deficiência o valor <150 µg/L e adequado, valor ≥150 µg/L. Foram aferidas as medidas de peso e altura no momento da coleta e investigação do peso pré-gestacional para cálculo do IMC. As variáveis contínuas foram expressas em média, desvio padrão, mediana, percentil 25 e 75 e as categóricas em frequência simples e relativa e em percentual. Análises multivariadas investigaram associação entre IMC pré-gestacional e atual e UIC (Concentração urinária de iodo). Resultados: a média do IMC pré-gestacional foi 24,3 ± 4,5 kg/m2 e do IMC atual 27,2 ± 6,5 kg/m2. A mediana de concentração de iodo urinário foi de 181,3 µ/L (113,2-271,7) e 40,6% da amostra possuía deficiência de iodo. O aumento no IMC pré-gestacional e atual foi associado à redução da prevalência de deficiência de iodo em gestantes (RP = 0,94; (IC95% = 0,88; 0,99) e RP = 0,95; (IC95% = 0,88 - 0,99), respectivamente). Conclusão: o IMC elevado está positivamente associado à UIC e proporciona redução na prevalência de deficiência de iodo em gestantes.

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.

Proteoforms of ß-Casein, α-s1-Casein, α-Lactalbumin, Serum Albumin, and Lactotransferrin Identified in Different Lactation Phases of Human Milk by Proteomics Approach.

SCOPE: Human milk (HM) has a wide range of proteins with biological and nutritional functions, essential for newborns. The roles of proteins and their proteoforms in HM are not fully understood. This study aims to assess, by 2-DE proteomics, the differential proteoforms in HM, present in colostrum (COL), transition (TRA), and mature milk (MAT), aiming to contribute to understanding neonates' protein needs. METHODS AND RESULTS: HM samples are collected from 39 healthy lactating women. COL presents the higher concentration of essential amino acids. After MALDI-MS/MS and bioinformatics analysis, proteoforms are differentially detected. Abundances of ß-casein (CSN2), α-s1 casein, and α-lactalbumin (LALBA) are higher in MAT; CSN2s are found in 11 spots and the isoforms increase in size as the pI becomes more acidic; regarding LALBA, two variant forms are found with different abundances in TRA and MAT; CSN2, LALBA, lactotransferrin (LTF), and serum albumin forms are present in all lactation phases. CONCLUSION: This study reveals differential proteoforms in COL involved in tissue growth and body development, besides essential amino acids, and, in MAT, involved in muscle mass gain, strengthening of the immune system, and energy production. The results provide new insight about proteoforms involved in maturation of the newborn's organs and systems.

Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis.

Food insecurity is a public health problem as it affects a wide array of individuals in the population. It can be characterized by food deprivation, lack of essential nutrition, lack of dietary education, lack of adequate storage conditions, poor absorption, and poor overall nutrition. The relationship between food insecurity and micronutrient deficiency requires more effort to deepen and discuss the relationship. This systematic review aimed to evaluate the association between food insecurity and micronutrient deficiency in adults. The research was conducted according to PRISMA using the Medline/Pubmed, Lilacs/BVS, Embase, Web of Science, and Cinahl databases. Studies carried out with male and female adults were included, which investigated the correlation or association between food insecurity and the nutritional status of micronutrients. There were no publication year, country, or language restrictions. A total of 1148 articles were found, and 18 of these were included, carried out mainly on the American continent and with women. The most evaluated micronutrients were iron and vitamin A. Food insecurity was associated with nutrient deficiency in 89% (n = 16) of the studies. As a result of the meta-analysis, it was observed that there is a greater chance of anemia and low levels of ferritin among food insecure individuals. It is concluded that food insecurity is associated with micronutrient deficiency. Understanding these problems allows the creation of public policies capable of contributing to changes. Protocol registration: This review was registered on the PROSPERO-International Prospective Register of Systematic Reviews database-CRD42021257443.

Food insecurity and its socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic: A systematic review and meta-analysis.

Background: The COVID-19 pandemic has reduced access to adequate food in terms of quality and quantity, especially for the most vulnerable population groups. The objective of this study was to evaluate the prevalence of Food Insecurity and its main socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021278033). The descriptors "Pregnant Woman", "Postpartum Women", "Breastfeeding Women", "COVID-19", "Food Insecurity", "Food Security" were combined in Scopus (Elsevier), Medline/PubMed (via National Library of Medicine), Embase (Elsevier), Web of Science and Science Direct independently by two researchers in September 2022. Original articles about Food Insecurity in households with pregnant women and mothers of children under 2 years of age during the COVID-19 pandemic were included. The meta-analysis of the prevalence of Food Insecurity was conducted using the RStudio software (4.0.4). Results: The initial search resulted in 539 records, and 10 articles met the proposed criteria and were included in this review. The prevalence of Food Insecurity ranged from 11.5 to 80.3% and in the meta-analysis it was 51% (IC: 30-71) (I 2 = 100.0%). The main socioeconomic and health determinants were ethnicity, domain language, low education, low income, informal employment, unemployment, occurrence of mental disorders, domestic violence, in addition to the unavailability of food in markets and lack of transport. The inclusion of studies with data collection by telephone stands out as a limitation, due to the non-inclusion of vulnerable groups without access to this means of communication. Conclusion: It is necessary to implement and strengthen specific public policies for the maternal and child group with the objective of protecting and strengthening the rights of women to maintain the physical and mental integrity of this group and guarantee Food Security.

Socioeconomic status, screen time, and time spent at school, and children's food consumption. / Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças.

The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças / Socioeconomic status, screen time, and time spent at school, and children's food consumption

Resumo Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Abstract The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Correlation Between Drinking Water and Iodine Status: a Systematic Review and Meta-analysis.

Iodine is a micronutrient essential for maintaining normal body functioning, and the consumption depends on the distribution in the environment, and insufficient or excessive intake results in thyroid dysfunction. The purpose of this review was to evaluate the correlation between iodine concentration in drinking water and the iodine status of the population. The systematic review was conducted following the PRISMA guidelines and was registered at the International Prospective Register of Ongoing Systematic Reviews (CRD42019128308). A literature search was conducted using MEDLINE/PUBMED (National Library of Medicine), LILACS (Latin-American and Caribbean Literature on Health Sciences), and Cochrane Library, June 2021. The quality of the studies was assessed by a checklist for cross-sectional studies developed by Joanna Briggs Institute. The initial search identified 121 articles, out of which ten were included in this systematic review, and five were included in the meta-analysis. Among the articles listed, six adopted cutoff points to classify the iodine content in the drinking water. The study identified median iodine concentration in drinking water from 2.2 to 617.8 µg/L and the correlation between iodine concentration in drinking water and urinary iodine concentration was 0.92, according to meta-analysis. Furthermore, the iodine status was correlated to the iodine content in water. The determination of a cutoff point can contribute to the implementation of iodine consumption control measures.

Proinflammatory maternal diet and early weaning are associated with the inflammatory diet index of Brazilian children (6-12 mo): A pathway analysis.

OBJECTIVE: The aim of this study was to assess the dietary inflammatory index (DII) and its association with maternal factors and excess body weight in Brazilian children aged <2 y during complementary feeding. METHODS: This was a cross-sectional study (2016-2019), conducted with 231 mothers and children ages 6 to 24 mo. The food consumption of the mother-child dyad was obtained through the mean of three 24-h recalls, as well as information on the consumption of breast milk. The DII was used to verify the quality of the diet. Children's weight and length were measured, and the weight/height index was calculated. Path analysis was used to assess the interrelationships between variables. Multiple linear regression was conducted to identify the components of the child's DII (C-DII) that contributed the most to explaining its variation. RESULTS: The children had an anti-inflammatory diet (C-DII -0.37 ± 0.91) whereas the mothers had a proinflammatory diet (M-DII +0.24 ± 0.86). Fiber was the nutrient that contributed most to the variations in the C-DII. Approximately 28% of children were overweight. In the pathway analysis, we verified a direct negative effect of education on excess body weight (standardized coefficients [SC], -0.180; P = 0.034) and C-DII (SC, -0.167; P = 0.002); negative direct effect of breastfeeding on the C-DII (SC, -0.294; P < 0.001); and positive direct effect of M-DII on C-DII (SC, 0.119; P = 0.021). CONCLUSION: Children's proinflammatory diet during the period of complementary feeding was associated with maternal proinflammatory diets, lower education, and absence of breastfeeding practice.

Metabolic syndrome and risk factors in children: a risk score proposal.

INTRODUCTION/OBJECTIVE: The lack of international consensus on the definition of Metabolic Syndrome (MS) in the pediatric population makes it difficult to estimate its prevalence. In this study, we intend to identify MS prevalence and a cutoff point based on a continuous score in children aged four to seven years. METHODS: A cross-sectional study of 402 children (4-7 years) monitored by the Lactation Support Program (PROLAC). A continuous MS risk score was assessed using Principal Component Analysis (PCA). In order to calculate the score, the following MS risk factors were considered: Waist circumference (WC), High Density Lipoprotein (HDL), Triglycerides (TG), Blood Pressure (BP) and Blood sugar. Using a Receiver Operating Characteristics (ROC) curve, the cutoff point for predicting MS risk based on continuous score was evaluated. RESULTS: A progressive increase in MS scores was observed according to increase in the number of risk factors. This increase was also observed when comparing boys and girls (p < 0.001). In the absence of MS, the median score among the children was -0.0486 (-0.2929-0.2151). For children with MS, the median score was 0.5237 (0.2286-0.7104) (p < 0.001). The best cutoff score for predicting MS in children aged four to five years was >0.09 (100% sensitivity and specificity 72.67%). For children aged six to seven years, this value was >0.14 (100% sensitivity and 64.65% specificity). CONCLUSION: The calculated continuous risk score can predict MS with good accuracy and high sensitivity and reasonable specificity.

Nutritional indicators of food and nutrition security of families: 2008/2009 Household Budget Survey / Indicadores nutricionais da segurança alimentar e nutricional de famílias: Pesquisa de Orçamentos Familiares 2008/2009

ABSTRACT Objective To evaluate the food and nutrition insecurity of Brazilian families, according to indicators of food consumption and nutritional status, by location and situation of the households investigated using the 2008/2009 Household Budget Survey. Methods Inadequate consumption of macronutrients and nutritional dystrophies (underweight, short stature or overweight) in at least one family member were used as indicators, according to location and geographical situation of households. The prevalence of food and nutritional insecurity and their confidence intervals were calculated. Results Food consumption was assessed in a total of 13,569 households; a total of 67.55%, 43.96% and 6.85% revealed inadequacy for lipids, carbohydrates and proteins, respectively. Among the 53,640 households assessed by nutritional status, 15.10%, 35.15% and 45.50% had, at least one resident with low weight, short stature or overweight respectively. The Northeastern Region showed statistically higher prevalence than other Brazilian macro-regions for inadequate lipids (24.88%) and carbohydrates (15.32%), as well as for the presence of underweight (6.15%), overweight (14.77%) and short stature (15.17%), in at least one of the residents of the household. Conclusion Assessing the nutritional aspect of food insecurity allows for a better understanding of the dimensions of this situation by considering the effects of access and availability of food, as well as biological use and stability, based on indicators of inadequate food consumption and the presence of nutritional dystrophy. The results found in this study enhance the need to include nutritional indicators in the assessment of food security.

RESUMO Objetivo Avaliar a insegurança alimentar e nutricional de famílias brasileiras segundo indicadores de consumo alimentar e estado nutricional, por localização e situação dos domicílios investigados pela Pesquisa de Orçamento Familiar 2008/2009. Métodos Foram utilizados, como indicadores de insegurança alimentar e nutricional, o consumo inadequado de macronutrientes e distrofias nutricionais (baixo peso, baixa estatura ou excesso de peso) em pelo menos um membro da família, conforme localização e situação geográfica dos domicílios. Calculou-se a prevalência de insegurança alimentar e nutricional e seus intervalos de confiança. Resultados Foram avaliados 13.569 domicílios pelo consumo alimentar, sendo que 67,55%, 43,96% e 6,85% apresentaram inadequação para lipídios, carboidratos e proteínas, respectivamente. Entre os 53.640 domicílios avaliados pelo estado nutricional, 15,10%, 35,15% e 45,50% apresentam, respectivamente, pelo menos um morador com baixo peso, baixa estatura ou excesso de peso. O Nordeste apresentou prevalências estatisticamente maiores do que as demais macrorregiões para as inadequações de lipídios (24,88%) e de carboidratos (15,32%), bem como para presença de baixo peso (6,15%), excesso de peso (14,77%) e baixa estatura (15,17%), em pelo menos um dos moradores do domicílio. Conclusão Avaliar a vertente nutricional da insegurança alimentar permite maior compreensão das dimensões dessa situação por considerar os reflexos do acesso e disponibilidade de alimentos, bem como a utilização biológica e estabilidade, a partir dos indicadores de consumo alimentar inadequado e presença de distrofia nutricional. Os resultados encontrados reforçam a necessidade de incluir indicadores nutricionais na avaliação da segurança alimentar.

Dietary exposure to low-calorie sweeteners in a sample of Brazilian pregnant women.

The dietary exposure to low-calorie sweeteners (LCS) was estimated in a sample of pregnant Brazilian women. Consumption data were obtained with a 24-h Dietary Recall interview. Because of the uncertainty in assessing foods with LCS, they were classified into three scenarios to ensure inclusion of the 15 LCS allowed for use in Brazil: ranging from a less to a more conservative scenario. The concentration of LCS was estimated using the amount declared on the label or the maximum permitted levels and analytical determination data for table-top sweeteners. The frequency of consumption was higher for acesulfame-K, aspartame, and cyclamate. The food groups contributing the most to the consumption of LCS were non-alcoholic beverages, table-top sweeteners, confectionary and desserts. The level of dietary exposure to LCS was within the safety limit. However, continued efforts to monitor their dietary exposure are necessary given the limitations highlighted in this study.

Factors Associated with Anemia among Adults and the Elderly Family Farmers.

The majority of studies on anemia are focused on children and women of reproductive age. Although the disease is a widespread public health problem, studies that include the rural population are scarce. This study determined the prevalence of anemia and associated factors in adults and the elderly living in the rural area of a municipality in Minas Gerais. Twelve rural communities were included. During home visits, hemoglobin levels were measured using a hemoglobinometer to check for the presence or absence of anemia. Additionally, anthropometric data and food insecurity data based on the Brazilian Food Insecurity Scale (EBIA) were collected. A questionnaire about socioeconomic, demographic, and housing conditions was applied. Analyses were performed using the Stata software version 13.0. Spearman correlation and regression analysis logistics were performed (p < 0.05) on 124 families (n = 297 farmers). The prevalence of anemia was 41.1%, being higher among women (55.7%). Additionally, 40.1% of the farmers were food insecure; 52.7% and 80.5% presented excess weight and cardiovascular risk, respectively. Poverty was a reality for 39.7% of individuals. A positive correlation between hemoglobin levels and per capita income was found as well as a negative correlation with EBIA scores and cardiovascular risk. Multivariate analysis showed that individuals experiencing food insecurity, the elderly, and those who do not own a property, were more likely to be anemic. Farmers with per capita income above 1/2 minimum wage were less likely to have anemia. The prevalence of anemia in the group studied was higher than previous studies. The disease is associated with factors that also predispose to food insecurity. The improvement of the determinants of insecurity can contribute to the fight against anemia.

Iodine Concentration in Brazilian Drinking Water and Its Possible Contribution to Iodine Intake for Different Physiological Groups.

Objective: The objective is to analyze the concentration of iodine in Brazilian drinking water and its possible contribution to iodine intake for different groups. Methods: Water samples collected from primary healthcare units in eight locations distributed across all five macroregions of Brazil were analyzed. The quantification of iodine in the water samples was done by spectrophotometry (leuco crystal violet method). To classify the degree of iodine concentration, the recommendation of the Ministry of Health (China) was followed since Brazil lacks a classification standard. To verify the possible contribution of drinking water to iodine intake for different groups, the recommended water intake for each group according to the United States Institute of Medicine (2004) was considered. The percentage of iodine in drinking water and its contribution to iodine intake for different physiological groups were calculated based on the estimated average requirement (EAR) of iodine. A descriptive statistical analysis was performed using SPSS version 21.0 and Statistical Analysis Systems (SAS) version 9.2. Results: Significant differences were found between the maximum and minimum concentrations of iodine in water samples from the same location. In Pinhais (south region), the difference was 44.32 µg· L-1; in Viçosa (southeast region), it was 27.86 µg·L-1; in Rondonópolis (midwest region), it was 12.66 µg·L-1; in São Luís (northeast region), it was 11.82 µg·L-1; in Brasilian Federal District (midwest region), it was 10.98 µg·L-1; in Macaé (southeast region), it was 10.14 µg· L-1; in Palmas (north region), it was 4.22 µg·L-1; and in Vitória (southeast region), it was 1.69 µg·L-1. The maximum concentrations of iodine found in the drinking water of Pinhais and Viçosa can contribute more than 70.0% and 50.0%, respectively, to daily iodine intake for all groups. Conclusion: Monitoring the concentration of iodine in drinking water from different locations in each city or Federal District is a preventive measure against inadequate iodine intake and possible adverse changes in population health.

Iodine Concentration in Drinking Water in the Same or Different Seasons of the Year in Brazilian Macroregions.

Objective: The aim of this study was to compare the concentration of iodine in drinking water in the same or different seasons of the year in Brazilian macroregions. Method: Water samples were collected from the Basic Health Units of eight municipalities that make up the different Brazilian macroregions and the Federal District. Sample collection took place in the summer, autumn, winter, and spring seasons. The spectrophotometric method with "leuco crystal violet" was used to determine the concentration of iodine in the water. Descriptive statistics on the data were performed. To verify if there was a difference in the concentration of iodine in the water between the climatic seasons of the year in the same place and between the same seasons in different locations, the Mann-Whitney or Kruskal-Wallis test was used and a p < 0.05 value was considered significant. Results: Among the climatic seasons throughout the year in the same location, there was a difference in the concentration of iodine in the water in the municipality of Pinhais, state of Paraná/South macroregion, between autumn and summer (p=0.041) and winter and summer seasons (p=0.003). There was a difference in the concentration of iodine in the water in the summer season between the Midwest and South macroregions; Northeast and Midwest, Southeast and South; North and Midwest, Southeast and South (p < 0.05). In the autumn season, there was a difference in the concentration of iodine in the water between the Midwest and South macroregions; Northeast and Midwest, Southeast and South; North and Midwest, Northeast and South (p < 0.05). In the winter season, there was a difference in the concentration of iodine in the water between the Southeast and Midwest and Southeast and South macroregions (p < 0.05). In the spring season, there was a difference in the concentration of iodine in the water between the Southeast and Midwest and Southeast and South macroregions (p < 0.05). Conclusion: There were differences in the iodine concentrations in drinking water in different locations in Brazil, when analyzed in the same seasons, and in the municipality of Pinhais between the autumn and summer and winter and summer seasons. Thus, it is suggested to monitor the iodine concentrations in water, considering the differences in climate, characteristics of each region, and soils throughout the Brazilian territory, since the deficiency or excess of iodine can bring risks to the health of the population.

Is Dietary Iodine Intake Excessive According to the Theoretical Model of Healthy Dietary Intake Pattern in Pregnant Women and Schoolchildren: Water, Salt, or Food?

Introduction: Iodine deficiency during pregnancy can cause hypothyroidism and goiter; in schoolchildren, it can cause reduced intelligence quotient. In excess, iodine can cause thyroiditis, goiter, and Hashimoto's hypothyroidism. Currently, schoolchildren and pregnant women are classified as risk groups for excessive iodine intake and iodine deficiency, respectively. Thus, determining iodine from all sources of consumption is important for intervention planning. Objective: To construct a theoretical model for the iodine intake of schoolchildren and pregnant women of a city in the Zona da Mata Mineira region, considering a healthy diet, salt consumption and water intake. Methodology: The dietary iodine intake of pregnant women was analyzed based on a dietary iodine table compiled from an international database. A dietary plan was prepared following the Brazilian Food Guide. Iodine concentration of different salt brands sold in local establishments was checked, and drinking water samples from healthcare facilities were analyzed. A descriptive and exploratory statistical analysis was performed and the results were presented in absolute and relative frequencies, and measures of central tendency and dispersion. Results: According to the proposed diet, pregnant women and schoolchildren would have a daily intake of 71.6 µg and 71 µg, respectively. Thirteen salt brands were evaluated, 69.2% complied with the legislation and the mean iodine content was 29.88 mg. The mean concentration of iodine in water was 25 µg iodine/liter and 14 µg iodine/liter, respectively, in summer and autumn. Considering the intake of food, salt, and drinking water according to the proposed dietary plan, the daily intake for pregnant women would be 279.5 and 253.5 µg for schoolchildren. Conclusion: The daily iodine intake of schoolchildren and pregnant women according to this theoretical model was excessive, considering a healthy dietary pattern. This theoretical model can guide actions and public policies aimed at targeting all forms of iodine intake.

[Critical analysis of the indicators of the nutritional status of iodine in individuals and populations: a systematic review]. / Análise crítica dos indicadores do estado nutricional de iodo em indivíduos e populações: uma revisão sistemática.

The scope of this article is to evaluate the potentialities of indicators of the nutritional status of iodine in individuals or populations. The review was based on PRISMA. The search for articles occurred in January 2019, in the Pubmed, Scopus and LILACS databases, using the key words: indicators AND nutritional status AND iodine. The selection followed the stages of excluding the duplicates, reading the titles, abstracts and analyses in full. The methodological quality of the studies was evaluated by the Downs and Black instrument. A total of 178 studies were identified and 20 were included. Urinary Iodine Concentration (UIC) was analyzed in 65% of the studies and was considered the best indicator to evaluate the nutritional status of iodine in the population. Thyroglobulin was determined in 20% of the studies and reflected the pre-existing state of iodine. Thyroid stimulating hormone was verified in 45% of the articles and was important for the surveillance of iodine deficiency among newborns. Only one study evaluated capillary iodine, useful for analyzing long-term dietary intake. In the evaluation of methodological quality, the lowest score was 12 and the highest 16, in 17 possible points. The use of UIC is recommended for the diagnosis of deficiency and excess of iodine in the population.

O objetivo deste artigo é avaliar as potencialidades dos indicadores do estado nutricional de iodo em indivíduos ou populações. A revisão foi baseada no PRISMA. A busca pelos artigos ocorreu em janeiro de 2019, nas bases Pubmed, Scopus e LILACS, utilizando a combinação "indicadores AND estado nutricional AND iodo". A seleção seguiu as etapas de exclusão dos duplicados, leitura de títulos e resumos e análise na íntegra. A qualidade metodológica dos estudos foi avaliada pelo instrumento de Downs e Black. Foram identificados 178 estudos e 20 foram incluídos. A Concentração Urinária de Iodo (CUI) foi analisada em 65% dos estudos e foi considerado o melhor indicador para avaliar o estado nutricional de iodo populacional. A tiroglobulina foi determinada em 20% dos estudos e refletiu o estado de iodo pregresso. O hormônio estimulante da tireoide foi verificado em 45% dos artigos e mostrou-se sensível para a vigilância de deficiência de iodo em recém-nascidos. Apenas um estudo avaliou o iodo no cabelo, útil para analisar a ingestão dietética em longo prazo. Na avaliação da qualidade metodológica, a menor pontuação foi 12, e a maior 16, em 17 pontos possíveis. Para diagnóstico de deficiência e excesso de iodo na população, recomenda-se a CUI.

Análise crítica dos indicadores do estado nutricional de iodo em indivíduos e populações: uma revisão sistemática / Critical analysis of the indicators of the nutritional status of iodine in individuals and populations: a systematic review

Resumo O objetivo deste artigo é avaliar as potencialidades dos indicadores do estado nutricional de iodo em indivíduos ou populações. A revisão foi baseada no PRISMA. A busca pelos artigos ocorreu em janeiro de 2019, nas bases Pubmed, Scopus e LILACS, utilizando a combinação "indicadores AND estado nutricional AND iodo". A seleção seguiu as etapas de exclusão dos duplicados, leitura de títulos e resumos e análise na íntegra. A qualidade metodológica dos estudos foi avaliada pelo instrumento de Downs e Black. Foram identificados 178 estudos e 20 foram incluídos. A Concentração Urinária de Iodo (CUI) foi analisada em 65% dos estudos e foi considerado o melhor indicador para avaliar o estado nutricional de iodo populacional. A tiroglobulina foi determinada em 20% dos estudos e refletiu o estado de iodo pregresso. O hormônio estimulante da tireoide foi verificado em 45% dos artigos e mostrou-se sensível para a vigilância de deficiência de iodo em recém-nascidos. Apenas um estudo avaliou o iodo no cabelo, útil para analisar a ingestão dietética em longo prazo. Na avaliação da qualidade metodológica, a menor pontuação foi 12, e a maior 16, em 17 pontos possíveis. Para diagnóstico de deficiência e excesso de iodo na população, recomenda-se a CUI.

Abstract The scope of this article is to evaluate the potentialities of indicators of the nutritional status of iodine in individuals or populations. The review was based on PRISMA. The search for articles occurred in January 2019, in the Pubmed, Scopus and LILACS databases, using the key words: indicators AND nutritional status AND iodine. The selection followed the stages of excluding the duplicates, reading the titles, abstracts and analyses in full. The methodological quality of the studies was evaluated by the Downs and Black instrument. A total of 178 studies were identified and 20 were included. Urinary Iodine Concentration (UIC) was analyzed in 65% of the studies and was considered the best indicator to evaluate the nutritional status of iodine in the population. Thyroglobulin was determined in 20% of the studies and reflected the pre-existing state of iodine. Thyroid stimulating hormone was verified in 45% of the articles and was important for the surveillance of iodine deficiency among newborns. Only one study evaluated capillary iodine, useful for analyzing long-term dietary intake. In the evaluation of methodological quality, the lowest score was 12 and the highest 16, in 17 possible points. The use of UIC is recommended for the diagnosis of deficiency and excess of iodine in the population.

Factors associated with alcohol, tobacco and illicit drug use among Brazilian undergraduate students.

OBJECTIVES: to analyze the factors associated with the use of alcohol, tobacco and illicit drugs among Brazilian undergraduate students. METHODS: observational, cross-sectional study, with convenience sampling, conducted in 2014/2015, involving institutional data and a self-completed online questionnaire, analyzed using measures of frequency, central tendency/dispersion and logistic regression. RESULTS: among 126,326 students, 62.8% reported alcohol use; 11%, tobacco; and 7.5%, illicit drugs. Several academic factors-such as not residing with family (sororities [alcohol: aOR:2.38;95%CI:2.28-2.48; tobacco: AOR:2.20;95%CI:2.09-2.33; illicit drugs: AOR:2.53;95%CI:2.38-2.70]), acting in university movements (student [alcohol: AOR:1.74;95%CI:1.65-1.83; tobacco: AOR:1.97;95%CI:1.86-2.08; illicit drugs: AOR:2.43;95%CI:2.28-2.59] and religious [alcohol: AOR:0.28;95%CI:0.26-0.29; tobacco: AOR:0.23;95%CI:0.21-0.26; illicit drugs: AOR:0.18;95%CI:0.16-0.21]) and lack of discipline/study habit (alcohol: AOR:1.41;95%CI:1.37-1.45; tobacco: AOR:1.53;95%CI:1.46-1.59; illicit drugs: AOR:1.85;95%CI:1.76-1.94) - were associated with the use of the three categories of substances. CONCLUSIONS: we identified that a number of academic factors are associated with licit and illicit drug use. These findings may help in designing preventive strategies among college students.

Assessment of the Impact of Salt Iodisation Programmes on Urinary Iodine Concentrations and Goitre Rates: A Systematic Review.

INTRODUCTION: Two main strategies are currently recommended for the prevention and control of iodine deficiency in the world: implementation of universal salt iodisation programmes and permanent monitoring of iodine consumption by the population. Although iodine intake and coverage iodised salt have increased in the world population, iodine deficiency disorders (IDDs) may still be a public health problem in a few countries or communities. OBJECTIVE: To assess the impact of salt iodisation programmes on urinary iodine concentrations and goitre rates in the world population. Methodology. A systematic review based on the PRISMA method. We obtained articles from Scopus, Science Direct, MEDLINE databases, and other sources between March and April 2020, without limitation of dates. "Iodisation" AND "urinary iodine concentrations" AND "goitre" in English, Portuguese, and Spanish without filters and clinical trial, case-control, and cross-sectional studies were included in this review. RESULTS: Of 479 abstracts, twenty-three were eligible. Coverage on iodised salt was in the range of 16 to 98%, and 11 studies had been sufficient, whilst eight studies had adequate iodine concentration in salt and three excess. 81.8% of studies that had an adequate median of UIC had a good impact in their respective salt iodisation programmes. CONCLUSION: After 18 years of salt iodisation programme implementation in the 13 countries, the majority achieved sustaining elimination of IDD whilst all had adequate median UIC; however, more detailed studies are still needed to confirm that all communities are equally protected of IDD.