Serum retinol concentrations in mothers and newborns at delivery in a public maternity hospital in Recife, northeast Brazil.

Serum retinol concentrations were compared in a consecutive series of 65 mother-newborn pairs at delivery in a public maternity hospital in Recife, Brazil, from January to August 2008 and examined their association with biological, socioeconomic, environmental and obstetrical characteristics. Serum retinol concentrations of the newborns (umbilical cord) and mothers (brachial venipuncture) were analyzed by high-performance liquid chromatography. Prevalence of low (< 0.70 micromol/L) and inadequate (< 1.05 micromol/L) serum retinol concentrations were observed in 23.1% (95% CI 13.9-35.5) and 23.0% (95% CI 13.5-35.8) among newborns and mothers respectively. The serum retinol distribution was lower in male than female infants (-0.4 micromol/L, p = 0.01) and, across both sexes, concentrations in paired newborn and mother were correlated (r = 0.27, p = 0.04). Further, maternal status explains only 7% of the variance in retinol concentrations in newborn's cord plasma. Among mothers delivering in public facilities in Recife, hypovitaminosis may exist.

NUTRISCORE as a tool to predict greater weight loss and longer hospital stay in cancer patients.

Introduction: Introduction: malnutrition in cancer patients is quite common and can cause various types of harm such as reduced tolerance to therapeutic measures and increased hospital stay. Identification of nutritional risk for these patients may minimize these problems. NUTRISCORE screening has been associated with Global Subjective Assessment Produced by Patient (ASG-PPP) screening, which is considered as the gold standard in cancer patients. No study has evaluated its predictive value in relation to weight loss and length of hospital stay in Brazil. Thus, the present study aims to analyze the NUTRISCORE tool, translated and adapted to the Brazilian population, as a predictor of longer hospital stays, as well as greater hospital weight loss. Methods: first, the NUTRISCORE tool was translated and adapted to the Brazilian population and subsequently applied to patients of both sexes, over 20 years old, admitted to the Cancer Hospital of Pernambuco. The patients were screened and classified as nutritionally "at risk" or "not at risk", their weight was measured at the time of admission and time of discharge from the hospital, and they were followed up throughout their stay to assess their weight loss and length of hospital stay. Results: one hundred and one patients participated in the study, with a higher prevalence of adults and males. The NUTRISCORE showed that patients "at nutritional risk" had a higher risk of greater weight loss (p = 0.001) and longer hospital stay (p = 0.007). Conclusion: NUTRISCORE proved to be a good predictor of longer hospital stay and greater weight loss among hospitalized patients.

Introducción: Introducción: la desnutrición en pacientes con cáncer es bastante común y puede causar diversos daños, como la reducción de la tolerancia a las medidas terapéuticas y el aumento de la estancia hospitalaria. Por tanto, es fundamental identificar a los pacientes con riesgo nutricional para minimizar estos problemas. El tamizaje NUTRISCORE tiene una buena asociación con el tamizaje Global Subjective Assessment Produced by Patient (ASG-PPP), que se considera el estándar de oro en pacientes con cáncer, y ningún estudio evaluó su valor predictivo en relación con la pérdida de peso y la duración de la estancia hospitalaria en Brasil. Así, el presente estudio tiene como objetivo analizar la herramienta NUTRISCORE, traducida y adaptada a la población brasileña, como predictor de estancias hospitalarias más prolongadas, así como de mayor pérdida de peso hospitalario. Métodos: primero, la herramienta NUTRISCORE fue traducida y adaptada a la población brasileña y posteriormente aplicada a pacientes de ambos sexos, mayores de 20 años, internados en el Hospital del Cáncer de Pernambuco. Los pacientes fueron tamizados y clasificados como nutricionalmente "de riesgo" o "sin riesgo", se midió su peso al momento del ingreso y el alta del hospital y se les hizo seguimiento durante toda su estadía para evaluar su pérdida de peso y el tiempo de estancia hospitalaria. Resultados: participaron en el estudio 101 pacientes, con mayor prevalencia de adultos y de sexo masculino. El NUTRISCORE mostró que los pacientes "en riesgo nutricional" tenían mayor riesgo de mayor pérdida de peso (p = 0,001) y mayor estancia hospitalaria (p = 0,007). Conclusión: NUTRISCORE demostró ser un buen predictor de mayor estancia hospitalaria y mayor pérdida de peso entre los pacientes hospitalizados.

Body mass index-adjusted calf circumference is associated with mortality in hospitalized older patients with excess weight.

OBJECTIVES: Given the innovative nature of the method, our study aimed to assess the prognostic significance of body mass index (BMI)-adjusted calf circumference (CC) in older patients who are hospitalized. METHODS: This was a unique analysis as part of other cohorts comprising general hospitalized patients aged 60 years or older of both sexes. Only patients with excess weight (BMI ≥ 25 kg/m2) were included. CC was adjusted by reducing 3, 7, or 12 cm for BMI (in kg/m2) within 25-29.9, 30-39.9, and ≥40 kg/m2, respectively. CC was considered low if ≤ 34 cm for males and ≤ 33 cm for females. Clinical outcomes included prolonged length of hospital stay (LOS) and mortality. RESULTS: A total of 222 patients were included. After BMI adjustments, 72.1% of the patients were reclassified from a normal CC category to a low CC category. The frequency of low CC increased from 33.8% to 81.9% following BMI adjustments. Among those reclassified to the low CC, 11 died, compared to only 2 patients in the group that maintained a normal CC classification. BMI-adjusted CC was inversely associated with mortality (HR adjusted 0.84, 95% CI 0.73 to 0.95), but not with prolonged LOS. CONCLUSIONS: Our novel study highlights the prognostic value of BMI-adjusted CC. As an anthropometric marker of muscle mass, it proved to be a predictor of mortality in older patients with high BMI. This adjustment is further important because it may help to better detect low muscle mass in these patients where such conditions might be masked.

Influence of the BsmI polymorphism of the vitamin D receptor gene on the levels of vitamin D, inflammatory and oxidative stress profile in patients with cystic fibrosis supplemented with Colecalciferol megadose.

OBJECTIVE: Evaluate the influence of the BsmI polymorphism of the vitamin D receptor gene on vitamin D levels, and inflammatory and oxidative stress markers in patients with Cystic Fibrosis supplemented with cholecalciferol megadose. METHODS: We performed a single-arm, non-randomized pre- and post-study of 17 patients aged 5 to 20 years with cystic fibrosis diagnosed with vitamin D insufficiency/deficiency 25-hydroxy vitamin< 30 ng/mL. Individuals were genotyped for the BsmI polymorphism of the vitamin D receptor gene and all received cholecalciferol supplementation of 4,000 IU daily for children aged 5 to 10 years and 10,000 IU for children over 10 years of age for 8 weeks. Interviews were conducted with personal data, sun exposure, anthropometric and blood samples of 25-hydroxy vitamin parathormone, serum calcium, ultrasensitive C-reactive protein, alpha 1 acid glycoprotein, total antioxidant capacity, malondialdehyde and kidney and liver function. Inter- and intra-group assessment was assessed by paired t-test Anova test or its non-parametric counterparts. RESULTS: The individuals were mostly male and reported no adverse effects from the use of supplementation, 64 % had 25-hydroxy vitamin levels >30 ng/mL. Patients with BB and Bb genotypes showed increased serum levels of 25-hydroxy vitamin. The group with BB genotype showed a reduction in alpha 1 acid glycoprotein. And individuals with the bb genotype had high levels of malondialdehyde compared to the pre-intervention time. CONCLUSION: It is concluded that variations of the BsmI polymorphism of the vitamin D receptor gene have different responses in vitamin D levels and markers of inflammation and oxidative stress.

Frailty but not low muscle quality nor sarcopenia is independently associated with mortality among previously hospitalized older adults: A prospective study.

AIM: There are few studies comparing the effects of geriatric syndromes and abnormalities in nutritional status and body composition on outcomes among older individuals who have been previously hospitalized. Our study aimed to evaluate the frequency and diagnosis of geriatric syndromes, low muscle quality, and nutritional status in hospitalized older individuals, and to examine their impact on both short- and long-term outcomes. METHODS: This was a prospective study involving older adults (≥60 years). We assessed nutritional status, muscle quality, sarcopenia, and frailty. The outcomes were functional dependence, length of hospital stay, transfer to the Intensive Care Unit, number of readmissions, and mortality. Multivariate analysis was conducted to identify independent risk factors. RESULTS: Even after adjustment for age and sex, increased risk of death was associated with possible undernourishment, sarcopenia, low muscle quality, and frailty (P < 0.05), but not the length of hospital stay (P > 0.05). Our multivariate analysis showed that frailty was independently associated with mortality and functional dependence. Low muscle quality was independently associated with functional dependence. CONCLUSIONS: Geriatric syndromes, abnormalities in body composition, and the overall nutritional status of older patients are important risk factors for adverse outcomes, including functional dependence and mortality. These findings emphasize the need for interventions to improve muscle quality, prevent and treat malnutrition and sarcopenia, and address frailty in hospitalized patients. Geriatr Gerontol Int 2023; 23: 736-743.

Is low phase angle a risk indicator for frailty and pre-frailty among community-dwelling older adults?

Studies investigating the association between the phase angle (PA) and frailty are scarce. The PA is considered a practical, low-cost, noninvasive measure for the early identification of this clinical condition. To investigate the association between PA and frailty/pre-frailty, nutritional and clinical aspects in older people. A cross-sectional study was conducted with 51 older people (≥ 60 years). PA was determined using bioelectrical impedance analysis. Frailty profile was determined using the criteria of unintentional weight loss, self-reported fatigue, slow gait speed, low grip strength and insufficient physical activity. Nutritional status was evaluated based on the body mass index and appendicular skeletal muscle mass index (ASMMI). Sarcopenia and sarcopenic obesity were also investigated. Sociodemographic data were collected through interviews. Prevalence of frailty/pre-frailty was 84.3%, with no difference between the sexes. The first tercile of the sample had a PA lower than 6º, which was considered low. No significant difference in PA was found between older people with or without frailty/pre-frailty. In the multiple linear regression analysis, age and ASMMI were shown to be potential independent predictors for PA. Age showed an inverse correlation with PA, while ASMMI showed a direct correlation. No association was found between PA and frailty or pre-frailty.

Vitamin D levels and their association with oxidative stress and inflammation markers in patients with cystic fibrosis.

Introduction: Introduction: cystic fibrosis is a disease that causes inflammation, oxidative stress and metabolic changes that lead to nutrient deficiency, such as vitamin D deficiency. On the other hand, it is suggested that vitamin D has anti-inflammatory and antioxidant actions. Objective: to evaluate the prevalence of hypovitaminosis D and the association between serum 25 hydroxyvitamin D levels with markers of oxidative stress and inflammation in patients with cystic fibrosis. Method: a cross-sectional study was carried out with 48 patients with cystic fibrosis including children, adolescents and adults in the northeast region of Brazil. Blood collection was performed for analysis of 25-hydroxyvitamin D, calcium, parathyroid hormone, inflammatory process (C-reactive protein (CRP) and alpha-1-acid glycoprotein-A1 (A1GPA)) and oxidative stress (malondialdehyde (MDA) and total antioxidant capacity (CAOT)). The statistical analysis was performed using the "Statistical Package for the Social Sciences", adopting a significance level of p < 0.05. Results: Vitamin D insufficiency/deficiency was found in 64.6 % of patients. After multiple linear regression analysis, MDA showed an inverse association with blood values of 25-Hydroxyvitamin D (p < 0.05) conditioned by the presence of inflammatory process markers. When only oxidative stress was evaluated, this association disappeared. Conclusion: in conclusion, there was a high prevalence of hypovitaminosis D, with 25(OH)D levels associated with greater oxidative stress when combined with inflammatory markers. Improved vitamin D levels may be an alternative to reduce the damage caused by excess oxidative stress and inflammation in CF patients.

Introducción: Introducción: la fibrosis quística es una enfermedad que cursa con inflamación, estrés oxidativo y cambios metabólicos que conducen a deficiencia de nutrientes como la vitamina D. Por otro lado, se sugiere que la vitamina D tiene acción antiinflamatoria y antioxidante. Objetivo: evaluar la prevalencia de hipovitaminosis D y la asociación entre los niveles séricos de 25 hidroxivitamina D con los marcadores de estrés oxidativo e inflamación en pacientes con fibrosis quística. Método: estudio transversal realizado con 48 pacientes con fibrosis quística, niños, adolescentes y adultos, de la región nordeste de Brasil. Se realizó una extracción de sangre para el análisis de 25-hidroxivitamina D, calcio, hormona paratiroidea, proceso inflamatorio (proteína C-reactiva (PCR) y alfa-1-glucoproteína ácida-A1 (A1GPA)) y estrés oxidativo (malondialdehído (MDA) y capacidad antioxidante total (CAOT). El análisis estadístico se realizó utilizando el "Paquete Estadístico para las Ciencias Sociales", adoptando un nivel de significancia de p < 0,05. Resultados: se encontró insuficiencia/deficiencia de vitamina D en el 64,6 % de los pacientes. Después de un análisis de regresión lineal múltiple, la MDA mostró una asociación inversa con los valores sanguíneos de 25-hidroxivitamina D (p < 0,05) condicionado a la presencia de marcadores de proceso inflamatorio; cuando solo se evalúa el estrés oxidativo, esta asociación desaparece. Conclusión: en conclusión, hubo una alta prevalencia de hipovitaminosis D, con niveles de 25(OH)D asociados a mayor estrés oxidativo cuando se combina con marcadores inflamatorios. La mejora de los niveles de vitamina D puede ser una alternativa para reducir el daño causado por el exceso de estrés oxidativo y la inflamación en pacientes con FQ.

[Vitamin A deficiency in preschool children of Recife, Northeast of Brazil]. / Deficiência de vitamina A em pré-escolares da cidade do Recife, Nordeste do Brasil.

The purpose of the study was to evaluate the extent of vitamin A deficiency (VAD) among preschool children in the city of Recife, Northeast Brazil. The sample comprised 344 children of both sexes, 24 to 60 months old, in 18 public day care centres in the city of Recife, in 2007. The nutritional status of vitamin A was assessed by biochemical (serum retinol) and dietetic (vitamin A rich-food consumption) indicators and the pondo-stature status through anthropometric indicators weight-for-age, height-for-age and weight-for-height. The prevalence of hyporetinolemia (< 0.70 micromol/L) was 7.7% (IC 95% 4.88 - 11.81), which characterizes the VAD as a light-type public health problem, according to World Health Organization criteria. On the other hand, 29.6% (IC 95% 24.22 - 35.63) of children had acceptable or marginal levels (0.70 to 1.04 micromol/L) of retinol. Regarding the vitamin A rich-food intake, values below the EAR (Estimated Average Requirement) - 210 microg/ day for children of 1 to 3 years old and 275 microg/day for children of 4 to 8 years old - were 8.1% and 21.3% respectively. The prevalence of anthropometrical deficits (< -2 scores -Z) in preschool children were 2.5% for the indicator weight-for-age, 8.6% for height-for-age and 1.5% for weight-for-height. The research findings point out to the importance of institutionalization for the appropriate nutritional status of children and maintenance of adequate reserves of vitamin A. However, more studies are needed focusing on non-institutionalized preschool, or children living outside the privileged environment of public day care centres.

Problematization educational intervention to promote healthy habits in elderly people with diabetes: randomized clinical trial.

OBJECTIVE: to assess the effects of a problematization educational intervention to promote healthy habits in elderly people with diabetes. METHODS: a randomized clinical trial conducted with 202 individuals drawn for the intervention group and the control group. The intervention consisted of problematization educational activities on a monthly basis for over six months. The control group participated in conventional monitoring at the health unit. Data were collected through semi-structured interviews before and after the intervention, in addition to laboratory tests. RESULTS: after the intervention, when compared to the control group, there was an increase in knowledge about the disease (p<0.001), positive attitude towards self-care (p=0.011), physical activity (p=0.020), diet variety (p=0.002), and lower consumption of oils and fats (p<0.05). CONCLUSION: the intervention performed has a beneficial effect to promote healthy habits.

Variants rs1544410 and rs2228570 of the vitamin D receptor gene and glycemic levels in adolescents from Northeast Brazil.

INTRODUCTION: Objective: to verify the association of serum concentrations of 25-hydroxyvitamin D and glycemic levels with the genetic variants rs1544410 and rs2228570 of the VDR gene in adolescents from the Northeast region of Brazil. Materials and methods: a cross-sectional epidemiological study with 208 adolescents from public schools in the city of João Pessoa (Paraíba, Brazil) between 15 and 19 years of age. Blood samples were collected for DNA extraction and analysis of polymorphisms rs1544410 and rs2228570, as well as biochemical analyses (25-hydroxyvitamin D, parathyroid hormone, calcium and glycemia). Results: the mean age was 17.7 (± 1.14) years. Half of adolescents had sufficient serum levels of 25-hydroxyvitamin D and the other half had insufficient/deficient vitamin. The most frequent genotypic distribution was bb and Ff and of lesser frequency BB and ff. There was a significant relationship between the genotypes of rs1544410 and glycemia values (p = 0.049) in the relationships between the genotypes BBxbb (p = 0.012) and Bbxbb (p = 0.037); (p = 0.036, OR = 2.15, 95% CI = 1.05-4.41), and in the BB+Bb group analysis when compared to the bb (p = 0.025, OR = 1.89, 95% CI = 1.08-3.29) presented higher risk of glycemia above the median. On the other hand, when Bb+bb was analyzed in relation to BB, adolescents had a greater chance of blood glucose below the median (p = 0.025, OR = 0.66, CI = 0.47-0.95). Conclusion: this study showed a significant relation of glycemia with the distribution of rs1544410 polymorphism genotypes.

INTRODUCCIÓN: Objetivo: verificar la asociación de las concentraciones séricas de 25-hidroxivitamina D y los niveles de glucemia con las variantes genéticas rs1544410 y rs2228570 del gen VDR en adolescentes de la región noreste de Brasil. Materiales y métodos: se realizó un estudio epidemiológico transversal con 208 adolescentes de escuelas públicas en la ciudad de João Pessoa (Paraíba, Brasil) de entre 15 y 19 años de edad. Se recogieron muestras de sangre para la extracción de ADN y el análisis de los polimorfismos rs1544410 y rs2228570, así como para análisis bioquímicos (25-hidroxivitamina D, hormona paratiroidea, calcio y glucemia). Resultados: la edad media fue de 17,7 (± 1,14) años. La mitad de los adolescentes tenía niveles séricos suficientes de 25-hidroxivitamina D y la otra mitad, vitamina insuficiente/deficiente. La distribución genotípica más frecuente fue bb y Ff y la de menor frecuencia, BB y ff. Hubo una relación significativa entre los genotipos de rs1544410 y los valores de glucemia (p = 0,049) en las relaciones entre los genotipos BBxbb (p = 0,012) y Bbxbb (p = 0,037); (p = 0,036, OR = 2,15, IC 95% = 1,05-4.41), y el análisis del grupo BB + Bb en comparación con el bb (p = 0,025, OR = 1,89, IC 95% = 1,08-3,29) mostró un mayor el riesgo de glucemia, por encima de la mediana. Por otro lado, cuando se analizó Bb+bb en relación con la BB, los adolescentes tuvieron una mayor probabilidad de que la glucosa en sangre estuviera por debajo de la mediana (p = 0,025, OR = 0,66, IC = 0,47-0,95). Conclusión: este estudio mostró una relación significativa entre la glucemia y la distribución de genotipos de polimorfismo rs1544410.

Food Intervention with Folate Reduces TNF-α and Interleukin Levels in Overweight and Obese Women with the MTHFR C677T Polymorphism: A Randomized Trial.

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism associated with body fat accumulation could possibly trigger an inflammatory process by elevating homocysteine levels and increasing cytokine production, causing several diseases. This study aimed to evaluate the effects of food intervention, and not folate supplements, on the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1ß (IL-1ß) in overweight and obese women with the MTHFR C677T polymorphism. A randomized, double-blind eight-week clinical trial of 48 overweight and obese women was conducted. Participants were randomly assigned into two groups. They received 300 g of vegetables daily for eight weeks containing different doses of folate: 95 µg/day for Group 1 and 191 µg/day for Group 2. MTHFR C677T polymorphism genotyping was assessed by digestion with HinfI enzyme and on 12% polyacrylamide gels. Anthropometric measurements, 24-h dietary recall, and biochemical analysis (blood folic acid, vitamin B12, homocysteine (Hcy), TNF-α, IL-1ß, and IL-6) were determined at the beginning and end of the study. Group 2 had a significant increase in folate intake (p < 0.001) and plasma folic acid (p < 0.05) for individuals with the cytosine-cytosine (CC), cytosine-thymine (CT), and thymine-thymine (TT) genotypes. However, only individuals with the TT genotype presented reduced levels of Hcy, TNF-α, IL-6, and IL-1ß (p < 0.001). Group 1 showed significant differences in folate consumption (p < 0.001) and folic acid levels (p < 0.05) for individuals with the CT and TT genotypes. Food intervention with folate from vegetables increased folic acid levels and reduced interleukins, TNF-α, and Hcy levels, mainly for individuals with the TT genotype.

[Retinolemia, vitamin A intake, and blood pressure in the elderly]. / Retinolemia, consumo de vitamina A e pressão arterial em idosos.

The objective of this study was to evaluate the retinolemia and consumption of vitamin A rich foods and their association with blood pressure levels in the elderly. This is a cross-sectional study, with a systematic sample of 297 elderly subjects enrolled at the Family Health Program of Camaragibe, Pernambuco, between November/December of 2003. Vitamin A status was assessed by retinolemia (HPLC) and by the consumption of vitamin A rich foods (food frequency questionnaire). Blood pressure levels were classified according to the V Brazilian Guidelines on Hypertension. A prevalence of inadequate retinolemia (< 1.05 micromol/L) of 26.3% (CI95% 21.4-31.9) was found. The frequency of preformed vitamin A intake (> 3x/week) was lower (p = 0.000) than the provitamin A intake. The prevalence of systemic arterial hypertension (SAH) was 58.6% (CI95% 52.7-64.3). Isolated systolic hypertension was more prevalent among subjects. There was no correlation between retinolemia and vitamin A rich-food intake (p > 0.05). In addition, there was no association between blood pressure levels and vitamin A rich-food intake (p > 0.05). However, retinolemia in the elderly classified in stage 1 of SAH was higher (p = 0.02) than in the elderly with great/normal blood pressure. The findings suggest a vulnerability of these subjects to hypovitaminosis A and SAH. Nevertheless, the role of vitamin A in the endothelial function modulation and inflammatory responses associated to SAH should be addressed in future studies.

Prevalence of Systemic Arterial Hypertension and Associated Factors Among Adults from the Semi-Arid Region of Pernambuco, Brazil.

BACKGROUND: Systemic arterial hypertension is a substantial public health problem responsible for millions of deaths per year worldwide. However, little is known about the epidemiology of this disease in areas distant from large urban centers in Brazil. Such information is necessary to plan health promotion strategies. OBJECTIVE: To estimate the prevalence of hypertension and determine its associated factors in adults residing in the semi-arid region of the state of Pernambuco, Northeastern Brazil. METHOD: This is a cross-sectional study conducted with a random sample of male and female adults. Individuals with systolic blood pressure ≥ 140 mm/Hg and/or diastolic blood pressure ≥ 90 mm/Hg and those who reported being under treatment with antihypertensive drugs were considered hypertensive. We collected data on demographic, socioeconomic, behavioral, and anthropometric characteristics, as well as health and nutrition. The statistical analysis used Pearson's chi-square test, the chi-square test for trend, and multivariate Poisson regression analysis. A p-value < 0.05 in the final model was considered indicative of statistical significance. RESULTS: The sample consisted of 416 individuals, and the prevalence of hypertension was 27.4% (95%CI 23.2 - 32.0). In the final model, the independent predictors of hypertension were age of 40 years or older (p = 0.000), low economic class (p = 0.007), smoking (p = 0.023), overweight determined by the body mass index (p = 0.003), and reduced glucose tolerance/diabetes mellitus (p = 0.012). CONCLUSION: The prevalence of hypertension was high and related to important risk factors. Thus, prevention and control strategies are recommended.

Adiposity, inflammation and fat-soluble vitamins in adolescents.

OBJECTIVE: Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender. METHODS: Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, ß-carotene, α-tocopherol, and 25-hydroxy-vitamin D. RESULTS: The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p=0.03) and an increased risk of 25-hydroxy-vitamin D and ß-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient ß-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5). CONCLUSION: Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.

Knowledge and attitude about diabetes self-care of older adults in primary health care. / Conhecimento sobre o diabetes e atitude para o autocuidado de idosos na atenção primária à saúde.

This study aimed to assess the knowledge about diabetes, the attitude for self-care and associated factors through a cross-sectional study, the baseline of a randomized clinical trial with elderly diabetic in primary health care in Recife, Northeastern Brazil. We used the Diabetes Knowledge Scale (DKN-A) and Diabetes Attitudes Questionnaire (ATT-19). Of the 202 elderly, 77.7% had insufficient knowledge of the disease, especially for ketonuria, food replacement and were unaware of the causes and care of hypoglycemia. As for attitude, 85.6% had a negative psychological adjustment for diabetes. The logistic regression model showed that living alone was a protective factor (OR = 0.24; 95% CI 0.09-0.65; OR = 0.22; 95% CI 0.07 to 0.71), and low education, a risk factor (OR = 7.78; 95% CI 3.36-18.01; OR = 13.05; 95% CI 4.63-36.82) for the insufficient knowledge and the negative attitude for self-care, respectively. The findings reinforce the need for interdisciplinary educational actions that include socioeconomic, psycho-emotional and educational aspects in diabetes management to maintain elderly autonomy and functionality.

Objetivou-se avaliar o conhecimento sobre o diabetes, a atitude para o autocuidado e os fatores associados, por meio de estudo transversal, na linha de base de um ensaio clínico randomizado, com idosos diabéticos na atenção primária de saúde do Recife, Nordeste do Brasil. Utilizou-se o Diabetes Knowledge Scale (DKN-A) e o Diabetes Attitudes Questionnaire (ATT-19). Dos 202 idosos, 77,7% apresentaram conhecimento insuficiente sobre a doença, com destaque para a cetonúria, substituição de alimentos e desconhecimento das causas e dos cuidados com a hipoglicemia. Quanto à atitude, 85,6% tiveram ajustamento psicológico negativo em relação ao diabetes. O modelo de regressão logística mostrou que morar sozinho foi fator de proteção (OR = 0,24; IC95% 00,9-0,65; OR = 0,22; IC95% 0,07-0,71) e baixa escolaridade fator de risco (OR = 7,78; IC95% 3,36-18,01; OR = 13,05; IC95% 4,63-36,82) para conhecimento insuficiente e atitude negativa para o autocuidado, respectivamente. Os achados reforçam a necessidade de ações educativas interdisciplinares que incluam aspectos socioeconômicos, psicoemocionais e educacionais na gestão do diabetes com vistas à manutenção da autonomia e funcionalidade do idoso.

NUTrISCorE as a tool to predict greater weight loss and longer hospital stay in cancer patients / NUTRISCORE como herramienta para predecir mayor pérdida de peso y mayor estancia hospitalaria en pacientes oncológicos

Introduction: malnutrition in cancer patients is quite common and can cause various types of harm such as reduced tolerance to therapeuticmeasures and increased hospital stay. Identification of nutritional risk for these patients may minimize these problems. NUTRISCORE screeninghas been associated with Global Subjective Assessment Produced by Patient (ASG-PPP) screening, which is considered as the gold standardin cancer patients. No study has evaluated its predictive value in relation to weight loss and length of hospital stay in Brazil. Thus, the presentstudy aims to analyze the NUTRISCORE tool, translated and adapted to the Brazilian population, as a predictor of longer hospital stays, as wellas greater hospital weight loss.Methods: first, the NUTRISCORE tool was translated and adapted to the Brazilian population and subsequently applied to patients of both sexes,over 20 years old, admitted to the Cancer Hospital of Pernambuco. The patients were screened and classified as nutritionally “at risk” or “not atrisk”, their weight was measured at the time of admission and time of discharge from the hospital, and they were followed up throughout theirstay to assess their weight loss and length of hospital stay.Results: one hundred and one patients participated in the study, with a higher prevalence of adults and males. The NUTRISCORE showed thatpatients “at nutritional risk” had a higher risk of greater weight loss (p = 0.001) and longer hospital stay (p = 0.007).Conclusion: NUTRISCORE proved to be a good predictor of longer hospital stay and greater weight loss among hospitalized patien.(AU)

Introducción: la desnutrición en pacientes con cáncer es bastante común y puede causar diversos daños, como la reducción de la toleranciaa las medidas terapéuticas y el aumento de la estancia hospitalaria. Por tanto, es fundamental identificar a los pacientes con riesgo nutricionalpara minimizar estos problemas. El tamizaje NUTRISCORE tiene una buena asociación con el tamizaje Global Subjective Assessment Producedby Patient (ASG-PPP), que se considera el estándar de oro en pacientes con cáncer, y ningún estudio evaluó su valor predictivo en relacióncon la pérdida de peso y la duración de la estancia hospitalaria en Brasil. Así, el presente estudio tiene como objetivo analizar la herramientaNUTRISCORE, traducida y adaptada a la población brasileña, como predictor de estancias hospitalarias más prolongadas, así como de mayorpérdida de peso hospitalario.Métodos: primero, la herramienta NUTRISCORE fue traducida y adaptada a la población brasileña y posteriormente aplicada a pacientes deambos sexos, mayores de 20 años, internados en el Hospital del Cáncer de Pernambuco. Los pacientes fueron tamizados y clasificados comonutricionalmente “de riesgo” o “sin riesgo”, se midió su peso al momento del ingreso y el alta del hospital y se les hizo seguimiento durante todasu estadía para evaluar su pérdida de peso y el tiempo de estancia hospitalaria.Resultados: participaron en el estudio 101 pacientes, con mayor prevalencia de adultos y de sexo masculino. El NUTRISCORE mostró que lospacientes “en riesgo nutricional” tenían mayor riesgo de mayor pérdida de peso (p = 0,001) y mayor estancia hospitalaria (p = 0,007).Conclusión: NUTRISCORE demostró ser un buen predictor de mayor estancia hospitalaria y mayor pérdida de peso entre los pacientes hospitalizados.(AU)

Vitamin D insufficiency/deficiency and its association with cardiometabolic risk factors in Brazilian adolescents.

INTRODUCTION: Objective: this study aimed to investigate the association between serum 25-hydroxyvitamin D (25 [OH] D) and cardiometabolic risk factors in Brazilian adolescents. Methods: a cross-sectional study with 220 school adolescents aged 15 to 19 years was performed in the city of João Pessoa-PB, Brazil. The variables studied were: 25 hydroxyvitamin D (25 OH), dietary intake of vitamin D, anthropometric data (body mass index (BMI), waist circumference (WC) and waist / height ratio (RCA) and biochemistry, total cholesterol (TC), Low Density Lipoprotein (LDL), High Density Lipoproteins (HDL), triglyceride (TG), C-reactive protein (CRP), alpha acid glycoprotein (AGPA), malondialdehyde (MDA) and total antioxidant capacity (CAT), blood pressure, parathyroid hormone (PTH) and serum calcium. Enough and insufficient /deficient adolescents were compared by qui-square test and analysis of multiple lineal regression was accomplished to identify the factors cardiometabólicos associated to the seric concentration of 25 (OH) D (p < 0,05). Results: a total of 57.3% had vitamin D insufficiency/deficiency, which was more prevalent in females (79.35%). The chi-square test revealed an evident relationship between the three indicators involved in overweight assessed in this study BMI (p = 0.01), WC (p = 0.04) and AGR (p = 0.02). There was an association between the independent variable (vitamin D) and calcium and triglyceride levels. Conclusion: a high proportion of adolescents presenting insufficiency/vitamin D deficiency was ssociated with cardiometabolic risk factors.

INTRODUCCIÓN: Objetivo: este estudio tuvo como objetivo investigar la asociación entre la 25-hidroxivitamina D sérica (25 [OH] D) y los factores de riesgo cardiometabólico en adolescentes brasileños. Metodologia: se realizó un estudio transversal con 220 adolescentes escolares de 15 a 19 años en la ciudad de João Pessoa-PB, Brasil. Las variables estudiadas fueron: 25 hidroxivitamina D (25 OH), ingesta dietética de vitamina D, datos antropométricos (índice de masa corporal (IMC), circunferencia de la cintura (WC) y relación cintura / altura (RCA) y bioquímica, colesterol total (TC) , Lipoproteínas de baja densidad (LDL), lipoproteínas de alta densidad (HDL), triglicéridos (TG), proteína C reactiva (PCR), glicoproteína alfaácida (AGPA), malondialdehído (MDA) y capacidad antioxidante total (CAT), presión arterial, Hormona paratiroidea (PTH) y calcio sérico. Se compararon adolescentes suficientes e insuficientes/deficientes mediante la prueba de qui cuadrado y se realizó un análisis de regresión lineal múltiple para identificar los factores cardiometabólicos asociados a la concentración sérica de 25 (OH) D (p < 0,05). Resultados: un 57,3% tenía insuficiencia/deficiencia de vitamina D, que era más prevalente en las mujeres (79,35%). La prueba de ji cuadrado reveló una relación evidente entre los tres indicadores involucrados en el sobrepeso evaluados en este estudio IMC (p = 0,01), WC (p = 0,04) y AGR (p = 0,02). Hubo una asociación entre la variable independiente (vitamina D) y los niveles de calcio y triglicéridos. Conclusión: una alta proporción de adolescentes con insuficiencia de deficiencia de vitamina D de 25 (OH) D se asociaron con factores de riesgo cardiometabólico. Conclusión: una alta proporción de adolescentes con insuficiencia/deficiencia de vitamina D se asoció con factores de riesgo cardiometabólico.

[Effect of partially hidrolized guar-gum in the treatment of functional constipation among hospitalized patients]. / Efeito terapêutico da fibra goma-guar parcialmente hidrolisada na constipação intestinal funcional em pacientes hospitalizados.

The effect of hydrolyzed partially guar-gum was evaluated in the treatment of functional constipation among hospitalized patients. Following a randomized blind controlled-trial 64 adults were allocated to two groups: one received daily high-fiber diet (approximately 30 g) and the other similar diet plus 10 g of hydrolyzed partially guar-gum, during 15 days. Dietary fiber reduced functional constipation by 78.0%. Hydrolyzed partially guar-gum did not show any additional effect in defecation frequency, fecal consistence, need of laxative drug use, although a reduction in bowel complaints. Dietary fiber may be used in the treatment of functional constipation. However the therapeutic role of hydrolyzed partially guar-gum should be further investigated.

Evaluation of ultrasonographic approaches aimed at determining distinct abdominal adipose tissue depots

ABSTRACT Objective: To analyze different anatomical sites in the abdominal region, in order to determine the positional parameter that identifies a higher level of visceral adipose tissue (VAT) and confers a greater cardiometabolic risk. Materials and methods: This is a methodological study in which VAT was evaluated by ultrasonography (USG) in three anatomical sites in the abdomen, while the abdominal circumference (AC) was measured using seven different protocols. Additionally, the glycemic and lipid profile, C-reactive protein, and the presence of systemic arterial hypertension were evaluated. Results: One hundred and six individuals with an average age of 42 (36.8-46.2) years were included. The evaluation of the calibration of the ultrasound procedure for the analysis of VAT by intra- and inter-evaluators showed high reproducibility. The pattern of abdominal fat distribution differed between sexes, with higher mean VAT in males (p < 0.05) and higher mean SAT (subcutaneous adipose tissue) in females (p < 0.005). In the abdominal scan applied to women, higher levels of VAT and lower levels of SAT were observed in the narrower waist region, between the iliac crest and the last rib (p < 0.001). In males, the profile of adipose disposition along the abdomen was uniform (p > 0.05). Correlations between VAT measured by USG and cardiometabolic parameters were relatively stronger in the upper abdomen (p < 0.05). Conclusion: Women accumulate more VAT in the narrower waist region, while men accumulate VAT uniformly across the abdomen. There was relative superiority in predicting cardiometabolic risk in the upper abdomen for both sexes.