RESUMO
BACKGROUND AND AIMS: Obesity and insulin resistance development are related to known risk factors (such as diet) that begin in childhood. Among dietary factors, the consumption of ultra-processed foods has received attention. The present study investigated the association between ultra-processed foods consumption at preschool age and changes in anthropometric measurements from preschool to school age and glucose profile at school age. METHODS AND RESULTS: The present study was a follow-up of a randomized controlled trial, conducted with 307 children of low socioeconomic status from São Leopoldo, Brazil. At ages 4 and 8 years, children's anthropometric assessments were collected from preschool to school age including body-mass index (BMI) for-age, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold. At the age 8 years, blood tests were performed to measure glucose profile. Dietary data were collected through 24-h recalls and the children's ultra-processed food intake was assessed. Linear regression analysis was used to assess the relationship between ultra-processed food consumption and the outcomes. The percentage of daily energy provided by ultra-processed foods was 41.8 ± 8.7 (753.8 ± 191.0 kcal) at preschool age and 47.8 ± 8.9 (753.8 ± 191.0 kcal) at school age, on average. The adjusted linear regression analyses showed that ultra-processed food consumption at preschool age was a predictor of an increase in delta WC from preschool to school age (ß = 0.07; 95%CI 0.01-0.14; P = 0.030), but not for glucose metabolism. CONCLUSION: Our data suggest that early ultra-processed food consumption played a role in increasing abdominal obesity in children. These results reinforce the importance of effective strategies to prevent the excessive consumption of ultra-processed foods, especially in early ages.
Assuntos
Antropometria , Glicemia/metabolismo , Fast Foods/efeitos adversos , Manipulação de Alimentos , Obesidade Abdominal/epidemiologia , Obesidade Infantil/epidemiologia , Fatores Etários , Biomarcadores/sangue , Brasil , Criança , Comportamento Infantil , Desenvolvimento Infantil , Pré-Escolar , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Estudos Longitudinais , Masculino , Valor Nutritivo , Obesidade Abdominal/sangue , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/fisiopatologia , Obesidade Infantil/sangue , Obesidade Infantil/diagnóstico , Obesidade Infantil/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Classe SocialRESUMO
BACKGROUND: Proper feeding practices in early life can enhance the full human potential development of children. We aimed to evaluate the impact of a primary health care intervention on infant feeding practices among children from low-income families. METHODS: A cluster randomised controlled trial was conducted in Porto Alegre, Brazil. Healthcare centres were randomised into intervention (n = 9) and control (n = 11) groups. In intervention sites, health workers were trained in accordance with the national guidelines. Infant feeding practices were assessed in children at 6 months (n = 617) and 12 months (n = 516) of age. Feeding practice quality was assessed using the Infant and Child Feeding Index (ICFI). Additionally, we evaluated the introduction of nonrecommended foods. RESULTS: At 6 months, the mean ICFI score was higher in the intervention group [MD = 0.22; 95% confidence interval (CI) = 0.24-1.11]. The prevalence of infants who met the recommendation for meat into the food-frequency score was higher in the intervention than the control group [relative risk (RR) = 1.63; 95% CI = 1.26-2.11]. At 12 months of age, the ICFI mean (MD = 0.23; 95% CI = 0.35-0.56) and the prevalence of children who met the recommendation for dietary diversity (RR = 1.11; 95% CI = 1.01-1.22) and meal frequency (RR = 4.68; 95% CI = 1.34-16.36) were higher in the intervention group, although only among children who had more than seven follow-up appointments during the first year of life. The children from intervention group had a significant delay for added sugar (MD = 0.51; 95% CI = 0.13-0.89), tea (mean = 0.47; 95% CI = 0.13-0.82), jelly (MD = 0.35; 95% CI = 0.11-0.58) and filled cookies (MD = 0.29; 95% CI = 0.06-0.52) compared to the control group. CONCLUSIONS: The health workers' training was effective with respect to improving infant feeding practices.
Assuntos
Dieta Saudável/estatística & dados numéricos , Dieta/métodos , Comportamento Alimentar , Educação em Saúde/métodos , Alimentos Infantis/análise , Brasil , Análise por Conglomerados , Dieta/psicologia , Inquéritos sobre Dietas , Feminino , Pessoal de Saúde/educação , Humanos , Lactente , Masculino , Pobreza/psicologia , Atenção Primária à SaúdeRESUMO
BACKGROUND AND AIMS: Cardiovascular disease development is related to known risk factors (such as diet and blood lipids) that begin in childhood. Among dietary factors, the consumption of ultra-processing products has received attention. This study investigated whether children's consumption of processed and ultra-processing products at preschool age predicted an increase in lipid concentrations from preschool to school age. METHODS AND RESULTS: Cohort study conducted with 345 children of low socioeconomic status from São Leopoldo, Brazil, aged 3-4 years and 7-8 years. Blood tests were done to measure lipid profile. Dietary data were collected through 24-h recalls and the children's processed and ultra-processing product intake was assessed. Linear regression analysis was used to assess the relationship between processed and ultra-processed product intake at 3-4 years on changes in lipid concentrations from preschool to school age. The percentage of daily energy provided by processed and ultra-processed products was 42.6 ± 8.5 at preschool age and 49.2 ± 9.5 at school age, on average. In terms of energy intake, the main products consumed were breads, savoury snacks, cookies, candy and other sweets in both age groups. Ultra-processed product consumption at preschool age was a predictor of a higher increase in total cholesterol (ß = 0.430; P = 0.046) and LDL cholesterol (ß = 0.369; P = 0.047) from preschool to school age. CONCLUSION: Our data suggest that early ultra-processed product consumption played a role in altering lipoprotein profiles in children from a low-income community in Brazil. These results are important to understanding the role of food processing and the early dietary determinants of cardiovascular disease.
Assuntos
Doenças Cardiovasculares/etiologia , Desenvolvimento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Fast Foods/efeitos adversos , Manipulação de Alimentos , Hipercolesterolemia/etiologia , Lipídeos/sangue , Brasil/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Criança , Pré-Escolar , Colesterol/sangue , LDL-Colesterol/sangue , Estudos de Coortes , Ingestão de Energia , Feminino , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/epidemiologia , Estudos Longitudinais , Perda de Seguimento , Masculino , Áreas de Pobreza , Fatores de RiscoRESUMO
Family expenditures on food for children may represent an important barrier to the adoption of healthy feeding practices in populations of low socioeconomic status. The aim of this study was to explore the relationship between cariogenic feeding practices, expenditures on food for children and dental caries. This cross-sectional study included 329 four-year-old children from São Leopoldo in southern Brazil. Cariogenic dietary practices were assessed at 4 years of age using two 24-hour recalls conducted with the children's mothers. Expenditures on food for children were estimated based on all reported food items and the respective amounts ingested. Early childhood caries and severe early childhood caries were assessed by clinical examination at 4 years of age. Cariogenic dietary habits were not associated with lower food expenditures. On the contrary, in multivariable regression analysis, the intake of chocolate (p = 0.007), soft drinks (p = 0.027) and a higher number of meals and snacks per day (p < 0.001) was associated with greater expenditures on food for children. No statistically significant differences were observed in food expenditures or in the proportion of household income spent on feeding children between caries-free children, those with early childhood caries and those with severe early childhood caries. In conclusion, keeping children free of dental caries does not necessarily increase food expenditures or the proportion of household income spent on feeding children in low-socioeconomic status populations. Some cariogenic dietary practices were associated with greater expenditures on child feeding.
Assuntos
Cárie Dentária/epidemiologia , Dieta Cariogênica/estatística & dados numéricos , Comportamento Alimentar , Alimentos/economia , Animais , Brasil/epidemiologia , Cacau , Doces/estatística & dados numéricos , Bebidas Gaseificadas/estatística & dados numéricos , Estudos de Casos e Controles , Pré-Escolar , Custos e Análise de Custo , Estudos Transversais , Índice CPO , Escolaridade , Ingestão de Energia , Feminino , Seguimentos , Humanos , Renda/estatística & dados numéricos , Masculino , Refeições , Carne/estatística & dados numéricos , Mães/educação , Pobreza/estatística & dados numéricos , Lanches , Classe SocialRESUMO
BACKGROUND: The assessment of the factors that influence children's diets is important for supporting the development of public health policies for the prevention of diet-related diseases. The present study aimed to evaluate the diet quality of preschoolers by using the Healthy Eating Index (HEI) and to identify maternal and family characteristics associated with this score and its components. METHODS: The present study comprised a cohort study conducted with 345 low socioeconomic status children from São Leopoldo in southern Brazil aged 6 months and 3-4 years old. Dietary data were collected through 24-h recalls and diet quality was evaluated according to the HEI. RESULTS: The mean (SD) total HEI score was 65.7 (11.2). Only 9.6% (n = 33) of the children had a good diet. No significant association was detected between the overall diet quality of children and the characteristics. The prevalence of children who achieved the 75th percentile of the scores for grains [prevalence ratio (PR) = 0.65; 95% confidence interval (CI) = 0.43-0.98] and total fat (PR = 0.80; 95% CI = 0.69-0.93) was lower among children whose families had higher incomes, whereas the prevalence for grains was lower in those whose fathers were employed (PR = 0.53; 95% CI = 0.34-0.81). The prevalence for diet variety (PR = 1.44; 95% CI = 1.01-2.05) and milk (P = 1.18; 95% CI = 1.04-1.35) was higher and for total fat (PR = 0.83; 95% CI = 0.70-0.98) and saturated fat (PR = 0.76; 95% CI = 0.59-0.98) was lower among children whose mothers had higher levels of education. CONCLUSIONS: The total HEI score in these children indicates that compliance with dietary guidelines is generally poor. Although the overall diet quality did not show variation across maternal and family characteristics, some components of the diet were affected by these features.
Assuntos
Dieta/normas , Família , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Mães , Classe Social , Adolescente , Adulto , Brasil , Pré-Escolar , Gorduras na Dieta/administração & dosagem , Grão Comestível , Escolaridade , Ácidos Graxos/administração & dosagem , Feminino , Humanos , Lactente , Masculino , Rememoração Mental , Recomendações Nutricionais , Adulto JovemRESUMO
PURPOSE: Estimate the incidence of teething symptoms and investigate risk factors at three centers in different regions of Brazil. METHODS: A prospective cohort study enrolled children at birth in the cities of Manaus (northern region), Porto Alegre (southern region) and Salvador (northeast region). Sociodemographic and anthropometric variables were collected at baseline and 6 months. At 12 months, data were collected on the child's health through structured interviews and dental examinations, including the primary outcome: occurrence of signs and symptoms of tooth eruption reported by parents. Statistical analysis involved Poisson regression with robust variance, with calculation of relative risks (RR). RESULTS: The incidence of teething symptoms was 82.4% (238/289). The multivariate analysis revealed a higher occurrence of the outcome in the city of Salvador (RR = 1.39; 95% CI 1.23-1.58), when mother's education was more than 11 years (RR = 1.31; 95% CI 1.04-1.65), when a larger number of individuals resided in the home (RR = 1.15; 95% CI 1.02-1.29), when a smoker resided in the home (RR = 1.16; 95% CI 1.03-1.31) and when the child presented flu or cold in the first year of life (RR = 1.23; 95% CI 1.09-1.38). The most reported symptoms were fever (50.5%), irritability (42.6%), itching (40.8%) and diarrhea (35.3%). Most parents (82%) took some action to alleviate symptoms, including unprescribed systemic medication, such as analgesic, anti-inflammatory and anti-diarrheic agents. CONCLUSION: Reports of teething symptoms were associated with the city investigated, socioeconomic factors of the families and characteristics of the child's health. A high rate of administering unprescribed medication was also found.
Assuntos
Erupção Dentária , Recém-Nascido , Criança , Humanos , Estudos de Coortes , Brasil/epidemiologia , Estudos Prospectivos , Fatores de RiscoRESUMO
The aim of this study was to investigate the relationship between feeding practices in the first year of life and the occurrence of severe early childhood caries (S-ECC) at 4 years of age. A birth cohort study (n = 500) was conducted in children who were born within the public health system in São Leopoldo, Brazil. Feeding practices were assessed using standardized methods at 6 and 12 months of age. A total of 340 children were examined at 4 years of age. S-ECC was defined as recommended by an expert panel for research purposes: ≥1 cavitated, missing or filled smooth surfaces in primary maxillary anterior teeth or d(1+) mfs ≥5. Poisson regression with robust variance was used in order to determine the early feeding practices which represent risk factors for the occurrence of S-ECC at 4 years of age. The multivariable model showed a higher adjusted risk of S-ECC for the following dietary practices at 12 months: breastfeeding ≥7 times daily (RR = 1.97; 95% CI = 1.45-2.68), high density of sugar (RR = 1.43; 95% CI = 1.08-1.89), bottle use for liquids other than milk (RR = 1.41; 95% CI = 1.08-1.86), as well as number of meals and snacks >8 (RR = 1.42; 95% CI = 1.02-1.97). Mother's education ≤8 years was also associated with the outcome. The present study identified early feeding practices which represent risk factors for caries severity in subsequent years. These findings may contribute to developing general and oral health interventions, with special attention to families with low maternal education.
Assuntos
Cárie Dentária/epidemiologia , Comportamento Alimentar , Bebidas/estatística & dados numéricos , Alimentação com Mamadeira/estatística & dados numéricos , Brasil/epidemiologia , Aleitamento Materno/estatística & dados numéricos , Pré-Escolar , Estudos de Coortes , Dente Canino/patologia , Índice CPO , Restauração Dentária Permanente/estatística & dados numéricos , Sacarose Alimentar/administração & dosagem , Escolaridade , Feminino , Seguimentos , Humanos , Incisivo/patologia , Renda/estatística & dados numéricos , Lactente , Masculino , Maxila , Mães/educação , Estudos Prospectivos , Fatores de Risco , Classe Social , Perda de Dente/epidemiologia , Dente Decíduo/patologia , Escovação Dentária/estatística & dados numéricosRESUMO
BACKGROUND: The prevalence of childhood obesity has been dramatically increasing in developing countries as it has been reported for developed nations. Identifying susceptibility genes in early life could provide the foundations for interventions in lifestyle to prevent obese children to become obese adults. OBJECTIVES: The objective of this study was to evaluate the influence of genetic variants related to obesity identified by genome-wide association studies (MC4R, TMEM18, KCTD15, SH2B1, SEC16B, BDNF, NEGR1, OLFM4 and HOXB5 genes) on anthropometric and dietary phenotypes in two Brazilian cohorts followed-up since birth. METHODS: There were 745 children examined at birth, after 1 year and after 3.5 years of follow-up. Ten single nucleotide polymorphisms were genotyped. Anthropometric and dietary parameters were compared among genotypes. Children were classified as overweight when body mass index Z-score was >+1. RESULTS: Overweight prevalence was 30.7% at 3.5 years old. Significant associations were identified at 3.5 years old for TMEM18 rs6548238, NEGR1 rs2815752, BDNF rs10767664 and rs6265 (1 year old and 3.5 years old) with anthropometric phenotypes and at 3.5 years old for SEC16B rs10913469 with dietary parameters. CONCLUSIONS: Our results indicate that genetic variants in/near these genes contribute to obesity susceptibility in childhood and highlight the age at which they begin to affect obesity-related phenotypes.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Moléculas de Adesão Celular Neuronais/genética , Proteínas de Ligação a DNA/genética , Proteínas de Membrana/genética , Sobrepeso/genética , Obesidade Infantil/genética , Adulto , Índice de Massa Corporal , Brasil , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Proteínas Ligadas por GPI/genética , Predisposição Genética para Doença , Variação Genética , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Lactente , Masculino , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Polimorfismo de Nucleotídeo ÚnicoRESUMO
OBJECTIVES: to assess the accuracy of the two most used anthropometric criteria: Must and Cole to diagnose obesity in adolescence comparing with percentage of fat mass determined by DXA. METHODOLOGY: cross-sectional study with 418 adolescents (52.4% males) attending a private school in São Paulo/Brazil. Anthropometric measures of height and weight were taken and BMI was calculated. Analysis of body composition was performed using the DXA to detect percentage of fat mass. Using the method proposed by Ellis & Wong (ERM) two sex-specific linear regression models of fat percentage for age in years were fitted. The comparison between the methods was carried out through the analyses of specificity and sensitivity with two residual percentiles as cutoff points (ERM85th and ERM95th) as standards. A logistic model was fitted to estimate the probability curves of obesity classification. RESULTS: the comparison of the two classic criteria for the diagnosis of obesity with the ERM85th and ERM 95th, yields for females the same sensitivities of 0.50 and 0.20 for both criteria. For males sensitivities for ERM 85th were 0.61 (Must) and 0.49 (Cole); while for ERM95th the sensitivities were 0.81 (Must) and 0.64 (Cole). Therefore, there are high probabilities that those criteria diagnose adolescents as obese, when actually they are not. CONCLUSION: the Must and Cole criteria were similar and present flaws for the diagnosis of obesity. In clinical practice and field studies anthropometric criteria should be evaluated as to the diagnostic accuracy along with other clinical parameters and, when feasible, the analysis of fatness percentage. However, the anthropometric criteria evaluated are efficient in the identification of non-obese adolescent in the two cutoff points considered.
Assuntos
Absorciometria de Fóton , Tecido Adiposo , Índice de Massa Corporal , Obesidade/diagnóstico , Adolescente , Fatores Etários , Brasil , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Fatores SexuaisRESUMO
The levels of certain components, notably total protein, total fat, energy, and fatty acids, of mature milk from 48 adolescent and 44 adult mothers was studied. These two groups were subdivided into high and low socioeconomic level (SEL). All mothers were primiparous, eutrophic, and with term pregnancy; and their newborns weighted over 2500 g at birth. The age factor appeared to have significant influence on the concentration of total protein, with higher levels in the group of adolescent mothers possibly as a compensatory mechanism to maintain the caloric value of the milk. The fatty acid content was altered significantly by the SEL probably due to the direct effect of maternal diet. The milk in adolescent mothers of low SEL demonstrated higher concentration of lauric and myristic acids, while the milk in low SEL adults contained higher proportions of linoleic and linolenic acids. The milk in adult mothers of high SEL demonstrated higher concentrations of palmitic, palmitoleic, and oleic acids. The different feeding habits of two socioeconomic groups may explain these results. The regular intake of soya oil, corn oil, and margarine by the urban population in general resulted in higher levels of linoleic acid in the milk of all groups studied.
Assuntos
Adolescente/fisiologia , Gorduras/análise , Ácidos Graxos/análise , Leite Humano/química , Proteínas/análise , Adulto , Fatores Etários , Feminino , Humanos , Lactose/análise , Fatores SocioeconômicosRESUMO
The aim of this study was to evaluate the dietary fiber intake and the dietary habits of children with and without functional chronic constipation. We enrolled 58 children with functional chronic constipation and 58 controls without constipation matched for sex and age. Food and fiber intake were evaluated by 24 hour dietary recall and a complete clinical history was performed. The age of onset of constipation occurred during the first year of life in 55.4% of the patients while the median age of evaluation was 78 months. Soiling was found in 41.7% of patients. The median period of exclusive breast feeding was shorter (P = 0.002) in the constipation group (one month) than in the control group (three month). The proportion of constipation was similar for mothers of children of both groups as well as for siblings in both groups. The fathers of children with constipation presented higher frequency of constipation (12.3%) than the fathers of children in control group (1.8%), but the difference did not reach statistical significance (P = 0.06). The amount of food measured by 24 hour recall was similar in both groups. The calorie intake of constipated children (1526 +/- 585 calories/day) was lower (P = 0.07) than in the control group (1712 +/- 513 calories/day) but the difference did not reach statistical significance. The intake of protein, fat and iron was lower in the constipation group than in the control group. The volume of cow's milk intake was similar in both groups. The median of total dietary fiber intake in the constipation group (13.5 g/day) was statistically (P = 0.009) lower than in the control group (16.8 g/day). The daily intake of insoluble dietary fiber was also statistically lower (P = 0.001) in the constipation group (6.3 g) than in the control group (9.4 g). The intake of soluble dietary fiber was similar in both groups. The intake of dietary fiber per 1,000 calories of diet was 10.3 g in the constipation group and 10.4 in the control group (P = 0.41). There was a considerable intersection of individual values in fiber intake of the constipation and control groups, suggesting that low fiber intake acts in association with others factors on the genesis of constipation in children. However, the low intake of insoluble fiber, suggests that it plays an important role on the pathogenesis of chronic constipation in children.
Assuntos
Constipação Intestinal , Dieta , Fibras na Dieta , Aleitamento Materno , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Doença Crônica , Comportamento Alimentar , Feminino , Humanos , Masculino , Inquéritos NutricionaisRESUMO
Mothers of malnourished children were evaluated by psychologist, nutritionist, social worker and pediatrician with the objective of verifying in which ways the psychological, social and nutritional aspects interact. All mothers were from the low socioeconomic level, with extremely low family incomes, lower school levels were predominant,with 57.6% up to 4 years of formal education; 27.3% of the mothers were single, 48.5% single with male partners, 18.2% married and 6% separated. Main personality traits found: immaturity, difficulties in relationships, low self-regard, feelings of insufficiency/inferiority, aggressiveness. The intellectual level was average or below average in 82.6%. Concerning food preparation,we observed that 80% were disorganized and showed poor hygiene, 64% did not show interest, 77% wasted foodstuffs, 61.9% were insecure in handling foods and 37% prepared foods with inadequate aspect and consistency. Results confirm that social aspects effectively are a risk factor for malnutrition in families from the low socioeconomic level. Other aspects are also very relevant, since certain characteristics of the mothers personality disturb her performance and determine external disorder and absence of interest during preparation of meals, an activity directly related to child care.
RESUMO
The importance of dietary fiber intake in the prevention and treatment of adult diseases has been widely emphasized in the literature for several years. Recommendations for fiber intake by children have only recently began to be published. The present study estimated the fiber intake by children with or without constipation according to five food composition tables. We studied 114 children under 12 years of age, of whom 56 were constipated and 58 had normal bowel movements. We used a 24 hour recall questionnaire and fiber consumption was analysed by five food composition tables: 1. Association of Official Agricultural Chemist-AOAC, 2. Southgate, 3. Mendez, 4. Englyst and 5. crude fiber. The statistical analysis showed significant differences between the medians of the estimated fiber consumption calculated using all tables, except the AOAC and Southgate tables. The median value and percent is 25th and 75th presented between parenthesis were (grams/day): Mendez--15.4 (11.9-19.6); Southgate--10.5 (7.8-13.5); AOAC--10.2 (7.3-14.0); Englyst--4.5 (3.0-6.0) and crude fiber--2.1 (1.4-2.9). There were statistical significant correlations between all pairs of tables but the best correlation was observed between Mendez and Southgate (r = +0.90), AOAC and Southgate (r = +0.88); and Mendez and AOAC (r = +0.84). Constipated children presented lower estimated fiber intake than those with normal bowel movements, with statistical significance according to all tables. In conclusion, it is important to determine which reference table should be utilized when recommending dietary fiber.
Assuntos
Fibras na Dieta/estatística & dados numéricos , Ingestão de Alimentos , Análise de Alimentos , Criança , Constipação Intestinal , Feminino , Humanos , MasculinoRESUMO
Concentrations of calcium and magnesium were measured in mature milk, collected between 30 and 90 days after childbirth, from a group of 90 mothers between 14 and 39 years of age, exclusively breastfeeding. The group was divided into three sub-groups: low socioeconomic-level adolescents (LSAd), low socioeconomic-level adults (LSA), and high socioeconomic-level adults (HSA). Each mother's nutritional status was determined using the body-mass index (BMI) and her eating habits, obtained on the basis of a 24-h dietary recall. Adolescent and adult mothers in the low socioeconomic-level group had lower average calcium intake (LSAd = 618.4 +/- 555.2 mg and LSA = 679.4 +/- 411.4 mg) than adult mothers in the higher socioeconomic-level group (853.6 +/- 415.5 mg). The average concentration of calcium in the adolescent mothers' milk (LSAd) was significantly lower (5.30 +/- 1.42 mmol Ca/L, P = 0.01) than that of the two adult groups (LSA = 5.82 +/- 1.55 mmol Ca/L and HSA = 6.40 mmol Ca/L). The average magnesium concentrations for all groups did not show significant differences (LSAd = 1.06 +/- 0.18, LSA = 1.16 +/- 0.23 and HSA = 1.11 +/- 0.23 mmol Mg/L, for P= 0.16). These results indicate that magnesium concentrations in mature human milk do not seem to depend on maternal nutritional status. The condition of adolescence, however, associated with lower calcium intake by the mother, resulted in lower calcium concentrations in the milk secreted when compared to that of adult mothers.
Assuntos
Cálcio da Dieta/análise , Cálcio/análise , Magnésio/análise , Leite Humano/química , Adolescente , Adulto , Fatores Etários , Ingestão de Alimentos , Comportamento Alimentar , Feminino , Humanos , Estado Nutricional , Classe SocialRESUMO
Alterations in plasmatic lipid profile are known to be risk factors for atherosclerotic disease and have been associated with obesity. This research was designed in order to study the incidence of these alterations in obese children and adolescents according to two different reference patterns. Analyses of seric levels of Total Cholesterol (CT) and fractions and of Triglycerides (TG) were done. The sample included 74 obese children and adolescents with average age equal to 11 years and 10 months for boys and 10 years and 9 months for girls and with mean weight/height ratio (W/H) equal to 151 and 149% for boys and for girls, respectively. Plasmatic lipid values obtained were classified according to the American Heart Position Statement Circulation (AHPSC) and to Kwiterovich reference patterns. It was observed that patients with abnormal seric HDL-cholesterol (HDL) levels had a significantly greater (W/H) then the other group. It was also noticed that a greater number of individuals presented abnormal or borderline plasmatic lipid levels (91.9%), specially HDL (93.6%) and TG (67.6%), according to Kwiterovich than AHPSC. Obesity showed to be an important factor in determining lipid profile values and should be included as a variable to indicate screening of these lipoproteins in childhood and adolescence.
Assuntos
Colesterol/sangue , Obesidade/metabolismo , Triglicerídeos/sangue , Adolescente , Estatura , Peso Corporal , Criança , Doença da Artéria Coronariana/etiologia , Feminino , Humanos , Masculino , Fatores de RiscoRESUMO
The objective of this study was to estimate the caries impact of providing training in infant feeding guidelines to workers at Brazilian public primary care clinics. In a cluster-randomized controlled trial (n = 20 clinics), health care workers either were trained in guidelines for infant nutrition, stressing healthful complementary feeding, or were assigned to a 'usual practices' control, which allowed for maternal counseling at practitioner discretion. Training occurred once; the amount of counseling provided to mothers was not assessed. Eligible pregnant women were enrolled to follow health outcomes in their children. Early childhood caries (ECC) was measured at age three years (n = 458 children). The overall reductions in ECC (relative risk, 0.92; 95%CI, 0.75, 1.12) and severe ECC (RR, 0.87; 95%CI, 0.64, 1.19) were not statistically significant. There was a protective effect among mothers who remained exclusively at the same health center (S-ECC RR, 0.68; 95%CI, 0.47, 0.99) and among those naming the health center as their principal source of feeding advice (S-ECC RR, 0.53; 95%CI, 0.29, 0.97). Health care worker training did not yield a statistically significant reduction in caries overall, although caries was reduced among children of mothers more connected to their health centers.
Assuntos
Cárie Dentária/prevenção & controle , Educação em Saúde Bucal , Pessoal de Saúde/educação , Fenômenos Fisiológicos da Nutrição do Lactente , Atenção Primária à Saúde , Adulto , Brasil , Aleitamento Materno , Pré-Escolar , Centros Comunitários de Saúde , Aconselhamento , Índice CPO , Assistência Odontológica , Dieta , Escolaridade , Pai/educação , Métodos de Alimentação , Feminino , Seguimentos , Manipulação de Alimentos , Humanos , Lactente , Alimentos Infantis , Idade Materna , Mães/educação , Gravidez , Classe Social , Recursos HumanosRESUMO
AIM: To identify risk factors for cariogenic feeding practices in the first year of life. STUDY DESIGN: Cohort study. METHODS: 500 children born within the public health care system in São Leopoldo, Brazil, were recruited in a follow-up program. Anthropometric and demographic data were collected soon after birth; data on feeding practices were assessed at 12 months of age using a standardised questionnaire; clinical examination at 4 years of age allowed identification of cariogenic feeding practices in the first year of life and to quantify their relative risks. In the present study, the attributable risks of each child were summed, and the outcome was assessed for the upper quartile of scores for cariogenic feeding practices. STATISTICS: Adjusted relative risks for the outcome were estimated using robust Poisson regression models. RESULTS: A total of 327 children comprised the final study sample, i.e. were followed from birth to 4 years of age. Multivariate analysis showed that the risk of cariogenic feeding practices doubled in children from mothers with less than 5 years of education (RR 2.19, 95%CI 1.26-3.82) and was 70% higher in children from mothers with 5-8 years of education when compared with maternal education >8 years. The other independent variables were not associated with the outcome. CONCLUSIONS: Low maternal education is a risk factor for cariogenic feeding practices, independently of other factors. Mothers with low educational levels should be the focus of child health promotion interventions, especially those aimed at controlling dental caries.