Effects of minimally and ultra-processed foods on blood pressure in Brazilian adults: a two-year follow up of the CUME Project.

AIM: To assess the association of food consumption according to degree of processing with changes in systolic (SBP) and diastolic (DBP) blood pressure in adult participants of a Brazilian cohort. METHODS: Longitudinal study with 2496 adult participants of the Cohort of Universities of Minas Gerais (CUME Project). Food consumption was categorized by food groups according to degree of processing following the NOVA grading system: unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). Changes in SBP and DBP were categorized (decreased, maintained, increased). Independent associations between exposure and outcomes were verified using multiple generalized ordered logistic models adjusted for potential confounders. RESULTS: After a two-year follow-up, the consumption of U/MPF&CI (% daily caloric intake) reduced the chance of increasing DBP (P for trend = 0.014), with a more evident effect among participants within the 5th quintile of this food group (odds ratio (OR) = 0.55; 95% confidence interval (CI): 0.34-0.97]. On the other hand, the consumption of UPFs (% daily caloric intake) raised the chance of increasing DBP (P for trend = 0.005) and was more evident among participants within the quintiles of higher consumption (4th quintile - OR = 1.97; 95% CI: 1.25-3.10; 5th quintile - OR = 1.79; 95% CI = 1.12-2.86). No associations were found between food consumption according to degree of processing and changes in SBP. CONCLUSION: Higher consumption of U/MPF&CI and UPFs were independently associated to lower and greater chances of increased DBP in adult participants from CUME Project.

Estimativa do risco de doenças cardiovasculares entre adultos indígenas da etnia krenak, Minas Gerais, Brasil / Estimación de riesgo de enfermedades cardiovasculares entre adultos indígenas de la etnia krenak, Minas Gerais, Brasil / Risk estimation of cardiovascular diseases among indigenous adults of the krenak ethnicity, Minas Gerais, Brazil

RESUMO Objetivo: estimar o risco de doenças cardiovasculares em indígenas Krenak por meio do Escore de Risco Cardiovascular de Framingham. Metodologia: estudo epidemiológico transversal realizado com indígenas de 30 a 74 anos, em Terra Indígena localizada na região leste de Minas Gerais, Brasil. Os dados coletados foram: peso e altura para cálculo do IMC, aferição da pressão arterial e glicemia capilar casual, sexo, idade e tabagismo. O risco cardiovascular estimado em 10 anos foi calculado a partir do algoritmo de Escore de Framingham. Além disso, foram calculados o risco cardiovascular normal, o risco cardiovascular ótimo e a idade cardiovascular. A amostra foi caracterizada com a apresentação das frequências absolutas e relativas das variáveis que compõem o escore de risco cardiovascular de Framingham, estratificada pelo sexo. Resultados: observou-se que o risco cardiovascular em 10 anos entre os indígenas Krenak foi superior ao risco normal, bem como a idade cardiovascular foi maior que a idade cronológica, apesar da maioria da amostra ter apresentado um baixo risco cardiovascular em 10 anos, sem diferença estatística entre os sexos. Conclusão: apesar da predominância de baixo risco cardiovascular em 10 anos entre os indígenas Krenak, o resultado da idade cardiovascular superior à idade cronológica pode ocasionar morbimortalidade por doenças cardiovasculares ao longo do tempo nessa população.

RESUMEN Objetivo: estimar el riesgo de las enfermedades cardiovasculares a los indígenas Krenak por medio de la Puntuación de Riesgo Cardiovascular de Framingham. Metodología: estudio epidemiológico transversal realizado con indígenas de 30 a 74 años, en Tierra Indígena localizada en la región este de Minas Gerais, Brasil. Los datos recolectados fueron: peso y altura para calcular el IMC, medición de la presión arterial y glucemia capilar casual, sexo, edad y tabaquismo. El riesgo cardiovascular estimado en 10 años fue calculado a partir del algoritmo de Puntuación de Framingham. Además, se han calculado el riesgo cardiovascular normal, el riesgo cardiovascular óptimo y la edad cardiovascular. La muestra fue caracterizada con la presentación de las frecuencias absolutas y relativas de las variables que componen la puntuación de riesgo cardiovascular de Framingham, estratificada por sexo. Resultados: se observó que el riesgo cardiovascular en 10 años entre los indígenas Krenak fue superior al riesgo normal, así como la edad cardiovascular fue mayor que la edad cronológica, aunque la mayoría de la muestra presentó un bajo riesgo cardiovascular en 10 años, sin diferencia estadística entre los sexos. Conclusión: a pesar de la predominancia de bajo riesgo cardiovascular en 10 años entre los indígenas Krenak, el resultado de la edad cardiovascular superior a la edad cronológica puede ocasionar morbimortalidad por enfermedades cardiovasculares a lo largo del tiempo en esa población.

ABSTRACT Objective: to estimate the risk of cardiovascular diseases in indigenous Krenak through the Framingham Cardiovascular Risk Score. Methodology: cross-sectional epidemiological study conducted with indigenous people aged 30 to 74 years, in Indigenous Land located in the eastern region of Minas Gerais, Brazil. The data collected were: weight and height to calculate BMI, measurement of blood pressure and casual capillary blood glucose, sex, age and smoking. The cardiovascular risk estimated at 10 years was calculated from the Framingham Score algorithm. In addition, normal cardiovascular risk, optimal cardiovascular risk and cardiovascular age were calculated. The sample was characterized with the presentation of absolute and relative frequencies of the variables that make up the cardiovascular risk score of Framingham, stratified by sex. Results: it was observed that cardiovascular risk at 10 years among the Krenak indigenous was higher than normal risk, as well as cardiovascular age was higher than chronological age, although most of the sample had a low cardiovascular risk at 10 years, no statistical difference between the sexes. Conclusion: despite the predominance of low cardiovascular risk in 10 years among the Krenak indigenous, the result of cardiovascular age above chronological age can cause morbidity and mortality from cardiovascular diseases over time in this population.

Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review / Padrões alimentares durante a gravidez e ganho de peso gestacional: Uma revisão sistemática

Abstract The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

Resumo A presente revisão sistemática (PROSPERO: CRD42020148630) tem como hipótese que o ganho de peso excessivo durante a gravidez está associado aos padrões alimentares compostos por alimentos ultraprocessados. Desta forma, objetivou-se investigar a associação entre o padrão alimentar a posteriori e o ganho de peso durante a gestação. A busca de artigos foi realizada em nove bases de dados. Dois revisores selecionaram os artigos nestas bases e extraíram as informações utilizadas na revisão. Duas escalas foram utilizadas para avaliar a qualidade dos estudos selecionados: Escala de Avaliação da Qualidade de New Castle-Ottawa para estudos baseados em coortes e a Ferramenta de Avaliação de Estudos Transversais (escala AXIS) para estudos transversais. No total, foram identificados 11 trabalhos com variação do tamanho amostral (n=173-5.733). As mulheres que apresentaram maior adesão aos padrões alimentares saudáveis e tradicionais (frutas, hortaliças e vegetais, nozes e laticínios) apresentarammenor ganho de peso gestacional (GPG). A maior ingestão de padrões alimentares mistos e ocidentais ricos em alimentos ultraprocessados foi associada a uma maior prevalência de GPG excessivo (24,48-55,20%). Os padrões alimentares gestacionais derivados a posteriori que apresentaram componentes ultraprocessados ricos em gordura e açúcares apresentaram associação como maior GPG; os padrões alimentares saudáveis e tradicionais foram relacionados a melhores condições de saúde maternoinfantil, como GPG adequado.

Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review.

The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancy with dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n = 173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake of mixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48-55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

A presente revisão sistemática (PROSPERO: CRD42020148630) tem como hipótese que o ganho de peso excessivo durante a gravidez está associado aos padrões alimentares compostos por alimentos ultraprocessados. Desta forma, objetivou-se investigar a associação entre o padrão alimentar a posteriori e o ganho de peso durante a gestação. A busca de artigos foi realizada em nove bases de dados. Dois revisores selecionaram os artigos nestas bases e extraíram as informações utilizadas na revisão. Duas escalas foram utilizadas para avaliar a qualidade dos estudos selecionados: Escala de Avaliação da Qualidade de New Castle-Ottawa para estudos baseados em coortes e a Ferramenta de Avaliação de Estudos Transversais (escala AXIS) para estudos transversais. No total, foram identificados 11 trabalhos com variação do tamanho amostral (n = 173­5.733). As mulheres que apresentaram maior adesão aos padrões alimentares saudáveis e tradicionais (frutas, hortaliças e vegetais, nozes e laticínios) apresentaram menor ganho de peso gestacional (GPG). A maior ingestão de padrões alimentares mistos e ocidentais ricos em alimentos ultraprocessados foi associada a uma maior prevalência de GPG excessivo (24,48­55,20%). Os padrões alimentares gestacionais derivados a posteriori que apresentaram componentes ultraprocessados ricos em gordura e açúcares apresentaram associação com o maior GPG; os padrões alimentares saudáveis e tradicionais foram relacionados a melhores condições de saúde materno-infantil, como GPG adequado.

Alcohol consumption and overweight in Brazilian adults - CUME Project. / Consumo de bebidas alcoólicas e excesso de peso em adultos brasileiros - Projeto CUME.

This is a cross-sectional study with 2,909 participants (aged ≥18 years) from the baseline of the Cohort of Universities of Minas Gerais [CUME - Coorte de Universidades Mineiras] which verified the association between alcohol consumption and overweight. Data on sociodemographic factors, lifestyle, eating habits, anthropometric factors and clinical conditions were collected through an online questionnaire. Body mass index ≥ 25 kg/m² was considered an indicator of overweight. The daily consumption of alcohol was evaluated in grams (alcohol) and according to type in milliliters (beer, wine, hard liquor). The prevalence of alcohol consumption and overweight was 73.6% and 40.8%, respectively. There was a significant tendency of an increase in overweight with higher beer consumption (tendency p value of 0.038), which was not observed for the other types of alcohol. After sensitivity analyses, alcohol consumption was associated to overweight, with a tendency of increase in prevalence with higher daily consumption. There is a crucial need to curb the widely accepted idea that a low or moderate alcohol consumption is not harmful to one's health, and to be cautious of such a proposition. The influence of alcohol consumption regarding weight gain must be considered in public health policies and policies of alcohol consumption control.

Estudo transversal com 2.909 participantes (≥ 18 anos) da linha de base da Coorte de Universidades Mineiras (CUME), Brasil, que verificou a associação entre o consumo de bebidas alcoólicas e o excesso de peso. Por meio de questionário virtual, coletaram-se dados sociodemográficos, de estilo de vida, hábitos alimentares, antropométricos e condições clínicas. Considerou-se Índice de Massa Corporal ≥ 25 kg/m2 como excesso de peso. Avaliou-se o consumo diário de bebidas alcoólicas no total em gramas (álcool) e segundo tipo em mililitros (cerveja, vinhos e destiladas). As prevalências de consumo de álcool e excesso de peso foram 73,6% e 40,8%, respectivamente. Houve uma tendência significativa de aumento da prevalência de excesso de peso quanto maior o consumo de cerveja (p de tendência = 0,038), fato não observado para os demais tipos de bebidas. Após análises de sensibilidade, a ingestão de álcool associou-se ao excesso de peso, com tendência de aumento da prevalência quanto maior o consumo diário. Ressalta-se a necessidade de reduzir a visão amplamente aceita de que o consumo leve a moderado de álcool não é nocivo à saúde, adotando cautela nesta proposição. Deve-se considerar a influência da ingestão de bebidas alcoólicas no ganho de peso nas políticas públicas de saúde e de controle do consumo do álcool.

Online Food Frequency Questionnaire From the Cohort of Universities of Minas Gerais (CUME Project, Brazil): Construction, Validity, and Reproducibility.

Background: The Food Frequency Questionnaire (FFQ) is usually used in epidemiological studies to assess food consumption. However, the FFQ must have good accuracy, requiring its validation and reproducibility for the target population. Thus, this study aimed to describe the construction of the online Food Frequency Questionnaire (oFFQ) used at the Cohort of Universities of Minas Gerais (CUME project, Brazil) and evaluate its validity and reproducibility. Methods: The oFFQ was answered two times in 1 year (March/August 2018-March/April 2019; n = 108 participants-reproducibility), and four 24-h dietary recalls (24hRs) were applied in two seasons of the southern hemisphere [two 24hRs in autumn (March/June 2018) and two 24hRs in winter (August/September 2018); n = 146 participants-validity]. To assess the validity and reproducibility, the intraclass correlation coefficients (ICCs) were estimated. Results: The oFFQ had 144 food items separated into eight groups (dairy products; meat and fish; cereals and legumes; fruits; vegetables; fats and oils; drinks; other foods). In assessing the validity, ICCs for energy and macronutrients were considered moderate, ranging from 0.41 (energy) to 0.59 (protein), while the ICCs for micronutrients were considered low to moderate, ranging from 0.25 (fibers) to 0.65 (vitamin B6). Regarding reproducibility assessment, ICCs for energy and all the assessed items were considered moderate to excellent, ranging from 0.60 (vegetables) to 0.91 (vitamin E and retinol). Conclusions: The self-reported oFFQ had satisfactory validity and reproducibility. So, it can be used to analyze the association between food consumption and chronic diseases in the participants of the Cohort of Universities of Minas Gerais (CUME project-Brazil).

Consumo de bebidas alcoólicas e excesso de peso em adultos brasileiros - Projeto CUME / Alcohol consumption and overweight in Brazilian adults - CUME Project

Resumo Estudo transversal com 2.909 participantes (≥ 18 anos) da linha de base da Coorte de Universidades Mineiras (CUME), Brasil, que verificou a associação entre o consumo de bebidas alcoólicas e o excesso de peso. Por meio de questionário virtual, coletaram-se dados sociodemográficos, de estilo de vida, hábitos alimentares, antropométricos e condições clínicas. Considerou-se Índice de Massa Corporal ≥ 25 kg/m2 como excesso de peso. Avaliou-se o consumo diário de bebidas alcoólicas no total em gramas (álcool) e segundo tipo em mililitros (cerveja, vinhos e destiladas). As prevalências de consumo de álcool e excesso de peso foram 73,6% e 40,8%, respectivamente. Houve uma tendência significativa de aumento da prevalência de excesso de peso quanto maior o consumo de cerveja (p de tendência = 0,038), fato não observado para os demais tipos de bebidas. Após análises de sensibilidade, a ingestão de álcool associou-se ao excesso de peso, com tendência de aumento da prevalência quanto maior o consumo diário. Ressalta-se a necessidade de reduzir a visão amplamente aceita de que o consumo leve a moderado de álcool não é nocivo à saúde, adotando cautela nesta proposição. Deve-se considerar a influência da ingestão de bebidas alcoólicas no ganho de peso nas políticas públicas de saúde e de controle do consumo do álcool.

Abstract This is a cross-sectional study with 2,909 participants (aged ≥18 years) from the baseline of the Cohort of Universities of Minas Gerais [CUME - Coorte de Universidades Mineiras] which verified the association between alcohol consumption and overweight. Data on sociodemographic factors, lifestyle, eating habits, anthropometric factors and clinical conditions were collected through an online questionnaire. Body mass index ≥ 25 kg/m² was considered an indicator of overweight. The daily consumption of alcohol was evaluated in grams (alcohol) and according to type in milliliters (beer, wine, hard liquor). The prevalence of alcohol consumption and overweight was 73.6% and 40.8%, respectively. There was a significant tendency of an increase in overweight with higher beer consumption (tendency p value of 0.038), which was not observed for the other types of alcohol. After sensitivity analyses, alcohol consumption was associated to overweight, with a tendency of increase in prevalence with higher daily consumption. There is a crucial need to curb the widely accepted idea that a low or moderate alcohol consumption is not harmful to one's health, and to be cautious of such a proposition. The influence of alcohol consumption regarding weight gain must be considered in public health policies and policies of alcohol consumption control.

Food processing and risk of hypertension: Cohort of Universities of Minas Gerais, Brazil (CUME Project).

OBJECTIVE: To analyse the association between food consumption according to the degree of processing and incidence of hypertension in CUME project participants. DESIGN: Longitudinal study in which food consumption was evaluated according to the percentage contribution of daily energetic intake (%/d) of each NOVA classification group (unprocessed/minimally processed foods and culinary preparations (U/MPF&CP); processed foods and ultra-processed foods (UPF)). Hypertension was defined according to American College of Cardiology/American Heart Association (ACC/AHA) criteria. Adjusted relative risks (RR) and their 95% confidence intervals (95 % CI) were estimated by Poisson regression models with robust variances. SETTING: Brazil. PARTICIPANTS: 1221 graduates classified as non-hypertensive at baseline and monitored for 2 years. RESULTS: Daily energetic percentage from each group according to degree of processing was 64·3 (sd 12) % for U/MPF&CP; 9·9 (sd 5·8) % for processed foods and 25·8 (sd 11) % for UPF. Incidence of hypertension was high (152/1000 person-years; n 113, 193/1000 person-years in males and n 257, 138/1000 person-years in females). After adjusting for potential confounders, participants in the upper quintile of daily energetic intake of U/MPF&CP presented a reduced risk of hypertension (RR: 0·72; 95 % CI 0·52, 0·98), while those in the upper quintile of daily energetic intake of UPF presented an increased risk of the outcome (RR: 1·35; 95 % CI 1·01, 1·81). CONCLUSIONS: In this prospective cohort of Brazilian middle-aged adult university graduates, the highest consumptions of U/MPF&CP and UPF were associated with, respectively, reduced and increased risk of hypertension. Additional longitudinal studies are needed to confirm our results.

Binge drinking and overweight in brazilian adults - CUME Project.

OBJECTIVE: To verify the association between heavy episodic alcohol consumption [binge drinking (BD)] and overweight in 2,909 adults from the Cohort of Universities of Minas Gerais (CUME Project) baseline, Brazil. METHOD: Cross-sectional study in which sociodemographic, anthropometric (BMI ≥ 25 kg/m2 = overweight) and dietary intake data were collected. This study evaluated the occurrence and monthly frequency of BD (≥ 4 drinks at one time for women; ≥ 5 drinks at one time for men, in the last 30 days). RESULTS: The prevalence of BD and overweight were 41.3% and 40.8%, respectively. BD increased the prevalence of overweight by 19%, and, BD exposure by ≥ 5 days / month increased it by 31%. CONCLUSION: BD on a single or multiple occasion during the month was associated with a higher prevalence of overweight. Therefore, such a lifestyle should be considered in weight gain prevention strategies.

Binge drinking and overweight in brazilian adults - CUME Project / Borrachera y sobrepeso en adultos brasileños - Proyecto CUME / Consumo pesado episódico de álcool e excesso de peso em adultos brasileiros - Projeto CUME

ABSTRACT Objective: To verify the association between heavy episodic alcohol consumption [binge drinking (BD)] and overweight in 2,909 adults from the Cohort of Universities of Minas Gerais (CUME Project) baseline, Brazil. Method: Cross-sectional study in which sociodemographic, anthropometric (BMI ≥ 25 kg/m2 = overweight) and dietary intake data were collected. This study evaluated the occurrence and monthly frequency of BD (≥ 4 drinks at one time for women; ≥ 5 drinks at one time for men, in the last 30 days). Results: The prevalence of BD and overweight were 41.3% and 40.8%, respectively. BD increased the prevalence of overweight by 19%, and, BD exposure by ≥ 5 days / month increased it by 31%. Conclusion: BD on a single or multiple occasion during the month was associated with a higher prevalence of overweight. Therefore, such a lifestyle should be considered in weight gain prevention strategies.

RESUMEN Objetivo: Verificar la relación entre el episodio de exceso de alcohol [binge drinking (BD)] y el sobrepeso en 2.909 adultos de la línea de base de la Coorte de Universidades Mineiras (CUME), Brasil. Método: Estudio transversal en lo cual se recogieron datos sociodemográficos, antropométricos (IMC ≥ 25 kg/m2 = sobrepeso) y alimentares. Se evaluaron presencia y frecuencia mensual del BD (≥ 4 dosis en única ocasión para mujeres; ≥ 5 dosis para hombres, en los últimos 30 días). Resultados: Las prevalencias del BD y sobrepeso han sido 41,3% y 40,8%, respectivamente. BD ha aumentado en 19% la prevalencia del sobrepeso, y la exposición al BD en ≥ 5 días/mes ha aumentado en 31%. Conclusión: El BD en única o en varias ocasiones en el mes se relacionó a la mayor prevalencia de sobrepeso. Así que, tal hábito de vida debe ser considerado en las estrategias de prevención del aumento de peso.

RESUMO Objetivo: Verificar associação entre consumo pesado episódico de álcool [binge drinking (BD)] e excesso de peso em 2.909 adultos da linha de base da Coorte de Universidades Mineiras (CUME), Brasil. Método: Estudo transversal no qual se coletaram dados sociodemográficos, antropométricos (IMC ≥ 25 kg/m2 = excesso de peso) e alimentares. Avaliaram-se presença e frequência mensal do BD (≥4 doses em única ocasião para mulheres; ≥5 doses para homens, nos últimos 30 dias). Resultados: As prevalências do BD e excesso de peso foram 41,3% e 40,8%, respectivamente. O BD aumentou em 19% a prevalência do excesso de peso, e a exposição ao BD em ≥5 dias/mês aumentou em 31%. Conclusão: O BD em única ou em várias ocasiões no mês se associou à maior prevalência de excesso de peso. Portanto, tal hábito de vida deve ser considerado nas estratégias de prevenção do ganho de peso.

Padrões alimentares e síndrome metabólica em participantes da Linha de Base da Coorte de Universidades Mineiras (CUME) / Dietary patterns and metabolic syndrome among participants at baseline in the Cohort of Universities of Minas Gerais (CUME)

Introdução: A importância da síndrome metabólica (SM) está relacionada à sua magnitude e forte associação com doenças cardiovasculares (DCV) e diabetes mellitus tipo 2 (DM2), dois dos principais problemas de saúde pública no Brasil e no mundo. Entre os fatores de risco para a SM, destaca-se o consumo alimentar. Contudo, essa associação não está bem dimensionada na população brasileira. Objetivo: Analisar os padrões alimentares e as suas associações independentes com SM em participantes da linha de base da Coorte de Universidades Mineiras (CUME). Métodos: Trata-se de um estudo transversal, cuja coleta de dados contemplou um questionário online autopreenchido (Q_0) com perguntas sobre características sociodemográficas, estilo de vida, morbidade referida, dados antropométricos, bioquímicos e clínicos. O consumo alimentar foi avaliado por meio de um Questionário de Frequência de Consumo Alimentar (QFCA) online de 144 itens alimentares. Além da coleta de dados online, foi realizada uma etapa presencial com uma subamostra aleatória para a validação da SM e dos seus componentes, definidos segundo a International Diabetes Federation (IDF). Para a identificação dos padrões alimentares foi utilizada a análise de componentes principais e as suas associações independentes com a SM foram estimadas pela regressão de Poisson com variâncias robustas. Resultados: O primeiro artigo apresentou o perfil de 4.291 participantes, sendo que a maioria era mulher (68%) e adulto jovem (72%, 20 a 39 anos); 14,9% relataram obesidade, 22,6% colesterol total alto, 11,6% hipertensão arterial e 3,3% DM2. No segundo artigo, conduzido com 172 participantes, verificou-se que o coeficiente Kappa entre diagnósticos de SM autodeclarado e aferido foi 0,814, indicando concordância quase perfeita. No terceiro artigo, foram avaliados 2.909 participantes (68,7% mulheres; média de idade de 36 ± 9,5 anos). A prevalência de SM foi de 7,0% (10,8% entre os homens e 5,3% entre as mulheres). Foram identificados quatro padrões alimentares: 1) padrão I = frutas, hortaliças, ovos, azeites, nozes e sementes e bebidas naturais; 2) padrão II = arroz e massas, leguminosas, cereais, raízes e tubérculos, pão francês, margarina e ingredientes culinários; 3) padrão III = carnes, bebidas alcoólicas e fast food; 4) padrão IV = lácteos, queijos e doces processados e pães ultraprocessados. Após o ajuste por fatores de confusão, o maior consumo (quarto versus o primeiro quartil) do padrão alimentar I e do padrão alimentar III foram associados, respectivamente, a menor (RP=0,47; IC95%: 0,27-0,82) e maior (RP=1,82; IC95%: 1,03-3,22) prevalências de SM. Além disso, a prevalência de SM aumentou diretamente com o maior consumo do padrão alimentar II (p de tendência=0,010). Conclusões: Apesar dos participantes do projeto CUME serem jovens e com alto nível de escolaridade, a presença de doenças crônicas foi frequente entre eles. Assim, a adoção de bons hábitos de vida se mostra importante nesse contexto, especialmente porque padrões alimentares saudável e não saudável se associaram, respectivamente, à diminuição e ao aumento da prevalência da SM.

Introduction: The importance of the metabolic syndrome (MetS) is related to its magnitude and strong association with cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2), two of the main public health problems in Brazil and in the world. Among the risk factors for MetS, we highlight food consumption. However, this association is not well-defined in the Brazilian population. Objective: To analyze dietary patterns and their independent associations with MetS in the baseline participants of the Cohort of Universities of Minas Gerais (CUME). Methods: This was a cross-sectional study whose data collection included a self-administered online questionnaire (Q_0) with questions about sociodemographic, lifestyle, referred morbidity, anthropometric, biochemical and clinical data characteristics. Consumption was assessed using an online Food Frequency Questionnaire (FFQ) of 144 food items. In addition to the online data collection, a face-to-face session was conducted with a random sub-sample for the validation of MetS and its components, according to the International Diabetes Federation (IDF). The principal components analysis was used to identify the food patterns, and their independent associations with SM were estimated by Poisson regression with robust variances. Results: The first manuscript presented the profile of 4,291 participants, most of whom were women (68%) and young adults (72%, 20-39 years); 14.9% reported obesity, 22.6% high total cholesterol, 11.6% hypertension and 3.3% DM2. In the second article, conducted with 172 participants, it was verified that the Kappa coefficient between diagnoses of self-reported and measured MetS was 0.814, indicating near perfect agreement. In the third article, 2,909 participants were evaluated (68.7% women, mean age 36 ± 9.5 years). The prevalence of MetS was 7.0% (10.8% among men and 5.3% among women). Four dietary patterns were identified: 1) pattern I = fruits, vegetables, eggs, olive oils, nuts and seeds and natural beverages; 2) pattern II = rice and pasta, legumes, cereals, roots and tubers, French bread, margarine and culinary ingredients; 3) pattern III = meat, alcoholic beverages and fast food; 4) pattern IV = processed dairy, cheeses and sweets and ultra-processed breads. After adjustments for confounding factors, the highest consumption (fourth versus first quartile) of pattern I and pattern III were associated, respectively, the lowest (PR = 0.47, 95% CI: 0.27-0, 82) and higher (PR = 1.82, 95% CI: 1.03-3.22) prevalence of MetS. Moreover, the prevalence of MetS increased directly with the higher consumption of dietary pattern II (p for trend = 0,010). Conclusions: Although the CUME participants were young and with a high schooling level, the presence of chronic diseases was frequent among them. Thus, the adoption of good life habits is important in this context, especially since healthy and unhealthy dietary patterns were associated, respectively, with the decrease and increase in the prevalence of MetS. I

Validação da síndrome metabólica e de seus componentes autodeclarados no estudo CUME / Validation of metabolic syndrome and its self reported components in the CUME Study / Validación del síndrome metabólico y de sus componentes autodeclarados en el estudio cume

O objetivo deste estudo foi analisar a validade dos diagnósticos autodeclarados de síndrome metabólica (SM) e de seus componentes pelos participantes da Coorte de Universidades Mineiras (CUME). Uma subamostra de 172 participantes da coorte (33 homens e 139 mulheres, idade 38 ± 11 anos) foi aleatoriamente selecionada para este estudo. A presença de SM foi definida segundo os critérios da International Diabetes Federation (IDF). Dados de peso, altura, pressão arterial, concentração sérica de glicose, triglicerídeos e HDL-c foram autodeclarados em questionário online da coorte e as mesmas variáveis foram aferidas presencialmente mediante protocolo padronizado em laboratórios das instituições de ensino superior envolvidas no projeto. Os dados autodeclarados e aferidos foram comparados por meio de coeficiente de correlação intraclasse (CCI), coeficiente Kappa (k) e diferenças entre medidas autodeclaradas e aferidas segundo a metodologia de Bland e Altman. As prevalências da SM foram de 4,7%e 5,2%, de acordo com os dados autodeclarados e aferidos, respectivamente. O coeficiente Kappa entre diagnósticos de SM autodeclarado e aferido foi 0,814, indicando concordância quase perfeita, situação similar à observada para a obesidade (k=0,882). Os demais componentes da SM apresentaram concordâncias moderadas (k=0,41 a 0,60). Os CCIs também indicaram excelente concordância para peso, estatura, IMC e HDL-c, respectivamente, 0,989, 0,995, 0,983 e 0,761. A glicose apresentou baixa concordância (CCI: 0,336). Concluiu-se que participantes do projeto CUME forneceram informações válidas para os diagnósticos autodeclarados de SM e de seus componentes.

The aim of this study was to analyze the validity of self-reported diagnoses of metabolic syndrome (MetS) and its components through participantsof the Cohort of Universities of Minas Gerais (CUME). A subsample of 172 cohort participants (33 males and 139 females, age 38 ± 11 years) wasrandomly selected for this study. The presence of MetS was defined according to the criteria of the International Diabetes Federation (IDF). Data onweight, height, blood pressure, and serum concentration of glucose, triglycerides and HDL-c were self reported in an online cohort questionnaire, andthe same variables were measured using a standardized protocol in laboratories of higher education institutions involved in the project. Self-reportedand measured data were compared by means of intraclass correlation coefficient (ICC), Kappa coefficient (k) and differences between self-reported andmeasured data, according to the Bland and Altman method. The prevalence of MetS was 4.7% and 5.2% according to self-reported and measured data, respectively. The Kappa coefficient between diagnoses of self-reported and measured MetS was 0.814, indicating almost perfect agreement, a situationsimilar to that observed for obesity (k = 0.882). The other components of MetS had moderate agreement (k = 0.41 to 0.60). The ICC also indicated excellent agreement for weight, height, BMI and HDL-c, respectively, 0.989, 0.995, 0.983 and 0.761. Glucose presented low agreement (ICC: 0.366). The study concludes that the CUME project participants provided valid information for the self-reported diagnoses of MetS and its components.

El objetivo de este estudio fue analizar la validez de los diagnósticos autodeclarados de síndrome metabólico (SM) y de sus componentes por los participantes de la Cohorte de Universidades Mineras (CUME). Para este estudio fue aleatoriamente seleccionada una submuestra de 172 participantes de la cohorte (33 hombres y 139 mujeres, edad 38 ± 11 años). La presencia de SM fue definida según los criterios de la International Diabetes Federation(IDF). Los datos de peso, altura, presión arterial, concentración sérica de glucosa, triglicéridos y HDL-c fueron autodeclarados en un cuestionario en líneade la cohorte y las mismas variables fueron evaluadas presencialmente mediante un protocolo estandarizado en laboratorios de las instituciones deenseñanza superior involucradas en el proyecto. Los datos autodeclarados y evaluados se compararon mediante el coeficiente de correlación intraclase(CCI), el coeficiente Kappa (k) y las diferencias entre medidas autodeclaradas y evaluadas según la metodología de Bland y Altman. Las prevalenciasde la SM fueron del 4,7% y del 5,2% de acuerdo con los datos autodeclarados y evaluados, respectivamente. El coeficiente Kappa entre diagnósticos de SM autodeclarado y constatado fue 0,814, indicando concordancia casi perfecta, situación similar a la observada para la obesidad (k = 0,882). Losdemás componentes de SM presentaron concordancias moderadas (k = 0,41 a 0,60). Los CCI también indicaron una excelente concordancia para peso,estatura, IMC y HDL-c, respectivamente, 0,989, 0,995, 0,983 y 0,761. La glucosa presentó baja concordancia (CCI: 0,336). Se concluye que los participantes del proyecto CUME proporcionaron información válida para los diagnósticos autodeclarados de SM y sus componentes.