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1.
J Pediatr (Rio J) ; 100(6): 596-603, 2024.
Article in English | MEDLINE | ID: mdl-39025129

ABSTRACT

OBJECTIVES: To examine trends over time in diet and size of very preterm infants, and associations of diet with size at hospital discharge/transfer. METHODS: The authors studied 4062 surviving very preterm infants born < 32 weeks' gestational age and < 1500 g between January 2012 and December 2020 from 12 Brazilian Neonatal Intensive Care Units. Diet type at discharge/transfer was classified as exclusive human milk, exclusive formula, or mixed. Outcomes were weight and head circumference at hospital discharge and the change in each from birth to discharge. The authors used linear regression to estimate adjusted associations of diet type with infant size, overall, and stratified by fetal growth category (small vs. appropriate for gestational age). The authors also examined trends in diet and infant size at discharge over the years. RESULTS: Infants' mean gestational age at birth was 29.3 weeks, and the mean birth weight was 1136 g. Diet at discharge/transfer was exclusive human milk for 22 %, mixed for 62 %, and exclusive formula for 16 %. Infant size in weight and head circumference were substantially below the growth chart reference for all diets. Infants fed human milk and mixed diets were lighter and had smaller heads at discharge/transfer than infants fed formula only (weight z: -2.0, -1.8, and -1.5; head z: -1.3, -1.2 and -1.1 for exclusive human milk, mixed and exclusive formula respectively). CONCLUSION: Results suggest high human milk use but gaps in nutrient delivery among hospitalized Brazilian very preterm infants, with little evidence of improvement over time.


Subject(s)
Milk, Human , Nutritional Status , Patient Discharge , Humans , Infant, Newborn , Patient Discharge/statistics & numerical data , Brazil , Nutritional Status/physiology , Female , Male , Infant Formula , Gestational Age , Intensive Care Units, Neonatal , Infant, Premature/growth & development , Infant, Very Low Birth Weight/growth & development , Birth Weight/physiology , Infant Nutritional Physiological Phenomena/physiology , Infant, Extremely Premature/growth & development
2.
Rev Assoc Med Bras (1992) ; 70(7): e20240166, 2024.
Article in English | MEDLINE | ID: mdl-39045938

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the association between nutritional status, inflammation, and susceptibility to seizures in febrile children. METHODS: This observational single-center study was carried out from January 2020 to December 2023 with 324 children aged 6 months and 6 years; 106 were diagnosed with febrile seizure, 108 were febrile children, and 110 were healthy controls. The prognostic nutritional index and neutrophil-to-lymphocyte ratio were calculated, and the cutoff threshold was established through receiver operating characteristics. The study utilized correlation and univariate-multivariate logistic regression analysis. The comparison between simple and complex febrile seizure was conducted to analyze differences. RESULTS: The optimal cutoff values were identified as 61.25 for prognostic nutritional index and 1.04 for neutrophil-to-lymphocyte ratio. Our findings showed a significant negative association between febrile seizure and platelet count, high C-reactive protein, and high ferritin levels. Additionally, the febrile seizure group showed a significant positive correlation with high neutrophil-to-lymphocyte ratio values (≥1.04) and body temperature (≥38). Our findings revealed that high neutrophil-to-lymphocyte ratio, high C-reactive protein, and age less than 18 months were independently associated with seizure susceptibility in febrile children. CONCLUSION: High neutrophil-to-lymphocyte ratio values and low prognostic nutritional index scores may serve as novel surrogate independent factors for seizure susceptibility in febrile children. Febrile children who are less than 18 months old are more prone to experience seizures than older febrile children. Moreover, there was a correlation between febrile seizures and elevated C-reactive protein levels and neutrophil-to-lymphocyte ratio values.


Subject(s)
Neutrophils , Nutrition Assessment , Nutritional Status , Seizures, Febrile , Humans , Seizures, Febrile/blood , Female , Male , Child, Preschool , Nutritional Status/physiology , Infant , Child , Prognosis , Lymphocytes , C-Reactive Protein/analysis , Lymphocyte Count , Case-Control Studies , Inflammation/blood , ROC Curve
3.
J Med Primatol ; 53(3): e12699, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38725093

ABSTRACT

BACKGROUND: Studing the nutritional needs and dietary habits of primates is essential to ensure their health and well-being. This includes the understanding of the use of nutrients and its correlation with health parameters. METHODS: Diet and nutritional parameters of 13 captive capuchin monkeys (Sapajus sp.) were assesed. Apparent digestibility of dry matter and nutrients were evaluated. Nutritional status was established based on body condition score (BCS) and muscle mass score (MMS). RESULTS: High apparent digestibility coefficients (ADC) were observed for crude protein and ether extract, but low for minerals and crude fiber. The ADC of EE and CF were related to MMS, and the biochemical parameters did not correlate with the AD coefficients obtained in the group. The nutritional status of the animals remained inadequate in 84.6% of the individuals, suggesting a reformulation of the diet and nutritional management.


Subject(s)
Animal Nutritional Physiological Phenomena , Diet , Digestion , Nutritional Status , Animals , Nutritional Status/physiology , Digestion/physiology , Female , Male , Diet/veterinary , Animal Feed/analysis , Sapajus/physiology , Animals, Zoo/physiology
4.
Braz J Cardiovasc Surg ; 39(3): e20230366, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38748866

ABSTRACT

INTRODUCTION: Although there are publications in the literature stating that parameters related to the nutritional status of patients are associated with the clinical outcomes of those with coronary artery disease, it is also stated that there is insufficient data on the relationship between nutritional indices and long-term outcomes and major adverse cardiovascular events in patients undergoing isolated coronary artery bypass grafting. METHODS: This retrospective study was conducted with patients who underwent isolated elective on-pump coronary artery bypass grafting in our hospital. Patients who underwent emergency coronary artery bypass grafting or those with known atrial fibrillation in the preoperative period were excluded. Patients were analyzed and compared in two groups according to the development of postoperative atrial fibrillation. RESULTS: The data of 93 coronary artery bypass grafting patients (71 [76%] males) with a mean age of 62.86 ± 9.53 years included in the study were evaluated. Both groups had similar preoperative ejection fraction value, hemoglobin level, age, number of distal bypasses, and postoperative mortality rates. Although the mean cardiopulmonary bypass and aortic cross-clamping times were higher in Group 1, they were not statistically significant. In our study, the mean prognostic nutrition index value was 51.76 ± 3002. CONCLUSION: According to our study results, there was no statistically significant difference between prognostic nutrition index values and the development of atrial fibrillation after coronary artery bypass grafting, which is similar to some publications in the literature. We think that it would be beneficial to conduct randomized studies involving more patients on this subject.


Subject(s)
Atrial Fibrillation , Coronary Artery Bypass , Nutritional Status , Postoperative Complications , Humans , Retrospective Studies , Coronary Artery Bypass/adverse effects , Male , Atrial Fibrillation/etiology , Female , Middle Aged , Nutritional Status/physiology , Aged , Lymphocyte Count , Postoperative Complications/etiology , Preoperative Period , Coronary Artery Disease/surgery , Risk Factors , Time Factors , Reference Values
5.
J Pediatr (Rio J) ; 100(5): 491-497, 2024.
Article in English | MEDLINE | ID: mdl-38614136

ABSTRACT

OBJECTIVE: To compare the phase angle (PhA) through bioelectrical impedance (BIA) of children with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by an Intestinal Rehabilitation Program, with a control group. METHODS: Children under 10 years of age with IF using prolonged PN for >60 days (study group) were included. The control group consisted of healthy children without chronic pathologies, matched by sex and age. Anthropometric parameters evaluated were: weight, height, weight/age z-score (W/A), height/age z-score (H/A), BMI, BMI/A z-score, arm circumference, triceps skinfold, subscapular skinfold, mid-arm muscle circumference. BIA parameters were resistance (R), reactance (Xc), and phase angle (PhA). RESULTS: Twenty-eight children were included in the study group, median (IQR) age was 11 (8-27) months, 53.6 % were male. In the control group, 28 children were included, median (IQR) age was 12.5 (8-24.7) months, 50 % were male. Children from the study group had W/A z-scores and H/A z-scores significantly lower than controls. There was no significant difference between PhA in the study group and controls, [median (IQR) 4.3° (3.8;4.6) vs 4.0° (3.8;5.4) respectively, p = 0.980]. Prematurity was significantly higher in the study group than in the controls, but there was no significant correlation between gestational age at birth and PhA of the children from the study group. CONCLUSION: Children with IF using prolonged PN showed lower W/A and H/A compared to the control group, but without significant difference between the PhA of children with IF compared to controls.


Subject(s)
Electric Impedance , Intestinal Failure , Nutritional Status , Parenteral Nutrition , Humans , Male , Female , Infant , Nutritional Status/physiology , Child, Preschool , Case-Control Studies , Intestinal Failure/physiopathology , Body Composition/physiology , Anthropometry , Time Factors , Child
6.
J Pediatr (Rio J) ; 100(4): 406-412, 2024.
Article in English | MEDLINE | ID: mdl-38522477

ABSTRACT

OBJECTIVES: Age at menarche (MA) is a proxy for biological maturation and a parameter of socioeconomic changes. Worldwide, anticipation of menarche is associated with nutritional transition and excess weight. The objective of this study was to evaluate the MA in Amazonian students and its association with nutritional status, ethnicity, and socioeconomic level. METHODS: Cross-sectional study with 1,017 students aged 6 to 17 living in the city of Manaus, Brazil. MA was analyzed by status quo and recall; its association with body mass index (BMI), race, socioeconomic status, and adult height was examined. RESULTS: 559 (51.9%) participants had already experienced menarche. In 91.7%, menarche occurred between 10 and 14 years of age; the mean age at the onset of menarche was 11.9 years. Overweight (11.6 years) and obese (11.4 years) participants reached menarche earlier than those with normal weight (12 years) and lean (12.7 years) participants. The associations between MA and nutritional status showed that overweight and obesity are risk factors for the early occurrence of menarche. MA was not associated with socioeconomic status/parental education or race. However, excess weight was associated with earlier MA in all races and social classes. The adult height was slightly lower in girls with menarche before 12 years old (157.9 vs 159.4 cm). CONCLUSION: Regardless of socioeconomic level or ethnicity, excess weight was associated with earlier menarche in Amazonian students.


Subject(s)
Body Mass Index , Menarche , Nutritional Status , Socioeconomic Factors , Humans , Menarche/physiology , Female , Nutritional Status/physiology , Adolescent , Cross-Sectional Studies , Brazil , Child , Age Factors , Students/statistics & numerical data , Overweight/epidemiology , Risk Factors
7.
J Pediatr (Rio J) ; 100(4): 377-383, 2024.
Article in English | MEDLINE | ID: mdl-38346677

ABSTRACT

OBJECTIVE: To study the association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from a birth cohort. METHOD: This was a secondary cross-sectional analysis of data obtained in a cohort study (Brazilian RibeirãoPreto and São Luís Birth Cohort Studies - BRISA), whose deliveries were performed between 2010 and 2011. Standardized questionnaires were applied to mothers, and placentas and newborns were evaluated shortly after delivery. Placental efficiency was assessed using the ratio between birth weight and placental weight (BW/PW ratio); values below the lower quartile (25th percentile for gestational age) were considered to have low placental efficiency. Newborn phenotypes were small and large for gestational age, stunted and wasted, evaluated using the INTERGROWTH-21 growth standard. To identify the confounding variables theoretical model was constructed using Directed Acyclic Graphs, and unadjusted and adjusted logistic regression were performed. Placental measurements were obtained blindly from pregnancy and delivery data. RESULTS: 723 mother-placenta-child triads were studied. 3.2 % of newborns were small-for-gestational-age (SGA), 6.5 %large-for-gestational-age (LGA), 5.7 %had stunting, and 0.27 % wasting. A significantly higher risk was found between low placental efficiency and SGA (OR 2.82;95 % CI 1.05-7.57), stunting (OR 2.23; 95 % CI 1.07-4.65), and wasting (OR 8.22; 95 % CI 1.96-34.37). No relationship was found between LGA and placental efficiency. CONCLUSIONS: Low placental efficiency was associated with increased risk for small-for-gestational-age, stunting, and wasting. Placental morphometry can provide valuable information on intrauterine conditions and neonatal health, helping to identify newborns at higher risk of future comorbidities.


Subject(s)
Anthropometry , Birth Weight , Placenta , Humans , Female , Infant, Newborn , Pregnancy , Placenta/anatomy & histology , Birth Weight/physiology , Cross-Sectional Studies , Anthropometry/methods , Adult , Male , Infant, Small for Gestational Age , Phenotype , Brazil , Nutritional Status/physiology , Young Adult , Birth Cohort , Gestational Age
8.
Arq. ciências saúde UNIPAR ; 27(1): 332-358, Jan-Abr. 2023.
Article in Portuguese | LILACS | ID: biblio-1414877

ABSTRACT

Fatores de risco, incluindo os de cunho materno, interferem no crescimento e desenvolvimento infantil. Nesse sentido, o conhecimento desses fatores e avaliação ade- quada desses processos são necessários para articulação de estratégias preventivas de transtornos futuros. Assim, o estudo visou investigar o crescimento e desenvolvimento de crianças atendidas em consulta de puericultura em unidades básicas de saúde de um mu- nicípio cearense, que integra uma universidade brasileira de cunho internacional, e seus fatores de risco. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães no Centro de Saúde de Acarape e Posto de Saúde São Benedito (Acarape ­ CE), no período de fevereiro a julho de 2021. Após consentimento, as mães preencheram um questionário, seguido de avaliação do cresci- mento e desenvolvimento das crianças. Os dados obtidos foram analisados. Das 70 crian- ças, 50,00% (n = 17) e 51,43% (n = 18) dos meninos e meninas tinham baixa estatura para idade, respectivamente. Para o desenvolvimento psicossocial, dos 284 testes condu- zidos, 86,27% (n = 245) foram realizados em plenitude pelas crianças. Observou-se as- sociação significativa entre a gestante ter concebido o filho com, no mínimo, 9 meses de período gestacional e esse apresentar relação Peso/Idade adequada e Estatura/Idade ina- dequada. Houve associação significativa entre a criança não ingerir refresco em pó e apre- sentar relação Peso/Idade adequada. Conclui-se que as crianças tinham idade gestacional adequada e apresentavam estado nutricional apropriado, apesar da baixa estatura para idade. Manifestavam desenvolvimento psicossocial, de linguagem e físico normais. Sobre os fatores de risco, esses envolveram os de cunho materno e o consumo de alimentos cariogênicos.


Risk factors, including maternal ones, interfere with child growth and de- velopment. In this sense, knowledge of these factors and adequate evaluation of these processes are necessary to articulate preventive strategies for future disorders. Thus, the study aimed to investigate the growth and development of children seen in childcare con- sultations in primary health units in Ceará, part of a Brazilian university of international character, and their risk factors. This is an observational, analytical, cross-sectional study with a quantitative approach, conducted with children and their mothers at the Acarape Health Center and São Benedito Health Center (Acarape ­ CE), from February to July 2021. After consent, the mothers completed a questionnaire, followed by an assessment of the children's growth and development. The data obtained were analyzed. Of the 70 children, 50.00% (n = 17) and 51.43% (n = 18) of the boys and girls were short for their age, respectively. Of the 284 tests conducted for psychosocial development, 86.27% (n = 245) were entirely performed by the children. A significant association was observed between the pregnant woman having conceived her child at least nine months of gestation and having an adequate Weight/Age and Height/Age ratio. There was a significant asso- ciation between the child not ingesting powdered soft drinks and having an appropriate Weight/Age ratio. It was concluded that the children had an adequate gestational age and had an appropriate nutritional status, despite their low height for their age. They showed normal psychosocial, language, and physical development. The risk factors involved those of mother nature and the consumption of cariogenic foods.


Los factores de riesgo, incluidos los maternos, interfieren en el crecimiento y desarrollo infantil. En este sentido, el conocimiento de estos factores y la evaluación adecuada de estos procesos son necesarios para articular estrategias preventivas de futu- ros trastornos. Así, el estudio tuvo como objetivo investigar el crecimiento y desarrollo de niños atendidos en consultas de puericultura en unidades básicas de salud de un muni- cipio de Ceará, que forma parte de una universidad brasileña de carácter internacional, y sus factores de riesgo. Se trata de un estudio observacional, analítico, transversal, con enfoque cuantitativo, realizado con niños y sus madres en el Centro de Salud de Acarape y el Centro de Salud São Benedito (Acarape ­ CE), de febrero a julio de 2021. Después del consentimiento, las madres completaron un cuestionario, seguido de una evaluación del crecimiento y desarrollo de los niños. Los datos obtenidos fueron analizados. De los 70 niños, el 50,00% (n = 17) y el 51,43% (n = 18) de los niños y niñas eran bajos para su edad, respectivamente. Para el desarrollo psicosocial, de las 284 pruebas realizadas, el 86,27% (n = 245) fueron realizadas íntegramente por los niños. Se observó una asociación significativa entre la gestante haber concebido a su hijo con al menos 9 meses de gesta- ción y tener una adecuada relación Peso/Edad y Talla/Edad. Hubo asociación significativa entre el niño que no ingiere gaseosas en polvo y presentar una adecuada relación Peso/Edad. Se concluyó que los niños tenían una edad gestacional adecuada y un estado nutricional adecuado, a pesar de su baja talla para su edad. Presentaron un desarrollo psi- cosocial, lingüístico y físico normal. En cuanto a los factores de riesgo, estos involucraron los de naturaleza materna y el consumo de alimentos cariogénicos.


Subject(s)
Humans , Male , Female , Child , Universities , Child Development/physiology , Risk Factors , Cariogenic Agents , Child , Nutritional Status/physiology , Cross-Sectional Studies/methods , Gestational Age , Maternal-Fetal Relations/physiology , Growth and Development/physiology , Eating/physiology
9.
Rev. Nutr. (Online) ; 36: e220106, 2023. tab
Article in English | LILACS | ID: biblio-1507421

ABSTRACT

ABSTRACT Objective To evaluate the food practices and nutritional status of students who use the University Restaurant at a public university. Methods This is a cross-sectional study carried out with 958 university students. Data related to regular eating practices (≥5 times/week), routine food consumption and nutritional status were collected. The association between University Restaurant attendance and dietary practices and body mass index was reviewed by bivariate logistic regression model and multiple regression. Results Students who attended the University Restaurant three or more times a week were more likely to regularly consume beans (OR: 1.35, p=0.041) and fresh salad (OR: 1.77, p<0.001) and less likely to have afternoon snack (OR: 0.68; p=0.008). In addition, an association between soda consumption and overweight was observed. Conclusion Thus, the importance of strategies that seek to promote incentives for healthy eating and lifestyle practices in the university population become evident.


RESUMO Objetivo O objetivo do estudo foi avaliar as práticas alimentares e o estado nutricional de estudantes usuários do restaurante-escola em uma universidade pública. Métodos Trata-se de um estudo transversal realizado com 958 estudantes universitários. Foram coletados dados relacionados às práticas alimentares regulares (≥5 vezes/semana), à rotina alimentar e ao estado nutricional. A associação entre a frequência de ida ao restaurante-escola, práticas alimentares e índice de massa corporal foi analisada por modelo de regressão logística bivariada e regressão múltipla. Resultados Os estudantes que frequentaram o restaurante-escola 3 ou mais vezes por semana apresentaram maiores chances de consumir regularmente feijão (OR: 1,35, p=0,041) e salada crua (OR: 1,77, p<0,001) e menos chances de realizar o lanche da tarde (OR: 0,68; p=0,008). Além disso, foi observada associação entre o consumo de refrigerante e o excesso de peso. Conclusão Dessa forma, evidencia-se a importância de estratégias que busquem promover incentivos a práticas alimentares e de vida saudáveis na população universitária.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Students , Nutritional Status/physiology , Eating/ethnology , Restaurants , Universities , Body Mass Index , Cross-Sectional Studies , Overweight/epidemiology , Sugar-Sweetened Beverages/adverse effects
10.
Arq. ciências saúde UNIPAR ; 26(3): 809-819, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1399471

ABSTRACT

Considera-se gestação de alto risco quando a mulher apresenta comorbidade materna e/ou condição sociobiológica que levam as chances de ocorrer alguma intercorrência na evolução natural da gravidez, como hipertensão arterial, diabetes, anemia, alcoolismo e obesidade. É de grande importância o acompanhamento pré-natal com uma equipe de assistência capaz de identificar os problemas antes mesmo que possam ser agravados. O objetivo deste estudo foi rastrear o perfil clínico e nutricional de mulheres com gestação de alto risco na Estratégia de Saúde da Família de Santa Quitéria- CE. Trata-se de um estudo descritivo, com abordagem quantitativa realizado com 33 gestantes. Para a coleta de dados foi utilizado o cartão da gestante e prontuário, o estado nutricional foi avaliado através do peso pré- gestacional contido no cartão e peso atual através da balança. Para análise estatística, foram usados frequências, percentuais, médias e desvio padrão, verificadas por meio dos testes de Kolmogorov-Smirnov e Levene. Para a comparação de médias entre duas categorias, utilizou-se o teste t de Student para amostras independentes. Os resultados mostraram que a maioria tinha o ensino médio como nível de escolaridade, renda igual ou menor que um salário mínimo, multíparas com um ou mais abortos. Em relação às características do estado clínico patológico, as condições mais prevalentes nas gestantes do presente estudo foram hipertensão arterial sistêmica, pré-eclâmpsia, seguidos de DMG e eritoblastose. Excesso de peso antes e durante a gravidez com ganho ponderal de peso adequado. O que demonstra a necessidade de estratégias para a saúde da mulher. É apropriado acionar sinal de alerta no acompanhamento da saúde da mulher também antes da gestação e não somente no pré-natal para que transcorra bem durante e após o parto. PALAVRAS-CHAVE: Estado nutricional; Gestação de alto risco; Assistência Pré-Natal.


High-risk pregnancy is considered when the woman presents maternal comorbidity and/or sociobiological condition that increase the chances of some complication occurring in the natural evolution of pregnancy, such as arterial hypertension, diabetes, anemia, alcoholism, and obesity; It is of great importance the prenatal follow-up with an assistance team capable of identifying the problems even before they can be aggravated; The objective of this study was to track the clinical and nutritional profile of women with high-risk pregnancy in the Family Health Strategy of Santa Quitéria-CE; This is a descriptive study with a quantitative approach carried out with 33 pregnant women; For data collection the pregnant woman's card and medical records were used, the nutritional status was evaluated through the pre-gestational weight contained in the card and current weight through the scale; For statistical analysis, frequencies, percentages, means and standard deviation were used, verified by means of the Kolmogorov-Smirnov and Levene tests;For comparison of means between two categories, Student's t test for independent samples was used; The results showed that most had high school education, income equal to or less than one minimum wage, multiparous women with one or more abortions; Regarding the characteristics of the pathological medical condition, the most prevalent conditions in the pregnant women of the present study were hypertension, pre- eclampsia, followed by GDM and erythoblastosis; Overweight before and during pregnancy with adequate weight gain; This demonstrates the need for women's health strategies; It is appropriate to trigger warning signals in the monitoring of women's health also before pregnancy and not only in the prenatal period so that it goes well during and after delivery;


Se considera embarazo de alto riesgo cuando la mujer presenta comorbilidad materna y/o condición socio-biológica que conlleva las posibilidades de aparición de alguna complicación en la evolución natural del embarazo, como son la hipertensión, la diabetes, la anemia, el alcoholismo y la obesidad. Es de gran importancia el seguimiento prenatal con un equipo de asistencia capaz de identificar los problemas incluso antes de que puedan agravarse. El objetivo de este estudio fue rastrear el perfil clínico y nutricional de las mujeres con embarazo de alto riesgo en la Estrategia de Salud Familiar de Santa Quitéria-CE. Se trata de un estudio descriptivo con un enfoque cuantitativo realizado con 33 mujeres embarazadas. Para la recopilación de datos se utilizó el cartón de la gestante y el prontuario, el estado nutricional se evaluó a través del peso pregestacional contenido en el cartón y el peso actual a través de la balanza. Para el análisis estadístico se utilizaron frecuencias, porcentajes, medias y desviación estándar, verificados mediante las pruebas de Kolmogorov-Smirnov y Levene. Para la comparación de medias entre dos categorías, se utilizó la prueba t de Student para muestras independientes. Los resultados mostraron que la mayoría tenía estudios secundarios, ingresos iguales o inferiores a un salario mínimo, mujeres multíparas con uno o más abortos. En cuanto a las características del estado clínico patológico, las condiciones más prevalentes en las embarazadas del presente estudio fueron la hipertensión arterial sistémica, la preeclampsia, seguidas de la DMG y la eritoblastosis. Exceso de peso antes y durante el embarazo con un aumento de peso adecuado. Lo que demuestra la necesidad de estrategias de salud para las mujeres. Es conveniente activar la señal de alarma en el seguimiento de la salud de las mujeres también antes del embarazo y no sólo en la atención prenatal para que funcione bien durante y después del parto.


Subject(s)
Humans , Female , Pregnancy , Adult , National Health Strategies , Health Profile , Nutritional Status/physiology , Pregnancy, High-Risk , Pre-Eclampsia/diagnosis , Prenatal Care/statistics & numerical data , Women , Body Mass Index , Medical Records/statistics & numerical data , Women's Health , Pregnant Women , Diabetes Mellitus/diagnosis , Hypertension/complications , Obesity/complications
11.
J Parasitol ; 108(1): 1-9, 2022 01 01.
Article in English | MEDLINE | ID: mdl-34995352

ABSTRACT

Giardia duodenalis genotypes A and B have been reported in Colombia. The population consisted of 235 schoolchildren whose ages ranged from 2 to 10 yr of age from the municipalities of Soledad and Galapa in the department of Atlántico, Colombia. Fecal samples were obtained and then analyzed in triplicate using the sedimentation in formalin-ether (Ritchie's method) and direct examination techniques. Of the 235 fecal samples, 35 samples were positive for G. duodenalis; positive samples were concentrated in a sucrose gradient and sonicated for 3 cycles of 20 sec. DNA extraction was performed, and the parasites were genotyped by conventional PCR amplifying a region of the ß-giardin gene. A general prevalence of G. duodenalis of 13.2% was found, and of these genotyped samples, 13 (56.7%) and 7 (20%) corresponded to genotype A, 1 (4.3%), and 3 (25%) corresponded to genotype B, and 9 (39.1%) and 2 (16.7%) were not defined, in the municipalities Soledad and Galapa, respectively. Additionally, 23 children were diagnosed with symptomatologic giardiasis, and 12 were asymptomatic; the most relevant symptoms were abdominal pain (7, 20%) and diarrhea (13, 56.7%). The nutritional status of children with Giardia genotypes A and B were as follows: 3 in a state of malnutrition (10%), 10 normal (33.3%), and 6 overweight and obese (20%) with genotype A, and 1 in a state of malnutrition (3.3%) and 3 normal (10%) with genotype B. The genotypes found in G. duodenalis did not show an association with nutritional status or with the clinical manifestations evaluated in schoolchildren.


Subject(s)
Giardia lamblia/classification , Giardiasis/parasitology , Malnutrition/complications , Nutritional Status/physiology , Child , Child, Preschool , Colombia , Genotype , Genotyping Techniques , Giardia lamblia/genetics , Giardiasis/complications , Giardiasis/physiopathology , Humans , Malnutrition/parasitology
12.
J. Phys. Educ. (Maringá) ; 33: e3342, 2022. tab, graf
Article in English | LILACS | ID: biblio-1421869

ABSTRACT

ABSTRACT This study identified factors associated with dynapenia in older adults residing in a small town in northeastern Brazil. It is a population-based study conducted with 208 senior citizens (58.7% women) from Aiquara, BA. Sociodemographic, behavioral and health information were obtained from face-to-face interviews, and nutritional status was assessed by body mass index. To measure their level of physical activity and sedentary behavior, the International Physical Activity Questionnaire was used. Dynapenia was diagnosed by sex, from the 25th percentile of handgrip strength, by means of a hydraulic dynamometer. For inferential analyses, Poisson regression was used, with a robust estimator, calculation of Prevalence Ratios (PRs) and their respective 95% Confidence Intervals (CIs). The prevalence of dynapenia was higher in older adults aged 70-79 (PR: 3.21; 95%CI: 1.55-6.64) and ≥80 years (PR: 4.91; 95%CI: 2.32-10.39), in those with low weight (PR: 2.20; 95%CI: 1.26-3.82), in those who are insufficiently active (PR: 1.99; 95%CI: 1.12-3.54), and among those with high level of sedentary behavior (PR: 1.88; 95%CI: 1.19-2.98). The factors identified as being associated with dynapenia were: age between 70 and 79 and ≥80 years, insufficient level of physical activity; high level of sedentary behavior, and low weight.


RESUMO Este estudo identificou os fatores associados à dinapenia em idosos residentes em um município de pequeno porte do Nordeste brasileiro. Trata-se de um estudo populacional, conduzido com 208 idosos (58,7% mulheres) de Aiquara-BA. As informações sociodemográficas, comportamentais e de condições de saúde foram obtidas em entrevistas face a face, e o estado nutricional foi avaliado pelo índice de massa corporal. Para mensuração do nível de atividade física e do comportamento sedentário, utilizou-se o International Physical Activity Questionnaire. O diagnóstico da dinapenia foi realizado por sexo, a partir do percentil 25 da força de preensão manual, averiguada com um dinamômetro hidráulico. Para análises inferenciais foi utilizada a regressão de Poisson, com estimador robusto, cálculo das Razões de Prevalência (RP) e de seus respectivos intervalos de confiança de 95% (IC). A prevalência de dinapenia foi maior nos idosos com idade entre 70-79 (RP: 3,21; IC95%: 1,55-6,64) e ≥80 anos (RP: 4,91; IC95%: 2,32-10,39), nos com baixo peso (RP: 2,20; IC95%: 1,26-3,82), nos insuficientemente ativos (RP: 1,99; IC95%: 1,12-3,54) e entre os com elevado comportamento sedentário (RP: 1,88; IC95%: 1,19-2,98). Identificou-se que os fatores associados à dinapenia foram: idade entre 70-79 e ≥80 anos, nível de atividade física insuficiente; elevado comportamento sedentário e baixo peso.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged/physiology , Aging/physiology , Health Status , Sociodemographic Factors , Health Services Research , National Health Strategies , Brazil/epidemiology , Exercise , Body Mass Index , Nutritional Status/physiology , Muscle Strength/physiology , Sedentary Behavior
13.
J. Phys. Educ. (Maringá) ; 33: e3356, 2022. tab
Article in Portuguese | LILACS | ID: biblio-1421872

ABSTRACT

RESUMO O objetivo deste estudo é analisar a satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade e verificar quais fatores antropométricos e socioeconômicos estão associados a elas. Trata-se de um estudo transversal, realizado com 307 crianças de escolas públicas de Goiânia. A saúde da criança e os aspectos socioeconômicos da família foram avaliados por meio de um questionário semiestruturado; a imagem corporal foi avaliada por meio da Escala de Silhuetas Brasileiras Para Crianças; e também foram coletados dados antropométricos de peso, estatura, dobras cutâneas e circunferência da cintura. Observou-se homogeneidade do gênero neste estudo, predomínio de meninos (52%) eutróficos (73%). Apesar de se tratar de uma amostra com peso saudável, a insatisfação e a distorção da imagem corporal prevaleceram sobre a maior parte da amostra: a insatisfação esteve presente em 92% das crianças, prevalecendo o desejo por uma menor silhueta, enquanto a distorção esteve presente em 75% da amostra, com predomínio da subestimação da silhueta. No entanto, este estudo encontrou associação da insatisfação com a imagem corporal apenas com IMC (aferido, atual e desejado) e circunferência da cintura; e associação da distorção da imagem corporal apenas com os IMC (aferido e atual).


ABSTRACT The aim of this study is to analyze the satisfaction and distortion of body image in children from 7 to 10 years old and to verify which anthropometric and socioeconomic factors are associated with them. This is a cross-sectional study, carried out with 307 children from public schools in Goiânia. The child's health and the socioeconomic aspects of the family were assessed using a semi-structured questionnaire; body image was assessed using the Brazilian Silhouettes Scale for Children; and anthropometric data on weight, height, skinfolds and waist circumference were also collected. Gender homogeneity was observed in this study, with a predominance of eutrophic(73%) boys (52%). Despite being a sample with a healthy weight, dissatisfaction and distortion of body image prevailed over most of the sample: dissatisfaction was present in 92% of children, the desire for a smaller silhouette prevailing, while distortion was present in 75% of the sample, with a predominance of underestimation of the silhouette. However, this study found dissatisfaction association with body image only with BMI (measured, current and desired) and waist circumference; and association of the distortion of the body image only with the BMI (measured and current).


Subject(s)
Humans , Male , Female , Child , Body Image/psychology , Child , Nutritional Status/physiology , Schools/organization & administration , Socioeconomic Factors , Body Composition/physiology , Body Mass Index , Anthropometry/instrumentation , Child Health , Cross-Sectional Studies/methods , Waist Circumference/physiology
14.
J. health med. sci. (Print) ; 7(3): 169-176, jul.-sept. 2021.
Article in Spanish | LILACS | ID: biblio-1381613

ABSTRACT

La alta prevalencia de obesidad en Chile, y su tendencia al aumento, constituye un problema de Salud Pública por su asociación con enfermedades crónicas no transmisibles. Durante la década 2010-2020, el estado de Chile implementó estrategias de intervención nutricional dirigidas a mantener o disminuir la prevalencia de obesidad. Regulaciones como la ley 20.606 sobre composición nutricional de los alimentos y su publicidad para modificar los entornos alimentarios, sistema elige vivir sano como modelo de gestión intersectorial constituido por políticas, planes y programas elaborados y ejecutados por distintos organismos del Estado, destinados a contribuir a generar hábitos y estilos de vida saludable y a prevenir y disminuir los factores y conductas de riesgo asociados a las enfermedades no transmisibles. A pesar de todos los esfuerzos, las encuestas poblacionales han demostrado que la obesidad continúa en aumento a lo largo del ciclo vital, por lo que es necesario fortalecer las estrategias existentes, pero con enfoque de determinantes sociales y de salud en todas las políticas, y a su vez mejorar los sistemas de evaluación de las estrategias implementadas en la población, midiendo su impacto además de su ejecución.


The high prevalence of obesity in Chile, and its increasing trend, constitutes a Public Health problem due to its association with chronic non-communicable diseases. During the 2010-2020 decade, the state of Chile implemented nutritional intervention strategies aimed at maintaining or reducing the prevalence of obesity. Regulations such as Law 20.606 on the nutritional composition of food and its advertising to modify food environments, Sistema chooses to live healthy System "EVS" Choose Healthy lifestyles as an intersectoral management model made up of policies, plans and programs prepared and executed by different State agencies, intended to contribute to healthy habits and lifestyles and to prevent and reduce risk factors and behaviors associated with non-communicable diseases. Despite all efforts, population surveys have shown that obesity continues to increase throughout the life cycle, which is why it is necessary to strengthen existing strategies, but with a focus on social and health determinants in all policies, since in turn, improve the evaluation systems of the strategies implemented in the population, measuring their impact, in addition to their implementation.


Subject(s)
Humans , Caloric Restriction/methods , Obesity/diet therapy , Obesity/epidemiology , Chile/epidemiology , Nutritional Status/physiology , Prevalence , Practice Guidelines as Topic , Obesity/prevention & control
15.
Rev. habanera cienc. méd ; 20(4): e2929, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289622

ABSTRACT

Introducción: Ingresar a la universidad implica múltiples cambios que repercuten en el estado nutricional y pueden condicionar la aparición de enfermedades crónicas no transmisibles al futuro. Objetivo: Comparar el estado nutricional de las estudiantes de Nutrición y Dietética de México y Colombia mediante mediciones antropométricas y el consumo de alimentos. Material y Métodos: Se efectuó un estudio descriptivo, exploratorio, multidimensional de tipo transversal; con un tamaño de la muestra de 583 estudiantes elegidos aleatoriamente en centros universitarios de Colombia y México. Se aplicó una encuesta que indagó sobre el consumo de alimentos y el estilo de vida de las estudiantes, la toma de datos antropométricos se realizó de manera presencial mediante la técnica The International Society for the Advancement of Kinanthropometry (ISAK). Se emplearon las técnicas estadísticas: test de comparación de proporciones, MANOVA y distribuciones de frecuencias. Resultados: Se presentó mayor carga genética para diabetes mellitus, hipertensión arterial, cáncer y obesidad en las estudiantes mexicanas; quienes reportaron más sobrepeso y enfermedades gastrointestinales. El consumo frecuente de queso entero, huevo, grasas saturadas y poliinsaturadas, azúcares y dulces, y productos fritos fue mayor en las colombianas; mientras que el consumo de queso bajo en grasa, leguminosas y mezclas vegetales, grasas monoinsaturadas, salsas, frutas, verduras y hortalizas, nueces y semillas, enlatados y bebidas alcohólicas, fue superior en las mexicanas. Conclusiones: Se reportan cambios alimenticios desde el ingreso a la carrera, lo cual es un factor protector para el desarrollo de enfermedades crónicas no trasmisibles(AU)


Introduction: Entering the university implies multiple changes that affect the nutritional status and can condition the appearance of chronic non-communicable diseases in the future. Objective: To compare the nutritional status of Nutrition and Dietetics students from Mexico and Colombia through anthropometric measurements and food consumption. Material and Methods: Through the application of a survey, the food consumption and lifestyle of the students were investigated. The anthropometric data collection was carried out using the techniques adopted by The International Society for the Advancement of Kinanthropometry (ISAK). With the data obtained, a descriptive, exploratory, multidimensional and cross-sectional study was carried out. The sample size was 583 students randomly chosen from university centers in Colombia and Mexico. The statistical techniques used included: comparison test for proportions, MANOVA and frequency distributions. Results: There was a higher genetic load for diabetes mellitus, arterial hypertension, cancer and obesity in Mexican students who reported more overweight and gastrointestinal diseases. The frequent consumption of whole cheese, eggs, saturated and polyunsaturated fats, sugars and sweets and fried products was higher in Colombian women while the consumption of low-fat cheese, legumes and vegetable mixtures, monounsaturated fats, sauces, fruits, vegetables, nuts and seeds, canned goods and alcoholic beverages was higher in Mexican women, presenting a significant difference (p <0.05). Conclusions: Dietary changes are reported from the beginning of the studies, which is a protective factor for the development of non-communicable chronic diseases. There must be consistency among knowledge, eating practices and lifestyle to maintain health and achieve greater credibility of the knowledge imparted(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Students/statistics & numerical data , Universities , Dietetics , Nutritional Sciences , Nutritional Status/physiology , Epidemiology, Descriptive , Cross-Sectional Studies , Colombia , Eating/physiology , Alcohol Drinking in College , Mexico
16.
Metab Syndr Relat Disord ; 19(9): 513-523, 2021 11.
Article in English | MEDLINE | ID: mdl-34314624

ABSTRACT

Background: Child malnutrition represents a major public health problem with physiological, psychological, and social short- and long-term implications. Objective: To compare the influence of nutritional status on oxidative stress (OS) markers in children aged 3-6 years. Methods: Children were categorized into four groups: underweight, normal weight, overweight, and obesity. Glucose (Glu), cholesterol (Chol), high-density lipoproteins, insulin, triacylglycerols (TG), triacylglycerols/glucose (TyG) index, and the homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed. In addition, OS [malondialdehyde (MDA) and 3-nitrotyrosine (3-NT)] and antioxidant defense markers [superoxide dismutase (SOD), catalase (CAT), and the ratio of reduced/oxidized glutathione (GSH/GSSG)] were quantified. Results: Children with obesity showed significantly higher levels of MDA and 3-NT, and increased SOD activity compared with normal weight children. Glu, Chol, TG levels, TyG indexes, HOMA-IR, MDA, 3-NT, and SOD positively correlated with body mass index (BMI) and Centers for Disease Control and Prevention percentiles (CDC PC). However, CAT concentration and the GSH/GSSG ratio correlated negatively with BMI and CDC PC. In children with underweight, we found a positive correlation of TG levels and TyG indexes with BMI, whereas both markers positively correlated with BMI and CDC PC in children with overweight. MDA negatively correlated with BMI in children with underweight, while a positive association was observed in children with overweight. Finally, SOD, CAT, and GSH/GSSG negatively correlated with both BMI and CDC PC in children with overweight. Conclusions: Malnutrition, especially obesity, is associated with metabolic and OS disturbances in preschool children. It is urgent to design strategies to prevent malnutrition in this age group since this stage of development is crucial to potentially avoid future co-morbidities.


Subject(s)
Insulin Resistance , Nutritional Status , Oxidative Stress , Child , Child, Preschool , Humans , Insulin Resistance/physiology , Nutritional Status/physiology , Oxidative Stress/physiology , United States
17.
Clin Nutr ; 40(5): 3235-3249, 2021 05.
Article in English | MEDLINE | ID: mdl-33676775

ABSTRACT

BACKGROUND & AIMS: Debate still exists about the impact of dental implant-supported prostheses on nutritional status of partially and complete edentulous patients. This review aims to answer the focused question: "Do complete and partial edentulous patients, using implant-supported prostheses, present better nutritional and masticatory functions when compared to those using conventional rehabilitations?". A possible cause-effect relationship between masticatory improvements and nutritional gain was also evaluated. METHODS: Literature search included 6 databases (PubMed/Medline, Embase, LILACS, Scopus, Web of Science, and The Cochrane Library - CENTRAL), grey literature (Google Scholar, Proquest Dissertations and Thesis and Open Grey databases) and manual search (last update June 2020), without language, publication time and follow-up restrictions. We included only studies evaluating both masticatory and nutritional outcomes. The PICO question comprised complete and partial edentulous patients (Population), submitted to implant-supported prostheses (Intervention), in comparison to conventional dental prosthetic rehabilitation, evaluating masticatory function and nutrition parameters (outcomes). Risk of bias was assessed by using Cochrane Collaboration's tool (randomized clinical trials), Joanna Briggs Institute critical appraisal checklist (paired clinical trials), and Meta-Analysis of Statistics Assessment and Review Instrument" (JBI - MAStARI) critical appraisal tools (cohort studies). All meta-analyses were conducted at 5% level of significance. This report followed the PRISMA guidelines. (Review registration PROSPERO - CRD42019135744). RESULTS: We identified 1199 articles while searching databases. Fourteen articles met eligibility criteria, including 817 prostheses installed in 660 patients (mean age = 66.8 years-old). Patients wearing implant overdentures (IOD) presented better masticatory function in comparison to conventional complete denture (CD) wearers (p < 0.05). However, bioavailability of several nutrients remained within the same range, except for serum folate that was lower in IOD patients after 6 (mean difference 3.51 nmol/L; p = 0.01) and 12 months of rehabilitation (mean difference 3.69 nmol/L; p = 0.003). When comparing the effects of CD and IOD rehabilitations along time (for the same patient), serum albumin and vitamin B12 levels also decreased for both groups after 12 months-follow-up, but still within the reference range. The additional retention of the implants did not interfere in body weight, but reduced the risk of malnutrition (using the Mini Nutritional Assessment). Implant-supported partial prostheses also improved mastication in comparison to the conventional ones, increasing short-term daily intake of carbohydrates, protein, calcium, fiber, and iron, whereas decreasing the consumption of cholesterol. However, no long-term changes on bioavailability of most nutrients were observed, expect for a slight increase in ferritin and cholinesterase, and a small reduction in folate and Vitamin A. CONCLUSION: Current evidence indicates significant masticatory improvements for dental fixed implant-supported prostheses in comparison to conventional removable prostheses. However, bioavailability remained stable for most of the nutrients, especially for complete edentulous patients. These results indicate the importance of a multidisciplinary approach during oral rehabilitation (nutrient specialist), in order to enhance food choices and promote health benefits to the patients.


Subject(s)
Dental Implants , Mouth, Edentulous/physiopathology , Mouth, Edentulous/therapy , Nutrients/metabolism , Nutritional Status/physiology , Biological Availability , Humans , Mastication/physiology
18.
Rev Paul Pediatr ; 39: e2020076, 2021.
Article in English, Portuguese | MEDLINE | ID: mdl-33656144

ABSTRACT

OBJECTIVE: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. METHODS: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (

Subject(s)
Breast Feeding/statistics & numerical data , Nutritional Status/physiology , Obesity/epidemiology , Overweight/epidemiology , Adolescent , Adult , Body Height/physiology , Body Mass Index , Body Weight/physiology , Brazil/epidemiology , Breast Feeding/adverse effects , Case-Control Studies , Child , Child Nutrition Sciences/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Male , Mothers/statistics & numerical data , Obesity/etiology , Overweight/etiology , Prevalence , Surveys and Questionnaires/statistics & numerical data , Time Factors
19.
Acta sci., Health sci ; 43: e54483, Feb.11, 2021.
Article in English | LILACS | ID: biblio-1368749

ABSTRACT

The aim of this study was to detect early hypertension, diabetes and obesity, as well as their risk factors, in 105 young shooters from Tiro de Guerra 11-002 in the city of Ituiutaba-MG. This is a cross-sectional mixed study. A semi-structured questionnaire that contained questions related to the sociodemographic context, health status, lifestyle, eating habits, and psychosocial variables was applied. Blood pressure, anthropometric indexes, and lipid and glycemic profiles were measured. Descriptive and inferential statistics, including Pearson's correlation test and Spearman's coefficient, considering significative value (p < 0.05). The shooters had an average of 18.9 years old, most educated and brown. Anthropometric indices indicated a mainly eutrophic population, and normotensive and desirable lipid and glycemic profiles. However, overweight, high blood pressure, and self-declaration of family history for chronic diseases were identified. In addition, most shooters affirmed to ingest alcoholics beverages, to have insufficient time of physical activity, and to be aware of their levels of stress, pressure and anxiety and a few hours of sleep. Overall, the shooters showed good anthropometric and biochemical indicatorsof blood. Risk behavior, such as drinking alcoholic beverages and smoking, low level of physical activity and self-perception of stress, anxiety and pressure were also noted.


Subject(s)
Humans , Male , Young Adult , Health Status , Risk Factors , Adolescent Behavior/physiology , Noncommunicable Diseases/prevention & control , Anxiety , Quality of Life , Tobacco Use Disorder , Exercise , Nutritional Status/physiology , Chronic Disease , Diabetes Mellitus , Overweight , Feeding Behavior/physiology , Alcoholics , Arterial Pressure/physiology , Psychological Distress , Sociodemographic Factors , Hypertension , Life Style , Lipids/physiology , Obesity
20.
Acta sci., Health sci ; 43: e48747, Feb.11, 2021.
Article in English | LILACS | ID: biblio-1368155

ABSTRACT

Although malnutrition and risk of falls in the elderly have increased in recent years, uncertainties exist as to whether these conditions are associated after controlling for sociodemographic variables, body composition, metabolic condition, and Alzheimer's disease (AD). This study aimed to analyze the association between nutritional status and risk of fall in the elderly population. Participants were matched by gender and age, after they had been grouped on the basis of diagnosis of AD. The risk of falls, nutritional status, and mental status were assessed using the Downton Fall Risk Score (FRS), Mini Nutritional Assessment (MNA), and Mini Mental State Evaluation (MMSE), respectively. Logistic regression modelsadjusted for the main confounders were used in the analyses. Among the 68 elderly individuals studied, participants who were malnourished or at risk of malnutrition were more likely to fall (odds ratio = 8.29; 95% confidence interval = 1.49-46.04) than those with normal nutritional status, regardless of gender, age, education, body composition, and metabolic condition. This association did not remain significant after adjustment for AD, a potential confounder in this association. Malnutrition or its risk was independently associated with high risk of fall; thus, malnutrition should be considered in the prevention of falls among the elderly population.


Subject(s)
Humans , Male , Female , Accidental Falls/prevention & control , Elderly Nutrition , Alzheimer Disease/complications , Alzheimer Disease/diagnosis , Alzheimer Disease/metabolism , Body Composition/physiology , Aged/physiology , Aging/physiology , Nutritional Status/physiology , Dementia/complications , Malnutrition/complications , Metabolism/physiology
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