The Relationship between Anxiety Symptoms and Perceived Quality of Life among Caregivers of Children with Autism Spectrum Disorder in the Amazon.

The relationship between anxiety symptoms and perceived quality of life among caregivers of children with autism was verified. To assess perceived quality of life, the Short Form Healthy Survey Item was used; perception of anxiety symptoms was assessed using the Beck Anxiety Inventory. Eighty caregivers of children with autism participated, with 68.7% of caregivers being mothers. Of the total number of caregivers, 68.8% had a severe level of anxiety. Regarding perceived quality of life, they demonstrated greater impairment in limitation due to physical aspects, limitation due to emotional aspects, vitality, and pain. Caregivers with severe anxiety levels had a worse quality of life in the domains of pain (p = 0.012), social aspects (p < 0.001), limitation due to emotional aspects (p = 0.001), and mental health (p < 0.001). However, in the functional capacity domain, caregivers with a moderate level of anxiety had a better physical capacity score (p = 0.001). There was a negative correlation between the general anxiety score and the general physical (p = 0.029) and general emotional components of perceived quality of life (p < 0.001). It was found that caregivers of children with ASD have a high level of anxiety, which is a predictor of the perception of a worse quality of life.

Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery.

Given the changes in the digestive tract post-bariatric surgery, adapting to a new pattern of eating behavior becomes crucial, with special attention to the specifics of chewing mechanics. This study aimed to investigate the association between self-perception of chewing, chewing behavior, and the presence of gastrointestinal symptoms in preoperative patients undergoing bariatric surgery. Sixty adult candidates for bariatric surgery at a public hospital in Belém (Brazil) were analyzed. Participants predominantly exhibited unilateral chewing patterns (91.6%), a fast chewing rhythm (73.3%), a large food bolus (80%), liquid intake during meals (36.7%), and 41.7% reported that chewing could cause some issue. Significant associations were found between the perception of causing problems and chewing scarcity (p = 0.006), diarrhea (p = 0.004), absence of slow chewing (p = 0.048), and frequent cutting of food with front teeth (p = 0.034). These findings reveal a relationship between the perception of chewing problems and chewing scarcity, presence of diarrhea, and fast chewing.

Eating Behavior and Nutritional Profile of Children with Autism Spectrum Disorder in a Reference Center in the Amazon.

There is no single pattern for the evolution of the nutritional status of children with autism spectrum disorder (ASD). Previous studies have found a tendency towards food selectivity with food monotony and difficulties with food texture in children with ASD, but studies in this area, especially in Brazil, are still scarce. The nutritional profile and changes in eating behavior were analyzed in patients with autism spectrum disorder assisted at a reference center in Belém. Eating behavior was assessed using the Labyrinth Scale, nutritional status assessment through weight and height (to calculate body mass index-BMI), and consumption food through the 24 h reminder. A total of 80 children of both sexes participated in the study, the majority of whom were male (80%), 47.5% eutrophic, while for the food consumption of the children evaluated, there was an average energy consumption of 1911 kcal daily, with 57.3%, 15.4%, and 27.3% of carbohydrates, proteins, and lipids, respectively. In relation to eating behavior, the highest averages were demonstrated in the domains of food selectivity, behavioral aspects, and mealtime skills. Masticatory motor scores showed a positive correlation with weight, BMI, and the amount of energy consumed by the child. The gastrointestinal symptoms score showed a negative correlation with the child's age. Regarding mealtime skills, a negative correlation was observed with the proportion of carbohydrates in the diet and a positive correlation with the proportion of lipids consumed in the children's diet. Therefore, knowing the main changes in eating behavior is important to ensure a complete and safe approach for each patient.

Relationship between Quality of Life and Adult Attachment Factors in Mothers of Children with and without Type 1 Diabetes.

The mothers of children with a specific clinical situation such as type 1 diabetes mellitus may have a higher level of stress, causing a worse perception of their quality of life, greater anxiety, and greater avoidance (adult attachment factors). The objective of this research was to verify if there is a relationship between the adult attachment factors of mothers of children with and without type 1 diabetes mellitus and the perception of the quality of life of these mothers. This survey was carried out from July to September 2022, with mothers of children aged 5 to 10 years, with and without diabetes. The data were collected through an online questionnaire, with socioeconomic data from the attachment scale Experience in Close Relationship-(Reduced), and the questionnaire on the quality of life, the WHOQOL-abbreviated questionnaire. For statistical analysis, the Statistical Package for Social Science 24 was used. A total of 45 mothers of children with DM1 and 55 mothers of healthy children were evaluated. The mothers of children with DM1 had a worse perception of their quality of life when compared to the mothers of healthy children (p < 0.05), with no difference in terms of the attachment style. Therefore, it is understood that actions aimed at improving the quality of life of these mothers are necessary.

Characteristics of carbohydrate counting practice associated with adequacy of glycated hemoglobin in adults with type 1 diabetes mellitus in Brazil.

Background: The Carbohydrate Counting (CC) is directly associated with achieving glycemic control by people with Type 1 Diabetes Mellitus (T1DM). Therefore, this study aims to analyze characteristics of the CC practice associated with the adequacy of glycated hemoglobin (HbA1c) in adults with T1DM in Brazil. Methods: The study was cross-sectional, carried out using an online form with questions about knowledge of CC, clinical, anthropometric, sociodemographic data, follow-up with health professionals and understanding of the concepts of CC. Pearson's chi-square test and binomial logistic regression analysis (p<0.05) were applied. Results: 173 adults participated, of which 57.2% had increased HbA1c (≥7%). Having the diabetes duration <10 years (p=0.006), performing the CC at lunch (p=0.040) and dinner (p=0.018), using specific applications to perform the CC (p=0.001), having learned to perform CC with a nutritionist (p=0.037) and knowing how to correctly define the concepts of food bolus (p=0.001), correction bolus (p<0.001) and insulin/carbohydrate ratio (p<0.001) was associated with having adequate HbA1c (<7%). Participants who were undergoing CC practice were 3.273 times more likely to have adequate HbA1c and participants with diabetes duration <10 years were 2.686 times more likely to have adequate HbA1c. Conclusion: It was concluded that variables transversal to CC favor adequate HbA1c values in adults with T1DM and that practicing CC and having a diabetes duration of less than 10 years are predictive factors of having adequate HbA1c.

Correlations between Nutritional Status and Quality of Life of People with Parkinson's Disease.

Parkinson's disease (PD) is a neurodegenerative condition that can impact the nutritional status, and such impact seems to be related to the quality of life (QoL). OBJECTIVE: To evaluate the correlation between anthropometric variables and the QoL of people with Parkinson's disease (PD). METHODS: This is a cross-sectional, descriptive, and analytical study, carried out through the collection of anthropometric data and application of the Parkinson's Disease Questionnaire PDQ-39. RESULTS: 33 individuals (23 male) diagnosed with PD participated in the research, with a mean age of 58.9 ± 11.6 years. We observed overweight in 45.4% of participants. The perception of QoL showed lower scores for the subjects in the dimensions of body discomfort (75.3 ± 16.6), social support (62.7 ± 15.7), and mobility (61.0 ± 23.6). The correlation between the total QoL score and age (model 1, B = 0.347; CI 0.004-0.902; p = 0.048), which remained statistically significant in the multiple linear regression, regardless of gender (model 2, B = 0.365; CI 0.016-0.937; p = 0.043) and BMI (model 3, B = 0.363; CI 0.006-0.943; p = 0.047), suggests that, in the participants of this study, this relationship does not depend on gender and nutritional status. CONCLUSION: The perception of QoL was worse in the dimensions of body discomfort, social support, and mobility, worsening with advanced age. Correlations between the worst scores in QoL dimensions and nutritional status were observed. A positive correlation was also identified between age and overall PDQ-39 score, regardless of gender and nutritional status.

Adherence to Online Nutritional Monitoring Was Associated with Better Food Habits in People with T1DM during the COVID-19 Pandemic in Brazil.

Until this moment, no research has been found that has assessed adherence to online nutritional monitoring by adults with Diabetes Mellitus Type 1 (T1DM) during the pandemic. This article aims to analyze the association between eating habits and adherence to nutritional online care by adults with T1DM during social distancing because of the COVID-19 pandemic in Brazil. A cross-sectional study was carried out in July 2020. An online form was used to collect sociodemographic data, financial status, eating habits, carrying out online nutritional monitoring, and adherence to social distancing. Pearson's chi-squared test was performed with adjusted residual analysis and binomial logistic regression analysis (p < 0.05). Out of the 472 adults, only 8.9% had consulted with a nutritionist. Doing nutritional monitoring online during social distancing was associated with a reduction in the consumption of ultra-processed foods (p = 0.021), eating more servings of fruit (p = 0.036), and doing carbohydrate counting (CC) more frequently (p = 0.000). Doing nutritional monitoring online increased adherence to carbohydrate counting by 2.57 times and increased the consumption of fruits by 0.423 times. Therefore, nutritional monitoring, even if performed remotely, can influence the acquisition and maintenance of healthier eating habits, in addition to assisting adherence to the practice of CC.

Relationship between Determinants of Food Choices and Socioeconomic and Demographic Factors of Individuals with Hepatitis B and C in the Amazon Region.

Knowing the determinants of food choices allows the nutritionist to develop more assertive guidelines considering biopsychosocial factors to produce effective changes in eating practices. This cross-sectional, descriptive, and analytical study aimed to test the correlation between the determinants of food choices and the socioeconomic and demographic factors of individuals with hepatitis B and C. Patients with hepatitis B and/or C aged between 20 and 74 years were evaluated from August 2020 to August 2021. Their socioeconomic and demographic data and clinical data were collected, and The Eating Motivation Survey (TEMS) was applied. A total of 145 individuals were evaluated, with a mean age of 53.54 ± 12.14 years. There were positive weak correlations between gender (p2 = 0.193; p = 0.020) and age (p2 = 0.177; p = 0.033) with the scale "preference"; negative correlations between age and the scales "price" (p2 = -0.204; p = 0.014) and "emotion control" (p2 = -0.168; p = 0.044); negative correlations between education and the scales "convenience" (p2 = -0.172; p = 0.039) and "social norms" (p2 = -0.206; p = 0.013); and income showed a negative correlation with "price" (p2 = -0.208; p = 0.012) and a positive correlation with "weight control" (p2 = 0.186; p = 0.025). These findings contribute to the development of more realistic and feasible eating strategies that favor food autonomy.

Changes in Physical Activity Associated with Mental Health in People with Type 1 Diabetes during the COVID-19 Pandemic.

The social isolation carried out during the COVID-19 pandemic contributed to physical inactivity and impacted people's mental health, with physical activity being an important pillar in the treatment of Type 1 Diabetes Mellitus (T1DM). Thus, this study aims to verify whether there is an association between the perception of mental health and the practice of physical activity in individuals with T1DM during social isolation in the COVID-19 pandemic in Brazil. This was a cross-sectional study conducted in July 2020, with 472 adults with T1DM, using an online form to collect sociodemographic, mental health and physical activity data during social isolation. The Chi-Square test of independence was performed with adjusted residuals analysis (p < 0.05). A total of 51.3% of the participants remained sedentary or stopped doing physical activity during the period of social isolation. There was an association between being interested in performing daily activities (p = 0.003), not feeling depressed (p = 0.001), feeling slightly irritated (p = 0.006), having slight problems with sleep (p = 0.012) and practicing physical activity. There was also an association between maintaining physical activity and not feeling depressed (p = 0.017) and feeling very slightly irritated (p = 0.040). Adults with T1DM who practiced physical activity during the period of social isolation due to the COVID-19 pandemic showed better aspects of mental health.

Factors associated with grazing behavior in candidates for bariatric surgery at a hospital in the Amazon.

Blackground: To assess grazing behavior and associated factors in candidates for bariatric surgery monitored at a public hospital that is a reference in the care of people with severe obesity. Methods: Cross-sectional analytical study, with candidates for bariatric surgery of both genders, treated in a public hospital in the Amazon. To assess grazing behavior, the Repetitive Eating Questionnaire was used, and to investigate patterns of eating behavior, the Three Factor Eating Questionnaire was used, which assesses: Emotional Eating, Cognitive Restriction and Uncontrolled Eating. Sociodemographic information was obtained through self-report and the description of medication use through the medical record. Body mass index (BMI) was also calculated by measuring weight and height. The SPSS program, v. 21.0 was used. The study was approved by the Research Ethics Committee. Results: A total of 205 participants were evaluated, with a mean age of 37.5 ± 8.6 years, the majority (93.7%) being women and the majority (59.5%) was not also using medication to lose weight. About 66.3% of the participants had compulsive grazing. The factor with the highest score was cognitive restriction (p < 0.001). Individuals who used weight loss drugs had higher scores in the cognitive restriction factor (p = 0.015) and lower scores for uncontrolled eating (p = 0.008), compulsive grazing (p = 0.021) and non-compulsive grazing (p = 0.034). Conclusion: Linear regression showed that emotional eating and uncontrolled eating were predictors of both compulsive grazing and non-compulsive grazing behavior. It was observed that grazing behavior, cognitive restriction, emotional eating and uncontrolled eating are present and correlated in the studied patients. In addition, the use of weight loss drugs seems to help reduce dysfunctional eating behaviors in patients with severe obesity.

O nível de ansiedade, a renda e o acompanhamento psicológico podem influenciar na recorrência de peso corporal em mulheres submetidas a cirurgia bariátrica / Anxiety level, income and psychological monitoring can influence the recurrence of body weight in women submitted to bariatric surgery

Introdução: A melhora nos sintomas de ansiedade após a cirurgia bariátrica pode não permanecer estável em longo prazo, favorecendo a adoção de comportamentos alimentares disfuncionais. Objetivo: Testar a correlação entre o nível de ansiedade e a recorrência de peso em mulheres no pós-operatório tardio de cirurgia bariátrica e metabólica. Métodos: Foram avaliadas 50 mulheres adultas com no mínimo 24 meses após a cirurgia bariátrica e metabólica. Foram coletados dados sociodemográficos (idade, renda e nível de escolaridade) e de acompanhamento psicológico. Foram aferidos dados antropométricos (peso e altura). Para avaliar o nível de sintomas de ansiedade, foi utilizado o Inventário de Beck. Resultados: Foi encontrada média de idade de 40,9±11,4 anos. Todas apresentavam sintomas de ansiedade moderados a graves. Aquelas que estavam sem acompanhamento psicológico apresentavam maior peso corporal (p=0,049) e maior recorrência de peso (p=0,040). Observou-se correlação positiva entre o escore de ansiedade e a recorrência de peso, e correlação negativa entre o escore de ansiedade e a renda familiar. No modelo de regressão linear, a correlação entre o escore de ansiedade com a recorrência de peso (B=0,276; IC 0,003;0,594; p=0,048) e a renda (B=-0,310; IC -0,004;0,000; p=0,027) permaneceu significativa. Contudo, ao adicionar a variável "tempo de cirurgia", observou-se perda de significância entre ansiedade e recorrência de peso (B=0,270; IC -0,040; -0,624; p=0,083), mas manteve-se a correlação com a renda (B=-0,310; IC -0,004;-0,000; p=0,029). Conclusões: Ressalta-se a importância de suporte financeiro no pós-operatório, pelos custos com o tratamento, além de manter o acompanhamento com a equipe multiprofissional em longo prazo.

Introduction: The improvement in anxiety symptoms after bariatric surgery may not remain stable in the long term, favoring the adoption of dysfunctional eating behaviors. Objective: To test the correlation between anxiety level and weight recurrence in women in the late postoperative period of bariatric and metabolic surgery. Methods: Fifty adult women with at least 24 months after bariatric and metabolic surgery were evaluated. Sociodemographic data (age, income and level of education) and psychological monitoring were collected. Anthropometric data (weight and height) were measured. To assess the level of anxiety symptoms, the Beck Anxiety Inventory was used. Results: A mean age of 40.9±11.4 years was found. All had moderate to severe anxiety symptoms. Those who were without psychological support had higher body weight (p=0.049) and greater recurrence of weight (p=0.040). There was a positive correlation between the anxiety score and body weight recurrence, and a negative correlation between the anxiety score and family income. In the linear regression model, the correlation between anxiety score and weight recurrence (B=0.276; CI 0.003; 0.594; p=0.048) and income (B=-0.310; CI -0.004; 0.000; p=0.027) remained significant. However, when adding the variable "surgery time", there was a loss of significance between anxiety and weight recurrence (B=0.270; CI -0.040; -0.624; p=0.083), but the correlation with income was maintained (B=-0.310; CI -0.004; -0.000; p=0.029). Conclusions: We emphasize the importance of financial support in the postoperative period, due to treatment costs, in addition to maintaining monitoring with the multidisciplinary team in the long term.

Association between glycemic control in different emotional conditions and adherence to carbohydrate counting in people with type 1 diabetes during the COVID-19 pandemic in Brazil / Associação entre controle glicêmico em diferentes condições emocionais e adesão à contagem de carboidratos em pessoas com diabetes tipo 1 durante a pandemia de COVID-19 no Brasil

ABSTRACT Objective Evaluate the association between glycemic control in different emotional perceptions and the adherence to carbohydrate counting by adults with type 1 diabetes during the COVID-19 pandemic in Brazil. Methods This cross-sectional, descriptive, and analytical study was approved by the Research Ethics Committee (Opinion nº 4,147,663) and conducted in July 2020 using a Google Forms® form. Socioeconomic and demographic data were collected; glycemic monitoring according to the individuals' emotions at the time of measurement (happy, motivated, or hopeful; stressed or anxious; sad, distressed, or with depressive symptoms); data on adherence to carbohydrate counting and social distancing. Pearson's Chi-Square test was applied with adjusted residual analysis (p<0.05). Results Approximately 64.62% of the 472 participants, had hyperglycemia when stressed/anxious, and 52.97% when they felt sad/distressed/depressive (p<0.000). Associations were observed between having normoglycemia in any emotional situation and performing the carbohydrate counting (p<0.000); perceiving oneself as happy/motivated/hopeful and having hyperglycemia, and not measuring blood glucose was associated with not having the carbohydrate counting (p<0.000); being stressed or anxious was associated with not measuring blood glucose and not having the carbohydrate counting (p<0.000). Conclusion The need for multidisciplinary care to enhance mental health and adherence to treatment for people with type 1 diabetes is highlighted.

RESUMO Objetivo O estudo objetivou avaliar a associação entre o controle glicêmico em diferentes percepções emocionais e a adesão à contagem de carboidratos por adultos com diabetes tipo 1 durante a pandemia de COVID-19 no Brasil. Métodos Trata-se de um estudo transversal, descritivo e analítico aprovado pelo Comitê de Ética em Pesquisa (Parecer 4.147.663), realizado em julho de 2020 por meio de formulário Google Forms®. Foram coletados dados socioeconômicos e demográficos; monitoramento glicêmico de acordo com as emoções do indivíduo no momento da mensuração (feliz, motivado ou esperançoso; estressado ou ansioso; triste, angustiado ou com sintomas depressivos); dados sobre adesão à contagem de carboidratos e distanciamento social. Aplicou-se o teste qui-quadrado de Pearson com análise residual ajustada (p<0,05). Resultados Dos 472 participantes, 64,62% apresentavam hiperglicemia quando estressados/ansiosos, e 52,97%, quando se sentiam tristes/angustiados/depressivos (p<0,000). Foram observadas associações entre ter normoglicemia em qualquer situação emocional e realizar a contagem de carboidratos (p<0,000), perceber-se feliz/motivado/esperançoso e ter hiperglicemia, assim como não medir a glicemia foi associado a não ter a contagem de carboidratos (p<0,000). Estar estressado ou ansioso foi associado a não medir a glicemia e não ter a contagem de carboidratos (p<0,000). Conclusão Destaca-se a necessidade de atendimento multidisciplinar para potencializar a saúde mental e a adesão ao tratamento de pessoas com diabetes tipo 1.

Associations between Orthorexia Nervosa, Body Self-Image, Nutritional Beliefs, and Behavioral Rigidity.

Possible correlations between orthorexic self-reports, unhealthy nutritional beliefs, behavioral rigidity related to following rules, and distortion of body self-image were investigated. In total, 246 university students of both sexes, from different areas of knowledge, answered a sociodemographic form, the Ortho-15, the Body Shape Questionnaire, the Rigidity Scale, and a Nutritional Beliefs Form. Orthorexic self-reports were observed in 73 men and 106 women. A positive correlation was found between females and orthorexic self-reports (p = 0.036), and severe distortion of body self-image (p = 0.002) and between the latter, the behavioral rigidity scale (p2 = 0.189; p = 0.001), and female sex (p2 = 0.245; p < 0.000). In the logistic regression, women were 1.83 times more likely to present orthorexic behaviors than men. The creation of prevention and treatment strategies aimed at women is suggested and it recommended that studies investigating whether the presence of orthorexic self-reports is a risk factor for the development of eating disorders are carried out.

Adherence to Carbohydrate Counting Improved Diet Quality of Adults with Type 1 Diabetes Mellitus during Social Distancing Due to COVID-19.

To control glycemic variability in people with Type 1 diabetes mellitus (T1DM), it is essential to perform carbohydrate counting (CC), a strategy that ensures better quality of life for these patients. Thus, this study aims to analyze potential factors associated with adherence to CC in adults with T1DM during social distancing due to COVID-19 in Brazil. This was a single cross-sectional study carried out in July 2020. An online form was used to collect sociodemographic and economic data on the purchasing of supplies and food, as well as social distancing. The Chi-square test was performed with adjusted residuals analysis and a binomial logistic regression analysis (p < 0.05). Of 472 adults, 37.71% reported performing CC in the same frequency as before social distancing. There was an association between performance of CC and the type of city (p = 0.027), family income (p = 0.000), use of financial emergency aid (p = 0.045), type of insulin administration and glycemic monitoring (p < 0.000), and cooking more (p = 0.012). Participants who maintained or reduced consumption of ultra-processed foods were 0.62 times more likely to adhere to CC (OR 0.626, 95% IC: 0.419−0.935) and participants who cooked more were 1.67 times more likely to adhere to CC (OR 1.67, 95% CI: 1.146−2.447). There are still people with T1DM who did not know about and did not use CC method, which highlights the need for diabetes education.

Relationship between Eating Behavior, Quality of Life and Weight Regain in Women after Bariatric Surgery.

Individuals undergoing bariatric Surgery (BS) may have long-term weight regain. There is a need to investigate factors that may be related to this and if they can interfere with Quality of Life (QOL). This study aims to evaluate the relationship between eating behavior, perception of QOL, and weight regain in women after 24 months of bariatric surgery. This was a transversal study with 50 adult women residents in the city of Belém, Brazil. Sociodemographic, anthropometric, eating behavior (Three-Factor Eating Questionnaire­TFEQ-21) and perception of QOL (Item Short Form Healthy Survey­SF-36) data were collected. In 60% (n = 30) there was weight regain (≥15%), with a mean weight regain of 23.3% (±18.4). Emotional eating was the most frequent pattern (p = 0.047). Regarding QOL, the functional capacity and limitation due to physical aspects domains had a better perception (p < 0.0001). Women without weight regain showed a better perception of the functional capacity aspects (p = 0.007), limitation due to physical aspects (p = 0.044), social aspects (p = 0.048), and general physical components (p = 0.016) and also had an inverse association with the perception of QOL in physical components (p = 0.008). Patterns of eating behavior and weight regain can damage the perception of QOL, especially physical capacity. Long-term follow-up is essential to evaluate the behavior of people who have undergone BS in order to prevent weight regain and QOL damage.

Correlation between Anxiety Symptoms and Perception of Quality of Life in Women with More Than 24 Months after Undergoing Bariatric Surgery.

Purpose: To analyze the correlation between anxiety symptoms and perceived quality of life in women more than 24 months after undergoing bariatric surgery. Methods: Cross-sectional, descriptive and analytical study, carried out with women who underwent bariatric surgery after at least 24 months. To assess the level of anxiety symptoms, the Beck Inventory was used and to assess the perception of quality of life, the Item Short Form Healthy Survey was applied. Results: Of the 50 participants, 36.0% had reports indicative of moderate symptoms and 64.0% had severe symptoms of anxiety. The domains of quality of life that correlated with better perception were pain (p < 0.001), functional capacity (p = 0.013), general health status (p = 0.018), social aspects (p < 0.001), and mental health (p < 0.001). In linear regression, a significant inverse correlation was found between the general emotional component of quality of life and anxiety score (ß = −0.546; CI −1.419; −0.559; p < 0.001) and between the general physical component of quality of life and anxiety score (ß = −0.339; CI −0.899; −0.131; p = 0.010), both independent of weight regain and surgery time. Conclusions: It was observed that moderate to severe anxiety symptoms seem to interfere with the perception of quality of life, regardless of weight regain and surgery time.

Methodology and indicators for NBCAL monitoring in stores and health services: a multicenter study (Multi-NBCAL). / Metodologia e indicadores para monitoramento da NBCAL em estabelecimentos comerciais e serviços de saúde: estudo multicêntrico (Multi-NBCAL).

The Brazilian Code of Marketing of Infant and Toddlers Food, Nipples, Pacifiers and Baby Bottles (NBCAL), in force in Brazil since 1988, is still systematically violated, exposing mothers and family members to illegal marketing of products that compete with breastfeeding. This study aimed to describe a multicenter study methodology and propose standardized indicators for NBCAL monitoring. This is a Multicenter Study for NBCAL Compliance Assessment (Multi-NBCAL) conducted in seven Brazilian cities: Rio de Janeiro, São Paulo, Ouro Preto (Minas Gerais State), Florianópolis (Santa Catarina State), Brasília (Federal District), João Pessoa (Paraíba State), and Belém (Pará State). Assessment tools were adapted from NetCode/WHO and IBFAN Brazil (International Baby Food Action Network) to conduct two evaluations: (1) evaluation of NBCAL compliance in stores, and NBCAL knowledge and practices of store managers; (2) evaluation of the interaction between the baby food industry and health professionals and post-partum mothers in maternity hospitals. Five indicators were developed to assess NBCAL compliance in stores; seven indicators to assess the knowledge and practices of store managers; five indicators to assess the provision of incentives to maternity hospitals, health professionals, and mothers by sectors; and five indicators to assess NBCAL knowledge and practices of health professionals. The NBCAL assessment methodology with the proposal of standardized indicators allows comparability of studies about this theme. Using these indicators in periodic national or regional investigation can help monitor the level of NBCAL implementation in Brazil.

A Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeiras (NBCAL), vigente no Brasil desde 1988, ainda é sistematicamente infringida, expondo mães e familiares ao marketing ilegal de produtos que competem com o aleitamento materno. O objetivo foi descrever metodologia de estudo multicêntrico e propor indicadores padronizados para monitoramento da NBCAL. Estudo Multicêntrico para Monitoramento da NBCAL (Multi-NBCAL) conduzido em sete cidades brasileiras: Rio de Janeiro; São Paulo; Ouro Preto (Minas Gerais); Florianópolis (Santa Catarina); Brasília (Distrito Federal); João Pessoa (Paraíba) e Belém (Pará). Instrumentos de avaliação foram adaptados do NetCode/WHO e da IBFAN Brasil (Rede Internacional em Defesa do Direito de Amamentar) para condução de dois inquéritos: (1) avaliação do cumprimento da NBCAL em estabelecimentos comerciais e das práticas e conhecimento dos seus gerentes sobre a NBCAL; (2) avaliação em maternidades da interação da indústria de alimentos infantis com profissionais de saúde e mães. Foram elaborados cinco indicadores para avaliação do cumprimento da NBCAL em estabelecimentos comerciais; sete indicadores para avaliar conhecimentos e práticas dos seus responsáveis; cinco indicadores para avaliar a oferta de incentivos a maternidades, profissionais de saúde e mães pelas indústrias e cinco indicadores para avaliar conhecimento e práticas de profissionais de saúde quanto à NBCAL. A metodologia de avaliação da NBCAL, com a proposta de indicadores padronizados, permite a comparabilidade de estudos sobre o tema. A utilização desses indicadores em inquéritos periódicos, nacionais ou regionais, pode contribuir para monitorar o grau de implementação da NBCAL no Brasil.

La Norma Brasileña de Comercialización de Alimentos para Lactantes y Niños en la Primera Infancia, Tetillas, Chupetes y Biberones (NBCAL), vigente en Brasil desde 1988, todavía es sistemáticamente infringida, exponiendo a madres y familiares al marketing ilegal de productos que compiten con la lactancia materna. El objetivo fue describir la metodología de estudio multicéntrico y proponer indicadores estandarizados para el monitoreo de la NBCAL. Estudio Multicéntrico para Monitoreo de la NBCAL (Multi-NBCAL) llevado a cabo en siete (7) ciudades brasileñas: Río de Janeiro; São Paulo; Ouro Preto (Minas Gerais); Florianópolis (Santa Catarina); Brasilia (Distrito Federal); João Pessoa (Paraíba) y Belém (Pará). Se adaptaron instrumentos de evaluación del NetCode/OMS y de la IBFAN Brasil (Red Internacional de Acción por la Alimentación Infantil)para la realización de dos encuestas: (1) evaluación del cumplimiento de la NBCAL en establecimientos comerciales y de las prácticas y conocimiento de sus gerentes sobre la NBCAL; (2) evaluación en maternidades de la interacción de la industria de alimentos infantiles con profesionales de salud y madres. Se elaboraron cinco indicadores para la evaluación del cumplimiento de la NBCAL en establecimientos comerciales; siete indicadores para evaluar conocimientos y prácticas de sus responsables; cinco indicadores para evaluar la oferta de incentivos a maternidades, profesionales de salud y madres por las industrias y cinco indicadores para evaluar el conocimiento y prácticas de profesionales de salud, respecto a la NBCAL. La metodología de evaluación de la NBCAL, con la propuesta de indicadores estandarizados, permite la comparabilidad de estudios sobre el tema. La utilización de estos indicadores en encuestas periódicas, nacionales o regionales, puede contribuir a monitorear el grado de implementación de la NBCAL en Brasil.

Health-related quality of life in T1DM patients after high-dose cholecalciferol supplementation: data from a pilot clinical trial.

BACKGROUND: Type 1 Diabetes Mellitus (T1DM) impacts health-related quality of life (HRQoL). Cross-sectional studies suggest that low levels of vitamin D (VD) may impair HRQoL, however, the effect of VD supplementation on quality of life in T1DM patients has not yet been clarified. Our study evaluated the effects of high-dose VD supplementation on HRQoL in T1DM. METHODS: We performed a prospective study with 64 patients receiving cholecalciferol (4000 IU/day for patients with 25-OH-vitamin D [25(OH)D] between 30 and 60 ng/mL, and 10,000 IU/day for those with 25(OH)D below 30 ng/mL) for 12 weeks, as part of a research protocol. HRQoL was assessed with EuroQol instruments (EQ-5D and EQ-VAS). RESULTS: There was an improvement in global EQ-5D index, and analysing specifically the EQ-5D domains, we observed an improvement in mobility (1.3 ± 0.6 versus 1.1 ± 0.3, p < 0.01). Evaluating possible outcome influencing variables, we detected a reduction in albuminuria at the end of the trial, without changes in BMI, lipids, blood pressure, glycemic control and insulin doses. We found correlations between final albuminuria and the dimensions: mobility (r = 0.6; p < 0.01), personal care (r = 0.7; p < 0.01), pain and discomfort (r = 0.6; p < 0.01) and habitual activities (r = 0.6; p < 0.01), suggesting an association between albuminuria reduction and the impact of VD supplementation on HRQoL. CONCLUSION: Our data showed that high doses of cholecalciferol supplementation can improve HRQoL in patients with T1DM, and the reduction of albuminuria seems to be an important factor in this context. TRIAL REGISTRATION: (ISRCTN32601947), 03/06/2017 retrospectively registered.

Insumos para manejo do Diabetes Tipo 1 durante o distanciamento social por COVID-19 no Brasil / Supplies for Type 1 Diabetes management during COVID-19 social distancing in Brazil

O estudo analisou fatores socioeconômicos associados à aquisição de insumos para manejo da glicemia por pessoas com Diabetes Mellitus tipo 1 durante o distanciamento social pela Pandemia de COVID-19 no Brasil. Pesquisa transversal com coleta de dados realizada durante 21 dias do mês de julho de 2020, com um formulário online sobre dados socioeconômicos e aquisição de insumos para monitorização glicêmica. Foi aplicado o teste Qui-Quadrado de Pearson com análise de resíduos ajustados (p<0,05). Participaram 472 adultos de ambos os sexos. Foram encontradas associações entre o tipo de aparelho utilizado para monitorização glicêmica (glicosímetro ou sistema Flash) e renda (p<0,000), escolaridade (p=0,007), macrorregiões (p=0,049) e tipo de cidade (p=0,043); entre aquisição de insulinas e renda (p<0,000), macrorregião (p=0,027) e tipo de bairro (p=0,003); entre aquisição de fitas reagentes e renda (p<0,000); entre aquisição de lancetas e renda (p=0,001), tipo de cidade (p=0,035) e de bairro (p=0,010); entre o uso de Sistema Flash e renda (p<0,000) e tipo de bairro (p=0,006). Os resultados expõem as desigualdades sociais na aquisição de insumos para manejo da glicemia por pessoas com Diabetes Tipo 1 durante a Pandemia no Brasil.

This study analyzed socioeconomic factors related with the acquisition of supplies for blood glucose management by people with Type 1 Diabetes Mellitus during social distancing due to the COVID-19 Pandemic in Brazil. This was a cross-sectional study with data collected during 21 days in July 2020, by an online form on socioeconomic data and acquisition of supplies for glycemic monitoring. This research applied Pearson's Chi-Squared test with adjusted residual analysis (p<0.05). 472 adults of both sexes participated. Relationships were found between the type of device used for blood glucose monitoring (glucometer or Flash system) and income (p<0.000), education (p=0.007), macro-regions (p=0.049), and type of city (p=0.043); between insulin acquisition and income (p<0.000), macro-region (p=0.027) and type of neighborhood (p=0.003); between acquisition of reagent strips and income (p<0.000); between acquisition of lancets and income (p=0.001), type of city (p=0.035) and neighborhood (p=0.010); between the use of Flash System and income (p<0.000) and type of neighborhood (p=0.006). The results expose the social inequalities in the acquisition of supplies for blood glucose management by people with Type 1 Diabetes during the Pandemic in Brazil.

Hepatitis C virus eradication on glycemic control and insulin resistance.

OBJECTIVE: To review data regarding the effects of hepatitis C virus eradication on glycemic control and insulin resistance. METHODS: This is an integrative literature review, carried out in the PubMed, SciELO, and Lilacs databases. Studies published in the past five years that were fully available, written in English or Portuguese, and have addressed the effects of eradication of the hepatitis C virus on glycemic control and insulin resistance were selected. RESULTS: Nine studies were selected. Among the results found, it was observed that there is no consensus on the effects of viral eradication on glycemic control and IR, as some authors show an eventual improvement in insulin resistance and glycemic control, while other studies indicate that there are no significant differences between the parameters evaluated after viral eradication. CONCLUSIONS: Although there is a relationship between hepatitis C virus infection and the development of insulin resistance and type 2 diabetes mellitus and recent advances in research, it was observed that there is no consensus on improving insulin resistance and glycemic control after antiviral treatment, probably due to methodological differences between studies. However, it emphasizes the need to guide people diagnosed with hepatitis C, regarding changes in lifestyle, encouragement of multidisciplinary monitoring, and control of other risk factors.