Association between dietary patterns and carotid intima-media thickness: cross-sectional analysis of ELSA-Brasil study.

PURPOSE: We aimed to perform a cross-sectional evaluation of the association between dietary patterns and carotid intima-media thickness (cIMT), using baseline data from the Brazilian Longitudinal Study of Adult Health. METHODS: The participants with measurement of the cIMT were included (n = 9,624). cIMT was evaluated in a continuous way and categorized as < 75th and ≥ 75th and ≤ 0.9 mm and > 0.9 mm. Dietary patterns (DPs) were identified by principal component factor analysis. Linear and logistic regression models were used to evaluate the association between cIMT and DPs. RESULTS: Three DPs were derived. For each unit increase in the convenience DP score, the odds for cIMT ≥ 75th increased by 13% (OR 1.13; 95% CI 1.05: 1.22) and for cIMT > 0.9 mm increased by 14% (OR 1.14; 95% CI 1.07: 1.22) in the fully adjusted model. In contrast, each unit increase in the prudent DP score decreased by 8% the odds of having cIMT ≥ 75th (OR 0.92; 95% CI 0.86: 0.98) and by 11% of cIMT > 0.9 mm (OR 0.89; 95% CI 0.84: 0.95). Furthermore, each increase in the convenience DP score was associated with increase in the cIMT (ß 0.01; 95% CI 0.01: 0.02), while each increase in the prudent DP score was associated with decrease in the cIMT (ß -0.01; -0.01; -0.01) in linear regression models. CONCLUSIONS: Our results demonstrate that those individuals with adherence to the convenience dietary pattern are more likely to have high cIMT, while those with adherence to a prudent dietary pattern have lower odds for this characteristic.

Dietary patterns and subclinical atherosclerosis incidence and progression: Results from ELSA-Brasil.

BACKGROUND AND AIMS: Cardiovascular disease (CVD) is the main cause of disease burden worldwide. Coronary artery calcification (CAC) score is a subclinical atherosclerosis marker able to predict the risk of CVD in asymptomatic patients, and few studies have investigated the association between dietary patterns (DP) and CAC score prospectively. Thus, the aim of this study was to estimate the association between baseline DP and CAC score incidence and progression on the ELSA-Brasil cohort. METHODS AND RESULTS: This study is a longitudinal prospective analysis of the ELSA-Brasil participants who underwent a CAC exam on baseline and follow-up (n = 2,824). CAC incidence was defined as a baseline CAC score equal to zero (n = 2,131) and subsequent follow-up CAC score greater than zero. CAC progression was defined according to the Hokanson method for the individuals who presented a CAC score greater than zero at the baseline (n = 639). Dietary data were assessed at the baseline using a food frequency questionnaire (FFQ), and factor analysis was applied to identify DP. Poisson regression models with robust variance and linear regression models were applied to estimate the association between baseline DP and CAC incidence and progression. The incidence of CAC was 14.6%, while 60.3% of the individuals presented CAC progression. Three DP were identified: convenience, Brazilian traditional, and prudent. We did not find a significant association between baseline DP and CAC incidence or progression. CONCLUSION: Our findings from this longitudinal prospective analysis showed that baseline DP are not associated with CAC incidence or progression.

How sensitive are the evaluations of a school's effectiveness to the selection of covariates in the applied value-added model?

There is no final consensus regarding which covariates should be used (in addition to prior achievement) when estimating value-added (VA) scores to evaluate a school's effectiveness. Therefore, we examined the sensitivity of evaluations of schools' effectiveness in math and language achievement to covariate selection in the applied VA model. Four covariate sets were systematically combined, including prior achievement from the same or different domain, sociodemographic and sociocultural background characteristics, and domain-specific achievement motivation. School VA scores were estimated using longitudinal data from the Luxembourg School Monitoring Programme with some 3600 students attending 153 primary schools in Grades 1 and 3. VA scores varied considerably, despite high correlations between VA scores based on the different sets of covariates (.66 < r < 1.00). The explained variance and consistency of school VA scores substantially improved when including prior math and prior language achievement in VA models for math and prior language achievement with sociodemographic and sociocultural background characteristics in VA models for language. These findings suggest that prior achievement in the same subject, the most commonly used covariate to date, may be insufficient to control for between-school differences in student intake when estimating school VA scores. We thus recommend using VA models with caution and applying VA scores for informative purposes rather than as a mean to base accountability decisions upon. Supplementary Information: The online version contains supplementary material available at 10.1007/s11092-022-09386-y.

Value-added scores show limited stability over time in primary school.

Value-added (VA) models are used for accountability purposes and quantify the value a teacher or a school adds to their students' achievement. If VA scores lack stability over time and vary across outcome domains (e.g., mathematics and language learning), their use for high-stakes decision making is in question and could have detrimental real-life implications: teachers could lose their jobs, or a school might receive less funding. However, school-level stability over time and variation across domains have rarely been studied together. In the present study, we examined the stability of VA scores over time for mathematics and language learning, drawing on representative, large-scale, and longitudinal data from two cohorts of standardized achievement tests in Luxembourg (N = 7,016 students in 151 schools). We found that only 34-38% of the schools showed stable VA scores over time with moderate rank correlations of VA scores from 2017 to 2019 of r = .34 for mathematics and r = .37 for language learning. Although they showed insufficient stability over time for high-stakes decision making, school VA scores could be employed to identify teaching or school practices that are genuinely effective-especially in heterogeneous student populations.

Estimation of underreporting of energy intake using different methods in a subsample of the ELSA-Brasil study.

Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.

Biomarkers of Fruit Intake Using a Targeted Metabolomics Approach: an Observational Cross-Sectional Analysis of the ELSA-Brasil Study.

BACKGROUND: Advances in technology have led to the identification of a greater number of metabolites related to diet. Although fruit intake biomarkers have been reported in some studies, these findings require further replication, considering the relevance of fruits for diet quality and health. OBJECTIVES: The aim of this study was to explore the associations of a set of potential urinary biomarkers of diet, assessed using a targeted metabolomics approach, with self-reported fruit intake data in participants of a computer-assisted 24-h dietary recall (GloboDiet software) validation study. METHODS: A total of 93 individuals aged 43-72 y, 54% female, participated in this study. The subjects were a subsample of the Longitudinal Study of Adult Health (ELSA-Brasil). A 24-h dietary recall was obtained with the aid of GloboDiet software matching a 24-h urine sample from each participant. Candidate biomarkers were selected in a literature search and identified in urine by LC coupled to high-resolution MS. Spearman correlation analyses were performed between fruit intake and each biomarker. RESULTS: Spearman correlation analysis showed that total fruits intake was significantly correlated with citric acid (ρ = 0.213, P = 0.041), ferulic acid sulfate I (ρ = 0.240, P = 0.020), hesperetin glucuronide/homoeriodictyol glucuronide (ρ = 0.303, P = 0.003), hydroxyhippuric acid (ρ = 0.239, P = 0.021), homovanillic alcohol sulfate (ρ = 0.339, P = 0.001), methylgallic acid sulfate (ρ = 0.268, P = 0.009), naringenin glucuronide (NG; ρ = 0.278, P = 0.007), proline betaine (PB; ρ = 0.305, P = 0.003), syringic acid sulfate (ρ = 0.210, P = 0.044), and sinapic acid sulfate (ρ = 0.412, P < 0.001). Among them, 3 have been described in literature as promising biomarkers for intake of total fruit, oranges, and citrus fruit: NG, hesperetin glucuronide, and PB. CONCLUSIONS: Associations of total fruits intake with urinary measurements indicate the potential usefulness of dietary biomarkers in the Brazilian population as a complement to self-reported dietary assessments.

Estimation of underreporting of energy intake using different methods in a subsample of the ELSA-Brasil study / Estimativa da subnotificação de ingestão energética através de diferentes métodos em uma subamostra do estudo ELSA-Brasil / Estimación de la infradeclaración de la ingesta de energía utilizando diferentes métodos en una submuestra del estudio del ELSA-Brasil

Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.

Os métodos existentes para avaliar consumo alimentar estão sujeitos a erros de medição, especialmente à subnotificação de ingestão calórica, que descreve a ingestão calórica abaixo do mínimo necessário para manter o peso corporal. Este estudo buscou comparar a identificação de subnotificações de ingestão calórica através de diferentes equações preditivas e instrumentos para coletar dados dietéticos. Este estudo foi realizado com 101 participantes selecionados na terceira onda do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) do Hospital Universitário da Universidade de São Paulo. A partir da avaliação dietética, aplicamos um questionário de frequência alimentar (QFA), dois recordatórios de 24 horas (24hR) pelo software GloboDiet e dois 24hR utilizando o software Brasil-Nutri. A subnotificação de ingestão calórica obtida pelo QFA foi de 13%, 16% e 1%, utilizando-se as equações propostas por Goldberg et al. (1991), Black (2000) e McCrory et al. (2002), respectivamente. Com essas mesmas equações, o 24hR achou uma subnotificação de 9,9%, 14,9% e 0,9%, respectivamente, com o software GloboDiet e de 14,7%, 15,8% e 1,1%, respectivamente, com o software Brasil-Nutri. Verificou-se baixa prevalência de ingestão calórica subnotificada entre os três métodos de captação de dados dietéticos por autorrelato (FFQ e 24hR com GloboDiet e Brasil-Nutri). As equações para cada método diferem entre si embora não tenhamos encontrado diferenças estatisticamente significativas entre os três métodos. A concordância de ingestão calórica entre os métodos foi muito semelhante, mas a melhor foi entre a GloboDiet e a Brasil-Nutri.

Los métodos existentes para evaluar el consumo de alimentos están sujetos a errores de medición, especialmente la infradeclaración de la ingesta de energía, caracterizada por la notificación de la ingesta de energía por debajo del mínimo necesario para mantener el peso corporal. El objetivo de este estudio era comparar la identificación de las infradeclaraciones de ingesta energética utilizando diferentes ecuaciones de predicción e instrumentos de recogida de datos dietéticos. El estudio se realizó con 101 participantes seleccionados en la tercera ola del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) en el Hospital Universitario de la Universidad de São Paulo. Para la evaluación de la dieta, se aplicó un cuestionario de frecuencia de alimentos (QFA), dos recordatorios de dieta de 24 horas (24hR) utilizando el software GloboDiet, y dos 24hR utilizando el software Brasil-Nutri. La infradeclaración de la ingesta energética obtenida del QFA fue del 13%, el 16% y el 1,0% utilizando las ecuaciones propuestas por Goldberg et al. (1991), Black (2000) y McCrory et al. (2002), respectivamente. Con estas mismas ecuaciones, el 24hR describió una infradeclaración del 9,9%, el 14,9% y el 0,9% respectivamente con el software GloboDiet y del 14,7%, el 15,8% y el 1,1% respectivamente con el software Brasil-Nutri. Se verificó una baja prevalencia de ingesta de energía subdeclarada entre los tres métodos de recogida de datos dietéticos basados en el autoinforme (QFA, 24hR con GloboDiet y Brasil-Nutri). Aunque no se encontraron diferencias estadísticamente significativas entre los tres métodos, las ecuaciones de cada uno de ellos diferían entre sí. La concordancia de la ingesta de energía entre los métodos fue muy similar, pero la mejor fue entre GloboDiet y Brasil-Nutri.

Estimativa do erro da medida da ingestão energética: validação da versão brasileira do software GloboDiet / Error estimation of energy intake measurement: validation of the Brazilian version of GloboDiet software

Introdução: Todos os métodos existentes para avaliação da dieta estão sujeitos a erros de medida. Um dos principais e mais recorrentes erros de medida da dieta está no relato impreciso da ingestão energética. Embora vários procedimentos sejam utilizados para estimar a subnotificação da ingestão energética (IE), o mais acurado é a água duplamente marcada (ADM) que mensura o gasto energético total em indivíduos fora de confinamento e é usado como padrão-ouro para validar a IE relatada. Objetivo: Validar a versão brasileira do software GloboDiet, R24h computadorizado, quanto à ingestão energética. Metodologia: O estudo foi conduzido no Centro de Pesquisa Clínica e Epidemiológica no Hospital Universitário da Universidade de São Paulo (USP) que sedia o Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) em São Paulo com 101 participantes. Foram coletados dois recordatórios alimentares de 24 horas (R24h) em dias não consecutivos sendo a entrada de dados realizada no GloboDiet, simultaneamente à entrevista. O GloboDiet é uma metodologia padronizada e informatizada que permite conduzir a entrevista do R24h, dirigida por um roteiro padronizado para diminuir erros e assegurar elevada padronização na coleta. Os participantes ingeriram doses de ADM para avaliar o gasto energético (GET); responderam a um questionário de caracterização geral, sendo que este incluía perguntas sobre características individuais como hábitos de estilo de vida e de condição socioeconômica e o nível de atividade física foi classificado de acordo com a versão curta do Questionário Internacional de Atividade Física (IPAQ). Medidas antropométricas de peso, estatura e circunferência da cintura em duplicata foram realizadas com os participantes antes de ingerirem as doses de ADM e no último dia de coleta. O relato implausível foi calculado com a ADM, mas também com as equações preditivas propostas por Goldberg (1991), Black (2000) e McCrory (2002). Resultados: A média da IE foi de 2117Kcal enquanto que a média do GET foi de 2577Kcal. A subestimação da IE avaliada pelo GloboDiet em relação à ADM foi de 16,1% para a população total; observamos maior subestimação da ingestão em homens (16,6%), em idosos (20,2%), em pessoas com sobrepeso (22,5%) e com atividade física moderada a vigorosa (19,7%). A diferença média entre a IE e o GET foi de 460kcal em nível populacional e os limites de concordância foram amplos (limite de concordância superior de 1875kcal e limite de concordância inferior de -2795kcal), com alta dispersão entre os indivíduos. A IE da primeira medida do R24h foi maior quando comparada à IE da segunda medida do R24h na população total sendo essa diferença significativa. Registramos também que a IE da primeira medida do R24h está mais próxima do GET obtido pela ADM. Em relação à classificação dos participantes quanto o relato da IE comparada com a ADM 88,9% dos participantes foram considerados como relatores plausíveis, sendo 9,1% subrelatores e 2% superrelatores. Utilizando as equações preditivas para classificar os participantes quanto ao relato da IE foram 87,9% relatores plausíveis, 10,1% subrelatores e 2% superrelatores com a equação de Goldberg. Utilizando a equação de Black foram 83,8% relatores plausíveis contra 15,2% subrelatores e 1% superrelatores. No caso da equação de McCrory (2002) foram considerados 97% relatores plausíveis, 1% subrrelator es e 2% superrelatores. Conclusão: A versão brasileira do software GloboDiet é um método acurado para avaliar a IE a nível populacional.

Introduction: All existing methods for evaluating diet are subject to measurement errors. One of the main and most recurrent errors in diet measurement is the implausible reporting of energy intake. Although several procedures are used to estimate the underreporting of energy intake (EI), the most accurate is doubly labeled water (DLW), which measures total energy expenditure in individuals outside of confinement and is used as the gold standard to validate the reported EI. Objective: Validate the Brazilian version of the GloboDiet software, computerized R24h, regarding energy intake.Methodology: The study was conducted at the Clinical and Epidemiological Research Center at the University Hospital at University of São Paulo that hosts the Longitudinal Study of Adult Health (ELSA-Brasil) in São Paulo with 101 participants. Two 24-hour food recalls (R24h) were collected on non-consecutive days and the data entry was performed on GloboDiet, simultaneously with the interview. GloboDiet is a standardized and computerized methodology that allows conducting the R24h interview, guided by a standardized script to reduce errors and ensure high standardization in the collection. Participants ingested doses of DLW to assess total energy expenditure (TEE); answered a general characterization questionnaire, which included questions about individual characteristics such as lifestyle habits and socioeconomic status, and the level of physical activity was classified according to the short version of the International Physical Activity Questionnaire (IPAQ). Anthropometric measurements of weight, heightand waist circumference in duplicate were performed with the participants before ingesting the DLW doses and on the last day of collection. The implausible report was calculated with the DLW, but also with the predictive equations proposed by Goldberg (1991), Black (2000) and McCrory (2002). Results: The EI average was 2117Kcal while the TEE average was 2577Kcal. The underestimation of EI evaluated by GloboDiet in relation to DLW was 16.1% for the total population; we observed greater underestimation of intake in men (16.6%), in the elderly (20.2%), in overweight people (22.5%) and with moderate to vigorous physical activity (19.7%). The mean difference between EI and TEE was 460kcal at the population level and the limits of agreement were wide (upper limit of agreement of 1875kcal and lower limit of agreement of -2795kcal), with high dispersion among individuals. The EI of the first measurement of the R24h was higher when compared to the EI of the second measurement of the R24h in the total population, this difference being significant. We also note that the EI of the first measurement of the R24h is closer to the TEE obtained by the ADM. Regarding the classification of participants regarding the report of the EI compared to the DLW, 88.9% of the participants were considered as plausible reporters, with 9.1% being under-reporters and 2% over-reporters. Using the predictive equations to classify the participants in terms of the EI report, 87.9% were plausible reporters, 10.1% under-reporters and 2% over-reporters with the Goldberg equation. Using Black's equation, 83.8% were plausible reporters against 15.2% underreporters and 1% over-reporters. In the case of McCrory's equation (2002), 97% were considered plausible reporters, 1% under-reporters and 2% over-reporters. Conclusion: The Brazilian version of the GloboDiet software is an accurate method to assess EI at the population level.

Census of heat tolerance among Florida's threatened staghorn corals finds resilient individuals throughout existing nursery populations.

The rapid loss of reef-building corals owing to ocean warming is driving the development of interventions such as coral propagation and restoration, selective breeding and assisted gene flow. Many of these interventions target naturally heat-tolerant individuals to boost climate resilience, but the challenges of quickly and reliably quantifying heat tolerance and identifying thermotolerant individuals have hampered implementation. Here, we used coral bleaching automated stress systems to perform rapid, standardized heat tolerance assays on 229 colonies of Acropora cervicornis across six coral nurseries spanning Florida's Coral Reef, USA. Analysis of heat stress dose-response curves for each colony revealed a broad range in thermal tolerance among individuals (approx. 2.5°C range in Fv/Fm ED50), with highly reproducible rankings across independent tests (r = 0.76). Most phenotypic variation occurred within nurseries rather than between them, pointing to a potentially dominant role of fixed genetic effects in setting thermal tolerance and widespread distribution of tolerant individuals throughout the population. The identification of tolerant individuals provides immediately actionable information to optimize nursery and restoration programmes for Florida's threatened staghorn corals. This work further provides a blueprint for future efforts to identify and source thermally tolerant corals for conservation interventions worldwide.

Ingestion of magnesium was not associated with coronary calcium score in a cross-sectional study.

Background and aims: Magnesium plays a key role in glucose metabolism, vascular tone, and inflammation. Therefore, it might be a dietary risk factor for cardiovascular diseases. In vitro and animal studies have suggested a decrease in vascular calcification with an increase in the magnesium intake. The objective of the present study was to investigate the association between magnesium intake and coronary artery calcium (CAC) score among participants of the ELSA-Brasil. Methods: This is an observational, cross-sectional study undertaken with a sub-sample from the ELSA-Brasil baseline data. In this sub-sample, only participants with CAC examination data were included (n = 4,306). Dietary intake was assessed by a validated food frequency questionnaire. The association between magnesium intake and presence of CAC (0 versus > 0) was investigated using multiple logistic regression models. Results: The participants were predominantly female (54.4 %), with self-reported white skin color (59.1 %), no smoking habit (53.7 %) and undergraduate or postgraduate education (44.4 %). The range of magnesium consumption was 37.24 - 1266.31 mg/day. CAC prevalence was 28.4 %. No significant association was found between magnesium intake and CAC after adjustments for diet, lifestyle, and clinical characteristics. In a first univariate model, the fifth quintile of magnesium intake, in comparison to the first quintile (lowest intake), resulted in an OR = 1.25, 95 % CI: 1.01 - 1.54 (P-linear trend = 0.005). However, in the last fully adjusted model, the fifth quintile of magnesium intake resulted in OR = 0.86, 95 % CI: 0.64 - 1.17 (P-linear trend = 0.239). Conclusions: In ELSA-Brasil, the intake of magnesium was not associated with the presence of coronary artery calcification.

Contrasting Classical and Machine Learning Approaches in the Estimation of Value-Added Scores in Large-Scale Educational Data.

There is no consensus on which statistical model estimates school value-added (VA) most accurately. To date, the two most common statistical models used for the calculation of VA scores are two classical methods: linear regression and multilevel models. These models have the advantage of being relatively transparent and thus understandable for most researchers and practitioners. However, these statistical models are bound to certain assumptions (e.g., linearity) that might limit their prediction accuracy. Machine learning methods, which have yielded spectacular results in numerous fields, may be a valuable alternative to these classical models. Although big data is not new in general, it is relatively new in the realm of social sciences and education. New types of data require new data analytical approaches. Such techniques have already evolved in fields with a long tradition in crunching big data (e.g., gene technology). The objective of the present paper is to competently apply these "imported" techniques to education data, more precisely VA scores, and assess when and how they can extend or replace the classical psychometrics toolbox. The different models include linear and non-linear methods and extend classical models with the most commonly used machine learning methods (i.e., random forest, neural networks, support vector machines, and boosting). We used representative data of 3,026 students in 153 schools who took part in the standardized achievement tests of the Luxembourg School Monitoring Program in grades 1 and 3. Multilevel models outperformed classical linear and polynomial regressions, as well as different machine learning models. However, it could be observed that across all schools, school VA scores from different model types correlated highly. Yet, the percentage of disagreements as compared to multilevel models was not trivial and real-life implications for individual schools may still be dramatic depending on the model type used. Implications of these results and possible ethical concerns regarding the use of machine learning methods for decision-making in education are discussed.

Magnesium intake in a Longitudinal Study of Adult Health: associated factors and the main food sources.

This study aimed to identify the sociodemographic and lifestyle factors associated with magnesium intake and describe the main food sources in the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil). This observational, cross-sectional study was conducted using the baseline data from the ELSA-Brazil (2008-2010). Associations between usual magnesium intake and sociodemographic and lifestyle factors were analyzed using multiple linear regression. Food sources were identified by calculating the percentage contribution of each FFQ item to the amount of magnesium provided by all foods. The analysis was performed using Stata® software (version 12), assuming a statistical significance level of 5%. The top food sources to magnesium intake were as follows: beans, oats, nuts, white rice, orange, French bread, cooked fish, boneless meat, whole milk, and whole wheat bread. There were positive associations between magnesium intake and female sex; age ≥60 years; self-reported black, indigenous, or brown skin colors; per capita income ≥3 minimum wages, and moderate or vigorous physical activity levels. Sociodemographic and lifestyle factors were associated with magnesium intake among the evaluated individuals.

Magnesium intake in a Longitudinal Study of Adult Health: associated factors and the main food sources / Ingestão de magnésio no Estudo Longitudinal de Saúde do Adulto: fatores associados e os principais alimentos contribuintes

Abstract This study aimed to identify the sociodemographic and lifestyle factors associated with magnesium intake and describe the main food sources in the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil). This observational, cross-sectional study was conducted using the baseline data from the ELSA-Brazil (2008-2010). Associations between usual magnesium intake and sociodemographic and lifestyle factors were analyzed using multiple linear regression. Food sources were identified by calculating the percentage contribution of each FFQ item to the amount of magnesium provided by all foods. The analysis was performed using Stata® software (version 12), assuming a statistical significance level of 5%. The top food sources to magnesium intake were as follows: beans, oats, nuts, white rice, orange, French bread, cooked fish, boneless meat, whole milk, and whole wheat bread. There were positive associations between magnesium intake and female sex; age ≥60 years; self-reported black, indigenous, or brown skin colors; per capita income ≥3 minimum wages, and moderate or vigorous physical activity levels. Sociodemographic and lifestyle factors were associated with magnesium intake among the evaluated individuals.

Resumo O estudo tem por objetivo identificar fatores sociodemográficos e de estilo de vida associados à ingestão de magnésio e descrever seus principais alimentos contribuintes no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Trata-se de um estudo observacional, transversal, desenvolvido com dados da linha de base do ELSA-Brasil (2008-2010). Associações entre a ingestão habitual de magnésio e fatores sociodemográficos e de estilo de vida foram testadas por regressão linear múltipla. Contribuintes alimentares foram identificados a partir do cálculo do porcentual de magnésio fornecido por cada item do QFA em relação quantidade total proveniente de todos os alimentos. Os principais alimentos contribuintes para a ingestão de magnésio foram: feijão, aveia, nozes, arroz branco, laranja, pão francês, peixe cozido, carne sem osso, leite integral e pão integral. Foram encontradas associações positivas entre consumo de magnésio e sexo feminino, faixa etária ≥ 60 anos, cor de pele autodeclarada como negra, indígena ou parda, renda "per capita" ≥ 3 salários mínimos e níveis de atividade física moderado ou vigoroso. Alimentos da dieta tradicional do brasileiro foram os maiores contribuintes para a ingestão de magnésio, que também foi influenciada por fatores sociodemográficos e de estilo de vida.

Enhancing epilepsy self-management and quality of life for adults with epilepsy with varying social and educational backgrounds using PAUSE to Learn Your Epilepsy.

PURPOSE: People with epilepsy (PWE) come from a wide variety of social backgrounds and educational skillsets, making self-management (SM) education for improving their condition challenging. Here, we evaluated whether a mobile technology-based personalized epilepsy SM education intervention, PAUSE to Learn Your Epilepsy (PAUSE), improves SM measures such as self-efficacy, epilepsy SM behaviors, epilepsy outcome expectations, quality of life (QOL), and personal impact of epilepsy in adults with epilepsy. METHODS: Recruitment for the PAUSE study occurred from October 2015 to March 2019. Ninety-one PWE were educated using an Internet-enabled computer tablet application that downloads custom, patient-specific educational programs from Epilepsy.com. Validated self-reported questionnaires were used for outcome measures. Participants were assessed at baseline (T0), the first follow-up at completion of the PWE-paced 8-12-week SM education intervention (T1), and the second follow-up at least 3 months after the first follow-up (T2). Multiple linear regression was used to assess within-subject significant changes in outcome measures between these time points. RESULTS: The study population was diverse and included individuals with a wide variety of SM educational needs and abilities. The median time for the first follow-up assessment (T1) was approximately 4 months following the baseline (T0) and 8 months following baseline for the second follow-up assessment (T2). Participants showed significant improvement in all SM behaviors, self-efficacy, outcome expectancy, QOL, and personal impact of epilepsy measures from T0 to T1. Participants who scored lower at baseline tended to show greater improvement at T1. Similarly, results showed that participant improvement was sustained in the majority of SM measures from T1 to T2. CONCLUSION: This study demonstrated that a mobile technology-based personalized SM intervention is feasible to implement. The results provide evidence that epilepsy SM behavior and practices, QOL, outcome expectation for epilepsy treatment and management, self-efficacy, and outcome expectation and impact of epilepsy significantly improve following a personalized SM education intervention. This underscores a greater need for a pragmatic trial to test the effectiveness of personalized SM education, such as PAUSE to Learn Your Epilepsy, in broader settings specifically for the unique needs of the hard-to-reach and hard-to-treat population of PWE.

Survivorship and growth in staghorn coral (Acropora cervicornis) outplanting projects in the Florida Keys National Marine Sanctuary.

Significant population declines in Acropora cervicornis and A. palmata began in the 1970s and now exceed over 90%. The losses were caused by a combination of coral disease and bleaching, with possible contributions from other stressors, including pollution and predation. Reproduction in the wild by fragment regeneration and sexual recruitment is inadequate to offset population declines. Starting in 2007, the Coral Restoration Foundation™ evaluated the feasibility of outplanting A. cervicornis colonies to reefs in the Florida Keys to restore populations at sites where the species was previously abundant. Reported here are the results of 20 coral outplanting projects with each project defined as a cohort of colonies outplanted at the same time and location. Photogrammetric analysis and in situ monitoring (2007 to 2015) measured survivorship, growth, and condition of 2419 colonies. Survivorship was initially high but generally decreased after two years. Survivorship among projects based on colony counts ranged from 4% to 89% for seven cohorts monitored at least five years. Weibull survival models were used to estimate survivorship beyond the duration of the projects and ranged from approximately 0% to over 35% after five years and 0% to 10% after seven years. Growth rate averaged 10 cm/year during the first two years then plateaued in subsequent years. After four years, approximately one-third of surviving colonies were ≥ 50 cm in maximum diameter. Projects used three to sixteen different genotypes and significant differences did not occur in survivorship, condition, or growth. Restoration times for three reefs were calculated based on NOAA Recovery Plan (NRP) metrics (colony abundance and size) and the findings from projects reported here. Results support NRP conclusions that reducing stressors is required before significant population growth and recovery will occur. Until then, outplanting protects against local extinction and helps to maintain genetic diversity in the wild.

Characteristics of successful programmes targeting gender inequality and restrictive gender norms for the health and wellbeing of children, adolescents, and young adults: a systematic review.

BACKGROUND: In the context of the Sustainable Development Goals and the shifting global burden of disease, this systematic review analyses the evidence from rigorously evaluated programmes that seek to transform the gendered social norms undermining the health and wellbeing of children, adolescents, and young adults. The aim of this study was threefold: to describe the landscape of gender-transformative programmes that attempt to influence health-related outcomes; to identify mechanisms through which successful programmes work; and to highlight where gaps might exist in implementation and evaluation. METHODS: We systematically reviewed rigorous evaluations published between Jan 1, 2000, and Nov 1, 2018 of programmes that sought to decrease gender inequalities and transform restrictive gender norms to improve the health and wellbeing of 0-24 year olds. We included rigorously evaluated health programmes that met the Interagency Gender Working Group definition of gender-transformative programming, regardless of where in the world they were implemented and what area of health they focused on. FINDINGS: Among 22 993 articles identified by our search, 61 evaluations of 59 programmes met review criteria. Programmes were concentrated in sub-Saharan Africa (25 [42%]), south Asia (13 [22%]), and North America (13 [22%]) and mainly measured health indicators related to reproductive health (29 [48%]), violence (26 [43%]), or HIV (18 [30%]). Programmes most frequently focused on improving the individual power of the beneficiaries, rather than working on broader systems of inequality. 45 (74%) of the evaluations measured significant improvements in health-related and gender-related indicators; however, only ten (16%) showed evidence of, or potential for, broader norm change. These ten programmes worked with sectors beyond health, included multiple stakeholders, implemented diversified strategies, and fostered critical awareness and participation among affected community members. INTERPRETATION: This review can accelerate efforts to improve global health by leading to more strategic investment in programmes that promote gender equality and target restrictive gender norms among young people. Such programmes can lead to a lifetime of improved health and wellbeing by challenging not only attitudes and behaviours related to gender at an early age, but also the gendered systems that surround them. FUNDING: Bill & Melinda Gates Foundation.

Self-management skills and behaviors, self-efficacy, and quality of life in people with epilepsy from underserved populations.

PURPOSE: People with epilepsy (PWE) from underserved populations face significant barriers to epilepsy management and therefore may lack knowledge about epilepsy and self-management (SM) of epilepsy. This paper evaluates SM practices, self-efficacy, outcome expectancy, quality of life, and personal impact of epilepsy in PWE from underserved populations as compared with all PWE. METHODS: Recruitment for the Managing Epilepsy Well (MEW) Network PAUSE to Learn Your Epilepsy study occurred from October 2015 to March 2019. Participants were assessed at baseline; after SM education intervention; and 6-, 9-, and 15-month postbaseline assessment. Baseline data from 112 PWE were analyzed for this report. RESULTS: Study population was diverse: 63% were women, 47.3% were non-Hispanic black, 24.1% were Hispanic, and 57.4% had public healthcare coverage. Participants on average had epilepsy for 14 years, and 49.1% reported at least one seizure within the past month, but only 27% reported having used a seizure diary or calendar for seizure tracking. Self-management practices & behaviors were significantly lower among PWE from underserved populations than all PWE, though self-efficacy among PWE from underserved populations was significantly higher. CONCLUSION: This study identifies the unique epilepsy SM needs of PWE from underserved populations. We discuss the need for a personalized approach for developing SM skills and behaviors among these PWE.

Association between Vitamins and Minerals with Antioxidant Effects and Coronary Artery Calcification in Adults and Older Adults: A Systematic Review.

BACKGROUND: Coronary Artery Calcification (CAC) is considered an important cardiovascular risk factor. There is evidence that CAC is associated with an increased risk of atherosclerosis, coronary events and cardiovascular mortality. Inflammation is one of the factors associated with CAC and despite the interest in antioxidant compounds that can prevent CAC, its association with antioxidants remains unclear. OBJECTIVE: This study aimed to systematically review the association between vitamins and minerals with antioxidant effects and CAC in adults and older adults. METHODS: We conducted a systematic review using PubMed for articles published until October 2018. We included studies conducted in subjects aged 18 years and older with no previous cardiovascular disease. Studies involving animal or in vitro experiments and the ones that did not use reference methods to assess the CAC, dietary intake or serum levels of vitamin or mineral were excluded. RESULTS: The search yielded 390 articles. After removal of duplicates, articles not related to the review, review articles, editorials, hypothesis articles and application of the inclusion and exclusion criteria, 9 articles remained. The results of the studies included in this systematic review suggest that magnesium is inversely associated with CAC and results on the association between CAC and vitamin E have been conflicting. CONCLUSION: Additional prospective studies are needed to elucidate the role of these micronutrients on CAC.