Childhood Obesity Trends among 8-11-Year-Olds: Insights from a School Sample in Vienna, Austria (2017-2023).

In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017-2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3-10.5, min-max 8.0-10.9] from the EDDY study were calculated for trend analyses. Trend analysis was performed using a logistic regression using overweight and obesity as dependent binary variables, and study year and age as independent continuous variables. The percentage change over time was calculated, including the first period of the COVID-19 pandemic. Obesity percentages increased from 23.5 (95% CI 15.1-31.9)% in 2017 to 25.0 (95% CI 12.2-37.8)% in 2023. From 2017 to 2023, while overweight/obesity percentages decreased by 25.9 (-59.5-15.6)%, obesity increased by 6.4 (-51.2-94.9)%. A non-significant trend (p ≥ 0.38) was observed. During the first period of the pandemic, the percentage changes in overweight/obesity and obesity were 68.4 (5.6-187.9)% and 29.2 (-37.3-166.8)%, respectively. The current percentage of obesity in this sample is high and peaked in 2020 during the pandemic. These findings emphasize the need for future investigations considering the representativeness of the school-aged population in Austria to gain a broader picture of overweight and obesity trends.

BMI Z-Score (SDS) versus Calculated Body Fat Percentage: Association with Cardiometabolic Risk Factors in Obese Children and Adolescents.

INTRODUCTION: BMI or BMI-standardized deviation score (SDS) in children and adolescents is still the standard for weight classification. [BMJ. 2019;366:4293] developed a formula to calculate body fat percentage (%BF) based on age, sex, height, weight, and ethnicity. Using data from the German/Austrian APV registry, we investigated whether the calculated %BF is superior to BMI-SDS in predicting arterial hypertension, dyslipidaemia, and impaired glucose metabolism. METHODS: 94,586 children and adolescents were included (12.5 years, 48.3% male). Parental birth country (BC) was used to depict ethnicity (15.8% migration background); 95.67% were assigned to the ethnicity "white." %BF was calculated based on the Hudda formula. The relationship between BMI-SDS or %BF quartiles and outcome variables was investigated by logistic regression models, adjusted for age, sex, and migration background. Vuong test was applied to analyse predictive power. RESULTS: 58.4% had arterial hypertension, 33.5% had dyslipidaemia, and 11.6% had impaired glucose metabolism. Boys were significantly more often affected, although girls had higher calculated %BF (each p < 0.05). After adjustment, both models revealed significant differences between the quartiles (all p < 0.001). The predictive power of BMI-SDS was superior to %BF for all three comorbidities (all p < 0.05). DISCUSSION: The prediction of cardiometabolic comorbidities by calculated %BF was not superior to BMI-SDS. This formula developed in a British population may not be suitable for a central European population, which is applicable to this possibly less heterogeneous collective. Additional parameters, especially puberty status, should be taken into account. However, objective determinations such as bioimpedance analysis may possibly be superior to assess fat mass and cardiometabolic risk than calculated %BF.

Prevalence of vitamin D deficiency in seniors - A retrospective study.

BACKGROUND & AIMS: Vitamin D deficiency is a condition with different causes. It is associated with numerous comorbidities such as autoimmune diseases, bone diseases, cancer, cardiovascular diseases, neurodegenerative diseases, psychiatric diseases, and respiratory infections like COVID-19. Due to its high prevalence all over the world, it is a major task for health care systems worldwide. Through a combination of low sunlight exposure, insufficient nutrition, and age-related changes in skin, liver, and kidney function, especially seniors and nursing home residents, in particular, have a significantly increased risk of developing a vitamin D deficiency. METHODS: This retrospective study analyzed the prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 12 ng/ml) amongst selected Austrian nursing home seniors. It also examined whether demographic data and other laboratory values like calcium correlate with vitamin D levels by using the Pearson correlation coefficient. This correlation was graphically illustrated with a scatter plot and regression line. A total of 478 patients admitted to a nursing home in Vienna between January 3, 2017, and August 31, 2020, were included. RESULTS: A total of 106 seniors (22,2%) suffered from a manifest vitamin D deficiency. The vitamin D level of the men was significantly lower than the level of the women (22.9 ± 12.6 ng/ml vs. 26.2 ± 14.8 ng/ml, p = 0.027). The vitamin D serum levels significantly correlated with the serum calcium levels of the participants (r = 0.19, p < 0.001). 39.5% (189 out of 478) of the nursing home residents had inadequate serum vitamin D levels. CONCLUSIONS: In summary, it can be said that the prevalence of vitamin D deficiency among nursing home residents is considerably high. Inadequate vitamin D levels were often associated with reduced calcium levels. Given the high prevalence, the numerous negative health consequences of inadequate levels, and the large therapeutic index, this risk group should get a general supplementation with a dose of 25 µg (1000 IU) vitamin D3 per day. In addition, a blood examination should be performed as early as three months after the start of the supplementation therapy. If some residents do not achieve an adequate vitamin D concentration, the substitution has to be adapted to the individual needs to treat them as precisely as possible.

Blood pressure and cardiovascular risk in relation to birth weight and urinary sodium: an individual-participant meta-analysis of European family-based population studies.

BACKGROUND: Although the relation of salt intake with blood pressure (BP) is linear, it is U-shaped for mortality and cardiovascular disease (CVD). This individual-participant meta-analysis explored whether the relation of hypertension, death or CVD with 24-h urinary sodium excretion (UVNA) or sodium-to-potassium (UNAK) ratio was modified by birth weight. METHODS: Families were randomly enrolled in the Flemish Study on Genes, Environment and Health Outcomes (1985-2004) and the European Project on Genes in Hypertension (1999-2001). Categories of birth weight, UVNA and UNAK (≤2500, >2500-4000, >4000 g; <2.3, 2.3-4.6 and >4.6 g; and <1, 1-2, >2, respectively) were coded using deviation-from-mean coding and analyzed by Kaplan-Meier survival functions and linear and Cox regression. RESULTS: The study population was subdivided into the Outcome ( n  = 1945), Hypertension ( n  = 1460) and Blood Pressure cohorts ( n  = 1039) to analyze the incidence of mortality and cardiovascular endpoints, hypertension and BP changes as function of UVNA changes. The prevalence of low/medium/high birth weight in the Outcome cohort was 5.8/84.5/9.7%. Over 16.7 years (median), rates were 4.9, 8 and 27.1% for mortality, CVD and hypertension, respectively, but were not associated with birth weight. Multivariable-adjusted hazard ratios were not significant for any endpoint in any of the birth weight, UVNA and UNAK strata. Adult body weight tracked with birth weight ( P  < 0.0001). The partial r in the low-birth-weight group associating changes from baseline to follow-up in UVNA and SBP was 0.68 ( P  = 0.023) but not significant in other birth weight groups. CONCLUSION: This study did not substantiate its prior hypothesis but showed tracking of adult with birth weight and suggest that low birth weight increases salt sensitivity.

Periodontitis prevalence and associated factors: a comparison of two examination protocols / Prevalencia y factores asociados a periodontitis: comparación de dos protocolos de examen WHO

ABSTRACT The fact that there are different epidemiological definitions of periodontitis and different evaluation protocols affects the estimate of periodontitis prevalence and of the influence of associated factors. The gold standard for periodontal examination is full-mouth record assessing CAL and PD. However, there are not always sufficient human and financial resources available to apply such assessment for epidemiological surveillance systems. Aim: This study was conducted to compare different protocols and definitions of periodontitis for assessing prevalence and the impact of related factors in adult patients who requested care at the School of Dentistry, UdelaR. Materials and Method: This was a cross-sectional study of 410 subjects with a high burden of disease in terms of NCDs and periodontitis. Clinical examination evaluated PD in all teeth and CAL in the CPI sextants (WHO 2013). Four periodontitis criteria were defined based on two examination protocols (WHO 2013 and WHO 1997) and two definitions of epidemiological case. Comparisons were made taking the 2013 WHO protocol as a reference. Results: Comparison of the two examination protocols showed that prevalence was underestimated when the WHO 1997 protocol was used to define moderate-severe and severe periodontitis, by 20% and 60%, respectively. Conclusions: When the severity of periodontitis was not considered, the WHO 2013 protocol did not provide more information on what factors increase the chance of periodontitis. However, when severity was considered, the associated factors were different. Consequently, in a small population, it would be worth using the WHO 2013 protocol, which is the closest to the full-mouth gold standard criterion.

RESUMEN La variabilidad en la definición epidemiológica de la periodontitis y los protocolos de evaluación afectan la medición de la prevalencia y su asociación con ciertos factores. Si bien, el patrón oro para el examen periodontal es el registro de boca completa, que evalúa la pérdida de inserción (CAL, por sus siglas en inglés) y profundidad de sondaje (PS, por sus siglas en inglés), los recursos no siempre están disponibles para los sistemas de vigilancia epidemiológica. Objetivo: En este estudio se compararon diferentes protocolos y definiciones de periodontitis evaluando la prevalencia y la asociación de factores relacionados en pacientes adultos que solicitaron atención en la Facultad de Odontología de la UdelaR. Materiales y Método: Los datos provienen de un estudio transversal de 410 sujetos con una elevada carga de enfermedad en términos de ENT y periodontitis. Se utilizó un examen clínico registrando PD en todos los dientes y CAL en los sextantes CPI (WHO 2013). Se definieron cuatro criterios de periodontitis basados en dos protocolos de examen y dos definiciones epidemiológicas de caso. Las comparaciones se realizaron tomando como referencia el protocolo de la OMS de 2013. Resultados: Al comparar los dos protocolos de examen, se verificó la subestimación de la prevalencia cuando se utilizó el protocolo de la OMS de 1997 para la definición de caso moderado-grave y para la periodontitis grave, siendo en el primer caso del 20% y en el segundo caso tres veces mayor que. Conclusiones: Si no se considera la gravedad de la periodontitis, el uso del protocolo de la OMS 2013 no proporciona más información sobre qué factores aumentan la probabilidad de periodontitis. Sin embargo, al analizar la gravedad, los factores asociados fueron diferentes. En consecuencia, en una población pequeña estaría justificado el esfuerzo de utilizar el protocolo de la OMS de 2013, ya que el criterio de referencia es la boca completa.

Salt-related practices and its association with 24-hour urinary sodium excretion in an Uruguayan population cohort.

Objectives: To evaluate the association between knowledge, attitudes, and behavior (KAB) towards sodium use and sodium intake measured by 24-hour urinary collection in an adult cohort from Uruguay (Genotype Phenotype and Environment of Hypertension Study, GEFA-HT-UY). Methods: In a cross-sectional study (n = 159), a single 24-hour urinary sample, participants' physical, biochemical and blood pressure measurements and questionnaire data were collected. The association between KAB and 24-hour urinary sodium excretion was assessed using general linear models. Results: Mean age of participants was 49.8±15.5 years, 67.9% were women, and mean 24-hour urinary sodium excretion was 3.6±1.7 g/day. Although 90.6% of participants exceeded the maximum recommended intake as indicated by urinary sodium excretion, more than half misperceived their actual intake, reporting consuming "the right amount." Almost three-quarters of the participants reported being concerned about the amount of sodium in their diet, but only 52.8% reported taking action to control it. Lack of procedural knowledge was observed. There was no association between KAB and sodium use and intake assessed by 24-hour urinary sodium excretion. Conclusions: The lack of association between KAB towards the use of sodium and intake measured by 24-hour urinary excretion reflects the need to support people with opportunities and motivations to reduce sodium consumption. Structural actions to promote an adequate food environment, such as the effective implementation of the front-of-package nutrition labeling in Uruguay, are positive steps.

Salt-related practices and its association with 24-hour urinary sodium excretion in an Uruguayan population cohort

[ABSTRACT]. Objectives. To evaluate the association between knowledge, attitudes, and behavior (KAB) towards sodium use and sodium intake measured by 24-hour urinary collection in an adult cohort from Uruguay (Genotype Phenotype and Environment of Hypertension Study, GEFA-HT-UY). Methods. In a cross-sectional study (n = 159), a single 24-hour urinary sample, participants' physical, bio- chemical and blood pressure measurements and questionnaire data were collected. The association between KAB and 24-hour urinary sodium excretion was assessed using general linear models. Results. Mean age of participants was 49.8±15.5 years, 67.9% were women, and mean 24-hour urinary sodium excretion was 3.6±1.7 g/day. Although 90.6% of participants exceeded the maximum recommended intake as indicated by urinary sodium excretion, more than half misperceived their actual intake, reporting consuming “the right amount.” Almost three-quarters of the participants reported being concerned about the amount of sodium in their diet, but only 52.8% reported taking action to control it. Lack of procedural knowl- edge was observed. There was no association between KAB and sodium use and intake assessed by 24-hour urinary sodium excretion. Conclusions. The lack of association between KAB towards the use of sodium and intake measured by 24-hour urinary excretion reflects the need to support people with opportunities and motivations to reduce sodium consumption. Structural actions to promote an adequate food environment, such as the effective implementation of the front-of-package nutrition labeling in Uruguay, are positive steps.

[RESUMEN]. Objetivos. Evaluar la relación entre conocimientos, actitudes y comportamientos en lo relativo a la ingesta de sodio medida por la recolección de orina de 24 horas en una cohorte de adultos en Uruguay (GEnotipo, Fenotipo y Ambiente de la HiperTensión Arterial en UruguaY, GEFA-HT-UY). Métodos. En un estudio transversal (n = 159), se obtuvo una muestra urinaria de 24 horas y los datos de un cuestionario y de las mediciones físicas, bioquímicas y de presión arterial de los participantes. Se evaluó la asociación entre conocimientos, actitudes y comportamientos y la excreción urinaria de sodio en 24 horas con modelos lineales generales. Resultados. La edad media de los participantes fue 49,8±15,5 años, 67,9% eran mujeres y la excreción urinaria media de sodio en 24 horas fue de 3,6±1,7 g/día. Aunque 90,6% de los participantes excedieron la ingesta máxima recomendada de acuerdo con la excreción urinaria de sodio, más de la mitad percibió su ingesta real incorrectamente al señalar que consumía “la cantidad correcta”. Casi tres cuartas partes de los participantes manifestaron estar preocupados por la cantidad de sodio en su dieta, si bien solo 52,8% declaró haber tomado medidas para controlarla. Se observó una falta de conocimiento sobre los procedimientos. No se encontró una asociación entre conocimientos, actitudes y comportamientos y la ingesta de sodio evaluada mediante la excreción urinaria de sodio en 24 horas. Conclusiones. La falta de relación entre conocimientos, actitudes y comportamientos respecto del consumo de sodio y su ingesta medida por excreción urinaria en 24 horas refleja la necesidad de apoyar a las perso- nas con oportunidades y motivaciones para reducir el consumo de sodio. Adoptar medidas estructurales que promuevan unas condiciones alimentarias adecuadas, como la aplicación efectiva del etiquetado nutricional frontal en Uruguay, constituye un paso en la dirección correcta.

[RESUMO]. Objetivos. Avaliar a associação entre conhecimento, atitudes e comportamento (KAB, sigla do inglês Knowl- edge, Attitudes, Behavior) e o uso e ingestão de sódio, medida pela coleta de urina de 24 horas em uma coorte de adultos do Uruguai (Estudo do Genótipo, Fenótipo e Ambiente da Hipertensão, GEFA-HT-UY). Métodos. Em um estudo transversal (n = 159), foi coletada uma única amostra de urina de 24 horas dos par- ticipantes, medidas físicas, bioquímicas e de pressão arterial, e dados de questionários. A associação entre KAB e excreção urinária de sódio nas 24 horas foi avaliada por meio de modelos lineares gerais. Resultados. A idade média dos participantes foi de 49,8±15,5 anos; 67,9% eram mulheres e a excreção média de sódio na urina de 24 horas foi de 3,6±1,7 g/dia. Embora 90,6% dos participantes excedessem a ingestão máxima recomendada, conforme indicado pela excreção urinária de sódio, mais da metade dos participantes não tinha percepção da real ingestão de sódio, relatando consumir "a quantidade correta". Quase três quartos dos participantes relataram estar preocupados com a quantidade de sódio na dieta, mas apenas 52,8% relataram ter implementado medidas para controlá-la. Observou-se falta de conhecimento de procedimentos. Não houve associação entre KAB e o uso e a ingestão de sódio avaliada pela excreção de sódio na urina de 24 horas. Conclusões. A falta de associação entre KAB e o uso e a ingestão do sódio avaliada pela excreção urinária de 24 horas reflete a necessidade de oferecer apoio aos indivíduos por meio de oportunidades e motivações para reduzir o consumo de sódio. Ações estruturais para promover um ambiente alimentar adequado, como a implementação efetiva de advertências na rotulagem frontal dos alimentos no Uruguai, são passos positivos.

Periodontitis prevalence and associated factors: a comparison of two examination protocols.

The fact that there are different epidemiological definitions of periodontitis and different evaluation protocols affects the estimate of periodontitis prevalence and of the influence of associated factors. The gold standard for periodontal examination is full-mouth record assessing CAL and PD. However, there are not always sufficient human and financial resources available to apply such assessment for epidemiological surveillance systems. AIM: This study was conducted to compare different protocols and definitions of periodontitis for assessing prevalence and the impact of related factors in adult patients who requested care at the School of Dentistry, UdelaR. MATERIALS AND METHOD: This was a cross-sectional study of 410 subjects with a high burden of disease in terms of NCDs and periodontitis. Clinical examination evaluated PD in all teeth and CAL in the CPI sextants (WHO 2013). Four periodontitis criteria were defined based on two examination protocols (WHO 2013 and WHO 1997) and two definitions of epidemiological case. Comparisons were made taking the 2013 WHO protocol as a reference. RESULTS: Comparison of the two examination protocols showed that prevalence was underestimated when the WHO 1997 protocol was used to define moderate-severe and severe periodontitis, by 20% and 60%, respectively. CONCLUSIONS: When the severity of periodontitis was not considered, the WHO 2013 protocol did not provide more information on what factors increase the chance of periodontitis. However, when severity was considered, the associated factors were different. Consequently, in a small population, it would be worth using the WHO 2013 protocol, which is the closest to the full-mouth gold standard criterion.

La variabilidad en la definición epidemiológica de la periodontitis y los protocolos de evaluación afectan la medición de la prevalencia y su asociación con ciertos factores. Si bien, el patrón oro para el examen periodontal es el registro de boca completa, que evalúa la pérdida de inserción (CAL, por sus siglas en inglés) y profundidad de sondaje (PS, por sus siglas en inglés), los recursos no siempre están disponibles para los sistemas de vigilancia epidemiológica. OBJETIVO: En este estudio se compararon diferentes protocolos y definiciones de periodontitis evaluando la prevalencia y la asociación de factores relacionados en pacientes adultos que solicitaron atención en la Facultad de Odontología de la UdelaR. Materiales y Método: Los datos provienen de un estudio transversal de 410 sujetos con una elevada carga de enfermedad en términos de ENT y periodontitis. Se utilizó un examen clínico registrando PD en todos los dientes y CAL en los sextantes CPI (WHO 2013). Se definieron cuatro criterios de periodontitis basados en dos protocolos de examen y dos definiciones epidemiológicas de caso. Las comparaciones se realizaron tomando como referencia el protocolo de la OMS de 2013. RESULTADOS: Al comparar los dos protocolos de examen, se verificó la subestimación de la prevalencia cuando se utilizó el protocolo de la OMS de 1997 para la definición de caso moderado-grave y para la periodontitis grave, siendo en el primer caso del 20% y en el segundo caso tres veces mayor que. CONCLUSIONES: Si no se considera la gravedad de la periodontitis, el uso del protocolo de la OMS 2013 no proporciona más información sobre qué factores aumentan la probabilidad de periodontitis. Sin embargo, al analizar la gravedad, los factores asociados fueron diferentes. En consecuencia, en una población pequeña estaría justificado el esfuerzo de utilizar el protocolo de la OMS de 2013, ya que el criterio de referencia es la boca completa.

Salt-related practices and its association with 24-hour urinary sodium excretion in an Uruguayan population cohort / Prácticas relacionadas con la sal y su asociación con la excreción urinaria de sodio en 24 horas en una cohorte de población en Uruguay / Práticas relacionadas ao uso do sal e sua associação com a excreção de sódio na urina de 24 horas em uma coorte populacional uruguaia

Abstract Objectives. To evaluate the association between knowledge, attitudes, and behavior (KAB) towards sodium use and sodium intake measured by 24-hour urinary collection in an adult cohort from Uruguay (Genotype Phenotype and Environment of Hypertension Study, GEFA-HT-UY). Methods. In a cross-sectional study (n = 159), a single 24-hour urinary sample, participants' physical, biochemical and blood pressure measurements and questionnaire data were collected. The association between KAB and 24-hour urinary sodium excretion was assessed using general linear models. Results. Mean age of participants was 49.8±15.5 years, 67.9% were women, and mean 24-hour urinary sodium excretion was 3.6±1.7 g/day. Although 90.6% of participants exceeded the maximum recommended intake as indicated by urinary sodium excretion, more than half misperceived their actual intake, reporting consuming "the right amount." Almost three-quarters of the participants reported being concerned about the amount of sodium in their diet, but only 52.8% reported taking action to control it. Lack of procedural knowledge was observed. There was no association between KAB and sodium use and intake assessed by 24-hour urinary sodium excretion. Conclusions. The lack of association between KAB towards the use of sodium and intake measured by 24-hour urinary excretion reflects the need to support people with opportunities and motivations to reduce sodium consumption. Structural actions to promote an adequate food environment, such as the effective implementation of the front-of-package nutrition labeling in Uruguay, are positive steps.

RESUMEN Objetivos. Evaluar la relación entre conocimientos, actitudes y comportamientos en lo relativo a la ingesta de sodio medida por la recolección de orina de 24 horas en una cohorte de adultos en Uruguay (GEnotipo, Fenotipo y Ambiente de la HiperTensión Arterial en UruguaY, GEFA-HT-UY). Métodos. En un estudio transversal (n = 159), se obtuvo una muestra urinaria de 24 horas y los datos de un cuestionario y de las mediciones físicas, bioquímicas y de presión arterial de los participantes. Se evaluó la asociación entre conocimientos, actitudes y comportamientos y la excreción urinaria de sodio en 24 horas con modelos lineales generales. Resultados. La edad media de los participantes fue 49,8±15,5 años, 67,9% eran mujeres y la excreción urinaria media de sodio en 24 horas fue de 3,6±1,7 g/día. Aunque 90,6% de los participantes excedieron la ingesta máxima recomendada de acuerdo con la excreción urinaria de sodio, más de la mitad percibió su ingesta real incorrectamente al señalar que consumía "la cantidad correcta". Casi tres cuartas partes de los participantes manifestaron estar preocupados por la cantidad de sodio en su dieta, si bien solo 52,8% declaró haber tomado medidas para controlarla. Se observó una falta de conocimiento sobre los procedimientos. No se encontró una asociación entre conocimientos, actitudes y comportamientos y la ingesta de sodio evaluada mediante la excreción urinaria de sodio en 24 horas. Conclusiones. La falta de relación entre conocimientos, actitudes y comportamientos respecto del consumo de sodio y su ingesta medida por excreción urinaria en 24 horas refleja la necesidad de apoyar a las personas con oportunidades y motivaciones para reducir el consumo de sodio. Adoptar medidas estructurales que promuevan unas condiciones alimentarias adecuadas, como la aplicación efectiva del etiquetado nutricional frontal en Uruguay, constituye un paso en la dirección correcta.

RESUMO Objetivos. Avaliar a associação entre conhecimento, atitudes e comportamento (KAB, sigla do inglês Knowledge, Attitudes, Behavior) e o uso e ingestão de sódio, medida pela coleta de urina de 24 horas em uma coorte de adultos do Uruguai (Estudo do Genótipo, Fenótipo e Ambiente da Hipertensão, GEFA-HT-UY). Métodos. Em um estudo transversal (n = 159), foi coletada uma única amostra de urina de 24 horas dos participantes, medidas físicas, bioquímicas e de pressão arterial, e dados de questionários. A associação entre KAB e excreção urinária de sódio nas 24 horas foi avaliada por meio de modelos lineares gerais. Resultados. A idade média dos participantes foi de 49,8±15,5 anos; 67,9% eram mulheres e a excreção média de sódio na urina de 24 horas foi de 3,6±1,7 g/dia. Embora 90,6% dos participantes excedessem a ingestão máxima recomendada, conforme indicado pela excreção urinária de sódio, mais da metade dos participantes não tinha percepção da real ingestão de sódio, relatando consumir "a quantidade correta". Quase três quartos dos participantes relataram estar preocupados com a quantidade de sódio na dieta, mas apenas 52,8% relataram ter implementado medidas para controlá-la. Observou-se falta de conhecimento de procedimentos. Não houve associação entre KAB e o uso e a ingestão de sódio avaliada pela excreção de sódio na urina de 24 horas. Conclusões. A falta de associação entre KAB e o uso e a ingestão do sódio avaliada pela excreção urinária de 24 horas reflete a necessidade de oferecer apoio aos indivíduos por meio de oportunidades e motivações para reduzir o consumo de sódio. Ações estruturais para promover um ambiente alimentar adequado, como a implementação efetiva de advertências na rotulagem frontal dos alimentos no Uruguai, são passos positivos.

Association of Dietary Patterns with Cardiovascular and Kidney Phenotypes in an Uruguayan Population Cohort.

The impact of habitual diet on chronic diseases has not been extensively characterized in South America. We aimed to identify major dietary patterns (DP) in an adult cohort in Uruguay (Genotype Phenotype and Environment of Hypertension Study-GEFA-HT-UY) and to assess associations with metabolic, anthropometric characteristics, and cardiovascular and kidney phenotypes. In a cross-sectional study (n = 294), DP were derived by the principal component analysis. Blood and urine parameters, anthropometrics, blood pressure, pulse wave velocity, and glomerular filtration rate were measured. Multivariable adjusted linear models and adjusted binary logistic regression were used. Three DP were identified (Meat, Prudent, Cereal and Mate) explaining 22.6% of total variance in food intake. The traditional Meat DP, characterized by red and barbecued meat, processed meat, bread, and soft drinks, was associated with worse blood lipid profile. Prudent DP, characterized by vegetables, fish, and nuts, and lower loads for bread and crackers, was associated with reduced risk of vitamin D deficiency. Cereal and Mate DP, was characterized by higher loads of cereals, bread, and crackers, and mate infusion, with higher odds of excessive body weight. No direct associations of dietary patterns with hypertension, arterial stiffness, chronic kidney disease, and nephrolithiasis were found in the studied population, nor by age categories or sex.

Involvement of the food industry in nutrition conferences in Latin America and the Caribbean.

OBJECTIVE: Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean. DESIGN: Between February and April 2020, we conducted desk-based searches for nutrition and dietetics events held in the region between January 2018 and December 2019. Online freely accessible, publicly available information was collected on the involvement of the food industry through: sponsorship of events; sponsorship of sessions; speakers from the food industry; scholarships, fellowship, grants, awards and other prizes and; exhibition space/booths. SETTING: Nutrition and dietetics events in Latin America and the Caribbean. RESULTS: Thirty-one events held in twenty countries of the region had information publicly available online at the period of data collection. There was a lack of transparency on the involvement of industry actors in these events. When information was publicly available, we found that a total of ninety-two food industry actors sponsored 88 % of these events. CONCLUSIONS: There is a mostly unreported, but likely extensive, involvement of food industry actors in nutrition and dietetics events in Latin America and the Caribbean.

Involvement of the food industry in nutrition conferences in Latin America and the Caribbean

Objective: Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean. Design: Between February and April 2020, we conducted desk-based searches for nutrition and dietetics events held in the region between January 2018 and December 2019. Online freely accessible, publicly available information was collected on the involvement of the food industry through: sponsorship of events; sponsorship of sessions; speakers from the food industry; scholarships, fellowship, grants, awards and other prizes and; exhibition space/booths. Setting: Nutrition and dietetics events in Latin America and the Caribbean. Results: Thirty-one events held in twenty countries of the region had information publicly available online at the period of data collection. There was a lack of transparency on the involvement of industry actors in these events. When information was publicly available, we found that a total of ninety-two food industry actors sponsored 88 % of these events. Conclusions: There is a mostly unreported, but likely extensive, involvement of food industry actors in nutrition and dietetics events in Latin America and the Caribbean.(AU)

Salud Bucal y Enfermedades no transmisibles en pacientes de un centro de enseñanza universitaria, Montevideo-Uruguay. Parte 1 / Saúde bucal e doenças não transmissíveis em pacientes de uma instituição de ensino superior, Montevidéu, Uruguai 2016. Parte 1 / Oral Health and Non communicable Diseases in patients of a higher education institution, Montevideo, Uruguay 2016. Part 1

Resumen Las enfermedades no transmisibles (ENT) comparten factores de riesgo conductuales y metabólicos con las enfermedades bucales y ambas representan un problema de salud pública. Objetivo: Determinar la prevalencia ENT y sus factores de riesgo conductuales y metabólicos en personas que concurrieron a la Facultad de Odontología de la Universidad de la República. Metodos: Estudio transversal en el que se aplicó un cuestionario sobre características sociodemográficas y hábitos vinculados a factores de riesgo comportamentales. Se realizaron mediciones antropométricas, de presión arterial y glicemia capilar. Resultados: Fueron encuestados 602 individuos Conclusiones: En función de las prevalencias elevadas de varios factores de riesgo, se recomienda la instalación de un programa preventivo-educativo en las salas de espera de la Facultad.

Resumo As doenças não transmissíveis (DNT) compartem fatores de risco comportamentais e metabólicos com as doenças bucais, as duas representam um problema de saúde pública. Objetivo: Determinar a prevalência DNT e os fatores de risco comportamentais e metabólicos em pessoas que concorreram à Faculdade de Odontologia da Universidade da República. Métodos: Foi realizado um estudo transversal, onde foi aplicado um questionário relativo às características sociodemográficas e hábitos ligados com fatores de risco comportamentais. Se realizaram medições antropométricas, de pressão arterial e glicemia capilar. Resultados: Foram pesquisados 602 indivíduos. Constatou-se uma alta prevalência de inatividade física, ingestão problemática de álcool, consumo excessivo de sal, hipertensão e diabetes. Estes valores foram acima dos encontrados a nível nacional. Conclusão: Dada a alta prevalência encontrada de vários fatores de risco, recomenda-se a instalação de um programa educacional-preventivo nas salas de espera da Faculdade.

Summary Non-communicable diseases (NCD) share behavioral and metabolic risk factors with oral diseases and both represent a public health problem. Objective: to find out the prevalence of NCD and its behavioral and metabolic risk factors in people who attend at College of Odontology of the University of the Republic. Methods: A Cross-sectional study was conducted and a questionnaire related to socio-demograhic characteristics and habits linked to behavioral risk factors was applied. Anthropometric measurements of arterial pressure and capillary glucose were taken, Results: The final sample were 602 individuals. A high prevalence of physical inactivity, problematic alcohol intake, excessive salt consumption, hypertension and diabetes was found. These figures were larger than those found at the national level. Conclusions: Due to the high prevalence of various risk factors, the installation of a preventive-educational program in the waiting rooms of the Faculty is recommended.

Recomendaciones nutricionales para el personal de salud y el personal esencial expuesto a la COVID-19 en Latinoamérica / Nutritional Recommendations for Healthcare and Essential Personnel Exposed to COVID-19 in Latin America

Estas recomendaciones se basan en la evidencia científica actual derivada de meta-análisis y revisiones sistemáticas sobre nutrición y prevención de infecciones respiratorias causadas por los virus SARS-CoV, MERS-CoV o influenza, similares en su estructura al SARS-CoV-2. Están dirigidas al personal en la primera línea de atención de salud y al personal que presta servicios esenciales a la comunidad, con alto riesgo de infección por la COVID-19. Estas personas usan equipo de protección personal, cumplen largos turnos laborales, en ocasiones bajo condiciones extremas, lo que puede llevar a descanso insuficiente, alto nivel de estrés, depresión, pobre calidad en la alimentación y deshidratación. Todos estos factores influyen negativamente en el sistema inmune y podrían conllevar un mayor riesgo de infección. Una ingesta adecuada de micronutrientes y otros compuestos bioactivos es esencial para el desempeño óptimo del sistema inmune. Existe evidencia moderada que avala la suplementación, en forma individual, con vitamina C (2 000 mg), vitamina D (1 000-2 000 UI) y zinc (≤ 40 mg) en la prevención de infecciones respiratorias en adultos. No se encontró evidencia suficiente para avalar la suplementación con vitamina A, niacina, ácido fólico, B12, omega 3, probióticos y polifenoles, aunque si se recomienda el consumo de alimentos ricos en estos nutrientes para apoyar al sistema inmune. Se recomienda al personal seguir la recomendación de consumir 5 porciones/día (400 g) de frutas y vegetales/hortalizas, mantenerse hidratado y limitar la cafeína. No hay evidencia del consumo de alimentos alcalinos para prevenir infecciones. Estas recomendaciones son particularmente importantes durante la pandemia(AU)

These recommendations are based on current scientific evidence obtained through meta-analysis and systematic reviews on nutrition and the prevention of respiratory infections related to SARS-CoV, MERS-CoV or influenza, similar in structure to SARS-CoV-2. They are aimed at primary health care personnel and to those who provide essential services to the community and are, consequently, at high risk of COVID-19 infection. These individuals wear personal protective equipment, work long shifts, sometimes under extreme conditions, which can lead to insufficient rest, high stress levels, depression, poor nutrition and dehydration. Together, these factors have a negative impact on the immune system and could result in an increased risk of infection. An adequate intake of micronutrients and other bioactive compounds is essential for optimal immune performance. There is moderate evidence supporting supplementation, individually, with vitamin C (2 000 mg), vitamin D (1 000-2 000 IU) and zinc (≤40 mg) for the prevention of respiratory infections in adults. Insufficient evidence was found to support supplementation with vitamin A, niacin, folic acid, B12, omega 3, probiotics and polyphenols; however, the consumption of foods rich in these nutrients is recommended to support immune function. It is recommended that workers follow the recommendation of consuming 400 g/day of fruits and vegetables, remain hydrated and limit caffeine. There is no scientific evidence supporting the consumption of alkaline foods to prevent infections. The aforementioned recommendations are particularly relevant during the pandemic(AU)

Measuring Socioeconomic Status and Environmental Factors in the SAYCARE Study in South America: Reliability of the Methods.

OBJECTIVE: This paper aimed to test the reliability of two questionnaires in studies involving children and adolescents (aged 3-18 years) in seven South American cities. One assesses socioeconomic status (SES) and the other measures environmental factors. METHODS: The SES questionnaire was composed of 14 questions, which included the presence of several consumer goods, domestic services, family income, parental education level, and current parental occupation status. The environmental questionnaire was composed of 15 questions to measure the social and infrastructure characteristics of the area of residence. Parents or guardians completed the questionnaires on behalf of their children. Adolescents answered the questions themselves for environmental factors, while those related to SES factors were answered by their parents or guardians. We analyzed the reliability of the questionnaires through kappa coefficient determination. Multilevel linear regression models were applied to calculate the correlation between the total household scores, the household income, and parents' education level. RESULTS: The environmental questionnaire showed good reproducibility in both age groups (k = 0.132-0.612 in children and k = 0.392-0.746 in adolescents). The SES questionnaire showed strong reliability in both age groups for all indicators (k = 0.52-1.00 in children and k = 0.296-0.964 in adolescents). CONCLUSIONS: Our multiple indicator questionnaires focused on environmental factors and SES in pediatric health surveys provided useful and easily applicable additional indicators to measure these important determinants of cardiovascular health.

Is the Measurement of Blood Pressure by Automatic Monitor in the South American Pediatric Population Accurate? SAYCARE Study.

OBJECTIVE: This study aimed to test the validity of an automatic oscillometric device to measure the blood pressure (BP) in children (n = 191) and adolescents (n = 127) aged 3 to 18 years. METHODS: Systolic BP (SBP) and diastolic BP (DBP) levels were measured simultaneous by automatic device and mercury column with Y-connection. To verify the validity, Bland-Altman plots and limits of agreement of 95% (95% LOA), specificity and sensitivity of the device, and the grade of British Hypertension Society (BHS) criteria were used. RESULTS: The monitor measurements demonstrated lower measurement bias (mean difference [95% LOA]): 1.4 (-9.9 to 12.8) mmHg in children and 4.3 (-7.8 to 16.5) mmHg in adolescents for SBP. For DBP, it was 2.2 (-7.4 to 11.7) mmHg in children and 1.4 (-8.4 to 11.1) mmHg in adolescents. The sensitivity in children was 21.4 (95% CI = 16.3-26.6), and in adolescents, it was 20.0 (95% CI = 13.2-26.8); the specificity was 95.9 (95% CI = 93.4-98.4) in children and 100.0 (95% CI = 100.0-100.0) in adolescents. The monitor-tested ratings are Grade B for SBP in children and SBP and DBP in adolescents and Grade C for DBP in children. CONCLUSIONS: The automatic monitor presented high values of specificity and lower values of sensitivity to the diagnosis of HBP; however, it can be considered accurate (lower measurement bias) and valid for epidemiological and clinical practice in accordance with BHS criteria.

Blood Pressure in relation to 24-Hour Urinary Sodium and Potassium Excretion in a Uruguayan Population Sample.

Many public health policies in Latin America target an optimized sodium and potassium intake. The aims of this study were to assess the sodium and potassium intake using 24-hour urinary analysis and to study their association with blood pressure in a Uruguayan population cohort using cluster analysis. A total of 149 participants (aged 20-85 years) were included in the study, and office blood pressure, anthropometric measurements, biochemical parameters in the blood, and 24-hour urine samples were obtained. The overall mean sodium and potassium excretion was 152.9 ± 57.3 mmol/day (8.9 ± 3.4 g/day of salt) and 55.4 ± 19.6 mmol/day, respectively. The average office systolic/diastolic blood pressure was 124.6 ± 16.7/79.3 ± 9.9 mmHg. Three compact spherical clusters were defined in untreated participants based on predetermined attributes, including blood pressure, age, and sodium and potassium excretion. The major characteristics of the three clusters were (1) high systolic blood pressure and moderate sodium excretion, (2) moderate systolic blood pressure and very high sodium excretion, and (3) low systolic blood pressure and low sodium excretion. Participants in cluster three had systolic blood pressure values that were 23.9 mmHg (95% confidence interval: -29.5 to -1.84) lower than those in cluster one. Participants in cluster two had blood pressure levels similar to those in cluster one (P = 0.32) and worse metabolic profiles than those in cluster one and three (P < 0.05). None of the clusters showed high blood pressure levels and high sodium excretion. No linear association was found between blood pressure and urinary sodium excretion (r < 0.14; P > 0.47). An effect of sodium and potassium intake on blood pressure levels was not found at the population level using regression or cluster analysis.

Desphospho-uncarboxylated matrix Gla protein is a novel circulating biomarker predicting deterioration of renal function in the general population.

Background: Recent studies showing an inverse association between estimated glomerular filtration rate (eGFR), a microvascular trait, and inactive desphospho-uncarboxylated matrix Gla protein (dp-ucMGP) support the hypothesis that after vitamin K-dependent activation, matrix Gla protein (MGP) is renoprotective, but these were limited by their cross-sectional design. Methods: In 1009 randomly recruited Flemish (50.6% women), we assessed the association between eGFR and plasma dp-ucMGP, using multivariable-adjusted analyses. Results: From baseline to follow-up 8.9 years later (median), dp-ucMGP increased by 23.0% whereas eGFR decreased by 4.05 mL/min/1.73 m2 (P < 0.001). In 938 participants with baseline eGFR ≥60 mL/min/1.73 m2, the incidence of eGFR <60 mL/min/1.73 m2 at follow-up was 8.0% versus 4.1% in the top versus the bottom halve of baseline dp-ucMGP. For a 5-fold higher plasma dp-ucMGP at baseline, eGFR at follow-up decreased by 3.15 mL/min/1.73 m2 [95% confidence interval (CI) 1.26-5.05; P = 0.001]. The hazard ratio expressing the risk of progression to eGFR <60 mL/min/1.73 m2 was 3.49 (95% CI 1.45-8.40; P = 0.005). The hazard ratio relating the presence of microalbuminuria at follow-up to baseline dp-ucMGP was 4.70 (95% CI 1.57-14.1; P = 0.006). Conclusions: In conclusion, circulating inactive dp-ucMGP, a biomarker of poor vitamin K status, predicts renal dysfunction. Possible underlying mechanisms include protection by activated MGP against calcification and inhibition of the bone morphogenetic protein-signalling pathway.