Associação entre estado nutricional, indicadores socioeconômicos e quesito raça/cor em gestantes do Recôncavo da Bahia, Brasil / Association between nutritional status, socioeconomic indicators and race/color question in pregnant women in the Recôncavo da Bahia, Brazil

O estado nutricional gestacional adequado constitui-se como elemento essencial para a saúde materna e fetal. Este estudo teve como objetivo identificar a associação entre determinantes sociais, quesito raça/cor e estado nutricional, em gestantes do Recôncavo da Bahia, Brasil. Trata-se de um estudo ecológico, com dados extraídos do Sistema de Vigilância Alimentar e Nutricional no ano de 2020, referente ao estado nutricional de gestantes adultas e adolescentes dos 19 municípios do Recôncavo da Bahia. Foi utilizada a regressão quantílica para a análise do desfecho do estado nutricional de gestantes, variável exposição principal, raça/cor autorreferida e covariáveis Coeficiente de Gini (CG) e Índice de Desenvolvimento Humano (IDHM). Foram acompanhadas 4.061 gestantes (14,35% eram adolescentes) com predominância daquelas que se autodeclararam pretas ou pardas (62,34%). Houve prevalência de excesso de peso em 53,36% das gestantes. Identificou-se associação positiva do excesso de peso com a raça/cor preta ou parda e inversamente ao CG. Este estudo revelou que o estado nutricional de gestantes é influenciado pela raça/cor preta e/ou parda e pelo CG. Tais resultados podem contribuir para o planejamento de programas e/ou projetos que incluam ações de alimentação e nutrição e visam o acompanhamento nutricional de gestantes, principalmente dos grupos socialmente vulnerabilizados. (AU)

Adequate gestational nutritional status is an essential element for maternal and fetal health. The objective of this study was to identify the association between social determinants, race/color and nutritional status in pregnant women from Recôncavo da Bahia, Brazil. This ecological study, utilized data extracted from the 2020 Food and Nutrition Surveillance System, focusing on the nutritional status of adults and adolescents pregnant women across the 19 municipalities in the Recôncavo da Bahia. Quantile Regression was employed to analyze the nutritional status of pregnant women, considering the main exposure variable as self-reported race/color and covariates such as the Gini Coefficient and Human Development Index. In 2020, a total of 4,061 pregnant women were followed, with 14.35% being adolescents. The majority of pregnant women self-identified as black or brown (62.34%). The prevalence of overweight among pregnant women was 53.36%. The analysis revealed a positive association between overweight and black or brown race/color, while an inverse association was observed with the Gini Coefficient. These findings have implications for planning programs and projects that encompass food and nutrition interventions aimed at monitoring and improving the nutritional status of pregnant women, particularly those belonging to socially vulnerable groups. (AU)

Associação entre estado nutricional, indicadores socioeconômicos e quesito raça/cor em gestantes do Recôncavo da Bahia, Brasil / Association between nutritional status, socioeconomic indicators and race/color question in pregnant women in the Recôncavo da Bahia, Brazil

O estado nutricional gestacional adequado constitui-se como elemento essencial para a saúde materna e fetal. Este estudo teve como objetivo identificar a associação entre determinantes sociais, quesito raça/cor e estado nutricional, em gestantes do Recôncavo da Bahia, Brasil. Trata-se de um estudo ecológico, com dados extraídos do Sistema de Vigilância Alimentar e Nutricional no ano de 2020, referente ao estado nutricional de gestantes adultas e adolescentes dos 19 municípios do Recôncavo da Bahia. Foi utilizada a regressão quantílica para a análise do desfecho do estado nutricional de gestantes, variável exposição principal, raça/cor autorreferida e covariáveis Coeficiente de Gini (CG) e Índice de Desenvolvimento Humano (IDHM). Foram acompanhadas 4.061 gestantes (14,35% eram adolescentes) com predominância daquelas que se autodeclararam pretas ou pardas (62,34%). Houve prevalência de excesso de peso em 53,36% das gestantes. Identificou-se associação positiva do excesso de peso com a raça/cor preta ou parda e inversamente ao CG. Este estudo revelou que o estado nutricional de gestantes é influenciado pela raça/cor preta e/ou parda e pelo CG. Tais resultados podem contribuir para o planejamento de programas e/ou projetos que incluam ações de alimentação e nutrição e visam o acompanhamento nutricional de gestantes, principalmente dos grupos socialmente vulnerabilizados.

Adequate gestational nutritional status is an essential element for maternal and fetal health. The objective of this study was to identify the association between social determinants, race/color and nutritional status in pregnant women from Recôncavo da Bahia, Brazil. This ecological study, utilized data extracted from the 2020 Food and Nutrition Surveillance System, focusing on the nutritional status of adults and adolescents pregnant women across the 19 municipalities in the Recôncavo da Bahia. Quantile Regression was employed to analyze the nutritional status of pregnant women, considering the main exposure variable as self-reported race/color and covariates such as the Gini Coefficient and Human Development Index. In 2020, a total of 4,061 pregnant women were followed, with 14.35% being adolescents. The majority of pregnant women self-identified as black or brown (62.34%). The prevalence of overweight among pregnant women was 53.36%. The analysis revealed a positive association between overweight and black or brown race/color, while an inverse association was observed with the Gini Coefficient. These findings have implications for planning programs and projects that encompass food and nutrition interventions aimed at monitoring and improving the nutritional status of pregnant women, particularly those belonging to socially vulnerable groups.

Low urinary selenium levels are associated with iodine deficiency in Brazilian schoolchildren and adolescents.

BACKGROUND: Selenium (Se) and iodine (Io) are important micronutrients for the proper functioning of the thyroid gland, as they are crucial for the synthesis and activation of the thyroid hormones (TH) triiodothyronine (T3) and thyroxine (T4). OBJECTIVE: To evaluate the Se and Io nutritional status among schoolchildren. METHODOLOGY: Cross-sectional, descriptive and analytical study conducted in 982 schoolchildren aged 6-14 years from public schools in the state of Bahia, Brazil. Sociodemographic and anthropometric variables, as well as urinary Se (USC) and Io concentrations (UIC) using the inductively coupled plasma mass spectrometry (ICP-MS) method and thyroid-stimulating hormone (TSH) from filter paper blood collection, were evaluated. RESULTS: The median USC and UIC were 38.7 and 210.0 (IQR: 26.8-52.9 and 129.3-334.1 µg/L, respectively). The prevalence of iodine deficiency and excessive UIC were observed in 17.1% and 30.9% of schoolchildren, respectively. Concomitant low USC and IoD was found in 3.9% of schoolchildren. There was a positive correlation between USC and UIC (r = 0.60; p = 0.00). The median TSH was 0.95 (IQR: 0.69-1.30 µUI/L). CONCLUSIONS: This study demonstrates that USC is a good biomarker for assessing Se status, meantime more studies are needed to establish cutoff USC in child population. Despite adequate median intake, a subgroup of schoolchildren had IoD and low USC. The correlation between UIC and USC point at the importance of two micronutrients, raising the question whether measuring Se should be included in monitoring programs that address the prevention of nutritional disturbances.

Iodine Nutritional Status in Schoolchildren from Public Schools in Brazil: A Cross-Sectional Study Exposes Association with Socioeconomic Factors and Food Insecurity.

INTRODUCTION: National programs of salt iodization were implemented in Brazil to combat iodine deficiency (ID) in children of school age. Currently, there are limited data in Brazil on those still vulnerable to this deficiency and the state of nutritional iodine status in the northeast region of Brazil, where children are vulnerable to malnutrition. OBJECTIVE: The aim of this study was to analyze the iodine nutritional status, household food insecurity, socioeconomic and demographic characteristics among schoolchildren from the public school system living in state the state of Bahia, Brazil. METHODS: A cross-sectional study was conducted on 1419 schoolchildren in Bahia between the ages of 6 and 14 years old. Anthropometric parameters, urinary iodine concentrations (UIC), and thyrotropin (TSH) measurements were evaluated from blood spots on filter paper. RESULTS: The mean UIC was 206.4 ± 80.5 µg/L, with a median of 221.6 µg/L, indicating sufficient iodine intake in the region. Low urinary iodide concentration (<100 µg/L) was detected in 12.3% of the schoolchildren (n = 174), with 6.2% with mild (<100 µg/L), 3.0% with moderate (20-49 µg/L), and 3.1% with severe ID (<20 µg/L). Moreover, 9.4% (n = 134) had a urinary iodide concentration of >300 µg/L, indicating the coexistence of excessive iodine intake (EII). The mean TSH was 1.0 ± 0.6 mIU/L. The body mass index category "overweight/obesity" was a protective factor against EII (odds ratio [OR] = 0.64 [confidence interval (CI) 0.4-1.0]; p = 0.07). Urban areas (73%) had a mean UIC of 213.1 ± 80 µg/L compared with 176.8 ± 76.1 µg/L in rural areas. The risk for EII increased in children living in a house with more than six people (OR = 1.62 [CI 0.9-2.6]; p < 0.05) and water consumption from shallow wells (OR = 1.70 [CI 0.9-3.1]; p = 0.09). The risk of ID was increased by 70% in schoolchildren who had moderate or severe food insecurity (OR = 1.70 [CI 0.9-3.0]; p > 0.05). CONCLUSION: A significant proportion of schoolchildren still have ID or EII in the northeast region of Brazil, emphasizing the importance of committed public policies to address this problem. Socioeconomic factors and the lack of education about nutritional importance of iodine were important influencing factors in the presence of ID in schoolchildren.

Riesgo nutricional y factores asociados en pacientes pediátricos hospitalizados a través de STRONGKids / Nutritional risk and associated factors in hospitalized paediatric patients through the STRONGKids Moura

Introducción: El uso de instrumentos para la identificación del riesgo nutricional en niños hospitalizados contribuye para la evaluación y la intervención adecuada. Objetivo: Evaluar el riesgo nutricional y factores asociados en pacientes pediátricos hospitalizados, a través de instrumentos STRONGkids. Métodos: Estudio transversal, con 122 niños y adolescentes de ambos sexos, internados en un hospital público pediátrico en el municipio de Bahia entre octubre y noviembre de 2013. Todos los pacientes fueron sobmetidos, en las primeras 48 horas después de la admisión a proyección de riesgo nutricional (STRONGkids), a evaluación antropométrica y evaluación de las condiciones socioeconómicas. Se utilizó el programa STATA for MAC para análisis de los datos, adoptando el nivel de significancia menor que el 5%. Resultados: La edad media fue de 61,6 meses (±5.12DP), predominando el sexo masculino (68%). La edad materna media fue de 31.2 meses (±7.69DP). El tiempo medio de permanencia hospitalaria fue de 8.4 días (±7.31DP). La prevalencia de desnutrición fue de 13.9%, de acuerdo con la antropométrica. El STRONGkids identificó 63.1% de los pacientes con medio y alto riesgo nutricional. Algunos factores se asociaron con medio y alto riesgo nutricional, como la edad materna (p<0.02), diagnóstico nutricional (p<0.01) y baja condición socioeconómica (p<0.04). Además de eso, este estudio mostró asociación específica entre riesgo nutricional y tiempo de permanencia hospitalaria, que se hizo más evidente cuando se ajustó el modelo a la condición socioeconómica. Conclusiones: La edad materna, el diagnóstico antropométrico y la condición socioeconómica fueron factores de riesgo importantes para el medio y alto riesgo nutricional en esta población. Esas características pueden ser utilizadas para orientar protocolos de intervención preventiva de la desnutrición hospitalaria (AU)

Background: The use of nutritional screening tools to identify nutritional risk in hospitalized children contributes to the adequate evaluation and intervention. Objective: Evaluating the nutritional risk and associated factors in hospitalized paediatric patients through the STRONGkids. Methods: It is a cross-sectional study including 122 both sex children and adolescents admitted in a public paediatric hospital in Bahia, Brazil, between October and November 2013. The patients were submitted to the STRONGkids screening, anthropometric and socioeconomic evaluations at the first 48 hours of the admission. The statistical analyses included the Poisson regression model and it was adopted the significance level 5%. Results: The mean age was 61,6 months (±5.12SD), predominantly male (68%). The mean time of length of hospital stay was 8.4 days (±7.31). Malnutrition prevalence was 13.9%, according to anthropometry. The STRONGkids identified 63.1% of patients with medium or high nutritional risk. Maternal age (p=0.02), anthropometric diagnosis (p=0.01) and socioeconomic condition (p=0.02) were factors associated to the medium and high nutritional risk. Also, we identified an association between medium and high nutritional risk at the admission and a longer period of hospital stay (PR=3.27; p=0.01), which was more relevant when adjusted by socioeconomic condition (PR=4.17; p< 0.01). Conclusions: Maternal age, anthropometric diagnosis and socioeconomic condition were factors related to medium or high nutritional risk in this population. The medium or high nutritional risk at the admission was associated to a longer period of hospitalization. These are important findings that could guide the adoption of nutritional protocols to prevent hospital malnutrition (AU)

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity.

OBJECTIVES: Iodine deficiency disorder (IDD) is the result of an inadequate dietary intake of iodine, which physiological consequences are endemic goiter and thyroid dysfunction. The objective of this study was to a analyze studies that assessed the status of Brazil's population iodine nutrition and IDD prevalence. MATERIALS AND METHODS: Systematic review using PRISMA statement. Electronic database: PubMed, Medline, SciELO and Lilacs. Quality of studies: Newcastle-Ottawa Scale. Meta-analysis was carried out with R Core Team Statistical Software, version 3.1.0 (2014). The summary measure (WMD) and its confidence interval (CI) of 95% were calculated. The "Funnel plot" graph assessed publication bias and heterogeneity. RESULTS: Seventeen papers were eligible: pregnant women (2), school children (9), adults/elderly (4) and preschool children/infants (2). Geographic distribution: North (1), Northeast (1), Midwest (2), Southeast (13), South (3). Twenty-three thousand two hundred seventy-two subjects were evaluated between 1997 and 2013 and all have use urinary iodine (UI) measurement. However, only 7 studies could be included in meta-analysis, all from Southeast region. The overall prevalence of IDD in school children in southeast region was 15.3% (95% CI, 13-35%), however this data had an important heterogeneity, expressed by the I2 Statistic of 99.5%. CONCLUSION: Only few studies have been performed and enrolled populations from south/southeast region of Brazil. The actual IDD prevalence analysis is complex because it was detected bias due influence of individual studies and very high heterogeneity. IDD might still be high in some areas but this remained unknown even after this meta-analysis evaluation. The generation of a national program for analysis of iodine status in all regions is urgently required.

Iodine nutritional status in Brazil: a meta-analysis of all studies performed in the country pinpoints to an insufficient evaluation and heterogeneity

Objectives Iodine deficiency disorder (IDD) is the result of an inadequate dietary intake of iodine, which physiological consequences are endemic goiter and thyroid dysfunction. The objective of this study was to a analyze studies that assessed the status of Brazil’s population iodine nutrition and IDD prevalence. Materials and methods Systematic review using PRISMA statement. Electronic database: PubMed, Medline, SciELO and Lilacs. Quality of studies: Newcastle-Ottawa Scale. Meta-analysis was carried out with R Core Team Statistical Software, version 3.1.0 (2014). The summary measure (WMD) and its confidence interval (CI) of 95% were calculated. The “Funnel plot” graph assessed publication bias and heterogeneity. Results Seventeen papers were eligible: pregnant women (2), school children (9), adults/elderly (4) and preschool children/infants (2). Geographic distribution: North (1), Northeast (1), Midwest (2), Southeast (13), South (3). Twenty-three thousand two hundred seventy-two subjects were evaluated between 1997 and 2013 and all have use urinary iodine (UI) measurement. However, only 7 studies could be included in meta-analysis, all from Southeast region. The overall prevalence of IDD in school children in southeast region was 15.3% (95% CI, 13-35%), however this data had an important heterogeneity, expressed by the I2 Statistic of 99.5%. Conclusion Only few studies have been performed and enrolled populations from south/southeast region of Brazil. The actual IDD prevalence analysis is complex because it was detected bias due influence of individual studies and very high heterogeneity. IDD might still be high in some areas but this remained unknown even after this meta-analysis evaluation. The generation of a national program for analysis of iodine status in all regions is urgently required. Arch Endocrinol Metab. 2015;59(1):13-22 .

Fritura por imersão: um estudo de caso / Frying by immersion: a case study

Este trabalho teve por objetivo avaliar o processo de fritura por imersão em uma Unidade de Alimentação e Nutrição, localizada no Pólo Petroquímico de Camaçari – Bahia. Foram selecionadas aleatoriamente preparações à base de fritura por imersão dos cardápios oferecidos no almoço, durante três meses consecutivos. A coleta de dados realizou-se através da observação direta do processo e coleta de amostras de óleo. Para avaliar a qualidade dos óleos foram realizadas as seguintes determinações analíticas: ácidos graxos livres (%), índice de peróxido (mEq/Kg), índice de refração (40 °C) e compostos polares totais (%). A partir da avaliação do processo verificaram-se inadequações, entretanto, nenhuma das amostras analisadas apresentou valores fora dos limites especificados preconizados na literatura para as quatro determinações físico-químicas. Apesar de todas as amostras de óleo se apresentarem dentro dos limites aceitáveis, alguns condicionantes relacionados ao processo de fritura estariam contribuindo para redução do tempo de utilização dos óleos e aumento do custo de produção.