Short-chain fatty acids are associated with adiposity, energy and glucose homeostasis among different metabolic phenotypes in the Nutritionists' Health Study.

BACKGROUND AND AIMS: The gut microbiome is associated with obesity, mainly mediated by bacteria-produced short-chain fatty acids (SCFAs). It is unknown how SCFA concentrations are associated with the phenotypes metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obese/overweight (MHO), and metabolically unhealthy obese/overweight (MUO). We compared plasma and fecal SCFA concentrations among adult women categorized according to the metabolic phenotypes mentioned above and examined associations between SCFA and adiposity and components of energy and glucose homeostasis. METHODS: This was a cross-sectional study involving 111 participants. Body composition was assessed by DEXA. Energy and glycemic homeostasis were assessed by the standard mixed-meal tolerance test coupled with indirect calorimetry. SCFAs were quantified by gas chromatography and mass spectrometry. RESULTS: Only plasma propionate was increased in the MHNW phenotype compared to the MHO and MUO phenotypes [p < 0.05]. Fecal propionate and butyrate concentrations and plasma propionate concentrations were inversely associated with total and visceral adiposity [p < 0.05]. Fecal and plasma SCFA concentrations were associated with reduced glucose, insulin and HbA1c levels, increased fasting and postprandial GLP-1 levels; and more preserved beta-cell function [p < 0.05]. Fecal and plasma SCFA concentrations were positively correlated with resting energy expenditure and lipid oxidation rate and inversely correlated with the oxidation rate of carbohydrates [p < 0.05]. CONCLUSION: These findings reinforce the concept that fecal and plasma SCFA concentrations are linked to specific components of energy and glucose homeostasis; and body adiposity. However, it was not possible to discriminate the different metabolic phenotypes of adiposity based on the determination of fecal SCFA concentrations.

Parental body mass index and maternal gestational weight gain associations with offspring body composition in young women from the Nutritionists' Health Study

ABSTRACT Objective: Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood. Materials and methods: This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of pre-conception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m2. Results: No association between previous paternal BMI and offspring's body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring's total lean mass (β = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (β = 0.11, p = 0.003) and fat mass index (FMI) (β = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring's BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring's ASMI (β = 0.42, p = 0.046), FMI (β = 0.22, p = 0.005) and android-to-gynoid fat ratio (β = 0.09, p = 0.035). Conclusion: Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.

Parental body mass index and maternal gestational weight gain associations with offspring body composition in young women from the Nutritionists' Health Study.

Objective: Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood. Methods: This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of preconception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m2. Results: No association between previous paternal BMI and offspring's body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring's total lean mass (ß = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (ß = 0.11, p = 0.003) and fat mass index (FMI) (ß = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring's BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring's ASMI (ß = 0.42, p = 0.046), FMI (ß = 0.22, p = 0.005) and android-to-gynoid fat ratio (ß = 0.09, p = 0.035). Conclusion: Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.

Cardiometabolic diseases. / Doenças cardiometabólicas.

INTRODUCTION: Cardiometabolic diseases are prevalent in populations and are among the leading causes of death. Objective: This sub-study of the Health, Well-being and Aging (SABE) study describes the self-reported prevalence of diabetes mellitus (DM), hypertension, and atherosclerotic cardiovascular disease (CVD) for its three waves (2000, 2006, and 2010). It also analyses the associations with selected risk factors. METHODS: Logistic regression models were performed. RESULTS: Predominance of women and average age (68 years) were maintained in all the waves. During the period, there was a general tendency of increasing prevalence of hypertension (53.1 to 66.7%), DM (16.7 to 25.0%), and CVD (23.0 to 27.2%); and stabilization of the CVD prevalence rate occurred only from 2006 to 2010. Women, with body mass index (BMI) > 27 kg/m2, and ex-smokers had consistently higher risk of self-reported hypertension across the three waves. BMI >27kg/m2 was also associated with a higher probability of DM in the three waves, whereas with ex-smokers this occurred only in 2010. Ex-smokers presented higher risk of CVD in all the waves, but not excess weight. Wave pairs were analyzed to test changes in prevalence, and it was found a significant increase in diseases rates across the years. CONCLUSION: In summary, self-reported DM, hypertension, and CVD had high prevalence rates for participants of SABE Study, in São Paulo. The association of elevated BMI with cardiometabolic diseases suggests that body adiposity might favor their occurrence, although the study design does not guarantee a cause and effect relationship. Increased rates of affected individuals from the first to the third wave may reflect improvement in diagnostic conditions and/or control of these diseases' mortality during that period.

INTRODUÇÃO: Doenças cardiometabólicas são prevalentes nas populações, estando entre as principais causas de morte. Objetivos: Este subestudo do Saúde, Bem-Estar e Envelhecimento (Sabe) descreve as prevalências autorreferidas de hipertensão, diabete mellitus (DM) e doença cardiovascular aterosclerótica (DCV) nas suas três ondas (2000, 2006 e 2010) e analisa a associação com fatores de risco selecionados. MÉTODOS: Empregou-se regressão logística. RESULTADOS: O predomínio de mulheres e a idade (68 anos) foram mantidos nas três ondas. No período, verificou-se tendência geral de aumento nas prevalências de hipertensão (53,1 a 66,7%), DM (16,7 a 25%) e DCV (23,0 a 27,2%) - estabilização da prevalência de DCV apenas de 2006 a 2010. Indivíduos do sexo feminino, com índice de massa corporal (IMC) > 27 kg/m2 e ex-fumantes tenderam consistentemente à maior probabilidade de hipertensão autorreferida ao longo das ondas. Apresentar IMC > 27 kg/m2 associou-se à maior probabilidade de referir DM nas três ondas, enquanto com ex-fumantes isso aconteceu apenas em 2010. Ter sido fumante também se associou à DCV nas ondas, mas não o excesso de peso. Averiguando-se pares de ondas para testar alterações nas prevalências, viu-se que em geral houve elevação significativa nos percentuais das doenças com o tempo. CONCLUSÃO: Em suma, DM, hipertensão e DCV autorreferidos ocorreram com elevadas prevalências nos participantes do Sabe em São Paulo. A associação de IMC elevado com doenças cardiometabólicas sugere que adiposidade corporal pode favorecê-las, embora esta análise não permita assegurar relação causa × efeito. É possível que o aumento dos percentuais de doentes da primeira para a terceira onda reflita melhora nas condições de diagnóstico e/ou no controle dessas doenças no período.

Doenças cardiometabólicas / Cardiometabolic diseases

RESUMO: Introdução: Doenças cardiometabólicas são prevalentes nas populações, estando entre as principais causas de morte. Objetivos: Este subestudo do Saúde, Bem-Estar e Envelhecimento (Sabe) descreve as prevalências autorreferidas de hipertensão, diabete mellitus (DM) e doença cardiovascular aterosclerótica (DCV) nas suas três ondas (2000, 2006 e 2010) e analisa a associação com fatores de risco selecionados. Métodos: Empregou-se regressão logística. Resultados: O predomínio de mulheres e a idade (68 anos) foram mantidos nas três ondas. No período, verificou-se tendência geral de aumento nas prevalências de hipertensão (53,1 a 66,7%), DM (16,7 a 25%) e DCV (23,0 a 27,2%) - estabilização da prevalência de DCV apenas de 2006 a 2010. Indivíduos do sexo feminino, com índice de massa corporal (IMC) > 27 kg/m2 e ex-fumantes tenderam consistentemente à maior probabilidade de hipertensão autorreferida ao longo das ondas. Apresentar IMC > 27 kg/m2 associou-se à maior probabilidade de referir DM nas três ondas, enquanto com ex-fumantes isso aconteceu apenas em 2010. Ter sido fumante também se associou à DCV nas ondas, mas não o excesso de peso. Averiguando-se pares de ondas para testar alterações nas prevalências, viu-se que em geral houve elevação significativa nos percentuais das doenças com o tempo. Conclusão: Em suma, DM, hipertensão e DCV autorreferidos ocorreram com elevadas prevalências nos participantes do Sabe em São Paulo. A associação de IMC elevado com doenças cardiometabólicas sugere que adiposidade corporal pode favorecê-las, embora esta análise não permita assegurar relação causa × efeito. É possível que o aumento dos percentuais de doentes da primeira para a terceira onda reflita melhora nas condições de diagnóstico e/ou no controle dessas doenças no período.

ABSTRACT: Introduction: Cardiometabolic diseases are prevalent in populations and are among the leading causes of death. Objective: This sub-study of the Health, Well-being and Aging (SABE) study describes the self-reported prevalence of diabetes mellitus (DM), hypertension, and atherosclerotic cardiovascular disease (CVD) for its three waves (2000, 2006, and 2010). It also analyses the associations with selected risk factors. Methods: Logistic regression models were performed. Results: Predominance of women and average age (68 years) were maintained in all the waves. During the period, there was a general tendency of increasing prevalence of hypertension (53.1 to 66.7%), DM (16.7 to 25.0%), and CVD (23.0 to 27.2%); and stabilization of the CVD prevalence rate occurred only from 2006 to 2010. Women, with body mass index (BMI) > 27 kg/m2, and ex-smokers had consistently higher risk of self-reported hypertension across the three waves. BMI >27kg/m2 was also associated with a higher probability of DM in the three waves, whereas with ex-smokers this occurred only in 2010. Ex-smokers presented higher risk of CVD in all the waves, but not excess weight. Wave pairs were analyzed to test changes in prevalence, and it was found a significant increase in diseases rates across the years. Conclusion: In summary, self-reported DM, hypertension, and CVD had high prevalence rates for participants of SABE Study, in São Paulo. The association of elevated BMI with cardiometabolic diseases suggests that body adiposity might favor their occurrence, although the study design does not guarantee a cause and effect relationship. Increased rates of affected individuals from the first to the third wave may reflect improvement in diagnostic conditions and/or control of these diseases' mortality during that period.

Lifestyle intervention using the psychoeducational approach is associated with greater cardiometabolic benefits and retention of individuals with worse health status.

OBJECTIVE: This study aimed to compare the effects of two lifestyle intervention programs for type 2 diabetes mellitus (T2DM) prevention - traditional or interdisciplinary psychoeducation-based intervention - in daily habits and cardiometabolic risk factors and investigate the role of the psychoeducational approach for the retention of individuals in the program. SUBJECTS AND METHODS: Between 2008 and 2010, in a public health service, 183 pre-diabetic individuals were allocated to two 18-month interventions involving diet and physical activity. Physical activity, diet, quality of life (QOL) and depression and biochemical measurements were obtained. Linear mixed-effect models were used to assess the effect of the interventions. A student t test was used to compare dropouts versus non-dropouts. RESULTS: Improvements in energy intake and physical activity were greater in the interdisciplinary than the traditional intervention. A decrease in fat mass and blood pressure was more pronounced with interdisciplinary intervention. Dropouts from the traditional intervention only had higher BMI and lower fiber intake and QOL than non-dropouts. CONCLUSION: The interdisciplinary psychoeducation-based intervention revealed useful for reducing cardiometabolic risk and retaining individuals with worse health profiles. This approach represents a feasible strategy for motivating high-risk individuals to adopt a long-term healthy lifestyle.

Lifestyle intervention using the psychoeducational approach is associated with greater cardiometabolic benefits and retention of individuals with worse health status

ABSTRACT Objective This study aimed to compare the effects of two lifestyle intervention programs for type 2 diabetes mellitus (T2DM) prevention – traditional or interdisciplinary psychoeducation-based intervention – in daily habits and cardiometabolic risk factors and investigate the role of the psychoeducational approach for the retention of individuals in the program. Subjects and methods Between 2008 and 2010, in a public health service, 183 pre-diabetic individuals were allocated to two 18-month interventions involving diet and physical activity. Physical activity, diet, quality of life (QOL) and depression and biochemical measurements were obtained. Linear mixed-effect models were used to assess the effect of the interventions. A student t test was used to compare dropouts versus non-dropouts. Results Improvements in energy intake and physical activity were greater in the interdisciplinary than the traditional intervention. A decrease in fat mass and blood pressure was more pronounced with interdisciplinary intervention. Dropouts from the traditional intervention only had higher BMI and lower fiber intake and QOL than non-dropouts. Conclusion The interdisciplinary psychoeducation-based intervention revealed useful for reducing cardiometabolic risk and retaining individuals with worse health profiles. This approach represents a feasible strategy for motivating high-risk individuals to adopt a long-term healthy lifestyle.

Impact of the Content of Fatty Acids of Oral Fat Tolerance Tests on Postprandial Triglyceridemia: Systematic Review and Meta-Analysis.

Whether the content of saturated (SFA), monounsaturated (MUFA), and polyunsaturated fatty acids (PUFA) could differently influence postprandial triglycerides (TG) is unknown. We examined possible differences in the postprandial TG response to fat tolerance tests (FTTs), in which SFA or unsaturated fatty acids were used. Crossover clinical trials investigating the effects of FTTs containing SFA and unsaturated fats on postprandial triglyceridemia in databases from 1994 until 2016 were searched. Of 356 studies, 338 were excluded and 18 were considered. TG net incremental areas under the curve were calculated using time-points or changes from baseline. Pooled effects of standardized mean differences and I² test were used. RESULTS: In 12 studies, responses to SFA versus PUFA meals, and in 16 studies versus MUFA meals were compared. Over 4 hours, no differences between SFA and unsaturated fats were observed. Over 8 hours a lower response to PUFA (SMD -2.28; 95%CI -4.16, -0.41) and a trend to lower response to MUFA (SMD -0.89, 95%CI -1.82, 0.04) were detected. FTTs shorter than 8 hours may not be sufficient to differentiate postprandial TG after challenges with distinct fatty acids. Clinical significance of different postprandial TG responses on cardiovascular risk in the long-term deserves investigation.

Influence of depression on cardiometabolic responses to a lifestyle intervention in at-risk individuals.

BACKGROUND: Cardiometabolic diseases and depression are public health problems that are often related. The benefits of behavioral interventions on lifestyle are well documented. However, the influence of depression in these interventions is unclear. OBJECTIVE: To evaluate whether depression affects the impact of a lifestyle intervention on cardiometabolic response in an at-risk sample. METHODS: 129 individuals identified by the public health system to be at risk for cardiometabolic disease were allocated to 18-month interventions on diet and physical activity. Socio-demographic and clinical data were obtained. Depressive symptoms were assessed by the Beck Depression Inventory. Changes by at least 10% in each of 6 cardiometabolic risk factors were used to define responses to intervention. Logistic regression models were employed for each gender. RESULTS: Approximately 42% of individuals had depressive symptoms. They had higher adiposity, cholesterol, and blood pressure levels and lower quality of life and physical activity levels than non-depressed individuals. In adjusted models, only women with depression at baseline had lower chance of improving plasma glucose (OR: 0.32) and lower chance of improving mean blood pressure (OR: 0.29) after the follow-up, compared with non-depressed women. LIMITATIONS: The small sample size may have diminished the power of the results and the instrument used to measure depression does not provide clinical diagnosis according to DSM criteria. CONCLUSION: Depression at baseline of lifestyle interventions predicted a lower chance of improving long-term cardiometabolic risk, particularly in women, suggesting that screening and management of depression as part of lifestyle interventions can potentially improve cardiometabolic risk profile.

Biomarkers of inflammation may be of use for identification of more severe peripheral arterial occlusive disease / Biomarcadores inflamatórios circulantes podem ser úteis para identificar doença arterial obstrutiva periférica mais grave

Background: Atherosclerosis is a multifactorial disease with an inflammatory pathophysiological basis. Cytokines released during the atherosclerotic process induce production of C-reactive protein (CRP) in the liver, which is an important marker of inflammation. Objective: We tested whether inflammatory biomarkers were associated with deterioration of peripheral arterial occlusive disease (PAOD) in a population at high cardiovascular risk. Methods: 1,330 subjects ≥30 years of age underwent clinical and laboratory examinations as part of a population-based study of the prevalence of diabetes. PAOD was defined as an ankle-brachial index (ABI) ≤0.90. After application of exclusion criteria, the sample comprised 1,038 subjects. Traditional risk factors, CRP and interleukin 6 (IL-6) were also compared across three ABI categories (≤0.70; 0.71-0.90; ≥0.90). Mean values for these variables were compared by presence/absence of DAOP (Student's t test) and by ABI categories (ANOVA). Poisson regression and logistic regression models were used to test for associations between risk factors and DAOP and between risk factors and the ABI categories. Pearson's linear correlation coefficients were calculated for the relationship between CRP and IL-6 levels. Results: Mean age was 56.8±12.9 years, 54% of the sample were women and the prevalence of DAOP was 21.0% (95%CI 18.4-24.1). Individuals with ABI ≤0.70 had higher concentrations of CRP-us (2.1 vs. 1.8) and of IL-6 (1.25 vs. 1.17). Concentrations of CRP and IL-6 were only correlated in patients with DAOP, (p=0.004). Conclusions: The finding that CRP and IL-6 levels were only elevated among people with advanced DAOP may suggest that these biomarkers have a role to play as indicators of more severe disease. Prospective studies are needed to test this hypothesis...

Contexto: Aterosclerose é doença multifatorial, cuja base fisiopatológica é um processo inflamatório. Estudos são controversos quanto ao papel dos biomarcadores como fatores de risco. A liberação de citoquinas durante aterogênese promove síntese hepática de proteína C-reativa (PCR), importante marcador inflamatório. Objetivo: Avaliamos se biomarcadores inflamatórios estavam associados à deterioração da doença arterial obstrutiva periférica (DAOP), em população de risco cardiovascular. Métodos: Estudo populacional sobre prevalência de diabetes, em que 1.330 indivíduos com ≥30 anos foram submetidos a exames clínico-laboratoriais. Diagnóstico de DAOP foi feito pelo índice tornozelo-braço (ITB) ≤0,90. Após exclusões, 1.038 indivíduos foram analisados. Fatores de risco tradicionais, PCR e interleucina 6 (IL-6) foram comparados também segundo três categorias de ITB (≤0,70; 0,71-0,90; ≥0,90). Valores médios das variáveis foram comparados segundo presença de DAOP (teste t Student) e categorias do ITB (ANOVA). Utilizou-se modelo de Poisson e regressão logística para avaliar associações da DAOP e categorias do ITB com fatores de risco. Estimou-se coeficiente de correlação linear de Pearson para relação entre os valores de PCR e IL-6. Resultados: A idade média foi 56,8±12,9 anos, 54% mulheres e prevalência de DAOP 21,0% (IC95% 18,4-24,1). Indivíduos com ITB ≤0,70 apresentaram maiores valores de PCR-us (2,1 vs. 1,8) e IL-6 (1,25 vs. 1,17. Apenas em portadores de DAOP, valores de PCR e IL-6 mostraram-se correlacionados (p=0,004). Conclusão: O achado de concentrações mais elevadas de PCR e IL-6 apenas em indivíduos com DAOP avançada pode sugerir um...

Diet quality is associated with leisure-time physical activity in individuals at cardiometabolic risk.

OBJECTIVES: We investigated whether diet quality was associated with leisure-time physical activity (LTPA) and television viewing and the associations of these variables with traditional cardiovascular risk factors and novel biomarkers in individuals at cardiometabolic risk. METHODS: A total of 193 prediabetic adults (63.7% women, mean age 54.1 years), screened for a diabetes prevention program in Brazil, participated in this cross-sectional study. Clinical data and blood samples were collected for several determinations. Twenty-four-hour recalls were used to calculate the Healthy Eating Index (HEI) adapted to Brazilian dietary habits and the International Physical Activity Questionnaire to assess physical activity level. Analysis of covariance with adjustments for age and body mass index (BMI) was employed to test associations across categories of LTPA and television viewing. RESULTS: Stratifying according to LTPA categories, the most active subset (≥150 minutes/week) showed better HEI scores after adjustments (64.6 ± 11.0, 65.1 ± 10.3, and 68.6 ± 10.8, p = 0.02) and significant higher values of dark green and orange vegetables but not of whole grains (p = 0.06). Active individuals had lower BMI, waist circumference, inflammatory markers, and better insulin sensitivity (p < 0.05). Individuals at the highest category of television viewing had higher age-adjusted BMI (32.0 ± 6.2, 30.7 ± 6.0, and 28.8 ± 4.7 hours/week; p = 0.01) than the others. Time watching television was inversely associated with homeostasis model assessment (HOMA-IR) and C-reactive protein (CRP; p < 0.01) after adjustments but not with lipids and HEI score. Comparisons of individuals with healthy habits (better diet and higher physical activity [PA]), with those with unhealthy habits revealing better anthropometric and cardiometabolic profiles in the former group. CONCLUSION: Diet quality assessed by the HEI adapted for Brazilian eating habits attained significance in differentiating more active from inactive at-risk individuals during leisure time. Time watching television, as a surrogate of sedentary behavior, is not useful to detect unhealthy diet quality. LTPA is indicative of better cardiometabolic profile reflected by lipid and inflammatory markers and index of insulin resistance.

Healthy Eating Index is associated with certain markers of inflammation and insulin resistance but not with lipid profile in individuals at cardiometabolic risk.

Eating habits may influence inflammatory status and insulin resistance, both involved in the genesis of cardiometabolic diseases; an index of overall diet quality may be useful to identify risk for these diseases. We investigated whether the Healthy Eating Index (HEI-2005), adapted to Brazilian habits (B-HEI), was associated with markers of inflammation, insulin resistance and lipid profile in individuals at cardiometabolic risk. Two hundred and four prediabetic individuals (64.7% women) were enrolled in this cross-sectional study. Anthropometric measurements, 24-h dietary recalls used to calculate the B-HEI, and blood samples were collected. ANOVA was used for comparisons of clinical variables across the B-HEI tertiles and multiple linear regressions employed to test associations between clinical variables and B-HEI total score. Significant trends to decrease mean values of body mass index (BMI) (p = 0.03) and C-reactive protein concentrations (p = 0.02) across the tertiles of B-HEI, but not other biomarkers, were observed. Waist circumference, HOMA-IR and C-reactive protein were inversely associated with the B-HEI (p < 0.05), after adjusting for age, sex, BMI, and physical activity level. Also, a direct association of adiponectin concentrations with B-HEI was detected after adjustments (p = 0.001). Data from this study indicate that the B-HEI may be useful to identify the body adiposity-induced pro-inflammatory status and insulin resistance in individuals at cardiometabolic risk.

Association of fruits and vegetables consumption and related-vitamins with inflammatory and oxidative stress markers in prediabetic individuals.

BACKGROUND: Dietary guidelines of 5 servings per day of fruits and vegetables (FV) offer a reasonable amount of vitamins to control organic processes, which may contribute to a favorable cardiometabolic profile. This study aimed at investigating whether the intake of the FV group as well as pro-vitamin A carotenoids and vitamins C and E were associated with circulating markers of oxidative stress, inflammation and insulin resistance in Brazilians individuals at cardiometabolic risk. METHODS: This cross-sectional study included 205 individuals screened for diabetes prevention program in a healthcare center from the School of Public Health, University of São Paulo, conducted in 2008. Possible associations of consumption of FV group, as well as pro-vitamin A carotenoids and vitamins C and E, with circulating markers of oxidative stress (superoxide dismutase - SOD and oxidized LDL - oxLDL), inflammation (C reactive protein, TNF-α and adiponectin) and insulin resistance (HOMA-IR) were investigated. Pearson correlation coefficient, ANOVA and multiple linear regression were employed. RESULTS: The sample (64.7% women) had a mean age of 54.1 ± 12.7 years and body mass index of 30.7 ± 5.7 kg/m2. Dietary, physical activity, anthropometric and laboratory data were obtained. Participants consumed a mean of 3.8 servings/day of FV; their FV intake was categorized into three groups: <2.5, 2.5-5.0 and >5.0 servings/day. Significant trends for lower waist circumference (103.4 ± 13.6 vs. 100.1 ± 12.2 vs. 98.2 ± 12.7 cm, p-trend <0.05) and higher adiponectin concentrations (10.4 ± 1.8 vs. 11.9 ± 1.9 vs. 13.6 ± 2.1 ng/mL, p-trend <0.05) were detected across categories. Associations between SOD concentrations (ß 0.172 [0.110-0.688]) with FV consumption and between oxLDL concentrations with vitamins C (ß -0.333 [-2.568 - -0.218]) and E (ß -0.354 [-1.131- -0.110]) intakes, adjusted for age, gender, BMI, saturated fat intake, smoking and physical activity were found. Similar results were observed for the associations between oxLDL and FV intake, but significance disappeared adding adjustment for saturated fat, smoking and physical activity. CONCLUSION: Our data suggest that the intake of FV or selected vitamins may be useful for identifying the oxidative stress and inflammation involved in the genesis of cardiometabolic diseases and for motivating at-risk patients for changing dietary habits.

Realistic changes in monounsaturated fatty acids and soluble fibers are able to improve glucose metabolism.

BACKGROUND/OBJECTIVES: Cardioprotective effects of Mediterranean-style diet have been shown. Instead of excluding foods, replacement or addition may facilitate compliance with impact on glucose metabolism of individuals at cardiometabolic risk. This study investigated the effect of changing selected nutrients intake on glucose metabolism during a lifestyle intervention tailored to living conditions of prediabetic Brazilians. SUBJECTS/METHODS: 183 prediabetic adults treated under the Brazilian public health system underwent an 18-month intervention on diet and physical activity. Dietary counseling focused on reducing saturated fat replaced by unsaturated fatty acids. Data were collected at baseline and after follow-up. ANOVA and multiple linear regression were used to test association of changes in nutrients intake with changes in plasma glucose. RESULTS: Changes in fasting and 2-h plasma glucose but not in weight, HOMA-IR or C-reactive protein decreased after intervention across tertiles of MUFA changes (p-trend 0.017 and 0.024, respectively). Regression models showed that increase in MUFA intake was independently associated with reduction in fasting (ß -1.475, p = 0.008) and 2-h plasma glucose (ß -3.321, p = 0.007). Moreover, increase in soluble fibers intake was associated with decrease in fasting plasma glucose (ß -1.579, p = 0.038). Adjustment for anthropometric measurements did not change the results but did after including change in insulin in the models. CONCLUSIONS: Increases of MUFA and soluble fibers intakes promote benefits on glucose metabolism, independently of adiposity, during a realistic lifestyle intervention in at-risk individuals. Mechanisms mediating these processes may include mainly insulin sensitivity improvement.

Prevalence of metabolic syndrome in elderly Japanese-Brazilians.

BACKGROUND: Prevalence of individuals with a high cardiovascular risk is elevated in elderly populations. Although metabolic syndrome (MS) increases cardiovascular risk, information is scarce on the prevalence of MS in the elderly. In this study we assessed MS prevalence in a population of elderly Japanese-Brazilians using different MS definitions according to waist circumference cutoff values. MATERIAL/METHODS: We studied 339 elderly subjects, 44.8% males, aged between 60 to 88 years (70.1 ± 6.8). MS was defined according to criteria proposed by the Joint Interim Statement in 2009. As waist circumference cutoff point values remain controversial for Asian and Japanese populations, we employed 3 different cutoffs that are commonly used in Japanese epidemiological studies: 1) ≥ 90 cm for men and ≥ 80 cm for women; 2) ≥ 85 cm for men and ≥ 90 cm for women; 3) ≥ 85 cm for men and ≥ 80 cm for women. RESULTS: MS prevalence ranged from 59.9% to 65.8% according to the different definitions. We observed 90% concordance and no statistical difference (p>0.05) in MS prevalence between the 3 definitions. MS diagnosis according to all 3 cutoff values was found in 55.8% of our population, while in only 34.2% was MS discarded by all cutoffs. The prevalence of altered MS components was as follows: arterial blood pressure 82%, fasting glycemia 65.8%, triglyceride 43.4%, and HDL-C levels 36.9%. CONCLUSIONS: Elderly Japanese-Brazilians present high metabolic syndrome prevalence independent of waist circumference cutoff values. Concordance between the 3 definitions is high, suggesting that all 3 cutoff values yield similar metabolic syndrome prevalence values in this population.

Índice de Qualidade da Dieta Revisado para população brasileira / A revised version of the Healthy Eating Index for the Brazilian population / Índice de Calidad de la Dieta Revisado para población brasileña

O Índice de Qualidade da Dieta Revisado é um indicador de qualidade da dieta desenvolvido consoante com as recomendações nutricionais vigentes. Os dados dietéticos foram provenientes do estudo de base-populacional, Inquérito de Saúde e Alimentação (ISA)-Capital-2003. O Índice contém 12 componentes, sendo nove fundamentados nos grupos de alimentos do Guia Alimentar Brasileiro de 2006, cujas porções diárias são expressas em densidade energética; dois nutrientes (sódio e gordura saturada); e Gord_AA (calorias provenientes de gordura sólida, álcool e açúcar de adição). O Índice de Qualidade da Dieta Revisado propicia mensurar variados fatores de riscos dietéticos para doenças crônicas, permitindo, simultaneamente, avaliar e monitorar a dieta em nível individual ou populacional.

The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimentação (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels.

El Índice de Calidad de la Dieta Revisado es un indicador de calidad de la dieta desarrollado cónsono con las recomendaciones nutricionales vigentes. Los datos dietéticos fueron provenientes del estudio de base poblacional Inquérito de Saúde e Alimentação (ISA - Pesquisa de Salud y Alimentación)-Capital-2003. El Índice contiene 12 componentes, siendo nueve fundamentados en los grupos de alimentos de la Guía Alimentaria Brasileña de 2006, cuyas porciones diarias son expresadas en densidad energética; dos nutrientes (sodio y grasa saturada); y Gord_AA (calorías provenientes de grasa sólida, alcohol y azúcar de adición). El Índice de Calidad de la Dieta Revisado propicia medir varios factores de riesgos dietéticos para enfermedades crónicas, permitiendo, simultáneamente, evaluar y monitorear la dieta en nivel individual o poblacional.

A revised version of the Healthy Eating Index for the Brazilian population.

The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimentação (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels.

[Impact of a lifestyle intervention program on metabolic, anthropometrical and dietary profile of Japanese-Brazilians with and without metabolic syndrome]. / Impacto de um programa de intervenção sobre o estilo de vida nos perfis metabólico, antropométrico e dietético em nipo-brasileiros com e sem síndrome metabólica.

OBJECTIVE: We evaluated the changes in biochemical and nutritional profiles of Japanese-Brazilians with and without metabolic syndrome after two years of participation in the intervention program. MATERIALS AND METHODS: It was a non-controlled experimental study. The biochemical and clinical assessments were conducted at baseline (2005), after a year (2006) and after two years (2007) of intervention. On the present study, data of 360 individuals, who participated on the three assessments were considered. RESULTS: Both groups presented improvements on the anthropometric and metabolic profile, after two years of intervention. It was observed reduction in the intake of total fat, saturated fat, and dietary cholesterol, and increased intake of fiber among men without metabolic syndrome. It was observed reduction in the intake of total fat (p = 0,003) and monounsaturated fatty acid (p = 0,002). CONCLUSION: The results showed a positive impact of the lifestyle intervention program in metabolic and nutritional profile of Japanese-Brazilians with and without metabolic syndrome.

Hyperuricemia and associated factors: a cross-sectional study of Japanese-Brazilians.

This cross-sectional study aimed to estimate the prevalence of hyperuricemia and associated risk factors among Japanese-Brazilians. We obtained data on demographic, health history, food intake, and laboratory variables. Chi-square and prevalence ratios were used as measures of association. 35.3% of the subjects presented hyperuricemia, which was more frequent in smokers, males, age > 55 years, with co-morbidities, individuals on uric acid-increasing medication, serum creatinine > 1.4 mg/dL, high alcohol consumption, and low consumption of milk and dairy products. In the multivariate analysis, the associations remained significant with gender, overweight, central obesity, hypertriglyceridemia, and use of specific drugs. Among males, low intake of saturated fat was associated with hyperuricemia. Individuals with hypertension showed a negative association with dairy product consumption. The high hyperuricemia prevalence suggests that changes in nutritional profile and control of associated co-morbidities could help minimize occurrence of this condition.