Increased monocytes are associated with overweight in children and adolescents with autism spectrum disorder.

Introduction: Objective: to investigate the monocyte count and its association with nutritional status in children and adolescents with autism spectrum disorder (ASD). Methods: a cross-sectional study carried out at a Neurodevelopmental Center in the south of Brazil, with 68 ASD patients aged 3 to 18 years. The number of monocytes (per mm3) was determined in blood samples. Nutritional status was defined as BMI-for-age according to WHO standards. The Children's Eating Behaviour Questionnaire and a standard questionnaire to collect sociodemographic and clinical characteristics were administered to caregivers. Comparisons between sociodemographic, clinical, and eating behavior variables were performed with parametric tests. Linear regression was used to test the association between nutritional status and monocyte count. Results: mean age was 8.6 ± 3.3 years, 79 % were males and 66 % were overweight. In the unadjusted regression overweight was associated with higher monocyte counts compared to those non-overweight (B: 64.0; 95 % CI, 13.9 to 114.1; ß: 0.30, p = 0.01). This association remained significant after adjustment for the subscale of "emotional overeating" (B: 37.0; 95 % CI, 17.1 to 91.3; ß: 0.29; p = 0.02). The variability in monocyte count attributed to overweight was 14 %. Conclusions: overweight is associated with a higher monocyte count in children and adolescents with ASD. Nutritional intervention to control overweight is essential to mitigate the negative impact on inflammatory activity and immune dysfunction in these patients.

Introducción: Objetivo: investigar el recuento de monocitos y su asociación con el estado nutricional en niños y adolescentes con trastorno del espectro autista (TEA). Método: estudio transversal realizado en el Centro de Neurodesarrollo, en el sur de Brasil, con 68 pacientes con TEA de 3 a 18 años de edad. Se determinó el número de monocitos (por mm3) en muestras de sangre. El estado nutricional se definió como IMC para la edad según los estándares de la OMS. Se aplicó a los cuidadores el Cuestionario de Conducta Alimentaria Infantil y un cuestionario estándar para recoger características sociodemográficas y clínicas. Las comparaciones entre las variables sociodemográficas, clínicas y de conducta alimentaria se realizaron con pruebas paramétricas. Se utilizó la regresión lineal para probar la asociación entre el estado nutricional y el recuento de monocitos. Resultados: la edad media fue de 8,6 ± 3,3 años, el 79 % eran varones y el 66 % tenían sobrepeso. En la regresión no ajustada, el sobrepeso se asoció a un mayor número de monocitos en comparación con los que no tenían sobrepeso (B: 64,0; IC 95 %: 13,9 a 114,1; ß: 0,30; p = 0,01). Esta asociación siguió siendo significativa tras ajustar la subescala de "sobrealimentación emocional" (B: 37,0; IC 95 %: 17,1 a 91,3; ß: 0,29; p = 0,02). La variabilidad en el recuento de monocitos atribuida al sobrepeso fue del 14 %. Conclusiones: el sobrepeso se asocia a un mayor recuento de monocitos en niños y adolescentes con TEA. La intervención nutricional para controlar el sobrepeso es esencial para mitigar el impacto negativo sobre la actividad inflamatoria y la disfunción inmune en estos pacientes.

Sociodemographic inequalities in vegetables, fruits, and animal source foods consumption in children aged 6-23 months from 91 LMIC.

Introduction: No multi-country analysis described patterns and inequalities for the brand-new feeding indicators proposed by WHO/UNICEF: zero consumption of vegetables and fruits (ZVF) and consumption of eggs and/or flesh (EFF). Our aim was to describe patterns in the prevalence and social inequalities of ZVF and EFF among children aged 6-23 months in low-and middle-income countries. Methods: Data from nationally representative surveys (2010-2019) in 91 low-and middle-income countries were used to investigate within-country disparities in ZVF and EFF by place of residence, wealth quintiles, child sex and child age. The slope index of inequality was used to assess socioeconomic inequalities. Analyses were also pooled by World Bank income groups. Results: The prevalence of ZVF was 44.8% and it was lowest in children from upper-middle income countries, from urban areas, and those 18-23 months. The slope index of inequality showed that socioeconomic inequalities in the prevalence of ZVF were higher among poor children in comparison to richest children (mean SII = -15.3; 95%CI: -18.5; -12.1). Overall, 42.1% of children consumed egg and/or flesh foods. Being a favorable indicator, findings for EFF were generally in the opposite direction than for ZVF. The prevalence was highest in children from upper-middle income countries, from urban areas, and those 18-23 months of age. The slope index of inequality showed pro-rich patterns in most countries (mean SII = 15.4; 95%CI: 12.2; 18.6). Discussion: Our findings demonstrate that inequalities exist in terms of household wealth, place of residence, and age of the child in the prevalence of the new complementary feeding indicators. Moreover, children from low-and lower-middle countries had the lowest consumption of fruits, vegetables, eggs, and flesh foods. Such findings provide new insights towards effective approaches to tackle the malnutrition burden through optimal feeding practices.

Gestational age, intrauterine growth and body composition at 11 years of age.

OBJETIVE: To assess the association of gestational age (GA) and intrauterine growth with body composition at 11 years of age. METHOD: Analysis of data from the 2004 Pelotas birth cohort, whose outcomes were fat mass (FM, kg), fat mass index (FMI, kg/m2), fat-free mass (FFM, kg), fat-free mass index (FFMI, kg/m2) - measured by air displacement plethysmography - and body mass index for age (BMI/age, Z-score). The exposures of interest were the gestational index (GA) of infants born at less than 33 weeks, from 34 to 36 and from 37 to 41, and intrauterine growth categorized as small (SGA), adequate (AGA) and large (LGA) for gestational age. Analysis of variance was used to compare means and linear regression was used to assess the strength of association. The analyses were adjusted according to variables collected at birth, such as monthly family income, maternal characteristics - education, age, pre-gestational body mass index (BMI), weight gain during pregnancy, smoking during pregnancy, type of delivery, and parity - and adolescent characteristics - skin color and birth weight. For analysis, FM and FMI underwent logarithmic transformation due to data asymmetry. RESULTS: A total of 3,401 adolescents were analyzed, including boys and girls born at less than 33 weeks, with lower FM and FFM means than those born at term. However, in the adjusted analyses, there was no association between GA and any of the outcomes in either sex. LGA boys had a 10.5% higher FMI (p = 0.026) and +0.3 BMI/age Z-score (p = 0.019) as compared to AGA boys, and LGA girls had +0.3 kg/m 2 of FFMI (p = 0.039) than AGA girls. CONCLUSION: GA was not associated with body composition at 11 years of age. However, LGA boys had higher BMI and BMI/age Z-score, and LGA girls had higher FFMI than AGA girls.

Food profile of Yanomami indigenous children aged 6 to 59 months from the Brazilian Amazon, according to the degree of food processing: a cross-sectional study.

OBJECTIVE: The current study aimed to characterise the food profile of Yanomami indigenous children according to the degree of food processing and its associated factors. DESIGN: This is a cross-sectional study with Yanomami indigenous children aged 6 to 59 months. Socio-demographic, maternal and infant data were collected through a standardised questionnaire. The food profile was obtained by using a list of thirty-four foods to verify the child's consumption of these foods on the day preceding the interview. Foods were classified according to the degree of processing based on the NOVA system (in natura or minimally processed, processed culinary ingredients, processed and ultra-processed). In natura and minimally processed foods were subdivided into 'regional' and 'urban' foods. Poisson regression analysis was applied to estimate the associated factors according to the 90 % CI. SETTING: Three villages (Auaris, Maturacá and Ariabú) in the Yanomami indigenous territory, in the Brazilian Amazon. PARTICIPANTS: In total, 251 Yanomami children aged 6 to 59 months were evaluated. RESULTS: The prevalence of consumption of 'regional' and 'urban' in natura or minimally processed foods was 93 % and 56 %, respectively, and consumption of ultra-processed foods was 32 %. Ultra-processed food consumption was 11·6 times higher in children of Maturacá and 9·2 times higher in Ariabú when compared with the children of Auaris and 31 % lower in children who had mothers with shorter stature. CONCLUSION: Despite the high frequency of consumption of in natura and minimally processed foods, the consumption of ultra-processed foods was substantial and was associated with demographic and maternal factors in Yanomani indigenous children under 5 years of age.

Tooth loss severity and core and non-core food consumption among older Brazilian adults.

OBJECTIVE: To investigate the association between tooth loss severity and core and non-core food consumption in the older Brazilian population. METHODS: We analysed data from 20 756 people aged 60 years or older who participated in the 2019 Brazilian National Health Survey. The average consumption days a week of core (8-item) and non-core (4-item) foods were the outcomes, measured using a Food Frequency Questionnaire. Tooth loss severity was the main exposure, using a four-category ordinal variable: mild (1-12 teeth missing), moderate (13-22), severe (23-31) and edentulous (all 32). Sociodemographic, tobacco smoking, use of dental prosthesis, difficulty in chewing and systemic conditions were among the covariates. Linear regression models estimated the association between tooth loss and food consumption. RESULTS: Almost two-thirds of participants had moderate or worse levels of tooth loss. Older adults with more severe tooth loss reported an overall lower consumption of core and higher non-core foods than those with mild tooth loss. Worse tooth loss severity was associated with lower consumption of vegetables and/or legumes and fruits, and higher consumption of beans, artificial fruit juices and confectionery. CONCLUSIONS: Older Brazilian adults with more severe tooth loss are consuming lower core and higher non-core foods. Our findings reinforce the importance of the common risk factor approach to tackle the adverse effects of tooth loss on diet.

Linear growth and relative weight gain in childhood and bone mass in adolescence: findings from the Pelotas (Brazil) 2004 birth cohort.

With the objective to investigate the relationship of weight and height growth with bone mass at 11 years, we found that boys who grew in weight and height, especially at 48 months, and girls, who grew in weight at 24 months and height at 11 years, gained more bone mass. PURPOSE: To investigate independent relationships of linear growth and relative weight gain during defined periods of infancy, childhood, and early adolescence with areal bone mineral density (aBMD) of three sites at 11 years. METHODS: Data on weight and length/height were obtained at birth, 3, 12, and 24 months, and the ages of 4, 6, and 11. The outcome was whole body, femoral neck, and lumbar spine aBMD (g/cm2) measured at 11 years using dual-energy X-ray absorptiometry. The effects of weight gain and linear growth were analyzed using conditional relative weight and conditional length/height. Associations between conditional growth and outcomes were analyzed using linear regression, adjusted for multiple confounders. RESULTS: Individuals with data available for exposures and bone outcomes were 2875 and comprised the sample. For boys, the greatest magnitude of increase for whole body and height gain was at 48 months (ß 0.014, 95% CI 0.010; 0.018). For girls, higher aBMD was observed for those with greater height gain at 11 years, representing for lumbar spine an increase of 0.056 g/cm2 (95% CI 0.050; 0.062). For body weight, among boys, the greatest magnitude in the whole body was also associated with weight gain at 48 months (ß 0.014, 95% CI 0.010; 0.018). For girls, the highest coefficient was at 24 months, representing for lumbar spine an increase of 0.028 g/cm2, (95% CI 0.021; 0.035). CONCLUSION: Positive associations were demonstrated between length/height and weight gain and aBMD in both sexes, with emphasis on girls' aBMD in response to the linear growth achieved mainly at 11 years.

Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis.

This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.

Physical intimate partner violence and dietary patterns in pregnancy: a Brazilian cohort.

Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.

Physical intimate partner violence and dietary patterns in pregnancy: a Brazilian cohort / Violência física por parceiro íntimo e padrão de alimentação na gestação: uma coorte brasileira

Abstract Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns ("Healthy", "Common-Brazilian", and "Processed") were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with "Healthy" and "Common-Brazilian" dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.

Resumo Pouco se sabe sobre as repercussões da violência por parceiro íntimo (VPI) nos desfechos nutricionais da gravidez, principalmente no que diz respeito à dieta. O objetivo foi investigar se a ocorrência de VPI física na gestação está associada aos padrões alimentares gestacionais. 161 gestantes adultas participaram de um estudo prospectivo no Rio de Janeiro, Brasil. A VPI física geral e grave foi medida para avaliar a VPI a qualquer momento durante a gravidez. Três padrões alimentares gestacionais ("Saudável", "Brasileiro Comum" e "Processado") foram estabelecidos pela análise de componentes principais. O efeito da VPI física foi testado em relação ao escore de adesão a cada um dos padrões alimentares. A ocorrência de VPI física geral e grave em qualquer momento da gestação foi de 20,4% e 6,8%, respectivamente. Mulheres que viviam em relacionamentos íntimos em que ocorreu VPI física geral e grave tiveram um aumento médio de 0,604 unidades (IC95% 0,149-1,058) e 1,347 unidades (IC95% 0,670-2,024), respectivamente, no escore de adesão ao padrão alimentar processado. Não foi observada associação com os padrões alimentares "Saudável" e "Brasileiro Comum". A VPI física foi associada à maior adesão a um padrão alimentar de menor qualidade nutricional na gestação.

Gestational age, intrauterine growth and body composition at 11 years of age / Idade gestacional, crescimento intrauterino e composição corporal aos 11 anos de idade

ABSTRACT OBJETIVE To assess the association of gestational age (GA) and intrauterine growth with body composition at 11 years of age. METHOD Analysis of data from the 2004 Pelotas birth cohort, whose outcomes were fat mass (FM, kg), fat mass index (FMI, kg/m2), fat-free mass (FFM, kg), fat-free mass index (FFMI, kg/m2) - measured by air displacement plethysmography - and body mass index for age (BMI/age, Z-score). The exposures of interest were the gestational index (GA) of infants born at less than 33 weeks, from 34 to 36 and from 37 to 41, and intrauterine growth categorized as small (SGA), adequate (AGA) and large (LGA) for gestational age. Analysis of variance was used to compare means and linear regression was used to assess the strength of association. The analyses were adjusted according to variables collected at birth, such as monthly family income, maternal characteristics - education, age, pre-gestational body mass index (BMI), weight gain during pregnancy, smoking during pregnancy, type of delivery, and parity - and adolescent characteristics - skin color and birth weight. For analysis, FM and FMI underwent logarithmic transformation due to data asymmetry. RESULTS A total of 3,401 adolescents were analyzed, including boys and girls born at less than 33 weeks, with lower FM and FFM means than those born at term. However, in the adjusted analyses, there was no association between GA and any of the outcomes in either sex. LGA boys had a 10.5% higher FMI (p = 0.026) and +0.3 BMI/age Z-score (p = 0.019) as compared to AGA boys, and LGA girls had +0.3 kg/m 2 of FFMI (p = 0.039) than AGA girls. CONCLUSION GA was not associated with body composition at 11 years of age. However, LGA boys had higher BMI and BMI/age Z-score, and LGA girls had higher FFMI than AGA girls.

RESUMO OBJETIVO Avaliar a associação da idade gestacional (IG) e crescimento intrauterino com a composição corporal aos 11 anos de idade. MÉTODO Análise de dados da coorte de nascimentos de Pelotas de 2004, cujos desfechos foram massa gorda (MG, kg), índice de massa gorda (IMG, kg/m2), massa livre de gordura (MLG, kg), índice de massa livre de gordura (IMLG, kg/m2) - medidos por pletismografia por deslocamento de ar -, e índice de massa corporal para idade (IMC/Idade, escore-Z). Sendo as exposições de interesse o índice gestacional (IG) de nascidos com menos de 33 semanas, de 34 a 36 e de 37 a 41, e crescimento intrauterino categorizado em pequeno para a idade gestacional (PIG), adequado (AIG) e grande (GIG). Para comparar médias, utilizou-se análise de variância e, para avaliar a força de associação, regressão linear. As análises foram ajustadas de acordo com variáveis coletadas ao nascer, como renda familiar mensal, características maternas - escolaridade, idade, índice de massa corporal (IMC) pré-gestacional, ganho de peso na gestação, tabagismo na gestação, tipo de parto e paridade - e características dos adolescentes - cor da pele e peso ao nascer. Para análise, o MG e o IMG sofreram transformação logarítmica devido a assimetria dos dados. RESULTADOS Foram analisados 3.401 adolescentes, entre meninos e meninas nascidos com menos de 33 semanas, com médias de MG e MLG menores que as dos nascidos(as) a termo. Porém, nas análises ajustadas, não houve associação entre IG e qualquer um dos desfechos em ambos os sexos. Meninos GIG apresentaram IMG 10,5% maior (p = 0,026) e +0,3 escore-Z de IMC/Idade (p = 0,019) em relação aos AIG, e meninas GIG apresentaram +0,3 kg/m2 de IMLG (p = 0,039) do que as AIG. CONCLUSÃO A IG não se associou à composição corporal aos 11 anos. Entretanto, meninos GIG apresentaram maiores IMG e escore-Z de IMC/Idade e meninas GIG, maior IMLG, quando comparados aos AIG.

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort.

This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Intergenerational Association of Short Maternal Stature with Stunting in Yanomami Indigenous Children from the Brazilian Amazon.

To describe the factors associated to stunting in <5-year-old Yanomami Brazilian children, and to evaluate the association of short maternal stature to their offspring's stunting. A cross-sectional study carried out in three villages in the Yanomami territory. We performed a census, in which all households with children < 5-years-old were included. The length/height-for-age z-score <-2 standard deviations was used to classify the children as stunted. Short maternal height was defined as <145 cm for adult women, and <-2 standard deviations of the height-for-age z-score for adolescent women. We used adjusted Poisson regression models to estimate prevalence ratios (PR) along the 90% confidence interval. We evaluated 298 children. 81.2% of children suffered from stunting and 71.9% of the mothers from short stature. In the bivariate analysis, a significant association of stunting with short maternal stature, gestational malaria and child's place of birth were observed. Considering the variables of the children under five years of age, there were significant associations with age group, the child's caregiver, history of malaria, pneumonia, and malnutrition treatment. In the adjusted hierarchical model, stunting was 1.22 times greater in the offspring of women with a short stature (90% CI: 1.07-1.38) compared to their counterparts. Brazilian Amazonian indigenous children living in a remote area displayed an alarming prevalence of stunting, and this was associated with short maternal height, reinforcing the hypothesis of intergenerational chronic malnutrition transmission in this population. In addition, children above 24 months of age, who were born in the village healthcare units and who had had previous treatment in the past for stunting presented higher rates of stunting in this study.

Interest in food and triglyceride concentrations in children and adolescents with autistic spectrum disorder

Abstract Objective: To investigate eating behavior and serum concentration of triglycerides in children and adolescents with autistic spectrum disorder. Methods: Cross-sectional study conducted in the neurodevelopment nucleus, from October 2018 to April 2019 in a neurodevelopment center in the city of Pelotas/RS. Blood samples were collected, and serum was essayed for triglycerides by colorimetric enzymatic reaction. The Children's Eating Behavior Questionnaire was applied to the parents. The comparison between two or three categories of variables was performed with nonparametric tests. Linear regression was used to access the association between the log triglyceride serum concentration and the score above or below the median score of the food response and emotional overeating subscales. Results: Sixty patients were evaluated. The average age was 8.6 ± 3.2 years and most were white (75 %), male (80 %), and overweight (66%). Half of the sample had elevated triglycerides. Triglyceride concentrations were higher among overweight children and adolescents with higher median scores on the "food response" and "emotional overeating" subscales. In the adjusted analysis, the association between triglycerides and higher scores on subscales reflecting interest in food remained significant. Conclusion: Children and adolescents with autistic spectrum disorder present high triglyceride concentrations associated with a greater interest in food. Knowledge of this eating behavior may provide more effective nutritional intervention in this population.

Interest in food and triglyceride concentrations in children and adolescents with autistic spectrum disorder.

OBJECTIVE: To investigate eating behavior and serum concentration of triglycerides in children and adolescents with autistic spectrum disorder. METHODS: Cross-sectional study conducted in the neurodevelopment nucleus, from October 2018 to April 2019 in a neurodevelopment center in the city of Pelotas/RS. Blood samples were collected, and serum was essayed for triglycerides by colorimetric enzymatic reaction. The Children's Eating Behavior Questionnaire was applied to the parents. The comparison between two or three categories of variables was performed with nonparametric tests. Linear regression was used to access the association between the log triglyceride serum concentration and the score above or below the median score of the food response and emotional overeating subscales. RESULTS: Sixty patients were evaluated. The average age was 8.6±3.2 years and most were white (75 %), male (80 %), and overweight (66%). Half of the sample had elevated triglycerides. Triglyceride concentrations were higher among overweight children and adolescents with higher median scores on the "food response" and "emotional overeating" subscales. In the adjusted analysis, the association between triglycerides and higher scores on subscales reflecting interest in food remained significant. CONCLUSION: Children and adolescents with autistic spectrum disorder present high triglyceride concentrations associated with a greater interest in food. Knowledge of this eating behavior may provide more effective nutritional intervention in this population.

Ultra-processed foods and early childhood caries in 0-3-year-olds enrolled at Primary Healthcare Centers in Southern Brazil.

OBJECTIVE: To investigate the relationship between ultra-processed food consumption and early childhood caries. DESIGN: Cross-sectional analysis of baseline data from a cluster randomised controlled study. Outcomes included the prevalence of children with non-cavitated and cavitated caries. The main exposure was the total daily consumption of ultra-processed foods (up to three times and four times or more), assessed through a FFQ. Potential confounders were socio-demographic characteristics of the child and caregiver/family, child breast-feeding, oral hygiene and use of dental services. Poisson regression using robust variance adjustment was used to estimate prevalence ratios (PR) and their respective 95 % CI. SETTING: Primary Healthcare Centers in an urban area of Pelotas, Southern Brazil. PARTICIPANTS: Children aged 0-3 years (n 309). RESULTS: Consumption of ultra-processed foods four times or more a day was found in 67·6 % of children; 24·4 and 12·0 % presented non-cavitated and cavitated caries, respectively. After adjustment, children who consumed ultra-processed foods four times or more a day were more likely to present both non-cavitated caries (PR 2·25, 95 % CI 1·19, 4·27, P = 0·013) and cavitated caries (PR 3·48, 95 % CI 1·18, 10·30, P = 0·024) compared with those who have consumed them up to three times a day. CONCLUSIONS: Consumption of ultra-processed foods is associated with early childhood caries. Interventions aiming at reducing ultra-processed food consumption should be implemented to improve children's oral health.

Obesity and ADHD: Exploring the role of body composition, BMI polygenic risk score, and reward system genes.

The association between obesity and attention-deficit hyperactivity disorder (ADHD) has been extensively reported in the literature. However, the potential mechanisms underlying this association are not completely understood. This study aimed to evaluate the association between body composition and ADHD and explore the possible genetic mechanisms involved. We used data from the 1982 Pelotas (Brazil) Birth Cohort at age 30-year follow-up (N = 3630). We first used logistic regression analysis to test whether body mass index (BMI), fat mass (FM), and fat-free mass (FFM) were associated with ADHD. We further tested the association between BMI polygenic risk score (BMI-PRS) and ADHD and the role of the genes upregulated in the reward system using a gene-set association approach. BMI (odds ratio [OR] = 1.05; 95% confidence interval [CI], 1.00-1.09; p = 0.038) and FM (OR = 1.04; 95% CI, 1.00-1.07; p = 0.043) were associated with ADHD. The BMI-PRS was associated with ADHD (using p-value threshold (PT) = 0.4; OR = 1.65; 95% CI, 1.02-2.65) at a nominal level. In gene-set analysis, the reward system genes were associated with BMI in subjects with a high BMI-PRS score, considering PT = 0.4 (p = 0.014). The results suggest that BMI genetic components, especially those genes related to the reward system, may be involved in this association.

Intergenerational breastfeeding practices among parents and children: 1993 Pelotas (Brazil) birth cohort.

The objective of this study was to investigate intergenerational breastfeeding practices according to parental sex and age at delivery in the 1993 Pelotas (Brazil) birth cohort study. This is a prospective birth cohort study, and at the 22-year follow-up, a substudy with all children of the cohort members who had become parents was conducted (93Cohort-II). First generation breastfeeding data were collected at 3 months and 4-year-old follow-ups. In the 93Cohort-II, parents answered a questionnaire about their children's breastfeeding practices. Adjusted Tobit and Poisson regression models with robust variance were applied to estimate the association between predominant parental breastfeeding duration and exclusive breastfeeding duration of the children at 3 and 6 months. Out of 3,810 cohort participants, 955 (25%) had delivered at least one live-born infant, and 1,222 children were assessed. Fifty-four percent of parents were ≤19 years old. Direct effects of predominant parental breastfeeding duration on exclusive breastfeeding duration of their children were only observed when data were stratified by parental age: children born to parents aged ≥20 years old and who were predominantly breastfed for at least 3 months presented higher exclusive breastfeeding duration and higher prevalence of being exclusively breastfed for at least 3 months. When analyses were stratified by mothers and fathers, the result remained significant only among mothers. Longer predominant breastfeeding duration in the first generation was associated with longer exclusive breastfeeding duration in the second generation, but only among older mothers. Education and social support surrounding breastfeeding should be intensified among fathers and younger parents to create a positive environment supportive of breastfeeding.

Sintomas de ansiedade gestacional e pós-parto e intenção de amamentar exclusivo até os seis meses: resultados de uma coorte prospectiva do Rio de Janeiro / Symptoms of gestational and postpartum anxiety and intention to breastfeed exclusively until six months: results of a prospective cohort in Rio de Janeiro

Objetivo: Avaliar a associação entre sintomas de ansiedade gestacional e pós-parto e intenção de amamentar exclusivamente até os seis meses. Métodos Coorte prospectiva com uma população de mulheres atendidas no serviço de obstetrícia de um centro de saúde do município do Rio de Janeiro. Os sintomas de ansiedade foram avaliados pelo Inventário de Ansiedade Traço/Estado no primeiro trimestre da gestação (ansiedade-traço) e 30-45 dias pós-parto (ansiedade-estado). A intenção de amamentar exclusivamente até seis meses foi avaliada por questionário aplicado 30-45 dias pós-parto. Variáveis independentes foram obtidas de questionários padronizados com dados socioeconômicos, obstétricos e nutricionais. As associações brutas e ajustadas foram testadas por regressão de Poisson com variâncias robustas. Resultados: Foram avaliadas 195 mulheres no primeiro trimestre gestacional e 185 no pós-parto. A prevalência de sintomas de ansiedade-traço ao início da gestação foi de 53%, e ansiedade-estado no pós-parto 29%. Cinquenta e nove por cento das mulheres pretendiam amamentar exclusivamente até seis meses. Nas análises ajustadas, a presença de sintomas de ansiedade-traço associou-se com a intenção de não amamentar exclusivamente até os seis meses (RP=1,70; IC95%=1,07­2,72). A presença de sintomas de ansiedade-estado no pós-parto perdeu a associação com o desfecho após os ajustes (RP=1,54; IC95%=0,97­2,44). Conclusões: A presença de sintomas de ansiedade-traço influencia negativamente na intenção de amamentar exclusivamente até os seis meses. Ressalta-se a importância de avaliar a saúde mental da mulher na gestação e pós-parto visando proteger a manutenção do aleitamento materno exclusivo. (AU)

Objective: To evaluate association between symptoms of gestational and postpartum anxiety and intention to breastfeed exclusively until six months of age. Methods: This was a prospective cohort study with a population of women treated at the obstetrics service of a health center in the municipality of Rio de Janeiro. Anxiety symptoms were assessed by the State-Trait Anxiety Inventory in the first trimester of pregnancy (trait anxiety) and 30-45 days postpartum (state anxiety). Intention to breastfeed exclusively up to six months was assessed by a questionnaire administered 30-45 days postpartum. Independent variables were obtained from standardized questionnaires with socioeconomic, obstetric and nutritional data. Crude and adjusted associations were tested by Poisson regression with robust variance. Results: A total of 195 women were evaluated in the first trimester of pregnancy, and 185 were evaluated in the postpartum period. Prevalence of trait anxiety symptoms at the beginning of pregnancy was 53%, while postpartum state anxiety was 29%. Fifty-nine percent of women intended to breastfeed exclusively for up to six months. In the adjusted analyses, presence of trait anxiety symptoms was associated with the intention not to breastfeed exclusively until six months (PR=1.70; 95% CI = 1.07-2.72). Presence of state anxiety symptoms in the postpartum period lost its association with the outcome after adjustments (PR=1.54; 95% CI = 0.97-2.44). Conclusions: Presence of trait anxiety symptoms negatively influences intention to breastfeed exclusively up to six months. Emphasis is placed on the importance of evaluating the mental health of women during pregnancy and postpartum to ensure exclusive breastfeeding is maintained. (AU)

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort / Condição socioeconômica e índice de massa corporal em modelos de curso de vida: coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil / Estatus socioeconómico e índice de masa corporal en modelos de ciclo vital: cohorte de nacimientos de 1993 en Pelotas, Rio Grande do Sul, Brasil

Abstract: This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Resumo: O artigo busca avaliar a relação entre condição socioeconômica ao longo da vida e índice de massa corporal (IMC) aos 22 anos de idade, de acordo com as hipóteses geradas pelos modelos de acúmulo de riscos, período crítico e mobilidade social. Este é um estudo prospectivo de base populacional, na coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil. Os modelos de acúmulo de riscos, período crítico e mobilidade social foram testados em relação a um model saturado, e comparados através de um teste F parcial. Após escolher o melhor modelo, a análise de regressão linear foi realizada para determinar os coeficientes de regressão, brutos e ajustados, da associação entre a condição socioeconômica ao longo da vida e o IMC aos 22 anos. A amostra consistia em 3.292 indivíduos (53,3% mulheres). Foram identificados efeitos de dose-resposta em homens e mulheres, embora os efeitos fossem opostos. Entre os homens, um aumento na pontuação baixa no modelo de acúmulo de condição socioeconômica levou a um IMC médio mais baixo aos 22 anos de idade; enquanto isso, nas mulheres, um aumento na pontuação baixa no modelo de acúmulo de condição socioeconômica levou a um aumento no IMC aos 22 anos de idade.

Resumen: El objetivo de este artículo es evaluar la relación entre el estatus socioeconómico a lo largo del ciclo vital y el índice de masa corporal (IMC) con 22 años de edad, según las hipótesis generadas por riesgo de acumulación, período crítico y modelos de movilidad social. Se trata de un estudio prospectivo de base poblacional con la cohorte de nacimiento de 1993 en Pelotas, Rio Grande do Sul, Brasil. Se probaron tanto el riesgo de acumulación, como el período crítico y modelos de movilidad social, en relación con un modelo saturado y comparado mediante un F-test parcial. Tras haber elegido el mejor modelo, se llevó a cabo una regresión lineal para determinar los coeficientes de asociación crudos y ajustados entre estatus socioeconómico, a lo largo del ciclo vital, e IMC a los 22 años de edad. La muestra estuvo compuesta por 3.292 individuos (53,3% mujeres). Se encontraron efectos dosis-respuesta para ambos hombres y mujeres, a pesar de que los efectos fueron opuestos. Entre hombres, el aumento en la puntación del modelo de acumulación en el estatus socioeconómico bajo condujo a un promedio más bajo de IMC a los 22 años de edad, mientras que, entre mujeres, el aumento en la puntuación del modelo de acumulación en el estatus socioeconómico bajo provocó un incremento en el IMC a los 22 años de edad.