Frequency of breakfast consumption and its associations with food consumption by degree of industrial processing and with indicators of overweight in Brazilian adolescents (EVA-JF Study).

OBJECTIVE: The aim of this study was to investigate the frequency of breakfast consumption and estimate its associations with the consumption of food at different degrees of industrial processing and with overweight indicators in Brazilian adolescents. METHODS: This cross-sectional study involved a probabilistic sample of 14- to 19-y-old adolescents enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 805). The frequency of breakfast consumption was evaluated via a questionnaire (classified into "do not consume", "sometimes consume", and "regularly consume"). The evaluation of food consumption involved two 24-h dietary recalls, the items of which were analyzed according to the NOVA classification system. Overweight indicators (waist circumference, body mass index for age (BMI-for-age), and body fat percentage) were evaluated according to a standard protocol. Linear regression models were performed, first without and then with adjustments for sociodemographic characteristics. RESULTS: We found that 20% of adolescents skipped breakfast, and ∼46% of the caloric intake came from ultra-processed foods. Breakfast omission was associated with a mean increase of 3.02% (95% confidence interval [CI], 0.52-5.53) in energy intake from ultra-processed foods, in addition to a mean increase of 0.28 z-score (95% CI, 0.05- 0.52) of BMI-for-age and of 1.64% (95% CI, 0.21-3.08) in body fat. CONCLUSIONS: We verified that the omission of breakfast was associated with higher consumption of ultra-processed foods, as well as a higher BMI-for-age and higher percentage of body fat, reinforcing the importance of actions to encourage the consumption of this meal and the adoption of healthy eating practices in adolescents.

Factors associated with non-frequent breakfast consumption in adolescents (EVA-JF Study) / Fatores associados ao consumo não frequente de café da manhã em adolescentes (Estudo EVA-JF)

ABSTRACT Objective To estimate the association of infrequent breakfast consumption with socioeconomic, behavioral, and individual factors in a sample of Brazilian adolescents from public schools. Methods Cross-sectional study with adolescents aged from 14 to 19 from public schools in Juiz de Fora, state of Minas Gerais. The frequency of consumption of breakfast, snacks, soft drinks, industrialized drinks, the usual food consumption, body mass index, body fat percentage, and waist circumference were evaluated. Other socioeconomic, behavioral, and individual data were obtained through questionnaires. Logistic regression analysis and hierarchical selection of variables were used to verify the associated factors. Results The sample consisted of 805 adolescents; 53.4% reported infrequent breakfast consumption. Through hierarchical logistic regression analysis, it was evidenced that the house occupancy status (OR: 0.618; 95%CI: 0.4410.865; p=0.005) was the distal factor associated with infrequent breakfast consumption; the intermediate factors were the consumption of industrialized beverages (OR: 0.658; 95%CI: 0.486-0.890; p=0.007) and percentage of energy from processed foods (OR: 0.935; 95%CI: 0.907-0.964; p<0.001); and the proximal factors were the male gender (OR: 0.696; 95%CI: 0.520-0.932; p=0.0015) and being nonwhite (OR: 1.529; 95%CI: 1.131-2.069; p=0.006). Conclusion Male adolescents who lived in owned houses, with occasional consumption of industrialized beverages and a higher percentage of energy derived from processed foods, had lower chances of infrequent breakfast consumption, while non-white adolescents had higher chances.

RESUMO Objetivo Estimar as associações do consumo não frequente de café da manhã com fatores socioeconômicos, comportamentais e individuais em uma amostra de adolescentes de escolas públicas. Métodos Estudo transversal realizado com adolescentes de 14 a 19 anos matriculados em escolas públicas de Juiz de Fora (MG). Foram avaliadas a frequência de consumo de café da manhã, lanches, refrigerantes e bebidas industrializadas, consumo alimentar usual, IMC, percentual de gordura corporal e perímetro da cintura. Demais dados socioeconômicos, comportamentais e individuais foram obtidos através de questionários. A análise de regressão logística e seleção hierárquica das variáveis foram usadas para verificar fatores associados. Resultados A amostra foi composta por 805 adolescentes e 53,4% deles relataram consumo não frequente de café da manhã. Através da análise de regressão logística hierarquizada, evidenciou-se que a ocupação em domicílio próprio (OR: 0,618; IC95%: 0,441-0,865; p=0,005) foi o fator distal associado ao consumo não frequente de café da manhã, além dos fatores intermediários "consumo não frequente de bebidas industrializadas" (OR: 0,658; IC95%: 0,486-0,890; p=0,007) e "percentual de energia proveniente de alimentos processados" (OR: 0,935; IC95%: 0,907-0,964; p<0,001) e dos fatores proximais "sexo masculino" (OR: 0,696; IC95%: 0,520-0,932; p=0,0015) e "cor da pele não branca" (OR: 1,529; IC95%: 1,131-2,069; p=0,006). Conclusão Adolescentes que residiam em domicílios próprios, com consumo não frequente de bebidas industrializadas, com maior percentual de energia proveniente de alimentos processados e do sexo masculino apresentaram menores chances de consumo não frequente de café da manhã, enquanto, adolescentes com cor da pele não branca apresentaram maiores chances.

Risco nutricional em pacientes críticos utilizando o método Nutric Score Risk / Nutritional risk in critical patients using the Nutric Score Risk method

INTRODUÇÃO: Pacientes críticos apresentam maior risco de desnutrição e o suporte nutricional pode impactar favoravelmente na gravidade da doença. Deste modo, a identificação precoce de pacientes que se encontram em risco nutricional e com maior probabilidade de se beneficiarem de terapia nutricional é extremamente importante. OBJETIVOS: Avaliar o risco nutricional de pacientes críticos internados na Unidade de Terapia Intensiva de um hospital universitário utilizando a ferramenta NUTRIC Score. MÉTODOS: Estudo observacional e retrospectivo realizado com pacientes críticos maiores de 18 anos internados no período de março a agosto de 2018. Os dados foram coletados do prontuário eletrônico dos pacientes e em planilhas de controle. A análise estatística foi realizada utilizando o software Statistical Package for the Social Sciences(R) (SPSS) versão 23. RESULTADOS: Participaram do estudo 82 pacientes críticos, sendo a maioria do sexo masculino (52,4%), com média de idade de 63,1+/-16,1 anos. Os principais diagnósticos que levaram a internação na Unidade Intensiva foram casos de pré e pós-operatório (40,2%). O uso de ventilação mecânica foi observado em 31,7% dos pacientes e o principal desfecho clínico foi alta para enfermaria (76,8%). Grande parte dos pacientes (43,9%) foram classificados com risco nutricional pelo NUTRIC. Ao associar a presença ou não de risco nutricional com as variáveis, observou-se diferença significativa entre tempo de permanência na Unidade Terapia Intensiva (p > 0,004), escores prognósticos APACHE e SOFA (p > 0,000), uso de ventilação mecânica (p > 0,002) e desfecho clínico do paciente (p > 0,014). DISCUSSÃO: Estudos mostram a associação significativa entre pacientes com alto risco pelo NUTRIC e maior tempo em Terapia Intensiva, além de uso de ventilação mecânica e maiores taxas de mortalidade. CONCLUSÃO: O NUTRIC Score identificou risco nutricional em mais de 40% dos pacientes críticos avaliados, o que reforça a relevância do atendimento nutricional e identificação de risco nutricional precoce no cenário de cuidados intensivos

INTRODUCTION: Critical patients presenting a higher risk of malnutrition and nutritional support may favorably affect the severity of the disease. Thus, early identification of patients who are at nutritional risk and more likely to benefit from nutritional therapy is extremely important. OBJECTIVES: To evaluate the nutritional risk of critically ill patients admitted to the Intensive Care Unit of a university hospital using the NUTRIC Score tool. METHODS: An observational and retrospective study was performed with critically ill patients over 18 years of age admitted from March to August 2018. Data were collected from patients' electronic files and in control sheets. The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) software version 23. RESULTS: 82 critical patients participated in the study, most of them male (52.4%), with a mean age of 63, 1 +/- 16.1 years. The main diagnoses leading to Intensive Care Unit admission were pre- and postoperative (40.2%). The use of mechanical ventilation was observed in 31.7% of patients and the main clinical outcome was high for the ward (76.8%). Most of the patients (43.9%) were classified as having nutritional risk by NUTRIC. When associating the presence or not of nutritional risk with the variables, a significant difference was observed between length of stay in the Intensive Care Unit (p > 0,004), prognostic scores APACHE and SOFA (p > 0,000), use of mechanical ventilation (p > 0,002) and clinical outcome of the patient (p > 0,014). DISCUSSION: Studies show the significant association between patients with high NUTRIC risk and longer Intensive Care Unit stay, besides the use of mechanical ventilation and higher mortality rates. CONCLUSION: NUTRIC Score identified a nutritional risk in more than 40% of critically ill patients, which reinforces the relevance of nutritional care and the identification of early nutritional risk in the intensive care setting

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