Social vulnerability and cardiovascular risk factors in adolescents.

BACKGROUND: Social vulnerability can influence in the development of cardiovascular risk factors in adolescents (CRF). For this reason, the objective of our study was to evaluate the presence of CRF in adolescents, according to social vulnerability. METHODS: This is a cross-sectional study with 517 adolescents of both sexes, from 10 to 19 years of age, classified into 2 groups by social vulnerability, according to socioeconomic characteristics collected by means of questionnaires, where adolescents who did not have access to drinking water, sewage network, and adequate per capita income were classified as vulnerable. Anthropometric, biochemical, and blood pressure data were evaluated. Level of physical activity was assessed by an adapted questionnaire, and food intake was assessed by a 3-day food record. Independent T, Mann-Whitney, and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS, version 25, at a significance level of 5%. RESULTS: Adolescents had median age of 14 (11 to 15) years; 58.4% were female; 32.4% were overweight, and 52.4% were physically inactive in leisure. Mean consumption of ultra-processed food was observed to account for 45.0% of calorie intake. Adolescents classified as vulnerable had lower weight, body mass index, waist circumference, hip circumference, and neck circumference when compared to non-vulnerable adolescents. Both groups had cholesterol concentrations above the normal level. Non-vulnerable adolescents had higher triglyceride concentrations, higher alcohol consumption, and lower fiber intake compared to vulnerable adolescents. CONCLUSIONS: Adolescents with social vulnerability are less likely to have cardiovascular risk factors.

Association of Dietary Inflammatory Potential in Metabolically Healthy and Metabolically Unhealthy Obese Individuals

Abstract Introduction: Currently, two types of phenotypes have been recognized in individuals who are obese. Among the factors related to lifestyle, diet has a relevant influence, although there is no consensus regarding the role of diet in metabolic phenotypes; furthermore, diet is a strong moderator of chronic systemic inflammation. Objective: Investigate dietary inflammatory potential between metabolic phenotypes and to compare the differences between anti-inflammatory and pro-inflammatory diets in individuals with the same phenotype. Methods: This is a cross-sectional observational study that utilized the database of 533 individuals divided into 4 groups, according to metabolic phenotype and dietary inflammatory characteristic. Sociodemographic, clinical, anthropometric and biochemical characteristics were evaluated and the inflammatory index of the diet was calculated. Results: The mean Dietary Inflammatory index (DII) of the total sample was 0.974±1.02, with a maximum of 4.34 and a minimum of −1.74. In the metabolically unhealthy groups, we found a statistical difference in relation to systolic blood pressure when comparing the anti-inflammatory [median 120 (110.0-130.0)] and pro-inflammatory diets [median 130 (120.0-140.0); p = 0.022], and mean isoprostane concentrations were lower in the metabolically healthy group with anti-inflammatory diet. In regression analysis, the only variable that demonstrated a higher risk of alterations in all groups when compared to the metabolically healthy and anti-inflammatory group were isoprostane concentrations. Conclusion: We are able to conclude that an anti-inflammatory diet is associated with lower oxidative stress in metabolically healthy obese, and a pro-inflammatory diet is associated with higher systolic blood pressure values.

Food Consumption and Health Outcomes in Women During the COVID-19 Pandemic

Abstract Background The COVID-19 pandemic has changed food consumption. Objective Evaluate the association between metabolic phenotypes, changes in food consumption during the pandemic, and health outcomes in obese women. Methods Cross-sectional observational study including 491 women without previous diagnosis of chronic diseases, evaluated according to metabolic phenotype. During the pandemic, a subsample was re-evaluated by online questionnaires via Google Forms. Analyzed anthropometric, biochemical, and dietary data as well as health outcomes (coronary artery disease, type 2 diabetes, hypertension, dyslipidemia or death). Information on mortality was collected from the Internal Affairs Office of the State of Rio de Janeiro and the Health Department of the State of Rio de Janeiro. Statistical analysis was performed using the statistical program SPSS 21, with Mann-Whitney test, Pearson's chi-squared, Spearman correlation, and binary logistic regression, at a significance level of 5%. Results The anthropometric, glucose, and lipid profiles showed significant differences between the metabolically healthy and metabolically unhealthy groups (p = 0.00). Before the pandemic, women in the metabolically unhealthy group had higher dietary intakes of lipids (p = 0.01), saturated fat (p = 0.01) and sodium (p = 0.04), during the pandemic, they consumed more energy (p = 0.04), lipids (p = 0.02), saturated fat (p = 0.02), proteins (p = 0.03) and sodium from ultra-processed foods (p = 0.03). Consequently, health outcomes were more prevalent in the metabolically unhealthy group (p = 0.00). Conclusion Observed that metabolically healthy women had qualitatively better food intake and fewer health outcomes throughout the study.

Effect of Hypoenergetic Diet Combined With Pumpkin Seed Flour Consumption on Obese Women

Abstract Background Dietary treatment containing fiber-rich foods may contribute to lowering weight in obese women. Objective To investigate the effect of a hypoenergetic diet combined with pumpkin seed flour (PSF) consumption on diet quality, anthropometric indices, and glucose and lipid metabolism in obese women. Methods We conducted a randomized, double-blind, placebo-controlled, 90-day clinical trial with obese women, distributed into the following two groups: hypoenergetic diet + placebo (PG) and hypoenergetic diet + pumpkin seed flour (PSFG). A total of 100 participants were included in the PSFG (n = 47) and PG (n = 53). We evaluated neck circumference (NC); waist to height ratio; conicity index; fat mass (FM); lipid profile; blood concentrations of glucose and insulin; homeostatic model assessment for insulin resistance (HOMA-IR); quantitative insulin sensitivity check index (QUICKI); and blood pressure at baseline, 30, 60, and 90 days. Dietary analysis was determined by differences between diet quality indices before and after prescribing the experimental diet. Chi-squared, Student's t-tests and analysis for repeated measures were used, and values were considered significant at p < 0.05. Results The dietary pattern improved after 90 days in both groups. The PSFG presented lower NC (p < 0.001), FM (p = 0.010), triglycerides (TG) (p = 0.025), insulin (p = 0.003), and HOMA-IR (p = 0.018). The PG presented a lower diastolic blood pressure (p = 0.004) and low-density lipoprotein cholesterol (LDL-c) (p = 0.056). Conclusion A hypoenergetic diet combined with PSF consumption contributes to lowering NC, FM, HOMA-IR, TG, and insulin concentrations.

Vegetarian Diets and Cardiovascular Risk in Women

Abstract Introduction: Vegetarian diets have favorable effects on cardiovascular risk, provided that they do not contain ultra-processed foods (UPF). Objective: To compare the metabolic profile, cardiovascular risk, body composition, and food consumption in vegan (VEG), lacto-ovo vegetarian (LOV), and omnivorous (OMNI) women. To verify the association between UPF consumption and cardiovascular risk. Methods: Cross-sectional study with 119 VEG (n = 43), LOV (n = 38), and OMNI (n = 38) women. Anthropometric and biochemical parameters and the Framingham risk score were assessed. Food consumption was assessed by means of a 3-day food register, and intake of macronutrients, micronutrients, and UPF was estimated. The correlation between UPF consumption and cardiovascular risk was assessed using Spearman's coefficient, with a significance level of 5%. Results: The groups showed low cardiovascular risk, without significant difference between them. The VEG and LOV groups had lower body mass index, neck circumference, body shape index, and systolic blood pressure (p < 0.05) than the OMNI group; greater consumption of carbohydrates, sugars, dietary fibers, micronutrients, beta-carotene, and carotenoids; and lower consumption of total fat, saturated fatty acids, and cholesterol (p < 0.05). Consumption of UPF was lower in the LOV group (5.7 [0.0- 19.8]) than in the OMNI group (14.9 [5.1 - 22.3]; p < 0.05). UPF consumption was associated with SBP (ρ = 0.439; p = 0.007) and blood sugar (ρ = 0.422; p = 0.010) in the VEG group, and in the LOV group it was inversely associated with LDL-c (ρ = −0.456; p = 0.010). Conclusion: Vegetarian women showed better body composition and dietary quality than OMNI women. It is important to take consumption of UPF in vegetarians into consideration, in order to improve cardiovascular risk in women.

Gut microbiota of adults with different metabolic phenotypes.

OBJECTIVE: The aim of this study was to investigate the gut microbiota of individuals with different metabolic phenotypes and to compare their characteristics. METHODS: This was a cross-sectional study with 109 adults, classified according to metabolic status, by body mass index, and homeostasis model assessment. Anthropometric and biochemical characteristics and blood pressure were evaluated. Level of physical activity was evaluated by means of a questionnaire, and dietary consumption was evaluated using a 3-d food record. Feces samples were collected from each participant, and gut microbiota profile was analyzed by sequencing of the 16S rRNA gene. The Kruskal-Wallis and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS version 25, with significance level of 5%. RESULTS: Significantly lower values of saturated fat intake and fasting glycemia were observed in metabolically healthy individuals who were overweight and obese compared with their unhealthy counterparts. Diversity and richness of bacterial communities were lower in individuals who were obese and in the unhealthy phenotype. The genus Eubacterium rectale and genera of the family Prevotellaceae were more abundant in the metabolically healthy obese and metabolically healthy overweight groups than in the metabolically healthy normal weight one, whereas Bifidobacterium was more abundant in the metabolically healthy normal weight group. The genera Coprococcus and Ruminococcus were more abundant in the metabolically healthy overweight group than in the metabolically unhealthy overweight one. CONCLUSIONS: We observed distinct characteristics in the gut microbiota of different metabolic phenotypes. The intestines of individuals with unhealthy phenotypes hosted inflammation-associated microbiota, with lower butyrate production potential and reduced bacterial diversity.

Effects of a hypoenergetic diet associated with açaí (Euterpe oleracea Mart.) pulp consumption on antioxidant status, oxidative stress and inflammatory biomarkers in overweight, dyslipidemic individuals.

OBJECTIVE: To evaluate the effects of a hypoenergetic diet (HD)associated with açaí pulp consumption on oxidative stress, antioxidant status and inflammatory biomarkers in overweight, dyslipidemic individuals. RESEARCH METHODS & PROCEDURES: A randomized, double-blind, placebo-controlled clinical trial was conducted for 90 days. The study began with a 30-day run-in period, during which the intervention was exclusively a HD. Following this period, volunteers were randomized into 2 groups, and 200 g of either açaí pulp or placebo were added to the HD for 60 days. Anthropometric measurements, arterial pressure, oxidative stress and antioxidant status biomarkers, inflammatory and biochemical biomarkers were evaluated. RESULTS: Sixty-nine volunteers completed the clinical trial, 30 of which were in the HD + açaí group and 39 in HD + placebo group. Plasma 8-isoprostane concentrations significantly reduced 60 days after the intervention in the açaí group (p = 0.000), and there was a significant difference between the groups (açaí versus placebo; p = 0.037). Regarding inflammatory status parameters, a significant reduction in IL-6 was observed in the HD + açaí group (p = 0.042), and IFN-γ decreased significantly in both groups, HD + açaí (p = 0.001) and HD + placebo (p = 0.008); there were, however, no differences between the groups. Lipid profile parameters and blood glucose levels did not show change, regardless of nutritional intervention. CONCLUSION: The addition of açaí to a HD, for 60 days, reduced oxidative stress and improved inflammation in overweight, dyslipidemic individuals.

Is it Possible to Easily Identify Metabolically Healthy Obese Women?

BACKGROUND: Obesity is recognized as a major risk factor for the development of several metabolic complications. However, some obese individuals have a favorable metabolic profile. OBJECTIVE: The aim of this study was to identify an easy parameter for recognizing metabolically healthy obese (MHO) women. METHODS: A total of 292 non-diabetic women with a body mass index (BMI) ≥ 30 kg/m2 were selected, and 239 composed the final cohort. We classified the participants according to their metabolic state determined by homeostasis model assessment (HOMA) into MHO or metabolically unhealthy obese (MUO). Both groups were compared regarding biochemical, anthropometric, and body composition characteristics. RESULTS: The average age of the cohort was 43.9 ± 10.9 years and the average BMI was 37.2 ± 5.3 kg/m2. In total, 75.7% of the participants were classified as MHO by HOMA. A cutoff of 108.2 cm for waist circumference (WC) identified MHO participants with a sensitivity of 72.4% (95% confidence interval [CI]: 59.8-82.3%), specificity of 66.9% (95% CI: 59.71-73.3%), and negative likelihood ratio of 0.41 (95% CI: 0.36-0.47). Additionally, a visceral adiposity index cutoff value of 99.2 identified MHO women with a sensitivity of 89.7% (95% CI: 79.2-95.2%), specificity of 48.6% (95% CI: 41.4-55.9%), and negative likelihood ratio of 0.21 (95% CI: 0.15-0.30). CONCLUSION: Women classified as MHO exhibited smaller WC measurements and lower body fat percentages, as well as lower blood glucose and insulin levels. WC emerged as an easy parameter for identifying MHO women.

Is it Possible to Easily Identify Metabolically Healthy Obese Women? / É Possível Identificar Facilmente Mulheres Obesas Metabolicamente Saudáveis?

Abstract Background: Obesity is recognized as a major risk factor for the development of several metabolic complications. However, some obese individuals have a favorable metabolic profile. Objective: The aim of this study was to identify an easy parameter for recognizing metabolically healthy obese (MHO) women. Methods: A total of 292 non-diabetic women with a body mass index (BMI) ≥ 30 kg/m2 were selected, and 239 composed the final cohort. We classified the participants according to their metabolic state determined by homeostasis model assessment (HOMA) into MHO or metabolically unhealthy obese (MUO). Both groups were compared regarding biochemical, anthropometric, and body composition characteristics. Results: The average age of the cohort was 43.9 ± 10.9 years and the average BMI was 37.2 ± 5.3 kg/m2. In total, 75.7% of the participants were classified as MHO by HOMA. A cutoff of 108.2 cm for waist circumference (WC) identified MHO participants with a sensitivity of 72.4% (95% confidence interval [CI]: 59.8-82.3%), specificity of 66.9% (95% CI: 59.71-73.3%), and negative likelihood ratio of 0.41 (95% CI: 0.36-0.47). Additionally, a visceral adiposity index cutoff value of 99.2 identified MHO women with a sensitivity of 89.7% (95% CI: 79.2-95.2%), specificity of 48.6% (95% CI: 41.4-55.9%), and negative likelihood ratio of 0.21 (95% CI: 0.15-0.30). Conclusion: Women classified as MHO exhibited smaller WC measurements and lower body fat percentages, as well as lower blood glucose and insulin levels. WC emerged as an easy parameter for identifying MHO women.

Resumo Fundamento: A obesidade é reconhecida como um fator de risco importante no desenvolvimento de várias complicações metabólicas. Porém, alguns indivíduos obesos apresentam um perfil metabólico favorável. Objetivo: O objetivo do presente estudo foi identificar um parâmetro fácil para reconhecer mulheres obesas metabolicamente saudáveis (OMS) Métodos: Foram selecionadas 292 mulheres não diabéticas com índice de massa corporal (IMC) ≥ 30 kg/m2 e a coorte final foi composta de 239. De acordo com o estado metabólico determinado pelo modelo de avaliação da homeostase (HOMA), as participantes foram classificadas como obesas metabolicamente saudáveis (OMS) ou obesas metabolicamente não saudáveis (OMNS). Compararam-se ambos os grupos quanto às características bioquímicas, antropométricas e de composição corporal. Resultados: A idade média da coorte foi de 43,9 ± 10,9 anos e o IMC médio foi 37,2 ± 5,3 kg/m2. No total, 75,7% das participantes foram classificadas como OMS pelo HOMA. O ponto de corte para a circunferência da cintura (CC) de 108,2 identificou mulheres OMS com sensibilidade de 72,4% (intervalo de confiança [IC] de 95%: 59,8-82,3%), especificidade de 66,9% (IC 95%: 59,71-73,3%) e razão de verossimilhança negativa (RVN) de 0,41 (IC 95%: 0,36-0,47). Adicionalmente, o ponto de corte de 99,2 para o índice de adiposidade visceral (IAV) identificou mulheres OMS com sensibilidade de 89,7% (IC 95%: 79.2-95.2%), especificidade de 48,6% (IC 95%: 41,4-55,9%) e RVN de 0,21 (IC 95%: 0.15-0.30). Conclusões: Mulheres classificadas como OMS apresentaram menor CC, menor percentual de gordura corporal e menores níveis séricos de glicose e de insulina. A CC foi identificada como um parâmetro fácil para identificar mulheres OMS.

Anthropometric Profile, Serum Leptin, Antioxidant Vitamins, LEPR Q223R Polymorphism and Cardiovascular Risk Factors in Adolescents.

Cardiovascular disease (CVD) risk factors, such as bad eating habits, are typical in adolescence and lead to the consumption of meals that are not always sufficient in vitamins A, E, ß-carotene, excess calories and elevated serum leptin levels. The purpose of this research is to study the relationship between vitamin A deficiency (VAD), ß-carotene deficiency (ßcD), vitamin E deficiency (VED) and to explore the association of leptin receptor Q223R polymorphisms with obesity and other risk factors for CVD. Method: This observational study included 237 adolescents recruited from Adolescents Reference Center, Brazil. It was collected: socioeconomic and clinical data, laboratory and molecular samples. Results: The average age was 14.93 ± 2.18 years, 66.2 % were girls, 38.0 % had high levels of total cholesterol (TC) between 10-14 years Triceps (TSF) and subscapular skinfolds (SSF) measurements were inversely correlated with VAD. There was also an association between VAD, ßcD and high triglyceride (TG) levels. Adolescents with the RR genotype presented a trend toward higher levels of body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), TC, TG, low density lipoprotein (LDLC), leptin and low levels of high-density lipoprotein (HDL-c). Conclusion: The girls had higher levels of leptin than boys. Abdominal fat, ßcD and VED were observed in adolescents with VAD. Individuals with RR genotype have drawn attention to cardiovascular risk factors such as high rate of LDLC and reduced rate of HDLc. Thus, it is possible that individuals with this genotype may be more susceptible to the presence of cardiovascular risk factors.

The effect of dietary intake of sesame (Sesamumindicum L.) derivatives related to the lipid profile and blood pressure: A systematic review.

In this systematic review, we discuss the scientific evidence about the effect of dietary intake of seeds and sesame derivatives on lipid profile and blood pressure (BP) of hypertensive and dyslipidemic individuals. Clinical trials published in English, Portuguese or Spanish were searched on the following databases: Lilacs, PubMed, Isi Web of Knowledge, Cochrane Library, Scopus, Trip Data Base and Scielo. The bibliographic search period was started in September 2013 and ended in January 2014. The biases of risk analysis were carried out considering 6 of the 8 criteria of the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1. Of the 7 clinical trials included, five evaluating individuals with hypertension observed a significant reduction in systolic and/or diastolic blood pressure. The two articles that evaluated individuals with dyslipidemia showed improvement in lipid profile. The mechanisms of action are still being studied. Regarding the bias risk analysis, clinical trials included showed few descriptions of the methods applied. There are few studies about sesame ingestion, and it was observed high risk for bias in the selected studies. More standardized methods with attention to the design of studies are needed to improve the level of the evidence.

Avaliação de Compostos Bioativos, Composição Físico-Química e Atividade Antioxidante In Vitro da Farinha de Berinjela / Assessment of Bioactive Compounds, Physicochemical Composition, and In Vitro Antioxidant Activity of Eggplant Flour

Fundamento: A berinjela (Solanum melongena) é um fruto de consumo mundial. Seu processamento em forma de farinha é uma maneira de evitar perdas e aproveitar suas características nutricionais. Objetivos: Este estudo avaliou a composição físico-química (umidade, proteínas, lipídeos, fibra bruta, carboidratos, minerais, niacina, saponinas, acidez titulável, fibra alimentar e fenóis totais) da farinha de berinjela preparada a partir do fruto inteiro desidratado em estufa. Métodos: Avaliou-se a atividade antioxidante in vitro usando os seguintes ensaios: radical 2,2-difenil-1-picrilhidrazila (DPPH); poder antioxidante de redução do ferro (FRAP); e análise de polifenóis com Cromatografia Líquida de Alta Eficiência (CLAE - ácido clorogênico, ácido cafeico, ácido ferúlico e rutina). Resultados: Verificou-se a presença de: 23,09% de carboidratos; 13,34% de proteínas; 1,85% de lipídeos; 39,19% de fibras totais; 1.540 mg/100 g de compostos fenólicos solúveis totais; 840 mg/100 g de saponinas; minerais (potássio, magnésio, cobre, ferro, zinco, manganês); e niacina. Observou-se atividade antioxidante in vitro para DPPH (455,6 mg de ácido ascórbico/100 g) e FRAP (486,8 mg de ácido ascórbico/100 g). A CLAE determinou a presença de ácido ascórbico, tirosina e ácidos fenólicos (ácido clorogênico, ácido cafeico e ácido ferúlico). Conclusão: A farinha de berinjela tem alto teor de fibra além de bom teor de compostos fenólicos e saponinas com importante capacidade antioxidante observada através de ensaios in vitro. A farinha de berinjela é uma boa opção para ser adicionada à dieta da população, devido aos seus potenciais benefícios à saúde

Background: The eggplant (Solanum melongena) is a fruit of world consumption. Its processing in the form of flour is a way to avoid losses and to take advantage of its nutritional characteristics. Objective: This study assessed the physicochemical composition (moisture, proteins, lipids, crude fiber, carbohydrates, minerals, niacin, saponins, titratable acidity, dietary fiber, and total phenols) of eggplant flour prepared from the whole fruit dehydrated in an oven. Methods: In vitro antioxidant activity was assessed using the following methods: 2.2-diphenyl-1-picrylhydrazyl radical (DPPH); Ferric Reducing/ Antioxidant Power (FRAP); and analysis of polyphenols using HPLC (chlorogenic acid, caffeic acid, ferulic acid, and rutin). Results: It was possible to observe: 23.09% carbohydrates; 13.34% proteins; 1.85% lipids; 39.19% total fibers; 1,540 mg/100 g total soluble phenolic compounds; 840 mg/100 g saponins; minerals (potassium, magnesium, copper, iron, zinc, manganese); and niacin. In vitro antioxidant activity was observed through DPPH (455.6 mg ascorbic acid/100 g) and FRAP (486.8 mg ascorbic acid/100 g). The HPLC method determined the presence of ascorbic acid, tyrosine, and phenolic acids (chlorogenic acid, caffeic acid, and ferulic acid). Conclusion: The eggplant flour had great fiber content in addition to good content of phenolic compounds and saponins with important antioxidant capacity observed through in vitro assays. As a result, eggplant flour is a good addition to the diet of the population, since it can bring potential health benefits

Consumo de Vitaminas Antioxidantes em Dislipidêmicos com Excesso de Peso / Antioxidant Vitamin Intake in Dyslipidemic Overweight Individuals

Fundamentos: Dislipidemia e obesidade estão associadas com insuficiente consumo de frutas, verduras e legumes, e com desequilíbrio do estado antioxidante. Objetivos: Avaliar o consumo dietético das vitaminas A, E e C e dos macronutrientes, correlacionando-os com biomarcadores em dislipidêmicos com excesso de peso. Métodos: Foram selecionados indivíduos dislipidêmicos de ambos os sexos, com idade ≥ 20 anos e índice de massa corporal (IMC) ≥ 25 kg/m2. Foram excluídos aqueles em uso de medicamentos anorexígenos e/ou realizando dieta hipoenergética. Analisaram-se as variáveis antropométricas [massa corporal, estatura, circunferência da cintura (CC), IMC] e bioquímicas [colesterol total, HDL-C, LDL-C, triglicerídeos (TGs) e F2-isoprostano plasmático]. Avaliou-se o consumo alimentar pelo questionário de frequência alimentar. Testou-se a normalidade das variáveis pelo teste não paramétrico de Kolmogorov-Smirnov e realizou-se a correlação de Spearman, empregando-se o pacote estatístico SPSS18 com nível de significância de 5%.Resultados: Dos 284 participantes, 264 (93,1%) eram mulheres. As médias do IMC e da CC foram 36,0 ± 5,8 kg/m2 e 106,2 ± 12,7cm, respectivamente. O consumo de vitaminas A e C, carboidratos, proteínas, açúcar, ácidos graxos (AG) saturados e AG trans foi superior às recomendações, enquanto os consumos de vitamina E e AG poli- e monoinsaturados não alcançaram 50% das recomendações. Evidenciou-se correlação negativa entre as seguintes variáveis: vitamina E com LDL-C e colesterol total; açúcar e HDL-C; AG poli-insaturados e colesterol total e LDL-C. Observaram-se correlações positivas entre colesterol dietético, CC e IMC, e entre massa gorda e TGs. Conclusão: Observou-se inadequação no consumo dietético de vitamina E, açúcar, AG poli-insaturados e trans, o mesmo não acontecendo com as vitaminas A e C. Não houve correlação de biomarcadores e variáveis dietéticas com F2-isoprostano plasmático

Background: Insufficient consumption of fruits, vegetables and pulses is associated with dyslipidemia and obesity and with antioxidant status imbalance. Objective: To assess the dietary intake of vitamins A, E and C and of macronutrients, correlating them with biomarkers in dyslipidemic overweight individuals. Methods: Dyslipidemic individuals of both sexes, aged ≥ 20 years, with body mass index (BMI) ≥ 25 kg/m2 were selected. Individuals on anorectic drugs and/or hypocaloric diets were excluded. Anthropometric [body mass, height, waist circumference (WC), BMI] and biochemical variables [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, and plasma F2-isoprostane) were assessed. Food intake was assessed using the Food Frequency Questionnaire. Statistical analyses were performed with SPSS 18. Results: Of the 284 participants, 264 (93.1%) were women. Mean BMI and WC values were 36.0 ± 5.8kg/m2 and 106.2 ± 12.7cm, respectively. The intakes of vitamins A and C, carbohydrates, proteins, sugar, saturated and trans fatty acids were above the recommended values; the intakes of vitamin E, polyunsaturated fatty acids, and monounsaturated fatty acids were below 50% of the recommended values. There was a negative correlation between the following variables: vitamin E, LDL-C and TC; sugar and HDL-C; and polyunsaturated fatty acids, TC and LDL-C. Positive correlations were observed between dietary cholesterol, WC and BMI; and between fat mass and triglycerides. Conclusion: Inappropriate intakes of vitamin E, sugar, polyunsaturated and trans fatty acids were observed, but not of vitamins A and C. No correlation of biomarkers and dietary variables was observed with plasma F2-isoprostane

Effects of the Intake of Sesame Seeds (Sesamum indicum L.) and Derivatives on Oxidative Stress: A Systematic Review.

This study is aimed at assessing the scientific evidence on the effect of the intake of sesame seeds and derivatives on oxidative stress of individuals with systemic hypertension, dyslipidemia, and type 2 diabetes mellitus. A systematic review was conducted in seven databases (Lilacs, PubMed, ISI Web of Knowledge, Cochrane Library, Scopus, Trip Database, and Scielo) from September 2013 to January 2014. Clinical trials on the intake of sesame seeds and derivatives assessing the outcomes related to oxidative stress were retrieved. The risk of bias in the results of the studies selected was assessed according to the criteria of the Cochrane Handbook for Systematic Reviews of Interventions. This review included seven clinical trials showing that the intake of sesame resulted in the increase in enzymatic and nonenzymatic antioxidants, as well as in a reduction in oxidative stress markers. This was mainly observed with the use of sesame oil for hypertensive individuals during 2 months and black sesame meal capsules for prehypertensive individuals during four weeks. Most studies involved a small number of participants, sample size being considered a limiting factor for this review. In addition, a significant heterogeneity was observed in the type of population studied and the type of sesame and derivatives used, as well as their amount. The follow-up time was considered a limiting factor, because it varied in the different studies. The high risk of randomization and blinding biases found in the studies assessed determines lower scientific evidence of the results. Despite the limitations and biases identified in this systematic review, sesame showed relevant effects on oxidative stress, suggesting it could increase the antioxidant capacity.

Efeitos de Diferentes Tipos de Linhaça nas Sensações de Apetite eSaciedade no Sobrepeso e na Obesidade / Effects of Different Types of Flaxseed Flour in Appetite and Satiety Sensations Among Overweighed and Obese Women

A linhaça, rica em fibras, é estratégia nutricional para o tratamento da obesidade. Objetivo: Comparar os efeitos de três tipos de farinha de linhaça nas sensações de apetite e saciedade em mulheres com sobrepeso e obesidade. Métodos: Foram consumidos aleatoriamente cinco tipos de refeição-teste: 400g de iogurte de baixo teor de gordura com 30g de farinha de linhaça: marrom integral (FLMI), marrom desengordurada (FLMD), dourada (FLD) ou 14 g de fibra solúvel (goma guar) ou iogurte (controle). A avaliação da sensação de apetite e saciedade foi realizada em 0 (em jejum), 15, 45, 75 e 105 minutos após a refeição-teste, utilizando escala visual analógica adaptada. Avariação da taxa entre os tempos T0-T15 e T15-T105 foi calculada e os voluntários classificados em quatro quadrantes, de acordo com média e taxas de variação. Resultados: Os grupos suplementados com linhaça apresentaram comportamento semelhante na sensação de apetite e saciedade; com FLMD houve menor sensação de apetite e maior saciedade, e maior frequência no quadrante “Perde lento e ganha lento” do grupo com sobrepeso (47,0%) e do grupo obesidade grau 1 (47,6%). No quadrante “Perde rápido e ganha rápido” o grupo com sobrepeso (41,2%) foi o mais frequente e no quadrante “Perde lento e ganha rápido” o grupo obesidade grau 1 (31,8%) foi o mais frequente. Conclusão: A ingestão de FLMD favoreceu a redução do apetite e aumento da saciedade provavelmente por viscosidade mais elevada e maior quantidade de proteínas desta linhaça...

Flaxseed is rich in fibers and is a nutritional strategy for the treatment of obesity . Objective: To compare the effects of three types of flaxseed flours in the appetite and satiety sensations in overweighed and obese women. Methods: Five types of test meals were randomly consumed: 400g of low-fat yogurt with 30g of the following types of flaxseed flour: whole brown flaxseed flour (WBFF), brown defatted flaxseed flour (BDFF), golden flaxseed flour (GFF) or 14g of soluble fiber (guar gum) or yogurt (control). Evaluation of the appetite and satiety sensation was held 0 (fasting), 15, 45, 75 and 105 minutes after the test meal using an adapted visual analogue scale. Variation on the rate between times T0-T15 and T15-T105 was calculated and the volunteers were ranked into four quadrants according to the average and variation rates. Results: The groups supplemented with flaxseed showed similar behavior in the sensation of appetite and satiety; with BDFF, there was a weaker sensation of appetite and greater satiety, and greater frequency of the overweight group (47.0%) and grade 1 obesity group (47.6%) in the “Loses slowly and gains slowly” quadrant. The overweight group appeared more frequently (41.2%) in the “Loses quickly and gains quickly” quadrant. The grade 1 obesity group appeared more frequently (31.8%) in the “Loses slowly and gains quickly” quadrant. Conclusion: Intake of BDFF led to reduced appetite and increased satiety probably due to the higher viscosity and greater amount of protein found in flaxseed...

Additive effect of linseed oil supplementation on the lipid profiles of older adults.

BACKGROUND: Linseed oil has been investigated as a rich source of n-3 series polyunsaturated fatty acids, which mainly produce a non-atherogenic lipid profile. The objective of this study was to investigate the effect of linseed oil supplementation associated with nutritional guidelines on the lipid profiles of older adults, according to the intake of saturated fatty acids (SFA). METHODS: We conducted a double-blind, placebo-controlled clinical trial with 110 older adults randomized in two groups: placebo and linseed oil. The linseed oil group received supplementation with 3 g of linseed oil. Both groups received nutritional guidance and were supplemented for 90 days with monthly blood collection for biochemical analysis. The dietary intake of saturated fat was subdivided into low (<7% SFA/day of the total energy value) and high consumption groups (>7% SFA/day of the total energy value). RESULTS: Low SFA (<7% SFA/day of total energy value) consumption was associated with lower total cholesterol concentrations. However, we observed that the linseed oil group, including older adults who consumed >7% SFA/day, had a greater reduction in total cholesterol than the placebo group (P=0.020). The same was observed for low-density lipoprotein (LDL) cholesterol (P<0.050), suggesting an additive effect of linseed oil and diet. High-density lipoprotein (HDL) cholesterol concentrations were increased significantly in only the linseed group, suggesting that the nutritional intervention alone did not improve HDL cholesterol. CONCLUSION: The results suggest that the nutritional intervention was effective, but linseed oil showed notable effects by increasing the HDL cholesterol concentration. In addition, consumption of <7% SFA/day of the total energy value increased the effect of linseed oil, demonstrating the importance of reducing the consumption of saturated fat.

EFFECT OF CHIA SEED (SALVIA HISPANICA L.) CONSUMPTION ON CARDIOVASCULAR RISK FACTORS IN HUMANS: A SYSTEMATIC REVIEW.

INTRODUCTION: chia is a seed rich in such nutrients as proteins, n-3 fatty acids and especially alpha-linolenic acid (ALA), minerals, fibers and antioxidants. Efforts have been made to assess whether human consumption of chia can reduce cardiovascular risk factors; however, it has not been established as effective and the findings of the few studies to have looked into the matter are inconsistent. AIM: to systematize the findings of studies assessing the effect the consumption of chia seed, either milled or whole, has in the prevention/control of cardiovascular risk factors in humans. METHODS: this is a systematic literature review (SLR) with no meta-analysis. The articles scrutinizedwere identified in the electronic databases Lilacs, Medline (Pub- Med version), Cochrane, Scielo, Scopus, and Web of Science under the keywords"dyslipidemia" or "dislipidemia", "hyperlipidemia" or "hiperlipidemia", "obesity" or "obesidade", "salvia"or"salviahispanica", "Lamiaceae" or "chia", "hypertension" or "hipertensão", "hypertrygliceridemia" or "hipertrigliceridemia", and "riscocardiovascular" or "cardiovascularrisk." We chose for our selection English-, Portuguese- or Spanish-language articles about clinical trials on humans and published within the last ten years. The biases of risk analysis were carried out considering 6 of the 8 criteria of the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1. FINDINGS: seven studies (n = 200) fit our inclusion criteria. Of the chosen clinical trials, only one was not randomized. Five of the studies were blind experiments. Two of the studies were acute trials, both of them randomized. Of the chia seed interventions, one study showed a significant drop in systolic blood pressure (SBP) and inflammatory markers, yet there was no change in body mass, lipid profile or blood sugar. In four of the studies reviewed there was a significant spike in ALA and eicosapentaenoic acid (EPA), with no significant change to other parameters. In the acute trials, post-prandial blood sugar was significantly lower. Only one study showed a significant drop in triglycerides (TG), body mass and inflammatory markers; however, the chia seed in that case was mixed with other foods. Most of the studies showed unclear or low risk of bias. Two studies showed a high risk of bias because not all the pre-specified primary outcomes were reported in the findings. CONCLUSION: most of the studies did not demonstrate statistically significant results in relation to cardiovascular disease (CVD) risk factors. The evidence regarding the relationship between chia seed consumption and cardiovascular risk factors are insufficient, and the studies included in this review present numerous limitations. Further research is hence needed.

Introducción: la chía es una semilla rica en nutrientes tales como proteínas; ácidos grasos omega 3, especialmente ácido alfa-linolénico (ALA); minerales; fibras y antioxidantes. Se han hecho esfuerzos para evaluar si el consumo humano de chía puede reducir los factores de riesgo cardiovascular; sin embargo, no se ha establecido como eficaz y los resultados de los pocos estudios que han examinado la cuestión son incompatibles. Objetivo: sistematizar los hallazgos de los estudios que evaluaron el efecto del consumo de la semilla de chía, ya sea molida o entera, tiene en la prevención/control de los factores de riesgo cardiovascular en los seres humanos. Métodos: se trata de una revisión sistemática de la literatura (SLR), sin metaanálisis. Los artículos escrutados eran identificados en las bases de datos Lilacs electrónicos, Medline (PubMed versión), Cochrane, Scielo, Scopus y Web of Science bajo la palabra clave "dyslipidemia" o "dislipidemia", "hyperlipidemia" o "hiperlipidemia", "obesity" o "obesidade", "salvia" o "salviahispanica", "Lamiaceae" o "chia", "hypertension" o "hipertensão", "hypertrygliceridemia" o "hipertrigliceridemia" y "riscocardiovascular" o "cardiovascularrisk". Elegimos para nuestra selección artículos en inglés, portugues o español sobre ensayos clínicos en seres humanos publicados en los últimos diez años. Los sesgos de análisis de riesgo se realizaron considerando seis de los ocho criterios del Manual Cochrane para Revisiones Sistemáticas de Intervenciones Versión 5.1. Resultados: siete estudios (n = 200) encajan con los criterios de inclusión. De los ensayos clínicos seleccionados, solo uno no fue aleatorio. Cinco de los estudios fueron experimentos ciegos. Dos de los estudios eran ensayos agudos, ambos asignados al azar. De las intervenciones de semillas de chía, un estudio mostró una disminución significativa de la presión arterial sistólica (PAS) y los marcadores de inflamación; sin embargo, no hubo cambios en la masa corporal, el perfil de lípidos o el azúcar en sangre. En cuatro de los estudios revisados no había un pico significativo en ALA y ácido eicosapentaenoico (EPA), ni ningún cambio significativo en otros parámetros. En los ensayos agudos, el nivel postprandial de azúcar en sangre fue significativamente menor. Solo un estudio mostró un descenso significativo de los triglicéridos (TG), la masa corporal y los marcadores inflamatorios; sin embargo, la semilla de chía en ese caso se mezcló con otros alimentos. La mayoría de los estudios mostraron riesgos claros o bajo sesgo. Dos estudios mostraron un alto riesgo de sesgo, porque no todos los resultados primarios preespecificados fueron reportados en los hallazgos. Conclusión: la mayoría de los estudios no demostraron resultados estadísticamente significativos en relación con los factores de riesgo cardiovascular (ECV). La evidencia sobre la relación entre el consumo de semillas de chía y los factores de riesgo cardiovascular son insuficientes, y los estudios incluidos en esta revisión presentan numerosas limitaciones. Por lo tanto, se necesita más investigación.

Effects of Dietary Supplementation with Brazil Nuts on Microvascular Endothelial Function in Hypertensive and Dyslipidemic Patients: A Randomized Crossover Placebo-Controlled Trial.

OBJECTIVE: To investigate the effects of dietary supplementation with GBNs on microvascular endothelial function in hypertensive and dyslipidemic patients. METHODS: Ninety-one patients of both sexes aged 62.1 ± 9.3 years received 13 g/day of GBNs or a placebo for three months with a washout period of one month between treatments. Microvascular endothelial function was assessed using LSCI coupled with iontophoresis of ACh and PORH. We also used skin video capillaroscopy to measure capillary density and recruitment at rest and during PORH. Plasma concentrations of NOx were also measured as a marker of nitric oxide bioavailability. RESULTS: Supplementation with GBNs significantly increased the plasma levels of Se (p < 0.05) and NOx (p < 0.05). However, we did not observe any effects of GBN consumption on microvascular vasodilator responses to ACh or PORH (p > 0.05), and GBNs did not improve capillary density at baseline or recruitment during PORH (p > 0.05). CONCLUSIONS: Supplementation with GBNs induced significant increases in the plasma Se concentration and systemic bioavailability of nitric oxide. Nevertheless, GBN supplementation did not lead to any improvement in systemic microvascular reactivity or density in patients with arterial hypertension and dyslipidemia who were undergoing multiple drug therapies.

Intake of partially defatted Brazil nut flour reduces serum cholesterol in hypercholesterolemic patients--a randomized controlled trial.

OBJECTIVE: Thyroid hormones can lower levels of atherogenic lipoproteins, and selenium is important in thyroid hormone homeostasis. We aimed to investigate the effects of a healthy diet associated with the Brazil nut (Bertholletia excelsa) in dyslipidemic and hypertensive patients. METHODS: This study was a randomized, placebo-controlled, double-blind trial. Seventy-seven dyslipidemic and hypertensive patients already receiving lipid-lowering drugs received either a dietary treatment associated with partially defatted Brazil nut flour (13 g/day providing 227,5 µg of selenium/day),or with dyed cassava flour as a placebo. All patients received a personalized dietary guideline with nutritional recommendations for dyslipidemia and hypertension and were followed for 90 days. RESULTS: The Brazil nut group showed reductions in total cholesterol (-20.5 ± 61.2 mg/dL, P = 0.02), non HDL-cholesterol (-19.5 ± 61.2 mg/dL, P = 0.02) and Apo A-1 (-10.2 ± 26.7 mg/dL, P = 0.03) without significant alterations in the Apo B/Apo A-1 ratio. The placebo group showed a reduction in FT3 levels (-0.1 ± 0.4, P = 0.03) and increased Lp(a) levels (5.9 ± 18.0 mg/dL, P = 0.02). There were no statistical differences in blood pressure and serum lipids between Brazil nut and placebo group. CONCLUSIONS: Supplementation with Brazil nuts seems to favor the maintenance of FT3 levels and contributes to lipemia reduction in hypercholesterolemic and euthyroid patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01990391.

Characterization of metabolically healthy obese Brazilians and cardiovascular risk prediction.

OBJECTIVE: The aim of this study was to identify metabolically healthy obese individuals (MHOs) and their characteristics, as well as to estimate cardiovascular risk using the Framingham score. METHOD: In all, 258 adult individuals, with body mass index ≥30 kg/m(2), and no report of diabetes mellitus or cardiovascular disease, were classified according to their metabolic state considering two criteria: rhe National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and the homeostasis model assessment (HOMA). Biochemical, anthropometric, and body composition characteristics were compared between MHOs and metabolically unhealthy obese (MUO) individuals according to each criterion. Cardiovascular risk was estimated using the Framingham score. RESULTS: MHOs exhibited smaller waist circumference and lower body fat percentage, as well as lower blood glucose, triacylglycerols, and insulin levels, in addition to higher high-density lipoprotein cholesterol concentration, when HOMA criterion (P < 0.05) and associated criteria were adopted. The estimated cardiovascular risk was similar between the two groups according to the HOMA index; however, the risk was significantly lower according to the ATP III guidelines. Obese individuals at intermediate and high risk showed higher body fat percentage compared with those individuals at low risk. CONCLUSIONS: MHOs had biochemical and anthropometric characteristics, such as lower body mass index, waist circumference, percent fat mass, glucose, triacylglycerols, and increased high-density lipoprotein, that made them different from those individuals classified as MUO. The latter exhibited increased risk for cardiovascular disease according to the Framingham score, when using the ATP III criterion alone or in conjunction with the HOMA index.