Food Patterns of Hospitalized Patients with Heart Failure and Their Relationship with Demographic, Economic and Clinical Factors in Sergipe, Brazil.

Background: The high rates of hospitalization and mortality caused by Heart Failure (HF) have attracted the attention of health sectors around the world. Dietary patterns that involve food combinations and preparations with synergistic or antagonistic effects of different dietary components can influence the worsening and negative outcomes of this disease. Objectives: To describe the dietary patterns of patients hospitalized for HF decompensation and associate them with demographic, economic, and clinical factors, and the type of care provided in Sergipe. Materials and Methods: Cross-sectional study that is part of the Congestive Heart Failure Registry (VICTIM-CHF)" of Aracaju/SE. Prospective data collection took place with all patients hospitalized between April 2018 and February 2021 in cardiology referral hospitals, 2 public and 1 private. The data collected were sociodemographic, clinical, lifestyle, anthropometric and food consumption variables. Daily dietary intake was estimated by applying a semiquantitative food frequency questionnaire. The extraction of dietary patterns, by exploratory factor analysis, was performed after grouping the foods according to the nutritional value and form of preparation into 34 groups. To assess the association between the factorial scores for adherence to the standards and the variables studied, the Mann-Whitney U test was applied. Linear regressions were also performed, considering the dietary pattern (one for each pattern) as a dependent variable. Results: The study included 240 patients hospitalized for HF decompensation, most of them elderly (mean age 61.12 ± 1.06 years), male (52.08%) and attended by the Unified Health System­SUS (67.5%). Three dietary patterns were identified, labeled "traditional" (typical foods of the Brazilian northeastern population added to ultra-processed foods), "Mediterranean" (foods recommended by the Mediterranean diet) and "dual" (healthy foods combined with fast and easy-to-prepare foods like snacks, bread, sweets and desserts). Adherence to the "traditional" pattern was greater among men (p < 0.031) and non-diabetics (p < 0.003). The "Mediterranean" was more consumed by the elderly (p < 0.001), with partners (p = 0.001) and a lower income (p < 0.001), assisted by the SUS (p < 0.001) and without hypertension (p = 0,04). The "dual" diet pattern had greater adherence by the elderly (p < 0.001), self-declared non-black (p = 0.012), with higher income (p < 0.001), assisted in the private sector (p < 0.001) and with less impaired functional capacity (p = 0.037). It was also observed that being female (p = 0.031) and being older reduced the average scores of performing the "traditional" pattern (p = 0.002). Regarding the type of service, being from the public service reduced the average scores for adhering to the "dual" pattern (p = 0.008). Conclusions: Three dietary patterns representative of the population were found, called traditional, Mediterranean and dual, which were associated with demographic, economic and clinical factors. Thus, these standards must be considered in the development of nutritional strategies and recommendations in order to increase adherence to diets that are more protective against cardiovascular diseases.

Contribution of minimally processed and ultra-processed foods to the cardiometabolic risk of Brazilian young adults: a cross-sectional study / Contribución de los alimentos mínimamente procesados y ultraprocesados al riesgo cardiometabólico de adultos jóvenes brasileños: un estudio transversal

INTRODUCTION: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). OBJECTIVE: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. METHODS: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. RESULTS: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). CONCLUSIONS: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations

INTRODUCCIÓN: la alta prevalencia de enfermedades cardiometabólicas y el avance de los alimentos ultraprocesados en la dieta sugieren una posible relación entre ellos. OBJETIVO: valorar la asociación entre el consumo de alimentos clasificado por el grado de procesamiento y el riesgo cardiometabólico en adultos jóvenes. MÉTODOS: estudio transversal con una muestra compuesta por 120 jóvenes brasileños de 18 a 25 años, que fueron categorizados según el riesgo cardiometabólico (presencia o ausencia). El consumo de alimentos se evaluó mediante un cuestionario semicuantitativo de frecuencias a partir del que se clasificó la ingesta de acuerdo con el grado de procesamiento. Estos resultados se dividieron en terciles de gramos de alimentos (procesados y mínimamente procesados, procesados y ultraprocessados). Las diferencias de consumo diario de alimentos entre los terciles se compararon por medio del test de Kruskal-Wallis. Se realizó una regresión logística para asociar el grado de procesamiento con los componentes del riesgo cardiometabólico. RESULTADOS: se observó una alta contribución energética de los alimentos ultraprocesados en la dieta de la muestra estudiada. La ingestión de grasas totales (p = 0,04) y alimentos ultraprocesados (p = 0,03) fue mayor entre el grupo con riesgo cardiometabólico. El consumo de alimentos ultraprocesados fue un factor de riesgo de obesidad abdominal (OR = 1,09; IC 95 %: 1,00-1,18), mientras que el consumo de los mínimamente procesados fue protector frente a las alteraciones del LDL-c, independientemente del sexo, la actividad física y la ingesta de alcohol (OR = 0,70; IC 95 % = 0,50-0,98). CONCLUSIÓN: los alimentos ultraprocesados contribuyeron a aumentar la ingesta de grasas y a la obesidad abdominal; en cambio, los alimentos no procesados y mínimamente procesados redujeron los niveles de LDL-c

Contribution of minimally processed and ultra-processed foods to the cardiometabolic risk of Brazilian young adults: a cross-sectional study.

INTRODUCTION: Introduction: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). Objective: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. Methods: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. Results: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). Conclusions: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations.

INTRODUCCIÓN: Introducción: la alta prevalencia de enfermedades cardiometabólicas y el avance de los alimentos ultraprocesados en la dieta sugieren una posible relación entre ellos. Objetivo: valorar la asociación entre el consumo de alimentos clasificado por el grado de procesamiento y el riesgo cardiometabólico en adultos jóvenes. Métodos: estudio transversal con una muestra compuesta por 120 jóvenes brasileños de 18 a 25 años, que fueron categorizados según el riesgo cardiometabólico (presencia o ausencia). El consumo de alimentos se evaluó mediante un cuestionario semicuantitativo de frecuencias a partir del que se clasificó la ingesta de acuerdo con el grado de procesamiento. Estos resultados se dividieron en terciles de gramos de alimentos (procesados y mínimamente procesados, procesados y ultraprocessados). Las diferencias de consumo diario de alimentos entre los terciles se compararon por medio del test de Kruskal-Wallis. Se realizó una regresión logística para asociar el grado de procesamiento con los componentes del riesgo cardiometabólico. Resultados: se observó una alta contribución energética de los alimentos ultraprocesados en la dieta de la muestra estudiada. La ingestión de grasas totales (p = 0,04) y alimentos ultraprocesados (p = 0,03) fue mayor entre el grupo con riesgo cardiometabólico. El consumo de alimentos ultraprocesados fue un factor de riesgo de obesidad abdominal (OR = 1,09; IC 95 %: 1,00-1,18), mientras que el consumo de los mínimamente procesados fue protector frente a las alteraciones del LDL-c, independientemente del sexo, la actividad física y la ingesta de alcohol (OR = 0,70; IC 95 % = 0,50-0,98). Conclusión: los alimentos ultraprocesados contribuyeron a aumentar la ingesta de grasas y a la obesidad abdominal; en cambio, los alimentos no procesados y mínimamente procesados redujeron los niveles de LDL-c.

Adherence to Mediterranean diet is inversely associated with the consumption of ultra-processed foods among Spanish children: the SENDO project.

OBJECTIVE: To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake. DESIGN: Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index. SETTING: Spain. PARTICIPANTS: Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis. RESULTS: 74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption. CONCLUSIONS: Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.

Condições de trabalho de caminhoneiros: percepções sobre a saúde e autocuidado / Health perception and relationship with work activities among truck drivers

Resumo Os caminhoneiros estão expostos a situações nocivas à saúde o que favorece a elevada prevalência de morbimortalidade. Buscou-se conhecer a percepção de saúde e sua relação com as condições de trabalho entre caminhoneiros do estado de Sergipe, Brasil. Pesquisa qualitativa, com entrevistas semiestruturadas de 15 caminhoneiros e roteiro constando duas questões norteadoras: a primeira avaliando a sua saúde atribuindo notas de 0 a 10 e a segunda sobre a sua opinião a respeito da relação do seu próprio estado de saúde com a profissão. Na análise do conteúdo emergiram três categorias: autopercepção da saúde, determinantes de risco laboral e cuidados com a saúde. A autopercepção da saúde obteve notas 7,5±1,4, revelando percepção da saúde limitada a ausência de doença, resignados com a vulnerabilidade associada à rotina laboral extenuante. O entendimento sobre a relação entre saúde e trabalho mostrou-se associado aos determinantes do risco laboral, embora percebessem sua influência na saúde, mostraram-se pouco estimulados quanto ao autocuidado e apontaram como incompatível às rotinas laborais. Conhecer a percepção dos caminhoneiros sobre suas condições de trabalho possibilita o enfrentamento da vulnerabilidade da saúde laboral, viabilizando levantar discussões sobre a necessidade de reformulação e cumprimento das políticas trabalhistas com intuito de reduzir os impactos ocupacionais.

Abstract Truck drivers are exposed to harmful health situations, favoring the high prevalence of morbidity and mortality. We sought to know the perception of health and its relationship with working conditions among truckdrivers in the state of Sergipe, Brazil. Qualitative research, with semi-structured interviews of 15 truck drivers and script consisting of two main questions: the first evaluating their health assigning scores from 0 to 10 (0 as unhealthy and 10 totally healthy); and the second about his opinion about the relationship of his own state of health with the profession. In the content analysis, three categories emerged: self-perceived health, determinants of labor risk and health care. Self-perceived health obtained scores of 7.5±1,4, revealing a perception of health limited to the absence of disease, resigned to the vulnerability associated with strenuous work routine. The understanding of the relationship between health and work was associated with the determinants of occupational risk, although they perceived its influence on health, they were little stimulated in terms of self-care and pointed out as incompatible with work routines. Knowing the perception of truck drivers about their working conditions enables them to face the vulnerability of occupational health, making it possible to raise discussions about the need to reformulate and comply with labor policies in order to reduce occupational impacts.

Educação alimentar e nutricional melhora conhecimento sobre o tratamento de diabetes mellitus tipo 2: um estudo qualitativo / Food and nutrition education actions based on Pestalozzi's intuitive method

A educação alimentar e nutricional é um fator determinante para a prevenção e controle das doenças crônicas não transmissíveis como o diabetes mellitus tipo 2. Assim, o objetivo deste estudo foi avaliar o efeito de ações de educação alimentar e nutricional na percepção e no conhecimento sobre a doença, seu tratamento e dificuldades enfrentadas por pessoas com diabetes mellitus tipo 2. Estudo longitudinal do tipo quanti-qualitativo, realizado com 10 adultos com diabetesmellitus tipo 2, atendidos pela Liga Acadêmica de Nutrição em Diabetes da Universidade Federal de Sergipe. Os indivíduos foram convidados a participar de ações de educação alimentar e nutricional realizadas semanalmente durante seis semanas. Os participantes foram entrevistados antes (T0) e após (T1) as ações a fim de investigar os conhecimentos obtidos. Utilizou-se a entrevista semiestruturada com duas perguntas para obtenção dos discursos, a primeira relacionou-se com a percepção sobre a doença e tratamento, e a segunda com as dificuldades enfrentadas na busca da alimentação saudável. A análise foi realizada pela técnica de Análise de Conteúdo. Para a primeira pergunta emergiram discursos categorizados em significado emocional, fisiológico e tratamento, já para a segunda emergiram aspectos externos, internos e sem dificuldades. Após as ações, os discursos mostraram-se positivos quanto à adoção de uma alimentação saudável no tratamento. A intervenção permitiu que os indivíduos obtivessem maior conhecimento da doença e dos aspectos relacionados ao tratamento.

Food and nutrition education is a determining factor for the prevention and control of chronic non-communicable diseases such as type 2 diabetes mellitus. Thus, the aim of this study was to evaluate the effect of food and nutrition education actions on the perception and knowledge about the disease, its treatment, and the difficulties faced by people with type 2 diabetes mellitus. Longitudinal quantitative-qualitative study, carried out with 10 adults with type 2 diabetes mellitus, assisted by the Academic Diabetes Nutrition League of the Federal University of Sergipe. Individuals were invited to participate of the food and nutrition education activities carried out weekly for six weeks. Participants were interviewed before (T0) and after (T1) the activities in order to investigate the knowledge obtained. A semi-structured interview with two questions was used to obtain their responses, the first was related to the perception about the disease and treatment, and the second concerned the difficulties faced in the search for healthy eating. The analysis was performed using the Content Analysis technique. For the first question, responses were categorized into emotional, physiological meanings and treatment, while for the second, external, internal aspects and those without difficulties emerged. After the activities, the responses were positive about the adoption of healthy eating in the treatment. The intervention allowed individuals to gain more knowledge of the disease and aspects related to treatment.

Food and nutritional security of semi-arid farm families benefiting from rainwater collection equipment in Brazil.

The objective of this study was to identify and describe the experience of family farmers and their respective families after using the Boardwalk Cistern rainwater collection system and consequent impacts on nutrition profile and food security. This is a qualitative-quantitative study conducted in two municipalities in the semi-arid region of the state of Alagoas, northeastern Brazil. A structured questionnaire was applied to collect information on demographic and socioeconomic status and household access to food, based on the Brazilian Food Insecurity Scale of 29 family farmers' households. Food intake was assessed by food intake markers of the Ministry of Health, while nutritional status was determined by measuring the weight and height of all family members and waist circumference of adults. Nutrition diagnosis was performed using the cutoff points of body mass index for age. Three focus groups were conducted, and the information collected was analyzed through Content Analysis with the aim of knowing the participants' perception of the effects of the received water equipment. The study showed a high prevalence of excess weight (52.7%) and high risk for cardiovascular diseases (35.9%) marked by a high salt and sugar in the food intake. Food Insecurity Scale showed that food insecurity is a problem occurring in 75% of these families. However, focus groups showed that families have a positive perception of Boardwalk Cisterns for their food security. They believe that agricultural production has improved, thereby offering a wider range of foods and, consequently, improving food security. In conclusion, this study highlights the importance of water access programs for food production within public policies to guarantee FNS.

Ligas Acadêmicas na formação do profissional de saúde para o Sistema Único de Saúde: potencialidades e desafios / Academic Leagues in health care worker education for Brazil's Unified Health System: potential and challenges

Introdução: As Ligas Acadêmicas (LA) são associações estudantis que contribuem com o estreitamento da relação ensino-serviço-comunidade. Objetivo: Analisar as potencialidades e os desafios das Ligas Acadêmicas como dispositivos de aprendizagem a partir da percepção de alunos e egressos dos cursos da saúde de dois campi de uma universidade pública do Nordeste brasileiro, com modelos de ensino distintos. Métodos: Trata-se de um estudo qualitativo, cujos dados foram coletados por meio de Grupos Focais e analisados pela técnica de Análise de Conteúdo. Resultados: Foi identificado que, apesar dos desafios inerentes à gestão de pessoas, ao processo de normatização das Ligas e à necessidade de recursos financeiros para a realização das ações, as Ligas Acadêmicas, independentemente do modelo de ensino adotado pela instituição, desempenham importante papel na formação de profissionais de saúde com maior senso crítico, ampliada visão sobre o modo de promover saúde e maior atenção aos princípios e demandas do Sistema Único de Saúde. Conclusão: A partir dos resultados, sugere-se aos discentes e professores uma atuação que favoreça a superação de desafios e a troca de experiências para potencializar a formação complementar em saúde. Às instituições de ensino cabe o papel de acompanhamento das ações das Ligas para garantir e fortalecer a extensão universitária. (AU)

Introduction: Academic Leagues (AL) are student associations that help strengthen the teaching-service-community relationship. Objective: To analyze the potential and challenges of Academic Leagues as learning devices, based on the perception of students and graduates of health degree programs on two campuses at a public university in northeastern Brazil, which use different teaching approaches. Methods: This is a qualitative study, whose data were collected through Focus Groups and analyzed using the Content Analysis technique. Results: Despite the challenges posed by people management, the standardization of the Leagues and the need for financial resources for full operation, the Academic Leagues, regardless of the teaching model adopted by the institution, play an important role in education and training of health workers so that they can develop greater critical sense, broader vision on health promotion and greater attention to the principles and demands of the Unified Health System. Conclusion: The results showed that students and teachers are encouraged to take action to overcome challenges and to exchange experiences to enhance complementary health education. Educational institutions have the role of monitoring the actions of the Leagues to strengthen and ensure the offer of university extension activities. (AU)

Students' Perspective on Active Learning in Nutrition Education.

OBJECTIVE: To analyze the perception of nutrition undergraduates about the use of active methodologies as teaching-learning tools for the Nutrition Education course. METHODS: Quali-quantitative cross-sectional research with application of a structured questionnaire and subsequent use of focus groups. PARTICIPANTS: Fifty-three sixth and eighth semester nutrition students, taking or having taken the course of Nutrition Education, with mean age (SD) of 23.6 (±5.02) years; 84% were females, and 54% were sixth semester students. Ten students (8 females) participated in the qualitative phase of the research. PHENOMENON OF INTEREST: The use of active learning (AL) in the Nutrition Education course in a university with a traditional teaching method. ANALYSIS: Descriptive statistics was performed using absolute and relative frequencies, whereas qualitative analysis was based on categorical content analysis. RESULTS: Participants reported not knowing the meaning of AL, but they believed that these methodologies were useful for their learning process and different from what they had experienced in the traditional method. CONCLUSIONS AND IMPLICATIONS: In the above-mentioned course, AL improved students' skills, which should be developed throughout their degree program, and familiarized them with methods that can be replicated in their professional life, be it in an academic career or in other fields.

Intakes of Zinc, Potassium, Calcium, and Magnesium of Individuals with Type 2 Diabetes Mellitus and the Relationship with Glycemic Control.

The role of the concomitant intake of zinc, potassium, calcium, and magnesium in the glycemic control of individuals with type 2 diabetes mellitus (T2DM) has not been extensively discussed. We evaluated the relationship between the dietary intake of these micronutrients and glycemic markers in 95 individuals with T2DM (mean age 48.6 ± 8.4 years). Hierarchical grouping analysis was used to divide the individuals into two clusters according to their micronutrient intake, and differences between clusters were statistically assessed. Effects of individual and combination intake of micronutrients on glycated hemoglobin percentage (%HbA1c) were assessed using multiple linear regression and binary logistic regression analysis. We observed a high likelihood of inadequate intake of the four micronutrients. The group with lower micronutrient intake (cluster 1) displayed higher %HbA1c (p = 0.006) and triglyceride (p = 0.010) levels. High %HbA1c showed an association with cluster 1 (odds ratio (OR) = 3.041, 95% confidence interval (CI) = 1.131; 8.175) and time of T2DM diagnosis (OR = 1.155, 95% CI = 1.043; 1.278). Potassium (ß = -0.001, p = 0.017) and magnesium (ß = -0.007, p = 0.015) intakes were inversely associated with %HbA1c. Reduced concomitant intake of the four micronutrients studied proved to be associated with risk of increased %HbA1c in individuals with T2DM, which was particularly predicted by magnesium and potassium intakes.

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults / Capacidade Antioxidante Total do Plasma e Risco Cardiometabólico em Adultos Jovens, Não Obesos e Clinicamente Saudáveis

Abstract Background: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. Objective: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. Methods: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. Results: Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; β = 0.17; p = 0.001). Conclusions: The plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions.

Resumo Fundamentos: Os biomarcadores oxidativos exercem um importante papel na gênese dos processos relacionados ao risco cardiometabólico. Objetivo: Investigar a capacidade antioxidante total do plasma e sua associação com risco cardiometabólico em adultos jovens, não obesos e clinicamente saudáveis. Métodos: Estudantes universitários do estado de Sergipe, Brasil, com idade entre 18 e 25 anos, foram recrutados entre maio de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. Resultados: Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; β = 0,17; p = 0,001). Conclusões: A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

BACKGROUND:: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. OBJECTIVE:: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. METHODS:: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. RESULTS:: Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; ß = 0.17; p = 0.001). CONCLUSIONS:: The plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions. FUNDAMENTOS:: Os biomarcadores oxidativos exercem um importante papel na gênese dos processos relacionados ao risco cardiometabólico. OBJETIVO:: Investigar a capacidade antioxidante total do plasma e sua associação com risco cardiometabólico em adultos jovens, não obesos e clinicamente saudáveis. MÉTODOS:: Estudantes universitários do estado de Sergipe, Brasil, com idade entre 18 e 25 anos, foram recrutados entre maio de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. RESULTADOS:: Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; ß = 0,17; p = 0,001). CONCLUSÕES:: A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Zinc's role in the glycemic control of patients with type 2 diabetes: a systematic review.

Past research has shown the importance of zinc in several metabolic processes, such as the glucidic metabolism. The present systematic review aims to discuss zinc's participation in the glycemic control of type 2 diabetes mellitus (DM2) patients. In order to accomplish that, a systematic search was performed in the Pubmed database using the following indexed and theme-related descriptors: "zinc" AND "type 2 diabetes mellitus", AND MeSH terms related to glycemic control combined with the boolean operator OR. In total, 1078 articles were retrieved from the research, of which 15 articles of original studies conducted with DM2 patients were included, with three being about the effect of mineral supplementation and 12 reporting observational studies. The main findings of these studies consisted of low body contents of zinc and high excretion of zinc in urine. Hyperglycemia was one of the mechanisms that caused these alterations owing to its interference in zinc reabsorption via renal cells. Another evidence was the negative correlation between the glycated hemoglobin percentage (%HbA1c) and the plasma zinc levels. Additionally, it has been observed that zinc supplementation in DM2 patients has improved glycemic control, since the %HbA1c significantly reduced in these individuals. This present review shows the positive effect of adequate zinc levels on glycemic control, whether it is through dietetic ingestion or supplementation, since its role in insulin homeostasis is clear.

[Not Available]. / Nutrients can modulate the adiponectin concentrations in apparently healthy young adult.

INTRODUCTION: Adiponectin, an adipocyte derived peptide, has anti-inflammatory and antiatherogenic effects, and improves insulin sensitivity. However, little is known about dietary predictors and their interactions with lifestyle on adiponectin concentrations, in apparently healthy young adults. OBJECTIVE: To evaluate the associations between plasma concentrations of adiponectin with dietary components and lifestyle in apparently healthy young adults. METHODS: Anthropometric and body composition, systolic and diastolic blood pressure, diet and lifestyle data of 157 healthy young adults, aged 18 and 35, were collected and analyzed. Blood samples were collected after fasting for 12 hours to determine adiponectin concentrations. Dietary and anthropometric indexes were calculated and analyzed. RESULTS: Adiponectin concentrations were significantly higher for women compared to men; and there was an indirect and significant correlation between adiponectin concentrations with BMI. There was a significant association between adiponectin concentrations with the healthy eating index, calories, lipids, proteins, fibers, riboflavin, and phosphorus, among others; and a tendency with carbohydrates and niacin. In multiple linear regression analysis, fiber and riboflavin (r2 = 0.0928; p = 0.0013) and carbohydrates and phosphorus were associated with the concentrations of adiponectin. The association with carbohydrates and phosphorus suffered interaction with gender (r2 = 0.2400; p < 0.0001), as well as the association with phosphorus also suffered interaction with physical activity (r2 = 0.1275; p = 0.0003). CONCLUSION: Plasma concentrations of adiponectin, in healthy young adults, seem to be modulated by components of diet depending on gender and physical activity.

Frequency of healthy eating habits among students of a public university in Northeastern Brazil / Frequência de hábitos alimentares saudáveis entre estudantes de uma universidade pública do Nordeste do Brasil / Frecuencia de hábitos alimentarios saludables de Estudiantes de una universidad pública del Noreste de Brasil

Objective: The aim of this study was to measure the frequency of healthy eating habits among students of a public university in Northeastern Brazil. Methods: This is a cross-sectional population-based study. The sample was randomly composed of 933 undergraduate students of both genders aged 18-35 years. The frequency of healthy eating habits was assessed based on the adherence to the 10 Steps to Healthy Eating proposed by Brazil's Ministry of Health. The frequency of each step was measured through questions compiled from previous publications. Results: The steps to the healthy eating with the lowest frequencies of adherence were related to the practice of adding salt to prepared foods (18.6%, n=185) and to the consumption of fruits and vegetables (28.3%, n=281) and foods rich in fat (21.5%, n=213) and sugar (48.9%, n=486). However, there was an adequate consumption of beans (83.8%,n=832) and a prevalence of normal nutritional status of 69.6% (n=691) among the students. None of the interviewees followed all the steps to the healthy eating. The average adherence rate was at least 6 steps. Men and women presented different habits and food preferences. Conclusion: The university students presented a low frequency of healthy eating habits due to the high intake of food high in fat and sugar and mainly the low consumption of fruits and vegetables and the practice of adding salt to prepared foods. This may, in turn, predispose them to increased risks of morbidity and mortality from noncommunicable diseases.

Objetivo: O objetivo deste estudo foi medir a frequência de hábitos alimentares saudáveis entre estudantes de uma universidade pública do Nordeste do Brasil. Métodos: Este é um estudo transversal de base populacional. A amostra foi aleatoriamente composta por 993 graduandos, ambos os sexos e idade entre 18 e 35 anos. A frequência de hábitos alimentares saudáveis foi avaliada a partir da adesão aos 10 Passos para a Alimentação Saudável propostos pelo Ministério da Saúde do Brasil. A frequência de cada passo foi coletada por meio de perguntas compiladas a partir de publicações prévias. Resultados: Os passos da alimentação saudável, que tiveram as menores frequências de adesão, estiveram relacionados à prática de adicionar sal aos alimentos prontos (18,6%, n=185) e ao consumo de frutas e hortaliças (28,3%, n=281) e de alimentos gordurosos (21,5%, n=213) e ricos em açúcar (48,9%, n=486). No entanto, observou-se um adequado consumo de feijão (83,8%, n=832) e a prevalência de estado nutricional eutrófico de 69,6% (n=691) entre os estudantes. Nenhum dos indivíduos entrevistados aderiu a todos os passos da alimentação saudável. A taxa média de adesão foi de, pelo menos, 6 passos. Homens e mulheres apresentaram hábitos e preferências alimentares distintos. Conclusão: Os estudantes universitários apresentaram baixa frequência de hábitos alimentares saudáveis devido à alta ingestão de alimentos ricos em gordura e açúcar e devido, principalmente, ao baixo consumo de frutas e vegetais e a prática de adição de sal aos alimentos já preparados. Isto pode, por sua vez, predispô-los a um maior risco de morbidade e mortalidade por doenças não transmissíveis.

Objetivo: El objetivo del estudio fue medir la frecuencia de hábitos alimentarios saludables entre estudiantes de una universidad pública del noreste de Brasil. Métodos: Estudio transversal de base poblacional. La muestra fue randomizada y consistió de 933 estudiantes de graduación, de ambos los sexos y edades entre 18 y 35 años. La frecuencia de hábitos alimentarios saludables fue valorada a partir de la adhesión de 10 pasos para la Alimentación Saludable propuesta por el Ministerio de la Salud de Brasil.Se recogió la frecuencia de cada paso a través de cuestiones elaboradas de publicaciones anteriores. Resultados: Los pasos de la alimentación saludable los cuales tuvieron las más bajas frecuencias de adhesión estuvieron relacionadas con las practicas de la adición de sal en las comidas preparadas (18,6%, n=185) y al consumo de frutas y vegetales (28,3%, n=281) y de las comidas llenas de grasa (21,5%, n=213) y azúcar (48,9%, n=486). Sin embargo, un adecuado consumo de frijoles (83,8%, n=832) y la prevalencia del estado nutricional normal del 69,6% (n=691) fueron observados entre los estudiantes. Ninguno de los indivíduos entrevistados siguió los pasos de la alimentación saludable. La tasa media de adhesión fue de al menos 6 pasos. Hombres y mujeres han demostrado hábitos distintos y preferencias de comidas. Conclusión: Los estudiantes universitarios presentaron baja frecuencia de hábitos alimentarios saludables debido a la elevada ingesta de comidas con elevado nivel de grasa y azúcar y, principalmente, al bajo consumo de frutas y vegetables y la práctica de adicción de sal en las comidas preparadas. Eso puede contribuir a la predisposición de riesgos elevados de morbidad y mortalidad por enfermedades no comunicables.

Nutrients can modulate the adiponectin concentrations in apparently healthy young adults / Los nutrientes pueden modular las concentraciones de adiponectina en adultos jóvenes aparentemente sanos

Introduction: Adiponectin, an adipocyte derived peptide, has anti-inflammatory and antiatherogenic effects, and improves insulin sensitivity. However, little is known about dietary predictors and their interactions with lifestyle on adiponectin concentrations, in apparently healthy young adults. Objective: To evaluate the associations between plasma concentrations of adiponectin with dietary components and lifestyle in apparently healthy young adults. Methods: Anthropometric and body composition, systolic and diastolic blood pressure, diet and lifestyle data of 157 healthy young adults, aged 18 and 35, were collected and analyzed. Blood samples were collected after fasting for 12 hours to determine adiponectin concentrations. Dietary and anthropometric indexes were calculated and analyzed. Results: Adiponectin concentrations were significantly higher for women compared to men; and there was an indirect and significant correlation between adiponectin concentrations with BMI. There was a significant association between adiponectin concentrations with the healthy eating index, calories, lipids, proteins, fibers, riboflavin, and phosphorus, among others; and a tendency with carbohydrates and niacin. In multiple linear regression analysis, fiber and riboflavin (r2 = 0.0928; p = 0.0013) and carbohydrates and phosphorus were associated with the concentrations of adiponectin. The association with carbohydrates and phosphorus suffered interaction with gender (r2 = 0.2400; p < 0.0001), as well as the association with phosphorus also suffered interaction with physical activity (r2 = 0.1275; p = 0.0003) Conclusion: Plasma concentrations of adiponectin, in healthy young adults, seem to be modulated by components of diet depending on gender and physical activity (AU)

Introducción: la adiponectina, un péptido derivado de los adipocitos, tiene efectos antiinflamatorios y antiaterogénicos, y mejora la sensibilidad a la insulina. Sin embargo, se conoce poco sobre los predictores de la dieta, así como sobre las interacciones con el estilo de vida de las concentraciones de adiponectina en adultos jóvenes aparentemente sanos. Objetivo: evaluar la asociación entre las concentraciones plasmáticas de adiponectina con los componentes de la dieta y estilo de vida en los adultos jóvenes aparentemente sanos. Métodos: fueron recogidos y analizados datos antropométricos y de composición corporal, presión arterial sistólica y diastólica, datos de la dieta y del estilo de vida de 157 adultos jóvenes sanos, de entre 18 y 35 años de edad. Se tomaron muestras de sangre después de un ayuno de 12 horas para determinar las concentraciones de adiponectina y se calcularon y analizaron los índices dietéticos y antropométricos. Resultados: las concentraciones de adiponectina fueron significativamente mayores para las mujeres en comparación con los hombres; y había una correlación indirecta y significativa entre las concentraciones de adiponectina con el IMC. Hubo una asociación significativa entre las concentraciones de adiponectina con el índice de alimentación saludable, calorías, lípidos, proteínas, fibras, riboflavina y fósforo, entre otros; y una tendencia con los hidratos de carbono y niacina. En el análisis de regresión lineal múltiple, la fibra y la riboflavina (r2 = 0,0928, p = 0,0013) y los hidratos de carbono y el fósforo se asociaron con las concentraciones de adiponectina. La asociación con los hidratos de carbono y fósforo sufrió interacción con el género (r2 = 0,2400, p < 0,0001), así como la asociación con el fósforo también sufrió interacción con la actividad física (r2 = 0,1275, p = 0,0003). Conclusión: Las concentraciones plasmáticas de adiponectina, en adultos jóvenes aparentemente sanos, parecen estar moduladas por componentes de la dieta en forma dependiente de género y de la actividad física (AU)

Comparação entre o Índice de Massa Corporal e o percentual de gordura como indicadores do risco cardiometabólico / Body Mass Index as cardiometabolic risk indicator compared to body fat percentage

Objetivo ­ Avaliar a manifestação dos componentes do risco cardiometabólico (RCM) em adultos jovens saudáveis de acordo com o IMC e a gordura corporal. Métodos ­ Analisou-se as concentrações de glicemia de jejum, triglicérides, HDL-c, pressão arterial, circunferência da cintura, IMC, percentual de gordura corporal, além de informações sobre tabagismo e atividade física. Resultados ­ A população estudada foi composta por 163 jovens adultos com idade média de 21,5 ± 2,03 anos; sendo 74,2% mulheres. Os componentes do risco cardiometabólico mais frequentes na população estudada foram a redução da concentração de HDL-c (20,6%) e a obesidade abdominal (13,1%). O IMC apresentou melhor associação aos componentes do RCM, estando associado à obesidade abdominal (p<0,001), hiperglicemia (p=0,047), hipertrigliceridemia (p=0,001) e PAS (p<0,001). A gordura corporal associou-se a obesidade abdominal (p<0,001), hipertrigliceridemia (p=0,003) e PAS (p=0,028). Conclusão ­ Pode-se observar que apesar de clinicamente saudáveis e, predominantemente eutróficos, os adultos jovens já apresentavam alterações antropométricas, clínicas e/ou bioquímicas relativas aos componentes do RCM, e que o IMC foi o instrumento mais eficaz na detecção dos componentes do risco quando comparado a gordura corporal total.

Objective ­ To evaluate the expression of the components of cardiometabolic risk (CMR) in healthy young adults according to BMI and body fat. Methods ­ We analyzed the fasting glucose concentrations, triglycerides, HDL-c, blood pressure, waist circumference, BMI, body fat percentage, and information on smoking and physical activity. Results ­ The study population consisted of 163 young adults with an average age of 21.5 ± 2.03, from which 74.2% were women. Low HDL-c concentration (20.6%) and abdominal obesity (13.1%) were the most prevalent risk components in the studied population. BMI showed a better association with the components of CMR, being associated with abdominal obesity (p<0.001), hyperglycemia (p=0.047), hypertriglyceridemia (p=0.001) and systolic blood pressure (p<0.001). Body fat was associated to abdominal obesity (p<0.001), hypertriglyceridemia (p=0.003) and systolic blood pressure (p=0.028). Conclusion ­ Although the young adults are clinically healthy and predominantly normal weight, they already show anthropometric, clinical and/or biochemical alterations related to the components of CMR. In addition, BMI was the most effective measure in the detection of risk components when compared to total body fat

Low energy and carbohydrate intake associated with higher total antioxidant capacity in apparently healthy adults.

OBJECTIVES: The aim of this study was to investigate the associations between plasma total antioxidant capacity (TAC) and anthropometric, biochemical, clinical, and dietary measurements in young and apparently healthy individuals. METHODS: We evaluated 156 individuals (91 women and 65 men; ages 23.1 ± 3.5 y; body mass index 22 ± 2.9 kg/m(2)) for anthropometrics, biochemical markers, clinical, dietary, and some components of the antioxidant defense system, including the plasma TAC. Statistical analyses were performed to detect differences between individuals with TAC higher and lower than the mean value and to screen the associations between TAC and variables of interest. A linear regression model was fitted to identify TAC predictors. RESULTS: Daily caloric intake and macronutrient consumption were lower in individuals who exhibited the highest TAC values (P < 0.05). Linear regression analysis showed that daily calories and carbohydrate intake was a possible negative TAC predictor (P < 0.05). Nevertheless, there was no difference in the values of oxidized low-density lipoprotein in the individuals separated by means of TAC. In contrast, individuals whose plasma TAC values were above the mean showed higher low-density lipoprotein cholesterol concentrations, total cholesterol/high-density lipoprotein cholesterol values, and selenium in nails (P < 0.05). CONCLUSIONS: In physiological conditions, the caloric intake level seems to be an important factor to act in the modulation of plasma TAC, before establishing anthropometric impairments of body or metabolic composition, or both. Additionally, the plasma TAC increase may be able to act as a compensatory mechanism.

Modulators of erythrocyte glutathione peroxidase activity in healthy adults: an observational study.

The aim of this study was to investigate the potential modulators of erythrocyte glutathione peroxidase (GPx) activity in young and apparently healthy individuals. One hundred one individuals (53 women and 48 men) were evaluated for anthropometric measurements, biochemical markers, clinical, dietary, and endogenous and exogenous components of the antioxidant defense system. Statistical analysis was performed to detect differences among subjects by the median of GPx activity. A linear regression model and Spearman correlation coefficients were used to screen the associations between GPx activity and interest variables. Individuals with higher GPx enzymatic activity were older and higher circulating levels of oxidized low-density lipoprotein (ox-LDL) values, but conversely lower nail concentrations of selenium and copper (P < 0.05). The GPx activity was positively correlated to truncal fat percentage values (r = 0.24, P = 0.016), circulating levels of ox-LDL (r = 0.28, P = 0.004), and daily vitamin C intake (r = 0.28, P = 0.007), and negatively correlated to the nail concentration of selenium (r = -0.24, P = 0.026). Interesting, it was noticed that the truncal fat percentage and circulating levels of ox-LDL explained 5.9 and 7.4% of the GPx enzymatic activity. Thus, preventive measures such as adequate antioxidant intake and proper fat percentage would be a priority in the nutritional care of young and apparently healthy individuals.

Bariatric surgery reverses metabolic risk in patients treated in outpatient level.

BACKGROUND: The conventional treatment of obesity presents unsatisfactory results on weight loss and its long-term sustainability, therefore bariatric surgery has been suggested as an effective therapy, determining sustainable long-term weight loss, reversal of components of cardiometabolic risk and improved quality and life expectancy. AIM: To investigate the clinical component of the cardiometabolic risk in patients undergoing bariatric surgery assisted on outpatient basis. Methods : The sample consisted of 47 patients with ages between 18 and 60 years, 72% females. Diabetes mellitus, hypertension, and dyslipidemia were prospectively evaluated by using the Assessment of Obesity-Related Co-morbidities scale. RESULTS: Occurred improvement in these co-morbidities within 12 months after surgery. Co-morbidities resolved were greater than those improved. CONCLUSION: The study revealed that the Assessment of Obesity-Related Co-morbidities is a system that can be effectively used to quantify the degree of reduction of the severity of the cardiometabolic risk in response to bariatric surgery.