Association between nutrition intake and muscle mass in adult inpatients receiving nutrition support: A prospective cohort study.

OBJECTIVE: The present study aimed to evaluate the association between muscle mass variation, estimated by different equations, during hospitalization with the energy and protein intake and clinical and nutrition outcomes of patients using nutrition support. METHODS: A prospective observational study with patients older than 18 years in use of enteral and/or parenteral nutrition therapy and monitored by the Nutritional Therapy Committee between December 14, 2021, and December 14, 2022. Data were collected from the electronic records and were applied in 11 equations to estimate the four different portions of muscle mass of patients receiving nutrition support at the beginning and the end of hospitalization. RESULTS: A total of 261 patients were evaluated, with a median age of 61.0 (49.0-69.75) years, and 106 were women (40.6%). According to the nutrition diagnosis, several participants had severe malnutrition (39.5%). The most muscle mass estimation equations indicated a reduction of muscle mass during hospitalization. All patients presented negative energy and protein balances during hospitalization, but greater protein intake increased the lean soft tissue. Also, the greater the number of infections, metabolic complications, and scheduled diet interruption, the greater was the chance of losing muscle mass. CONCLUSION: There can be an association between the variation in muscle mass and energy and protein intake during hospitalization of patients using nutrition support. In addition, variation in muscle mass was associated with complications from nutrition support. The results emphasize the importance of anthropometric measurements to estimate muscle mass when other methods are not available.

Comparison of pre- and posttransplant energy expenditure in patients undergoing hematopoietic stem cell transplantation and evaluation of associated factors.

OBJECTIVES: Patients undergoing hematopoietic stem cell transplantation may present with metabolic alterations that can have an effect on their energy expenditure and nutritional status. This project aimed to compare the pre- and posttransplant energy expenditures of patients undergoing hematopoietic stem cell transplantation as well as related factors. METHODS: This prospective study was conducted at a single center. Patients, undergoing autograft or allograft, were evaluated before transplantation and on the 10th and 17th d posttransplantation. Energy expenditure was measured by indirect calorimetry. Diet intake was assessed by a 24-h dietary recall. Infectious and noninfectious complications were analyzed between days 1 to 10 after transplantation and days 11 to 17 after transplantation. Paired model analyses were carried out to identify the pretransplantation and posttransplantation periods. RESULTS: Twenty patients were evaluated with a mean age of 45.6 ± 17.2 y; a majority were male sex (65%), and the most frequent diagnoses were chronic myeloid leukemia (25%) and multiple myeloma (25%). Energy expenditure increased by 15% posttransplantation, and the energy requirement per kilogram of weight was 23 kcal/kg at day 10 after transplantation. Throughout the posttransplantation period, 45% of the patients required nutritional therapy. Negative energy and negative protein balance were observed at all analyzed times. Phase angle (P = 0.018), fever (P = 0.014), mucositis grades I to II (P = 0.018), and the total number of infectious and noninfectious events (P = 0.043) were associated with an increase in energy expenditure at day 10 after transplantation. CONCLUSIONS: Energy expenditure increased after transplantation compared with pretransplantation in 50% of patients. Phase angle, fever, grades I to II mucositis, and infectious and noninfectious events were associated with increased energy expenditure at day 10 after transplantation.

Prediction equations to estimate muscle mass using anthropometric data: a systematic review.

CONTEXT: Reduced muscle mass is linked to poor outcomes in both inpatients and outpatients, highlighting the importance of muscle mass assessment in clinical practice. However, laboratory methods to assess muscle mass are not yet feasible for routine use in clinical practice because of limited availability and high costs. OBJECTIVE: This work aims to review the literature on muscle mass prediction by anthropometric equations in adults or older people. DATA SOURCES: The following databases were searched for observational studies published until June 2022: MEDLINE, Embase, Scopus, SPORTDiscus, and Web of Science. DATA EXTRACTION: Of 6437 articles initially identified, 63 met the inclusion criteria for this review. Four independent reviewers, working in pairs, selected and extracted data from those articles. DATA ANALYSIS: Two studies reported new equations for prediction of skeletal muscle mass: 10 equations for free-fat mass and lean soft tissue, 22 for appendicular lean mass, 7 for upper-body muscle mass, and 7 for lower-body muscle mass. Twenty-one studies validated previously proposed equations. This systematic review shows there are numerous equations in the literature for muscle mass prediction, and most are validated for healthy adults. However, many equations were not always accurate and validated in all groups, especially people with obesity, undernourished people, and older people. Moreover, in some studies, it was unclear if fat-free mass or lean soft tissue had been assessed because of an imprecise description of muscle mass terminology. CONCLUSION: This systematic review identified several feasible, practical, and low-cost equations for muscle mass prediction, some of which have excellent accuracy in healthy adults, older people, women, and athletes. Malnourished individuals and people with obesity were understudied in the literature, as were older people, for whom there are only equations for appendicular lean mass. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42021257200.

The Mediterranean Diet Scale (MDS): Translation and validation of the Arabic version.

OBJECTIVES: The self-administered version of the Mediterranean Diet Scale (MDS) has been developed to test the inherent characteristics of this dietary pattern in a quick and simple way, due to the need of this assessment in the clinical and research setting. This study aimed to translate and psychometrically validate the self-administered MDS in Arabic (CRBS-A). METHODS: The original (English) version was originally translated to Arabic, followed by back-translation. Next, 10 healthcare providers, followed by 10 cardiovascular disease (CVD) patients rated the face and content validity (CV) of materials, providing input to improve cross-cultural applicability. Then, 200 patients from Saudi Arabia completed the questionnaire, of which factor structure, internal consistency, criterion and construct validity were assessed. RESULTS: Content and face validity was supported based on experts and patients' reviews (ranges: CV scores 0.9-1.0/1.0 and clarity 3.5 to 4.5/5). Minor edits were made. Subsequent factor analysis revealed 4 factors consistent with the original version of the instrument, all internally consistent. Total CRBS-A α was 0.74. Criterion validity was confirmed by the significantly higher scores in patients who participated in CR. Construct validity was also established by significant associations between MDS scores and monthly family income, having the diagnosis of acute coronary syndrome or with a history of valve repair or replacement, being obese or having dyslipidemia. CONCLUSIONS: Overall, these results confirm the validity and reliability of the MDS in Arabic-speaking patients.

Association of MTR and MTRR genes and oral health-related quality of life in children with dental caries.

This study aimed to assess whether genetic polymorphisms in MTR and MTRR are potential biomarkers of oral health-related quality of life (OHRQoL) in children with caries. A cross-sectional study was designed wherein pairs of parents/caregivers and children (aged two-five years) were selected. Clinical examination was used to detect dental caries, which were classified as low-severity and high-severity caries. The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was used to assess OHRQoL. Genomic DNA extracted from the saliva was used to analyze two missense genetic polymorphisms: MTR (rs1805087) and MTRR (rs1801394). Mann-Whitney non-parametric test was used to analyze candidate genes with OHRQoL scale and domain, with a significance level of p≤0.05. MTR (rs1805087) was found associated (p = 0.05) with children's OHRQoL subscale scores in the dominant model (GG + AG). Genetic polymorphisms in MTR may increase the risk of poor OHRQoL in children with caries. Further studies are needed to investigate genetics, molecular factors, and OHRQoL.

Olive oil and body fat: a systematic review with meta-analysis.

Diet composition has a great impact on body composition. Several studies have suggested a beneficial effect of adding olive oil to a calorie-restricted diet as a weight loss strategy. However, there is no clear direction regarding the effect of olive oil on body fat distribution. This systematic review with meta-analysis aims to investigate the effect of olive oil consumption (for cooking or as a supplement) on body fat distribution in adults. The present study was conducted following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42021234652). All randomized clinical trials of parallel or crossover design found in PubMed (via MEDLINE), EMBASE, Web of Science and Scopus databases that compared the effects of olive oil with other oils on body fat distribution in adults were included. 52 articles were included. The results indicate that the consumption of olive oil does not seem to alter the distribution of body fat, despite a small indication that supplementation in capsules can increase adipose mass (Mean Difference = 0.28 kg, 95% CI [-0.27, 0.83]; between-groups difference p = 0.59) and waist circumference (mean difference = 1.74 kg, 95% CI [0.86, 1.62]; between-groups difference p < 0.01) and decrease its auxiliary culinary use (mean difference = -0.32 kg, 95% CI [-0.90, 0.26]). Lean mass responds negatively to OO the higher the dose (slope = -0.61, 95% CI [-1.01, -0.21], p = 0.003) and time offered (slope = -0.8822, 95% CI [-1.44, -0.33], p = 0.002). In conclusion, this systematic review showed that OO ingestion in different delivery vehicles, dosages, and durations can interfere body composition. It is important to emphasize that some other aspects of the population and the intervention, that were not possible to be explored in the analysis, could confound the real effects of OO on body composition.

A Scoping Review of Observational Studies on Food and Beverage Advertising on Social Media: A Public Health Perspective.

Popular social media platforms have been actively used by ultra-processed food companies to promote their products. Being exposed to this type of advertising increases the consumption of unhealthy foods and the risk of developing obesity and other non-communicable diseases (NCDs). Thus, monitoring commercial content on social media is a core public health practice. We aimed to characterize the methods used for monitoring food advertising on social media and summarize the investigated advertising strategies via a scoping review of observational studies. This study is reported according to the MOOSE Statement, and its protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration nº. CRD42020187740). Out of the 6093 citations retrieved, 26 met our eligibility criteria. The studies were published from 2014 to 2021, mostly after 2018. They focused on Australia, Facebook, strategies aimed at children and adolescents, and advertising practices of ultra-processed food companies. We grouped strategies in eight classes: post features (n = 18); connectivity and engagement (n = 18); economic advantages, gifts, or competitions (n = 14); claims (n = 14); promotional characters (n = 12); brand in evidence (n = 8); corporate social responsibility or philanthropy (n = 7); and COVID-19 (n = 3). We found similarities in the investigation of strategies regardless of the type of social media. Our findings can contribute to the designing of tools for monitoring studies and regulatory mechanisms to restrict the exposure of food advertising.

Incidence of the first diabetic foot ulcer: A systematic review and meta-analysis.

AIM: Investigate the incidence of the first diabetic foot ulcer. METHOD: This is a systematic review with meta-analysis of cohort studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. A systematic search of Medline databases via PubMed, Embase, Lilacs, Scopus databases, and Web of Science was performed until July 2021. In addition to investigating the incidence of the first diabetic foot ulcer, the influence of the variables of the Human Development Index (HDI), glycated hemoglobin, and follow-up time of the participants on the incidence of the first diabetic foot ulcer (DFU) was analyzed through meta-regression. For the meta-analysis of cumulative incidence and possible variable associations, RevMan software was used in the Metaprop data package with 95% confidence interval (CI). RESULTS: A total of 9,772 articles were identified out of which 87 were selected and 12 studies ultimately included in the systematic review and meta-analysis. The meta-analysis of cumulative incidence was 5.65% (95% CI: 4.20; 7.57). By meta-regression, a significant inverse association was identified between DFU incidence and HDI (estimate - 2.38; 95% CI - 4.10--0.67; p = 0.01). CONCLUSION: The study presents the cumulative incidence for the first DFU, an inexistent datum in the national and international literature, and the HDI was inversely associated with the incidence of DFU.

Total cholesterol and low-density lipoprotein alterations in children and adolescents from Brazil: a prevalence meta-analysis

ABSTRACT Objective: The aim of the present study was to evaluate the prevalence of total cholesterol (TC) and low-density lipoprotein (LDL) alterations in children and adolescents in Brazil. Materials and methods: A systematic review and meta-analysis of prevalence. The search for articles was carried out in the databases: Medline (PubMed), Embase, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (Lilacs). The meta-analysis was performed using the random effects model. The I² test was used to identify heterogeneity. Results: The present metanalysis revealed a significant prevalence of altered lipid profile in children and adolescents in Brazil. Regarding lipoprotein fractions, the prevalence of altered TC level was 27.47% (95% CI 24.36-30.82), and a smaller prevalence was observed for LDL cholesterol (19.29% - 95% CI 15.21-24.16). The models revealed high heterogeneity (I² = 99%; p < 0.01), however the precise source of it was not identified; although type of school, age group, year and the region of Brazil appeared to influence the estimations of altered lipid profiles. Conclusion: An important prevalence of lipid alterations was observed among Brazilian children and adolescents. Those results reinforce the importance of knowing the lipid profile of children and adolescents to perform early interventions for this public.

Environmental factors associated with excessive gestational weight gain: a meta-analysis and systematic review.

The aim is, systematically examine the scientific evidences that associated environmental factors (environment, social environment, environmental planning and spatial population distribution) with the excessive gestational weight gain. A meta-analysis and systematic review carried out as per the Cochrane Handbook recommendations and following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The inclusion studies were done with the following PECO criteria: P-pregnant women, E-environmental factors, O-weight gain. The search procedure was conducted on the databases EMBASE, Web of Science, Cinahl, LILACS and MEDLINE (PubMed). The relationship between the socioeconomic factors of the micro-region of residence and gestational weight gain was evidenced by the linkage between residing in high-poverty neighborhoods and inadequate gestational weight gain. This study revealed the higher prevalence of excessive gestational weight gain in pregnant women those lives in urban areas. Environmental factors of the pregnant women's residence area implicated in the excessive gestational weight gain. Our findings can therefore contribute to the development of public policies to prevent inadequate gestational weight gain.

Environmental factors associated with excessive gestational weight gain: a meta-analysis and systematic review / Fatores ambientais associados ao ganho de peso gestacional excessivo: uma meta-análise e revisão sistemática

Abstract The aim is, systematically examine the scientific evidences that associated environmental factors (environment, social environment, environmental planning and spatial population distribution) with the excessive gestational weight gain. A meta-analysis and systematic review carried out as per the Cochrane Handbook recommendations and following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The inclusion studies were done with the following PECO criteria: P-pregnant women, E-environmental factors, O-weight gain. The search procedure was conducted on the databases EMBASE, Web of Science, Cinahl, LILACS and MEDLINE (PubMed). The relationship between the socioeconomic factors of the micro-region of residence and gestational weight gain was evidenced by the linkage between residing in high-poverty neighborhoods and inadequate gestational weight gain. This study revealed the higher prevalence of excessive gestational weight gain in pregnant women those lives in urban areas. Environmental factors of the pregnant women's residence area implicated in the excessive gestational weight gain. Our findings can therefore contribute to the development of public policies to prevent inadequate gestational weight gain.

Resumo O objetivo é examinar sistematicamente as evidências científicas que associam fatores ambientais (meio ambiente, meio ambiente social, planejamento ambiental e distribuição espacial da população) com o excessivo ganho de peso gestacional. Trata-se de uma revisão sistemática e meta-análise realizada seguindo os passos recomendados pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. Os estudos de incluídos basearam-se nos seguintes critérios PECO: P-gestantes, E-fatores ambientais, O-ganho de peso gestacional. O procedimento de pesquisa foi conduzido nas bases de dados EMBASE, Web of Science, Cinahl, LILACS e MEDLINE (PubMed). A relação entre os fatores socioeconômicos da microrregião de residência e o ganho de peso gestacional foi evidenciada pela ligação entre a residência em bairros de alta pobreza e o ganho de peso gestacional inadequado. Este estudo revelou a maior prevalência de ganho de peso gestacional excessivo em gestantes que vivem em áreas urbanas. Fatores ambientais da área de residência das gestantes implicados no ganho de peso gestacional excessivo. As descobertas desse estudo podem, portanto, contribuir para o desenvolvimento de políticas públicas para evitar o ganho de peso gestacional inadequado.

Total cholesterol and low-density lipoprotein alterations in children and adolescents from Brazil: a prevalence meta-analysis.

Objective: The aim of the present study was to evaluate the prevalence of total cholesterol (TC) and low-density lipoprotein (LDL) alterations in children and adolescents in Brazil. Subjects and methods: A systematic review and meta-analysis of prevalence. The search for articles was carried out in the databases: Medline (PubMed), Embase, Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (Lilacs). The meta-analysis was performed using the random effects model. The I2 test was used to identify heterogeneity. Results: The present metanalysis revealed a significant prevalence of altered lipid profile in children and adolescents in Brazil. Regarding lipoprotein fractions, the prevalence of altered TC level was 27.47% (95% CI 24.36-30.82), and a smaller prevalence was observed for LDL cholesterol (19.29% - 95% CI 15.21-24.16). The models revealed high heterogeneity (I2 = 99%; p < 0.01), however the precise source of it was not identified; although type of school, age group, year and the region of Brazil appeared to influence the estimations of altered lipid profiles. Conclusion: An important prevalence of lipid alterations was observed among Brazilian children and adolescents. Those results reinforce the importance of knowing the lipid profile of children and adolescents to perform early interventions for this public.

Medida do equilíbrio de decisões para redução do peso corporal entre pessoas com sobrepeso ou obesidade: uma revisão sistemática / Measuring the balance of decisions to reduce body weight among overweight or obesity people: a systematic review

Introdução: Abordagens comportamentais têm contribuído para a efetividade do tratamento da obesidade. A avaliação do equilíbrio de decisões (ED) para redução de peso, isto é, o equilíbrio entre prós e contras da mudança de comportamento, é estratégica no tratamento, contribuindo para a pactuação de estratégias para o enfrentamento dos desafios. É necessário, porém, utilizar instrumentos válidos para mensurar o ED. Objetivo: Avaliar a qualidade de instrumentos de avaliação do ED para redução do peso corporal visando qualificar o cuidado da pessoa com obesidade no Sistema Único de Saúde (SUS). Métodos: Realizou-se revisão sistemática da literatura sobre o desenvolvimento e a validação de instrumentos em sete bases de dados seguindo a metodologia Cosmin. Variações dos termos psicometria, obesidade e ED foram combinadas com operadores booleanos. Em duplicada e independentemente, duas pesquisadoras realizaram: extração de dados, avaliação da qualidade e síntese de evidências, sendo as divergências solucionadas por consenso. Esta revisão foi registrada na base internacional Prospero (CRD42020197797). Resultados: Identificaram-se cinco estudos, sendo que três realizaram a tradução e adaptação transcultural do mesmo instrumento. Todos os estudos apresentaram ED em duas dimensões (prós e contras), mas usaram métodos duvidosos ou inadequados, e a maioria apresentou evidências científicas de muito baixa qualidade. Conclusões: Os resultados não sustentaram o uso dos instrumentos existentes nem sua tradução e adaptação transcultural, sendo necessário o desenvolvimento de um novo instrumento. Este estudo, ao disponibilizar um instrumento válido para uso no SUS, poderá contribuir para qualificar o cuidado da pessoa com obesidade e deter o crescimento da obesidade no país.

Introduction: Behavioral strategies have been adding to the effectiveness of obesity treatment. And the assessment of the decisional balance (DB) for weight reduction, that is, the balance between expected losses and gains around the behavioral changes, is strategic for managing obesity. The DB assessment may contribute to the agreement on strategies to face the challenges of the treatment. But, there is a need to use a valid instrument to assess the DB. Objective: evaluate the quality of instruments assessing DB for weight reduction to qualify obesity management in the Sistema Único de Saúde ­ SUS (Unified Health System). Methods: A systematic review of studies about instrument development and/or validation was carried out on seven databases using the Cosmin methodology. Terms related to psychometrics, obesity, and DB were combined with Boolean operators to guide the search. Two researchers performed independently and in duplicate: data extraction, quality assessment, and evidence synthesis, and divergences were resolved by consensus. This review was registered in the international database Prospero (CRD42020197797). Results: Five studies were identified. Three of them reported translations and cross-cultural validity of the same instrument. All analyses presented DB in two dimensions (pros and cons, but used doubtful or inadequate methods. Most of the evidence was very low rate. Conclusions:The results did not support the instrument's use, translations, or cross-cultural adaptation. It is necessary to develop a new tool. By providing a valid instrument for use in SUS, this study could contribute to qualifying the care of people with obesity and stopping the growth of obesity in the country.

Association of MTR and MTRR genes and oral health-related quality of life in children with dental caries

Abstract This study aimed to assess whether genetic polymorphisms in MTR and MTRR are potential biomarkers of oral health-related quality of life (OHRQoL) in children with caries. A cross-sectional study was designed wherein pairs of parents/caregivers and children (aged two-five years) were selected. Clinical examination was used to detect dental caries, which were classified as low-severity and high-severity caries. The Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire was used to assess OHRQoL. Genomic DNA extracted from the saliva was used to analyze two missense genetic polymorphisms: MTR (rs1805087) and MTRR (rs1801394). Mann-Whitney non-parametric test was used to analyze candidate genes with OHRQoL scale and domain, with a significance level of p≤0.05. MTR (rs1805087) was found associated (p = 0.05) with children's OHRQoL subscale scores in the dominant model (GG + AG). Genetic polymorphisms in MTR may increase the risk of poor OHRQoL in children with caries. Further studies are needed to investigate genetics, molecular factors, and OHRQoL.

Medida do equilíbrio de decisões para redução do peso corporal entre pessoas com sobrepeso ou obesidade: uma revisão sistemática / Measuring the balance of decisions to reduce body weight among overweight or obesity people: a systematic review

Abordagens comportamentais têm contribuído para a efetividade do tratamento da obesidade. A avaliação do equilíbrio de decisões (ED) para redução de peso, isto é, o equilíbrio entre prós e contras da mudança de comportamento, é estratégica no tratamento, contribuindo para a pactuação de estratégias para o enfrentamento dos desafios. É necessário, porém, utilizar instrumentos válidos para mensurar o ED. Objetivo: Avaliar a qualidade de instrumentos de avaliação do ED para redução do peso corporal visando qualificar o cuidado da pessoa com obesidade no Sistema Único de Saúde (SUS). Métodos: Realizou-se revisão sistemática da literatura sobre o desenvolvimento e a validação de instrumentos em sete bases de dados seguindo a metodologia Cosmin. Variações dos termos psicometria, obesidade e ED foram combinadas com operadores booleanos. Em duplicada e independentemente, duas pesquisadoras realizaram: extração de dados, avaliação da qualidade e síntese de evidências, sendo as divergências solucionadas por consenso. Esta revisão foi registrada na base internacional Prospero (CRD42020197797). Resultados: Identificaram-se cinco estudos, sendo que três realizaram a tradução e adaptação transcultural do mesmo instrumento. Todos os estudos apresentaram ED em duas dimensões (prós e contras), mas usaram métodos duvidosos ou inadequados, e a maioria apresentou evidências científicas de muito baixa qualidade. Conclusões: Os resultados não sustentaram o uso dos instrumentos existentes nem sua tradução e adaptação transcultural, sendo necessário o desenvolvimento de um novo instrumento. Este estudo, ao disponibilizar um instrumento válido para uso no SUS, poderá contribuir para qualificar o cuidado da pessoa com obesidade e deter o crescimento da obesidade no país.

Introduction: Behavioral strategies have been adding to the effectiveness of obesity treatment. And the assessment of the decisional balance (DB) for weight reduction, that is, the balance between expected losses and gains around the behavioral changes, is strategic for managing obesity. The DB assessment may contribute to the agreement on strategies to face the challenges of the treatment. But, there is a need to use a valid instrument to assess the DB. Objective: evaluate the quality of instruments assessing DB for weight reduction to qualify obesity management in the Sistema Único de Saúde ­ SUS (Unified Health System). Methods: A systematic review of studies about instrument development and/or validation was carried out on seven databases using the Cosmin methodology. Terms related to psychometrics, obesity, and DB were combined with Boolean operators to guide the search. Two researchers performed independently and in duplicate: data extraction, quality assessment, and evidence synthesis, and divergences were resolved by consensus. This review was registered in the international database Prospero (CRD42020197797). Results: Five studies were identified. Three of them reported translations and cross-cultural validity of the same instrument. All analyses presented DB in two dimensions (pros and cons, but used doubtful or inadequate methods. Most of the evidence was very low rate. Conclusions: The results did not support the instrument's use, translations, or cross-cultural adaptation. It is necessary to develop a new tool. By providing a valid instrument for use in SUS, this study could contribute to qualifying the care of people with obesity and stopping the growth of obesity in the country.

Genetic polymorphisms in TNF-α as a potential biomarker for oral health-related quality of life in children.

This cross-sectional study aimed to assess if genetic polymorphisms in TNF- α are associated with a negative impact on Oral Health-Related Quality of Life (OHRQoL) in children with dental caries. A total of 307 pairs of parents/caregivers and children aged two to five years were selected. The children were clinically evaluated and classified according to caries experience and severity of active caries. The Brazilian Portuguese version of the Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess OHRQoL. Genotyping analysis of genetic polymorphisms in TNF- α (rs1799724, rs1799964, and rs1800629) was performed using real-time polymerase chain reaction. In the recessive model, children with the CC genotype of TNF-α (rs1799964) had a significantly high chance of poor OHRQoL in the symptom domain (pain), in both the caries experience (p = 0.045) and the high-severity active caries phenotypes (p = 0.033) (Mann-Whitney U test). It was concluded that genetic polymorphisms in TNF-α are associated with OHRQoL related to the symptom domain (pain), suggesting that TNF-α could be used as a potential biomarker for OHRQoL. Understanding the genetic aspects associated with OHRQoL will allow the early identification of patients with OHRQoL disparities and provide personalized healthcare.

Consumption of sourdough bread and changes in the glycemic control and satiety: A systematic review.

The aim of this study was to carry out a systematic review of clinical trials followed by meta-analysis, to evaluate the effect of sourdough bread on glycemic control and appetite and satiety regulators such as leptin, ghrelin, GLP-1 (glucagon-like peptide-1), GLP-2 (glucagon-like peptide-2), NPY (neuropeptide Y), AgRP (agouti-related protein), PYY (peptide YY), and GIP (glucose-dependent insulinotropic polypeptide). Clinical trials compared the intake of sourdough bread to that of an industrially fermented one or control glucose solution in adults over 18 years of age. This systematic review included all randomized, parallel, or crossover trials published up to June 2021 in the EMBASE, MEDLINE, Scopus, and Web of Science databases. After the selection process, 18 studies were included. The analysis of the final average difference of the change in serum glucose after 60 minutes for the intervention indicated that the consumption of sourdough bread has a lower impact on blood glucose compared to that of industrial bread or glucose (MD = -0.29, IC 95% = [-0.46; -0.12]; I2 = 0%). The evaluation of blood glucose 120 minutes after the consumption of the intervention also indicated a lower increment in blood glucose when compared to the consumption of other types of bread or the same amount of glucose (MD = -0.21, IC 95% = [-0.32; -0.09]; I2 = 0%). The certainty of evidence varied from low to very low. The results showed that sourdough is effective in reducing the increment of postprandial glycemia, especially when prepared with whole wheat flour, although it does not reduce fasting serum insulin, nor does it change plasma PYY.

Plant-based diet index score is not associated with body composition: A systematic review and meta-analysis.

We hypothesized that a plant-based diet, without excluding any specific animal food, may be beneficial for body composition. This study aims to evaluate if the consumption of a plant-based diet affects body composition of adults, through a systematic review of the literature. The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The literature search was conducted in EMBASE, PubMed, Scopus, and Web of Science in February 2021. Cross-sectionals, interventional trials, and cohort studies were included if changes in the body composition were associated with plant-based index (PDI). Meta-analyses were performed using DerSimonian and Laird random effects model with 95% confidence intervals (CIs) even in the absence of statistical heterogeneity. A total of 6680 citations were found in the systematic search, and after the screening process, 12 studies were included. Of the 11 studies evaluating body mass index, 8 provided data of body mass index (BMI) from a total of 134,128 participants among the quantiles of PDI. A meta-analysis was performed (standardized mean difference [SMD] = 0.17 kg/m²; 95% CI, 0.02-0.32). Of the 7 studies that evaluated waist circumference (WC), 4 provided data of WC among the quantiles of PDI from a total of 12,968 participants. As with BMI, the pooled analysis indicated an increase (SMD = 0.50 kg/m²; 95% CI, 0.01-1.00) of WC as greater was the PDI. Both analyses were influenced by a large study, and in the sensitive analysis the significance was lost. Our findings did not reflect an association between a higher PDI and body composition. Also, most studies evaluating total and central adiposity did not find any association with the PDI. Probably, PDI must be considered in the context of food processing, considering that not all vegetable foods are healthy.

Understanding weight regain after a nutritional weight loss intervention: Systematic review and meta-analysis.

BACKGROUND & AIMS: The purpose of this systematic review was to analyze the effects of lifestyle interventions on long-term weight maintenance of weight loss. In addition, we seek to address which period is most susceptible to weight regain; and what is the time required for following-up weight maintenance after the intervention. METHODS: Articles published up to August 2020 were identified using the Medline (PubMed), Embase, Web of Science, CENTRAL and Scopus. RESULTS: After the selection process, 27 clinical trials involving 7236 individuals were included. The results showed that around 36 weeks after the end of the intervention, weight variation reduces, and a sign of continuous weight gain begin to occur with some patients (n = 208,209) presenting even a completely regain of the lost weight before one year (∼40-48 weeks). However, some strategies used during the weight loss intervention and maintenance period may impact the amount and when the weight regain happens, like intervention type;, intervention duration;, presence of dietitian on the care team;, and maintenance period with counseling by a health professional at least once a month. CONCLUSION: This systematic review and meta-analysis showed that lifestyle interventions remained effective in maintaining the mean weight (5% lower than baseline weight) after weight loss interventions were over. However, weight regain started 36 weeks after intervention conclusion. And, it turns out, some strategies used during the weight loss intervention and maintenance period may impact the amount and when the weight regain happens. Obesity complexity and chronicity should be considered, therefore constant and lifelong monitoring and support are important.