Exposição a dieta hiperlipídica no período perinatal e pós desmame aumenta risco cardiometabólico e altera histomorfometria aórtica em ratos jovens / Exposure to high-fat diet in the perinatal and post-weaning period increases cardiometabolic risk and alters aortic histomorphometry in young rats

Introdução: estudos sugerem forte associação da exposição perinatal e pós-natal a dietas ricas em gordura e complicações cardiovasculares. Objetivo: avaliar os efeitos da exposição a dieta hiperlipídica no período perinatal e pós desmame sobre indicadores de risco cardiometabólico e alterações histomorfometrica na aorta em ratos. Metodologia: Ratas Wistar foram separadas em grupos de acordo com a dieta durante a gestação e lactação: dieta controle (n=3) e dieta hiperlipídica (n=3). No 21º dia de vida filhotes machos foram divididos em subgrupos (n=6): CC: formado por ratos expostos a dieta controle durante toda a vida; CH: formado por ratos cuja a mãe consumiu dieta controle e após o desmame os filhotes consumiram dieta hiperlipídica; HH: formado por filhotes expostos a dieta hiperlipídica durante toda a vida e HC: formado por ratos cuja a mãe consumiu dieta hiperlipídica e após o desmame os filhotes consumiram dieta controle. No 60º dia de vida, IMC, índices aterogênicos, proteína C reativa e histomorfometria da aorta dos descendentes foram avaliados. Resultados: o grupo HC apresentou maior IMC em comparação aos grupos HH e CH (p= 0,0004). A razão colesterol total / HDL-colesterol foi maior para o grupo CH comparado ao CC e HC (p = 0,016). Coeficiente aterogênico (p = 0,003), espessura da aorta (p = 0,003) e quantidade de lamelas elásticas (p = 0,0002) foram maiores nos grupos CH e HH em comparação a CC e HC. Conclusão: exposição a dieta hiperlipídica nos períodos perinatal e pós desmame aumentou o risco cardiometabólico e alterou a histomorfometria aórtica de ratos.

Background: studies suggest a strong association of perinatal and postnatal exposure to high-fat diets and cardiovascular complications. Objective: to evaluate the effects of exposure to a high-fat diet in the perinatal and post-weaning period on indicators of cardiometabolic risk and aorta histomorphometric changes in the rats. Methodology: Wistar rats were separated into groups according to the diet during pregnancy and lactation: control diet (n=3) and high fat diet (n=3). On the 21st day of life, male pups were divided into subgroups (n=6): CC: formed by rats exposed to a control diet for all life; CH: formed by rats whose mother consumed a control diet and after weaning the pups consumed a high-fat diet; HH: formed by pups exposed to a high-fat diet for all life and HC: formed by rats whose mother consumed a high-fat diet and after weaning the pups consumed a control diet. On the 60th day of life, BMI, atherogenic indices, C-reactive protein and histomorphometry of the aorta of the offspring were evaluated. Results: the HC group showed higher BMI compared to the HH and CH groups (p=0.0004). The total cholesterol / HDL-cholesterol ratio was higher for the CH group compared to CC and HC (p = 0.016). Atherogenic coefficient (p= 0,003), aortic thickness (p = 0.003) and amount of elastic lamellae (p = 0.0002) were higher in CH and HH groups compared to CC and HC. Conclusion: exposure to a high-fat diet in the perinatal and post-weaning periods increased cardiometabolic risk and altered aortic histomorphometry in rats.

Variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes da cidade de Salvador, Bahia, Brasil / Temporal variation in the incidence of overweight and abdominal obesity among adolescents in the city of Salvador, Bahia, Brazil

Resumo O objetivo do estudo foi analisar a variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes de escolas públicas de uma capital do nordeste brasileiro. Trata-se de um estudo incluindo informações de três levantamentos transversais realizados nos anos de 2001, 2009 e 2017, com 2.496 escolares de 10 a 18 anos de ambos os sexos, residentes na cidade de Salvador, Bahia. O excesso de peso foi avaliado por meio do Índice de Massa Corpórea para idade (IMC/I) e obesidade abdominal foi avaliada pela circunferência da cintura e razão cintura-estatura. A regressão Pooled OLS (Ordinary Least Squares), de efeito constante foi utilizada para avaliar a variação dos indicadores antropométricos ao longo do período. Os resultados deste estudo indicam que a prevalência de excesso de peso cresceu 103% e os indicadores da obesidade abdominal cresceram 153% e 142%, respectivamente no período analisado. Aumento na média do Índice de Massa Corpórea e da Razão cintura estatura foi maior entre as adolescentes e da média do IMC e da circunferência da cintura entre aqueles de 14 a 18 anos de idade. Conclui-se que houve expressivo crescimento nas prevalências do excesso de peso e da obesidade abdominal no período de 2001 a 2017 entre os adolescentes da cidade de Salvador.

Abstract The scope of this study was to analyze the temporal variation in the incidence of overweight and abdominal obesity among adolescents from public schools in a capital in northeastern Brazil. It is a study including information from three cross-sectional surveys carried out in 2001, 2009 and 2017, with 2,496 students aged 10 to 18 years of both sexes living in the city of Salvador, Bahia. Overweight was assessed using the Body Mass Index for Age (BMI/A) and abdominal obesity was assessed using waist circumference and waist-to-height ratio. Pooled OLS (Ordinary Least Squares) regression, with constant effect, was used to assess the variation of anthropometric indicators over the period. The results of this study indicate that the prevalence of overweight increased by 103% and the indicators of abdominal obesity increased by 153% and 142%, respectively, in the period under analysis. The increase in the mean body mass index and waist-to-height ratio was greater among adolescents and in the mean BMI and waist circumference among those aged 14 to 18 years old. The conclusion reached was that there was a significant increase in the prevalence of overweight and abdominal obesity in the period 2001 to 2017 among adolescents in the city of Salvador.

[Temporal variation in the incidence of overweight and abdominal obesity among adolescents in the city of Salvador, Bahia, Brazil]. / Variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes da cidade de Salvador, Bahia, Brasil.

The scope of this study was to analyze the temporal variation in the incidence of overweight and abdominal obesity among adolescents from public schools in a capital in northeastern Brazil. It is a study including information from three cross-sectional surveys carried out in 2001, 2009 and 2017, with 2,496 students aged 10 to 18 years of both sexes living in the city of Salvador, Bahia. Overweight was assessed using the Body Mass Index for Age (BMI/A) and abdominal obesity was assessed using waist circumference and waist-to-height ratio. Pooled OLS (Ordinary Least Squares) regression, with constant effect, was used to assess the variation of anthropometric indicators over the period. The results of this study indicate that the prevalence of overweight increased by 103% and the indicators of abdominal obesity increased by 153% and 142%, respectively, in the period under analysis. The increase in the mean body mass index and waist-to-height ratio was greater among adolescents and in the mean BMI and waist circumference among those aged 14 to 18 years old. The conclusion reached was that there was a significant increase in the prevalence of overweight and abdominal obesity in the period 2001 to 2017 among adolescents in the city of Salvador.

O objetivo do estudo foi analisar a variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes de escolas públicas de uma capital do nordeste brasileiro. Trata-se de um estudo incluindo informações de três levantamentos transversais realizados nos anos de 2001, 2009 e 2017, com 2.496 escolares de 10 a 18 anos de ambos os sexos, residentes na cidade de Salvador, Bahia. O excesso de peso foi avaliado por meio do Índice de Massa Corpórea para idade (IMC/I) e obesidade abdominal foi avaliada pela circunferência da cintura e razão cintura-estatura. A regressão Pooled OLS (Ordinary Least Squares), de efeito constante foi utilizada para avaliar a variação dos indicadores antropométricos ao longo do período. Os resultados deste estudo indicam que a prevalência de excesso de peso cresceu 103% e os indicadores da obesidade abdominal cresceram 153% e 142%, respectivamente no período analisado. Aumento na média do Índice de Massa Corpórea e da Razão cintura estatura foi maior entre as adolescentes e da média do IMC e da circunferência da cintura entre aqueles de 14 a 18 anos de idade. Conclui-se que houve expressivo crescimento nas prevalências do excesso de peso e da obesidade abdominal no período de 2001 a 2017 entre os adolescentes da cidade de Salvador.

Zinc supplementation combined with antidepressant drugs for treatment of patients with depression: a systematic review and meta-analysis.

CONTEXT: Zinc is an essential trace mineral required for the function of brain and neural structures. The role of zinc supplementation in the prevention and treatment of depression has been suggested in clinical studies that reported a reduction in depressive symptoms. OBJECTIVE: The aim of this review was to determine whether zinc supplementation vs placebo can prevent or improve depressive symptoms in children, adolescents, or adults. DATA SOURCES: Five electronic databases were searched, and studies published until September 2019 were included without language restriction. STUDY SELECTION: Randomized, controlled, crossover trials that evaluated the effect of zinc supplementation vs a comparator for prevention or improvement of depressive symptoms in children, adolescents, or adults were eligible for inclusion. DATA EXTRACTION: Two authors independently performed data extraction and risk-of-bias assessment. RESULTS: The initial search identified 12 322 studies, 5 of which were eligible for meta-analysis. The standardized mean difference (SMD) showed an average reduction of 0.36 point (95%CI, -0.67 to -0.04) in the intervention group compared with the placebo group. Forstudies in which the mean age of participants was ≥ 40 years, the SMD was reduced by 0.61 point (95%CI, -1.12 to -0.09) in the intervention group vs the placebo group. The meta-analysis by sample size (< 60 individuals and ≥ 60 individuals) did not show an effect of zinc supplementation in reducing depressive symptoms (SMD -0.28; 95%CI, -0.67 to -0.10; and SMD -0.52; 95%CI, -1.10 to 0.06). CONCLUSION: Zinc supplementation may reduce depressive symptoms in individuals treated with antidepressant drugs for clinical depression. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42018081691.

Cintura Hipertrigliceridêmica em Pacientes Hipertensos / Hypertriglyceridemic Waist in Hypertensive Patients

Fundamentos: O uso de diferentes critérios para a determinação da cintura hipertrigliceridêmica (CHT) pode resultar em interpretações imprecisas, podendo comprometer o diagnóstico de pacientes com risco de desenvolver doenças cardiovasculares. Objetivo: Avaliar a concordância no diagnóstico da CHT utilizando diferentes pontos de corte para classificação da circunferência da cintura, em pacientes hipertensos. Métodos: Trata-se de um estudo transversal realizado com 120 pacientes, de 30 a 74 anos de idade, de ambos os sexos em atendimento ambulatorial. Realizou-se avaliação antropométrica (peso, altura e circunferência da cintura) e dos níveis séricos de triglicérides. A CHT foi definida pela presença simultânea da circunferência da cintura aumentada e hipertrigliceridemia. A concordância entre os diagnósticos de cintura hipertrigliceridêmica foi avaliada pelo índice Kappa. Resultados: A prevalência da CHT foi maior em adultos, para ambos os sexos pelos critérios do International Diabetes Federation (IDF) e Organização Mundial de Saúde (OMS) (28%), já pelo National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) foram identificados 22,7% de indivíduos. Identificou-se uma concordância quase perfeita (0,864) entre o diagnóstico da CHT pelos pontos de corte da IDF versus NCEP-ATP III, OMS versus NCEP-ATP III. Entre o IDF e OMS a concordância foi perfeita. Conclusão: A utilização dos pontos de corte da circunferência da cintura propostos pelo IDF e OMS, para caracterizar indivíduos com cintura hipertrigliceridêmica foi melhor do que a do NCEP-ATP III

Background: The adoption of different criteria to determine the occurrence of the hypertriglyceridemic waist (HTW) can result in inaccurate interpretations, compromising the diagnosis of patients at risk of developing cardiovascular diseases. Objective: To evaluate the diagnostic agreement of HTW using different cut-off points for waist circumference in hypertensive patients. Methods: Cross-sectional study including 120 patients of both sexes, aged 30 to 74 years and receiving care on an outpatient basis. We assessed the participants' anthropometric data (weight, height, and waist circumference) and determined their serum triglycerides levels. The diagnosis of HTW was defined by concurrent increased waist circumference and hypertriglyceridemia. The agreement among the diagnoses of HTW was assessed with the kappa index. Results: In adults of both sexes, the HTW had a higher prevalence (28%) when determined by the criteria defined by the International Diabetes Federation (IDF) and the World Health Organization (WHO) than by those defined by the National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III, 22.7%). We identified an almost perfect agreement (0.864) between the diagnosis of HTW determined by the cut-off points of the IDF versus NCEP-ATP III and by the WHO versus NCEP-ATP III. The correlation was perfect between the diagnoses established by the IDF and WHO. Conclusion: The cut-off points for waist circumference proposed by the IDF and WHO was better than those by the NCEP-ATP III to characterize individuals with HTW

Risk Factors for Adopting Extreme Weight-Control Behaviors among Public School Adolescents in Salvador, Brazil: A Case-Control Study.

OBJECTIVE: This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil. METHODS: A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students' families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents. RESULTS: Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42-9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75-8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16-6.91). CONCLUSIONS: The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.