Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis.

Food insecurity is a public health problem as it affects a wide array of individuals in the population. It can be characterized by food deprivation, lack of essential nutrition, lack of dietary education, lack of adequate storage conditions, poor absorption, and poor overall nutrition. The relationship between food insecurity and micronutrient deficiency requires more effort to deepen and discuss the relationship. This systematic review aimed to evaluate the association between food insecurity and micronutrient deficiency in adults. The research was conducted according to PRISMA using the Medline/Pubmed, Lilacs/BVS, Embase, Web of Science, and Cinahl databases. Studies carried out with male and female adults were included, which investigated the correlation or association between food insecurity and the nutritional status of micronutrients. There were no publication year, country, or language restrictions. A total of 1148 articles were found, and 18 of these were included, carried out mainly on the American continent and with women. The most evaluated micronutrients were iron and vitamin A. Food insecurity was associated with nutrient deficiency in 89% (n = 16) of the studies. As a result of the meta-analysis, it was observed that there is a greater chance of anemia and low levels of ferritin among food insecure individuals. It is concluded that food insecurity is associated with micronutrient deficiency. Understanding these problems allows the creation of public policies capable of contributing to changes. Protocol registration: This review was registered on the PROSPERO-International Prospective Register of Systematic Reviews database-CRD42021257443.

Food insecurity and its socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic: A systematic review and meta-analysis.

Background: The COVID-19 pandemic has reduced access to adequate food in terms of quality and quantity, especially for the most vulnerable population groups. The objective of this study was to evaluate the prevalence of Food Insecurity and its main socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021278033). The descriptors "Pregnant Woman", "Postpartum Women", "Breastfeeding Women", "COVID-19", "Food Insecurity", "Food Security" were combined in Scopus (Elsevier), Medline/PubMed (via National Library of Medicine), Embase (Elsevier), Web of Science and Science Direct independently by two researchers in September 2022. Original articles about Food Insecurity in households with pregnant women and mothers of children under 2 years of age during the COVID-19 pandemic were included. The meta-analysis of the prevalence of Food Insecurity was conducted using the RStudio software (4.0.4). Results: The initial search resulted in 539 records, and 10 articles met the proposed criteria and were included in this review. The prevalence of Food Insecurity ranged from 11.5 to 80.3% and in the meta-analysis it was 51% (IC: 30-71) (I 2 = 100.0%). The main socioeconomic and health determinants were ethnicity, domain language, low education, low income, informal employment, unemployment, occurrence of mental disorders, domestic violence, in addition to the unavailability of food in markets and lack of transport. The inclusion of studies with data collection by telephone stands out as a limitation, due to the non-inclusion of vulnerable groups without access to this means of communication. Conclusion: It is necessary to implement and strengthen specific public policies for the maternal and child group with the objective of protecting and strengthening the rights of women to maintain the physical and mental integrity of this group and guarantee Food Security.

Body Fat Is Superior to Body Mass Index in Predicting Cardiometabolic Risk Factors in Adolescents.

BACKGROUND: Excess adiposity is one of the main risk factors for the development of cardiovascular and metabolic diseases. The purpose of this study is to compare cardiometabolic risk factors in eutrophic adolescents with a high body fat percentage (%BF) with eutrophic adolescents with adequate %BF and those with excess weight and %BF. METHODS: Cross-sectional study with 1043 adolescents. This study presented power equal to 99.75%. Body fat and anthropometric, clinical and biochemical indicators were evaluated. Participants were grouped according to body composition classified by body mass index (BMI) and body fat percentage. Statistical analyses were performed using R software version 4.0.2, adopting a significance level of 5%. The Mann-Whitney test, principal components analysis and logistic regression were performed. RESULTS: It was observed that the SG was more similar to GC2 than to GC1 for both sexes, demonstrating that there was a greater similarity between these groups in relation to the evaluated factors. Higher values for TC, SBP and TG were associated with the SG when the CG1 was used as reference, controlled for sex and age. Likewise, higher TC values and lower levels of SBP, TG and LDL were related to SG when the CG2 was used as reference. CONCLUSION: Body fat assessment is more effective in predicting risk factors and cardiometabolic diseases than BMI alone.

Socioeconomic status, screen time, and time spent at school, and children's food consumption. / Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças.

The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Situação socioeconômica, tempo de tela e de permanência na escola e o consumo alimentar de crianças / Socioeconomic status, screen time, and time spent at school, and children's food consumption

Resumo Este estudo objetivou avaliar a associação de fatores sociodemográficos e estilo de vida com consumo de alimentos in natura ou minimamente processados (INMP), ultraprocessados (AUP) e frutas e hortaliças. Trata-se de estudo transversal com 403 crianças de 4 a 7 anos de uma coorte retrospectiva. Variáveis sociodemográficas e estilo de vida foram investigadas através do questionário sociodemográfico. O consumo alimentar foi avaliado por três registros alimentares. Empregaram-se análises de regressão linear bivariadas e multivariadas para analisar as associações. Crianças com menor renda apresentaram maior consumo de alimentos INMP e menor consumo de AUP. Menor tempo de permanência na escola associou-se ao menor consumo de alimentos INMP e maior consumo de AUP. Crianças com maior tempo de tela e com pais de menor escolaridade, consumiram menos frutas e hortaliças. Fatores sociodemográficos desfavoráveis se associaram ao melhor perfil de consumo de alimentos segundo o nível de processamento, exceto para frutas e hortaliças. O maior tempo de permanência na escola e menor tempo de tela contribuíram para uma alimentação mais saudável.

Abstract The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.

Correlation Between Drinking Water and Iodine Status: a Systematic Review and Meta-analysis.

Iodine is a micronutrient essential for maintaining normal body functioning, and the consumption depends on the distribution in the environment, and insufficient or excessive intake results in thyroid dysfunction. The purpose of this review was to evaluate the correlation between iodine concentration in drinking water and the iodine status of the population. The systematic review was conducted following the PRISMA guidelines and was registered at the International Prospective Register of Ongoing Systematic Reviews (CRD42019128308). A literature search was conducted using MEDLINE/PUBMED (National Library of Medicine), LILACS (Latin-American and Caribbean Literature on Health Sciences), and Cochrane Library, June 2021. The quality of the studies was assessed by a checklist for cross-sectional studies developed by Joanna Briggs Institute. The initial search identified 121 articles, out of which ten were included in this systematic review, and five were included in the meta-analysis. Among the articles listed, six adopted cutoff points to classify the iodine content in the drinking water. The study identified median iodine concentration in drinking water from 2.2 to 617.8 µg/L and the correlation between iodine concentration in drinking water and urinary iodine concentration was 0.92, according to meta-analysis. Furthermore, the iodine status was correlated to the iodine content in water. The determination of a cutoff point can contribute to the implementation of iodine consumption control measures.

Nutritional indicators of food and nutrition security of families: 2008/2009 Household Budget Survey / Indicadores nutricionais da segurança alimentar e nutricional de famílias: Pesquisa de Orçamentos Familiares 2008/2009

ABSTRACT Objective To evaluate the food and nutrition insecurity of Brazilian families, according to indicators of food consumption and nutritional status, by location and situation of the households investigated using the 2008/2009 Household Budget Survey. Methods Inadequate consumption of macronutrients and nutritional dystrophies (underweight, short stature or overweight) in at least one family member were used as indicators, according to location and geographical situation of households. The prevalence of food and nutritional insecurity and their confidence intervals were calculated. Results Food consumption was assessed in a total of 13,569 households; a total of 67.55%, 43.96% and 6.85% revealed inadequacy for lipids, carbohydrates and proteins, respectively. Among the 53,640 households assessed by nutritional status, 15.10%, 35.15% and 45.50% had, at least one resident with low weight, short stature or overweight respectively. The Northeastern Region showed statistically higher prevalence than other Brazilian macro-regions for inadequate lipids (24.88%) and carbohydrates (15.32%), as well as for the presence of underweight (6.15%), overweight (14.77%) and short stature (15.17%), in at least one of the residents of the household. Conclusion Assessing the nutritional aspect of food insecurity allows for a better understanding of the dimensions of this situation by considering the effects of access and availability of food, as well as biological use and stability, based on indicators of inadequate food consumption and the presence of nutritional dystrophy. The results found in this study enhance the need to include nutritional indicators in the assessment of food security.

RESUMO Objetivo Avaliar a insegurança alimentar e nutricional de famílias brasileiras segundo indicadores de consumo alimentar e estado nutricional, por localização e situação dos domicílios investigados pela Pesquisa de Orçamento Familiar 2008/2009. Métodos Foram utilizados, como indicadores de insegurança alimentar e nutricional, o consumo inadequado de macronutrientes e distrofias nutricionais (baixo peso, baixa estatura ou excesso de peso) em pelo menos um membro da família, conforme localização e situação geográfica dos domicílios. Calculou-se a prevalência de insegurança alimentar e nutricional e seus intervalos de confiança. Resultados Foram avaliados 13.569 domicílios pelo consumo alimentar, sendo que 67,55%, 43,96% e 6,85% apresentaram inadequação para lipídios, carboidratos e proteínas, respectivamente. Entre os 53.640 domicílios avaliados pelo estado nutricional, 15,10%, 35,15% e 45,50% apresentam, respectivamente, pelo menos um morador com baixo peso, baixa estatura ou excesso de peso. O Nordeste apresentou prevalências estatisticamente maiores do que as demais macrorregiões para as inadequações de lipídios (24,88%) e de carboidratos (15,32%), bem como para presença de baixo peso (6,15%), excesso de peso (14,77%) e baixa estatura (15,17%), em pelo menos um dos moradores do domicílio. Conclusão Avaliar a vertente nutricional da insegurança alimentar permite maior compreensão das dimensões dessa situação por considerar os reflexos do acesso e disponibilidade de alimentos, bem como a utilização biológica e estabilidade, a partir dos indicadores de consumo alimentar inadequado e presença de distrofia nutricional. Os resultados encontrados reforçam a necessidade de incluir indicadores nutricionais na avaliação da segurança alimentar.

Factors Associated with Anemia among Adults and the Elderly Family Farmers.

The majority of studies on anemia are focused on children and women of reproductive age. Although the disease is a widespread public health problem, studies that include the rural population are scarce. This study determined the prevalence of anemia and associated factors in adults and the elderly living in the rural area of a municipality in Minas Gerais. Twelve rural communities were included. During home visits, hemoglobin levels were measured using a hemoglobinometer to check for the presence or absence of anemia. Additionally, anthropometric data and food insecurity data based on the Brazilian Food Insecurity Scale (EBIA) were collected. A questionnaire about socioeconomic, demographic, and housing conditions was applied. Analyses were performed using the Stata software version 13.0. Spearman correlation and regression analysis logistics were performed (p < 0.05) on 124 families (n = 297 farmers). The prevalence of anemia was 41.1%, being higher among women (55.7%). Additionally, 40.1% of the farmers were food insecure; 52.7% and 80.5% presented excess weight and cardiovascular risk, respectively. Poverty was a reality for 39.7% of individuals. A positive correlation between hemoglobin levels and per capita income was found as well as a negative correlation with EBIA scores and cardiovascular risk. Multivariate analysis showed that individuals experiencing food insecurity, the elderly, and those who do not own a property, were more likely to be anemic. Farmers with per capita income above 1/2 minimum wage were less likely to have anemia. The prevalence of anemia in the group studied was higher than previous studies. The disease is associated with factors that also predispose to food insecurity. The improvement of the determinants of insecurity can contribute to the fight against anemia.

Factors associated with normal-weight obesity in adolescents.

A new phenotype of obesity has been studied: normal-weight obesity (NWO), which describes individuals with normal-weight by BMI and excess body fat. Despite normal-weight, individuals with NWO have a higher cardiometabolic risk. There is still a gap in the literature on the subject, especially in adolescents, as studies with this population are scarce. This study aims to investigate the sociodemographic factors, family history of chronic non-communicable diseases, body perception, lifestyle and food consumption associated with NWO in adolescents. This is a cross-sectional study, with 506 normal-weight adolescents aged 10­19 years, of both sexes. Weight and height were obtained, and BMI/age was calculated. Body fat analysis was performed using dual-energy X-ray absorptiometry. Sociodemographic data, level of physical activity, food consumption, body self-perception and lifestyle habits were also obtained. Logistic regression with hierarchical approach was used to analyse the associations. The odds of NWO are greater with age (OR = 1·14; 95 % CI = 1·04, 1·26), lower in male adolescents (OR = 0·21; 95 % CI = 0·11, 0·41) and higher in those with a history of familial dyslipidemia (OR = 1·81; 95 % CI = 1·01, 3·28). Adolescents satisfied with their body (OR = 0·30; 95 % CI 0·16, 0·56) and physically active (OR = 0·44; 95 % CI = 0·24, 0·81) have a lower odds of NWO, compared with the others. In addition, it was observed that the odds of NWO is greater among adolescents who use sweeteners (sugar substitutes) (OR = 3·84; 95 % CI = 1·70, 8·65). The factors associated with NWO were female sex, older age, positive family history of dyslipidemia, lower body satisfaction, lower level of physical activity and greater use of sweeteners.

Iodine Concentration in Brazilian Drinking Water and Its Possible Contribution to Iodine Intake for Different Physiological Groups.

Objective: The objective is to analyze the concentration of iodine in Brazilian drinking water and its possible contribution to iodine intake for different groups. Methods: Water samples collected from primary healthcare units in eight locations distributed across all five macroregions of Brazil were analyzed. The quantification of iodine in the water samples was done by spectrophotometry (leuco crystal violet method). To classify the degree of iodine concentration, the recommendation of the Ministry of Health (China) was followed since Brazil lacks a classification standard. To verify the possible contribution of drinking water to iodine intake for different groups, the recommended water intake for each group according to the United States Institute of Medicine (2004) was considered. The percentage of iodine in drinking water and its contribution to iodine intake for different physiological groups were calculated based on the estimated average requirement (EAR) of iodine. A descriptive statistical analysis was performed using SPSS version 21.0 and Statistical Analysis Systems (SAS) version 9.2. Results: Significant differences were found between the maximum and minimum concentrations of iodine in water samples from the same location. In Pinhais (south region), the difference was 44.32 µg· L-1; in Viçosa (southeast region), it was 27.86 µg·L-1; in Rondonópolis (midwest region), it was 12.66 µg·L-1; in São Luís (northeast region), it was 11.82 µg·L-1; in Brasilian Federal District (midwest region), it was 10.98 µg·L-1; in Macaé (southeast region), it was 10.14 µg· L-1; in Palmas (north region), it was 4.22 µg·L-1; and in Vitória (southeast region), it was 1.69 µg·L-1. The maximum concentrations of iodine found in the drinking water of Pinhais and Viçosa can contribute more than 70.0% and 50.0%, respectively, to daily iodine intake for all groups. Conclusion: Monitoring the concentration of iodine in drinking water from different locations in each city or Federal District is a preventive measure against inadequate iodine intake and possible adverse changes in population health.

Cardiometabolic risk in adolescents with normal weight obesity.

BACKGROUND: Normal weight obesity (NWO), which is defined by the excess of body fat in normal weight individuals, has been neglected among adolescents, due to their normal weight and young age. Few studies were carried out on the topic with adolescents. OBJECTIVE: To analyze whether the NWO is associated with cardiometabolic risk factors in adolescents. SUBJECTS/METHODS: Cross-sectional study, with 506 normal weight adolescents aged 10-19 years, selected in schools in Brazil. Weight, height, waist circumference (WC) and neck circumference were obtained and the body mass index (BMI) and waist/height ratio (WHR) were calculated. Body composition analysis was performed using dual-energy X-ray absorptiometry. The clinical evaluation included lipid and glycid profile, platelets, leukocytes, lymphocytes, monocytes, uric acid and blood pressure, as well as the presence of metabolic syndrome (MS) and its components. NWO was defined by the presence of normal weight, according to BMI for age, and excess body fat (≥25% and ≥30% in males and females, respectively). Logistic regression models were used to analyze associations between normal weight adolescents with and without the NWO phenotype. RESULTS: NWO associated positively with abdominal obesity, analyzed through WC (OR = 1.36;95%CI = 1.27-1.47), WHR (OR = 25.89;95%CI = 10.43-64.26) and android fat (OR = 1.49;95%CI = 1.36-1.63); insulin resistance (OR = 4.09;95%CI = 1.72-9.70), hyperinsulinemia (OR = 3.83;95%CI = 1.50-9.76) and the highest values of the triglycerides-glycemia index (OR = 4.28;95%CI = 1.21-15.08); uric acid (OR = 1.81;95%CI = 1.29-2.55), as well as the changes in LDL (OR = 3.39;95%CI = 1.47-7.81), total cholesterol (OR = 2.77;95%CI = 1.22-6.29), and in at least one (OR = 1.87;95%CI = 1.04-3.37) or two (OR = 6.61;95%CI = 1.45-30.19) components of MS. CONCLUSION: NWO is associated with the presence of cardiometabolic risk factors in adolescents.

Physical activity and quality of life among college students without comorbidities for cardiometabolic diseases: systematic review and meta-analysis.

PURPOSE: To systematically review studies on the relationship between physical activity (PA) and quality of life (QOL) in university students without comorbidities for cardiometabolic diseases from around the world. METHODS: We included observational studies with university students of both sexes, from public or private institutions, and that investigated the association or correlation between physical activity and quality of life among these students, without delimitation of date, language, or location. Reviews, letters to the editors, studies with qualitative methodologies, case studies, book chapters, articles with college students who had some specific disease or condition, such as obesity, diabetes, and others; studies with children of parents with chronic diseases, and those that were institutions aimed only at very specific populations, were excluded. Meta-analysis was calculated. RESULTS: Thirty studies, consisting of 19,731 students, were included. The most commonly used instruments to assess the quality of life of the university population were the Quality of Life Questionnaire-short version (WHOQOL-BREF), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The International Physical Activity Questionnaire (IPAQ) was the most commonly used instrument to assess PA. For the meta-analysis, 22 studies were included. Weak but positive correlations were found between PA and the QOL domains: physical health (0.16. 95% CI 0.11 0.22; I2 = 99.96%); mental health (0.14; 95% CI 0.07-0.20; I2 = 99.97%); social relations (0.24, 95% CI 0.08-0. 38; I2 = 99.99%); environment (0.23, 95% CI 0.14-0.32; I2 = 99.90%); vitality (0.17. 95% CI 0.15-0.20; I2 = 99.49%) pain (0.02. 95% CI - 0.02 to 0.12; I2 = 99.96%); QOL and PA (0.21, 95% CI 0.08-0.34; I2 = 99.99%).An association of R = 0.60 (95% CI 0.25-0.95; I2 = 85.61%) was found between QOL and PA in total. CONCLUSION: The results of our study showed a weak but positive relationship between physical activity and overall quality of life in college students, and also between PA and the domains of QL: physical health, social relationships, mental health, environment, and vitality, in this same population. It is important to study this population, since risk behaviors in this phase tend to perpetuate in the other phases of life.

Anthropometric and body composition parameters in adolescents with the metabolically obese normal-weight phenotype.

We aimed to investigate the anthropometric and body composition parameters associated with the metabolically obese normal-weight (MONW) phenotype. This cross-sectional study was conducted with 506 adolescents in Brazil (aged 10-19 y). The MONW phenotype was defined as normal-weight, according to BMI/age, and at least one metabolic alteration. Anthropometric measurements were obtained and the DEXA was used for body composition analysis. Crude and adjusted Poisson regression models with robust variance were used to estimate the associations. The phenotype was positively associated with waist circumference (male: prevalence ratio (PR) = 1·05; 95% CI 1·01, 1·09; female: PR = 1·06; 95% CI 1·02, 1·09), waist:height ratio (male: PR = 1·26; 95% CI 1·07, 1·49; female: PR = 1·29; 95% CI 1·07, 1·56) and android:gynoid fat ratio (male: PR = 1·25; 95% CI 1·03, 1·51; female: PR = 1·39; 95% CI 1·20, 1·62), in both sexes. Furthermore, there was a positive association of phenotype with waist:hip ratio (PR = 1·32; 95% CI 1·06, 1·65) and trunk:arm fat ratio (PR = 1·13; 95% CI 1·02, 1·24) only in males and with trunk:leg fat ratio (PR = 2·84; 95% CI 1·46, 5·53), BAIp (PR = 1·06; 95% CI 1·01, 1·12), fat mass index (PR = 1·24; 95% CI 1·10, 1·41) and regional indices of metabolic load and capacity (PR = 1·29; 95% CI 1·09, 1·53), in females. Anthropometric and body composition parameters indicative of central and total fat are associated with the MONW phenotype.

Is Dietary Iodine Intake Excessive According to the Theoretical Model of Healthy Dietary Intake Pattern in Pregnant Women and Schoolchildren: Water, Salt, or Food?

Introduction: Iodine deficiency during pregnancy can cause hypothyroidism and goiter; in schoolchildren, it can cause reduced intelligence quotient. In excess, iodine can cause thyroiditis, goiter, and Hashimoto's hypothyroidism. Currently, schoolchildren and pregnant women are classified as risk groups for excessive iodine intake and iodine deficiency, respectively. Thus, determining iodine from all sources of consumption is important for intervention planning. Objective: To construct a theoretical model for the iodine intake of schoolchildren and pregnant women of a city in the Zona da Mata Mineira region, considering a healthy diet, salt consumption and water intake. Methodology: The dietary iodine intake of pregnant women was analyzed based on a dietary iodine table compiled from an international database. A dietary plan was prepared following the Brazilian Food Guide. Iodine concentration of different salt brands sold in local establishments was checked, and drinking water samples from healthcare facilities were analyzed. A descriptive and exploratory statistical analysis was performed and the results were presented in absolute and relative frequencies, and measures of central tendency and dispersion. Results: According to the proposed diet, pregnant women and schoolchildren would have a daily intake of 71.6 µg and 71 µg, respectively. Thirteen salt brands were evaluated, 69.2% complied with the legislation and the mean iodine content was 29.88 mg. The mean concentration of iodine in water was 25 µg iodine/liter and 14 µg iodine/liter, respectively, in summer and autumn. Considering the intake of food, salt, and drinking water according to the proposed dietary plan, the daily intake for pregnant women would be 279.5 and 253.5 µg for schoolchildren. Conclusion: The daily iodine intake of schoolchildren and pregnant women according to this theoretical model was excessive, considering a healthy dietary pattern. This theoretical model can guide actions and public policies aimed at targeting all forms of iodine intake.

[Critical analysis of the indicators of the nutritional status of iodine in individuals and populations: a systematic review]. / Análise crítica dos indicadores do estado nutricional de iodo em indivíduos e populações: uma revisão sistemática.

The scope of this article is to evaluate the potentialities of indicators of the nutritional status of iodine in individuals or populations. The review was based on PRISMA. The search for articles occurred in January 2019, in the Pubmed, Scopus and LILACS databases, using the key words: indicators AND nutritional status AND iodine. The selection followed the stages of excluding the duplicates, reading the titles, abstracts and analyses in full. The methodological quality of the studies was evaluated by the Downs and Black instrument. A total of 178 studies were identified and 20 were included. Urinary Iodine Concentration (UIC) was analyzed in 65% of the studies and was considered the best indicator to evaluate the nutritional status of iodine in the population. Thyroglobulin was determined in 20% of the studies and reflected the pre-existing state of iodine. Thyroid stimulating hormone was verified in 45% of the articles and was important for the surveillance of iodine deficiency among newborns. Only one study evaluated capillary iodine, useful for analyzing long-term dietary intake. In the evaluation of methodological quality, the lowest score was 12 and the highest 16, in 17 possible points. The use of UIC is recommended for the diagnosis of deficiency and excess of iodine in the population.

O objetivo deste artigo é avaliar as potencialidades dos indicadores do estado nutricional de iodo em indivíduos ou populações. A revisão foi baseada no PRISMA. A busca pelos artigos ocorreu em janeiro de 2019, nas bases Pubmed, Scopus e LILACS, utilizando a combinação "indicadores AND estado nutricional AND iodo". A seleção seguiu as etapas de exclusão dos duplicados, leitura de títulos e resumos e análise na íntegra. A qualidade metodológica dos estudos foi avaliada pelo instrumento de Downs e Black. Foram identificados 178 estudos e 20 foram incluídos. A Concentração Urinária de Iodo (CUI) foi analisada em 65% dos estudos e foi considerado o melhor indicador para avaliar o estado nutricional de iodo populacional. A tiroglobulina foi determinada em 20% dos estudos e refletiu o estado de iodo pregresso. O hormônio estimulante da tireoide foi verificado em 45% dos artigos e mostrou-se sensível para a vigilância de deficiência de iodo em recém-nascidos. Apenas um estudo avaliou o iodo no cabelo, útil para analisar a ingestão dietética em longo prazo. Na avaliação da qualidade metodológica, a menor pontuação foi 12, e a maior 16, em 17 pontos possíveis. Para diagnóstico de deficiência e excesso de iodo na população, recomenda-se a CUI.

Análise crítica dos indicadores do estado nutricional de iodo em indivíduos e populações: uma revisão sistemática / Critical analysis of the indicators of the nutritional status of iodine in individuals and populations: a systematic review

Resumo O objetivo deste artigo é avaliar as potencialidades dos indicadores do estado nutricional de iodo em indivíduos ou populações. A revisão foi baseada no PRISMA. A busca pelos artigos ocorreu em janeiro de 2019, nas bases Pubmed, Scopus e LILACS, utilizando a combinação "indicadores AND estado nutricional AND iodo". A seleção seguiu as etapas de exclusão dos duplicados, leitura de títulos e resumos e análise na íntegra. A qualidade metodológica dos estudos foi avaliada pelo instrumento de Downs e Black. Foram identificados 178 estudos e 20 foram incluídos. A Concentração Urinária de Iodo (CUI) foi analisada em 65% dos estudos e foi considerado o melhor indicador para avaliar o estado nutricional de iodo populacional. A tiroglobulina foi determinada em 20% dos estudos e refletiu o estado de iodo pregresso. O hormônio estimulante da tireoide foi verificado em 45% dos artigos e mostrou-se sensível para a vigilância de deficiência de iodo em recém-nascidos. Apenas um estudo avaliou o iodo no cabelo, útil para analisar a ingestão dietética em longo prazo. Na avaliação da qualidade metodológica, a menor pontuação foi 12, e a maior 16, em 17 pontos possíveis. Para diagnóstico de deficiência e excesso de iodo na população, recomenda-se a CUI.

Abstract The scope of this article is to evaluate the potentialities of indicators of the nutritional status of iodine in individuals or populations. The review was based on PRISMA. The search for articles occurred in January 2019, in the Pubmed, Scopus and LILACS databases, using the key words: indicators AND nutritional status AND iodine. The selection followed the stages of excluding the duplicates, reading the titles, abstracts and analyses in full. The methodological quality of the studies was evaluated by the Downs and Black instrument. A total of 178 studies were identified and 20 were included. Urinary Iodine Concentration (UIC) was analyzed in 65% of the studies and was considered the best indicator to evaluate the nutritional status of iodine in the population. Thyroglobulin was determined in 20% of the studies and reflected the pre-existing state of iodine. Thyroid stimulating hormone was verified in 45% of the articles and was important for the surveillance of iodine deficiency among newborns. Only one study evaluated capillary iodine, useful for analyzing long-term dietary intake. In the evaluation of methodological quality, the lowest score was 12 and the highest 16, in 17 possible points. The use of UIC is recommended for the diagnosis of deficiency and excess of iodine in the population.

Factors associated with alcohol, tobacco and illicit drug use among Brazilian undergraduate students.

OBJECTIVES: to analyze the factors associated with the use of alcohol, tobacco and illicit drugs among Brazilian undergraduate students. METHODS: observational, cross-sectional study, with convenience sampling, conducted in 2014/2015, involving institutional data and a self-completed online questionnaire, analyzed using measures of frequency, central tendency/dispersion and logistic regression. RESULTS: among 126,326 students, 62.8% reported alcohol use; 11%, tobacco; and 7.5%, illicit drugs. Several academic factors-such as not residing with family (sororities [alcohol: aOR:2.38;95%CI:2.28-2.48; tobacco: AOR:2.20;95%CI:2.09-2.33; illicit drugs: AOR:2.53;95%CI:2.38-2.70]), acting in university movements (student [alcohol: AOR:1.74;95%CI:1.65-1.83; tobacco: AOR:1.97;95%CI:1.86-2.08; illicit drugs: AOR:2.43;95%CI:2.28-2.59] and religious [alcohol: AOR:0.28;95%CI:0.26-0.29; tobacco: AOR:0.23;95%CI:0.21-0.26; illicit drugs: AOR:0.18;95%CI:0.16-0.21]) and lack of discipline/study habit (alcohol: AOR:1.41;95%CI:1.37-1.45; tobacco: AOR:1.53;95%CI:1.46-1.59; illicit drugs: AOR:1.85;95%CI:1.76-1.94) - were associated with the use of the three categories of substances. CONCLUSIONS: we identified that a number of academic factors are associated with licit and illicit drug use. These findings may help in designing preventive strategies among college students.

Assessment of the Impact of Salt Iodisation Programmes on Urinary Iodine Concentrations and Goitre Rates: A Systematic Review.

INTRODUCTION: Two main strategies are currently recommended for the prevention and control of iodine deficiency in the world: implementation of universal salt iodisation programmes and permanent monitoring of iodine consumption by the population. Although iodine intake and coverage iodised salt have increased in the world population, iodine deficiency disorders (IDDs) may still be a public health problem in a few countries or communities. OBJECTIVE: To assess the impact of salt iodisation programmes on urinary iodine concentrations and goitre rates in the world population. Methodology. A systematic review based on the PRISMA method. We obtained articles from Scopus, Science Direct, MEDLINE databases, and other sources between March and April 2020, without limitation of dates. "Iodisation" AND "urinary iodine concentrations" AND "goitre" in English, Portuguese, and Spanish without filters and clinical trial, case-control, and cross-sectional studies were included in this review. RESULTS: Of 479 abstracts, twenty-three were eligible. Coverage on iodised salt was in the range of 16 to 98%, and 11 studies had been sufficient, whilst eight studies had adequate iodine concentration in salt and three excess. 81.8% of studies that had an adequate median of UIC had a good impact in their respective salt iodisation programmes. CONCLUSION: After 18 years of salt iodisation programme implementation in the 13 countries, the majority achieved sustaining elimination of IDD whilst all had adequate median UIC; however, more detailed studies are still needed to confirm that all communities are equally protected of IDD.

Implications of iodine deficiency by gestational trimester: a systematic review.

As pregnant women are susceptible to changes in iodine, which can cause miscarriage, goiter, thyroid nodules, hypothyroidism, in addition to fetal neurological impairment or development. The aim of this study was to verify the implications of the iodine alteration in each gestational trimester and its consequences of physiological justification. The review was based on PRISMA. Searching for articles that took place in March 2020 without delimiting data. As bases consulted were the Clinical Trials, Cochrane Library, Lilacs and Medline (PubMed). The descriptors were combined as follows: "pregnancy" AND "iodine deficiency". Articles that addressed iodine deficiency and its implications were included. The selection followed the steps of reading the titles, abstracts and full articles. To assess the methodological quality of the studies, the STROBE Instruction instrument was used. The research resulted in 1,266 studies and 11 were included. In assessing methodological quality, the lowest score was and the maximum 20. According to studies, the fourth most affected by iodine loss are the second and third, it is possible to increase the volume and pneumatic nodules, subclinical hypothyroidism, pre-eclampsia, among others. The damages caused by iodine deficiency in the first or second trimester are still reversible, therefore, they need to be diagnosed early, to guarantee an iodic homeostasis and prevent damage to the health of the mother-child binomial.

[Factors associated with the nutritional status of iodine in the maternal-infant group: a systematic review]. / Fatores associados ao estado nutricional de iodo no grupo materno-infantil: uma revisão sistemática.

This article sets out to identify the socio-demographic and nutritional factors associated with the nutritional status of iodine in the maternal-infant group. The review was based on the Prisma method and the Medline (PubMed), Scopus and Lilacs databases were consulted. The search was conducted in December 2018, using the key words nutritional status, iodine, infant, pregnant and lactating. The selection followed the stages of excluding duplicated articles, reading the titles, abstracts and texts in full. A total of 1,500 studies were identified and 26 met the inclusion criteria. The methodological quality of the studies was evaluated using the questionnaire proposed by Downs and Black. There was an association between the sociodemographic factors of income, education, maternal and gestational age, uniformity and place of residence in rural or urban areas with the nutritional state of iodine. In relation to dietary factors, the consumption of supplements, iodized salt and dietary sources of iodine, especially dairy products, play a protective role to avoid the deficiency. It is necessary to create more specific and effective strategies that address all the factors that affect the nutritional state of iodine to avoid the disorders resulting from the deficiency.

O objetivo deste artigo é identificar os fatores sociodemográficos e alimentares associados ao estado nutricional de iodo do grupo materno-infantil. A revisão foi baseada no método PRISMA. As bases consultadas foram: Medline (PubMed), Scopus e Lilacs. A busca ocorreu em dezembro de 2018, utilizando os descritores estado nutricional, iodo, lactente, gestante e lactante. A seleção seguiu as etapas de exclusão dos duplicados, leitura dos títulos, resumos e análise na íntegra. Foram identificados 1.500 estudos e 26 contemplaram os critérios de inclusão. A qualidade metodológica dos estudos foi avaliada pelo questionário proposto por Downs e Black. Houve associação entre os fatores sociodemográficos renda, escolaridade, idade materna e gestacional, paridade e local de residência rural ou urbano com o estado nutricional de iodo. Já em relação aos fatores alimentares, o consumo de suplementos, sal iodado e alimentos fontes de iodo, em especial os produtos lácteos, exercem papel protetor contra a deficiência. É preciso criar estratégias mais específicas, efetivas e que contemplem todos esses fatores que afetam o estado nutricional de iodo para evitar as desordens provocadas pela deficiência.