Association of coffee intake and its polyphenols with mammographic findings in women who visited the Brazilian Public Health Service / Asociación de la ingesta de café y sus polifenoles con hallazgos mamográficos en mujeres atendidas en el Servicio de Salud Pública de Brasil

Objective: this study aimed to evaluate if there is an association of intake of coffee and its polyphenols with mammographic findings in women treated at a breast care service unit of the Unified Health System (SUS), Brazil. Research methods and procedures: this was a cross-sectional study with 532 women treated at a health service. The participants were divided according to their mammographic reports into two groups: without and with altered findings. Two 24-h dietary recalls were applied and coffee consumption was categorized into three groups (less than 1 cup, 1 to 3 cups, and more than 3 cups). Phenolic acids were determined using the Phenol Explorer program. The intake of polyphenols was calculated by adding the values obtained from the total amount of coffee consumed during the day. The Multiple Source Method (MSM) was applied to analyze the usual intake. Results: of the 532 women, 178 (33.5 %) had altered mammographic findings. The participants' average daily coffee intake was 193.4 mL. No significant association was found between coffee consumption and mammographic findings. However, it was found that the second tertile of polyphenols was a protective factor for breast changes. Conclusion: Coffee polyphenols are protective against breast changes in the group evaluated and, thus, can help prevent breast cancer. (AU)

Objetivo: este estudio tuvo como objetivo evaluar si existe una asociación de la ingesta de café y sus polifenoles con los hallazgos mamográficos de mujeres tratadas en una unidad de patología mamaria del Sistema Unificado de Salud (SUS), Brasil. Métodos y procedimientos de investigación: este fue un estudio transversal con 532 mujeres tratadas en un servicio de salud. Las participantes se dividieron de acuerdo con sus informes mamográficos en dos grupos: sin y con hallazgos alterados. Se aplicaron dos registros dietéticos de 24 horas y el consumo de café se clasificó en tres grupos (menos de 1 taza, 1 a 3 tazas y más de 3 tazas). Los ácidos fenólicos se determinaron utilizando el programa Phenol Explorer. La ingesta de polifenoles se calculó sumando los valores obtenidos de la cantidad total de café consumido durante el día. Se aplicó el método de fuentes múltiples (MSM) para analizar la ingesta habitual. Resultados: de las 532 mujeres, 178 (33,5 %) tenían hallazgos mamográficos alterados. La ingesta diaria promedio de café de los participantes fue de 193,4 ml. No se encontró una asociación significativa entre el consumo de café y los hallazgos mamográficos. Sin embargo, se encontró que el segundo tercil de polifenoles era un factor protector para los cambios mamarios. Conclusión: los polifenoles del café son protectores contra los cambios mamarios en el grupo evaluado y, por lo tanto, podrían ayudar a prevenir el cáncer de mama. (AU)

Association of coffee intake and its polyphenols with mammographic findings in women who visited the Brazilian Public Health Service.

Introduction: Objective: this study aimed to evaluate if there is an association of intake of coffee and its polyphenols with mammographic findings in women treated at a breast care service unit of the Unified Health System (SUS), Brazil. Research methods and procedures: this was a cross-sectional study with 532 women treated at a health service. The participants were divided according to their mammographic reports into two groups: without and with altered findings. Two 24-h dietary recalls were applied and coffee consumption was categorized into three groups (less than 1 cup, 1 to 3 cups, and more than 3 cups). Phenolic acids were determined using the Phenol Explorer program. The intake of polyphenols was calculated by adding the values obtained from the total amount of coffee consumed during the day. The Multiple Source Method (MSM) was applied to analyze the usual intake. Results: of the 532 women, 178 (33.5 %) had altered mammographic findings. The participants' average daily coffee intake was 193.4 mL. No significant association was found between coffee consumption and mammographic findings. However, it was found that the second tertile of polyphenols was a protective factor for breast changes. Conclusion: Coffee polyphenols are protective against breast changes in the group evaluated and, thus, can help prevent breast cancer.

Introducción: Objetivo: este estudio tuvo como objetivo evaluar si existe una asociación de la ingesta de café y sus polifenoles con los hallazgos mamográficos de mujeres tratadas en una unidad de patología mamaria del Sistema Unificado de Salud (SUS), Brasil. Métodos y procedimientos de investigación: este fue un estudio transversal con 532 mujeres tratadas en un servicio de salud. Las participantes se dividieron de acuerdo con sus informes mamográficos en dos grupos: sin y con hallazgos alterados. Se aplicaron dos registros dietéticos de 24 horas y el consumo de café se clasificó en tres grupos (menos de 1 taza, 1 a 3 tazas y más de 3 tazas). Los ácidos fenólicos se determinaron utilizando el programa Phenol Explorer. La ingesta de polifenoles se calculó sumando los valores obtenidos de la cantidad total de café consumido durante el día. Se aplicó el método de fuentes múltiples (MSM) para analizar la ingesta habitual. Resultados: de las 532 mujeres, 178 (33,5 %) tenían hallazgos mamográficos alterados. La ingesta diaria promedio de café de los participantes fue de 193,4 ml. No se encontró una asociación significativa entre el consumo de café y los hallazgos mamográficos. Sin embargo, se encontró que el segundo tercil de polifenoles era un factor protector para los cambios mamarios. Conclusión: los polifenoles del café son protectores contra los cambios mamarios en el grupo evaluado y, por lo tanto, podrían ayudar a prevenir el cáncer de mama.

Association between dietary patterns and alteredmammographic findings / Asociación entre patrones dietéticos y hallazgos mamográficos alterados

Introduction: Breast cancer is one of the main types ofcancer in women. Previous studies assessed the relationshipbetween diet and breast cancer risk, however, studies thatevaluate the relationship between diet and mammographicfindings are scarce. Aim: To evaluate the association between dietary patternsand mammographic findings of women monitored by a mas-tology service of the Brazilian Unified Health System. Materials and Methods: Cross-sectional study that eval-uated data from 504 women. Two 24-hour dietary recallswere applied and dietary patterns were identified by principalcomponent factor analysis. The mammography reports wereclassified into normal and altered mammographic findings. Logistic regression models were applied to evaluate the asso-ciation between dietary patterns and mammographic findings.The analyses were performed in the software Stata and R andconsidered significant values of p <0.05. Results: Three dietary patterns was identified: “traditionalBrazilian” (rice, beans, red meat, breads, oils and fats andcoffees and teas), “Western” (sugar sweetened beverages, eggs, cakes, pies and cookies, fast-food snacks and, sweetsand desserts) and “prudent” (whole grains, fruits, vegetables,tubers and their products, dairy and chicken). Women withless adherence (OR 0.54 CI 95% 0.30:0.95) to the “traditionalBrazilian” dietary pattern had 46% lower odds for having al-tered mammographic findings. No associations were foundbetween “Western” and “prudent” dietary patterns with mam-mographic findings.(AU)

Women with Abnormal Mammographic Findings and High Neutrophil-to-Lymphocyte Ratio have the Worst Dietary Carbohydrate Quality Index.

INTRODUCTION: There are gaps in knowledge in breast cancer prevention studies focusing on interactions among mammographic findings, inflammation, and diet, especially those related to carbohydrates. OBJECTIVE: We aimed to verify the association among mammographic findings, inflammatory markers, and carbohydrate quality index (CQI) in women. METHODOLOGY: This was a cross-sectional study of 532 women assisted in a healthcare service. The enrolled women were divided into two groups according to their mammographic findings: those without and those with abnormal mammographic findings. Two 24-hour dietary reminders were applied, and CQI was determined based on four components: fibers, glycemic index, ratio between whole and total grains, and ratio between solid and total carbohydrates. The neutrophil-to-lymphocyte ratio (NLR) was calculated as an inflammatory marker. RESULTS: There were 178 (33.5%) women with abnormal mammographic findings, and 20 (3.8%) had NLR. There was no association between CQI and mammographic findings and NLR. Women with abnormal mammographic findings and high NLR had lower CQI (p = 0.039) and lower whole total ratio (p = 0.024). CONCLUSION: Women with abnormal findings and high NLR had worse CQI and worse overall total grain ratio.

Concentrações dietéticas de micronutrientes antioxidantes e associação com achados mamográficos / Dietary concentrations of antioxidant micronutrients and association with mammographic findings

INTRODUÇÃO: O câncer de mama configura-se como um problema de saúde pública, sendo responsável por grande parte dos tipos de cânceres, acometendo sobretudo as mulheres. Diversos fatores estão relacionados ao seu desenvolvimento, como uma dieta com baixo aporte em micronutrientes. OBJETIVO: Avaliar a relação entre a adequação dietética de micronutrientes e os resultados das mamografias de mulheres atendidas em um serviço de mastologia. METODOLOGIA: Estudo transversal desenvolvido em um Serviço de Referência para Diagnóstico em Mastologia do Sistema Único de Saúde, situado na capital do estado do Ceará, no nordeste do Brasil. Os dados foram coletados entre os anos de 2016 a 2017 com 648 mulheres. Foram levantadas informações sociodemográficas, de consumo alimentar e os laudos das mamografias. O consumo alimentar foi avaliado através de dois recordatórios alimentares de 24 horas e foram avaliados de acordo com a Ingestão Dietética de Referência. As mamografias foram avaliadas de acordo com o Breast Image Reporting and Data System. As analises estatísticas foram feitas no SPPS versão 20.0 e foram considerados valores com p < 0,05 como significantes. RESULTADOS: A idade média das participantes foi de 52,4 (9,3) anos. Maiores prevalências de inadequação foram observadas para vitaminas A, D e E e para os minerais cálcio e magnésio, em ambos os grupos. Na avaliação do consumo médio, foram encontrados diferenças estatísticas para o consumo de magnésio (p = 0,008) e de fosforo (p = 0,009) entre as mulheres com achados alterados e não alterados. DISCUSSÃO: Dos micronutrientes avaliados em nosso estudo, os principais que obtiveram grandes proporções de inadequação, destacam-se as vitaminas A, D e E e os minerais magnésio e cálcio, independente do grupo avaliado, corroborando com outros estudos já realizados. CONCLUSÃO: A alta prevalência de ingestão inadequada gera preocupações, devido ao fato de tais micronutrientes serem propostos como componentes preventivos do câncer de mama

INTRODUCTION: Breast cancer is a public health problem, being responsible for most cancers, affecting mainly women. Several sizes are related to its development, such as a low micronutrient diet. OBJECTIVE: To obtain a relationship between dietary adequacy of micronutrients and mammogram results of women treated at a mastology service. METHODOLOGY: Cross-sectional study conducted in a reference service for the diagnosis of mastology of the Unified Health System, located in the state capital of Ceará, in northeastern Brazil. Data were collected between 2016 and 2017 with 648 women. Sociodemographic, food consumption and mammography reports were collected. Food intake was sampled using two 24-hour dietary records and was judged according to a Reference Dietary Intake. How mammograms were evaluated according to the Breast Image Reporting and Data System. As analyzes were made in SPPS version 20.0 and were values with p <0.05 as significant. RESULTS: The average participation was 52.4 (9.3) years. Higher prevalence of inadequacy was observed for vitamins A, D and E and for minerals, calcium and magnesium in both groups. In the average consumption evaluation, differences were found for magnesium (p = 0.008) and phosphorus (p = 0.009) consumption between women with altered and unchanged findings. DISCUSSION: Of the micronutrients evaluated in our study, the main ones that obtained large proportions of inadequacy, stand out as vitamins A, D and E the magnesium and calcium minerals, regardless of the group evaluated, corroborating with other studies already performed. CONCLUSION: The high prevalence of inadequate intake generates pain, while micronutrients are proposed as preventive components of breast cancer

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Inter-relações entre Helicobacter pylori, sensação subjetiva de apetite e consumo alimentar / Interrelationship between Helicobacter pylori infection, subjective appetite sensation and food intake / Interrelaciones entre Helicobacter pylori, sensación subjetiva del apetito y consumo de alimentos

Objetivo: Avaliar o efeito da infecção por Helicobacter pylori (Hp) sobre a sensação subjetiva de apetite e consumo alimentar de pacientes usuários do Sistema Único de Saúde. Métodos: Trata-se de um estudo do tipo transversal, realizado em duas unidades de saúde durante o período de julho de 2012 a maio de 2013, em que foram avaliados 38 pacientes, 14 Hp positivos e 24 negativos, que relataram fazer apenas três refeições principais por dia. A presença da infecção foi investigada a partir de endoscopia digestiva alta. O consumo alimentar foi investigado por meio de dois recordatórios de 24 horas. A sensação subjetiva de apetite foi investigada utilizando-se a escala analógica visual (EAV) de apetite. Os pacientes foram estratificados em Hp positivos e Hp negativos. Para todas as análises considerou-se significante p<0,05. Resultados: Não houve diferença significante no consumo de energia e de macronutrientes, por refeição, entre os grupos. A sensação subjetiva do apetite antes e após cada refeição foi semelhante entre os grupos, exceto quanto à fome (p=0,016) e saciedade (p=0,008) no desjejum. Constatou-se a influência da refeição anterior na refeição subsequente, sendo estes achados mais evidentes entre os pacientes Hp negativos. Conclusão: O estudo aponta homogeneidade dos dois grupos avaliados no que tange a ingestão alimentar. A sensação subjetiva do apetite é diferente entre os grupos nos tópicos fome e saciedade relacionados ao desjejum. A relação entre as sensações percebidas ao final de uma refeição e início da subsequente é mais evidente entre pacientes Hp negativos.

Objective: To evaluate the effect of Helicobacter pylori (Hp) infection on the subjective appetite sensation and food intake of patients using the Unified Health System. Methods: This is a cross-sectional study, carried out in two health units during the period from July 2012 to May 2013, which evaluated 14 Hp-positive and 24 Hp-negative subjects, totaling 38 patients who reported having only three main meals per day. The presence of infection was investigated through upper endoscopy. Food intake was investigated by means of two 24-hour recalls. Subjective appetite sensation was investigated with use of the Visual Analog Scale of Appetite (VAS). The patients were stratified as Hp-positive and Hp-negative. For all analyses, the significance level was p<0.05. Results: There was no significant difference in the energy and macronutrients intake, per meal, between the groups. The subjective appetite sensation before and after each meal was similar between groups, except for hunger (p=0.016) and satiety (p=0.008) at breakfast. The influence of the previous meal on the subsequent one was verified, these findings being more evident among the Hp-negative patients. Conclusion: The study showed homogeneity of the two evaluated groups in regard to food intake. The subjective appetite sensation is different between the groups on the topics hunger and satiety related to breakfast. The relationship between the sensations perceived by the end of a meal and the beginning of the subsequent one is more evident in Hp-negative.

Objetivo: Evaluar el efecto de la infección por Helicobacter pylori (Hp) sobre la sensación subjetiva del apetito y el consumo de alimentos de pacientes usuarios del Sistema Único de Salud. Métodos: Se trata de un estudio del tipo transversal realizado en dos unidades de salud entre julio de 2012 y mayo de 2013 en el cual se evaluaron 38 pacientes siendo 14 Hp positivos y 24 negativos que relataron comer solamente tres veces al día. La presencia de la infección ha sido investigada en la endoscopia digestiva alta. El consumo de alimentos ha sido investigado a través de dos recordatorios de 24 horas. La sensación subjetiva del apetito ha sido investigada utilizando la Escala Analógica Visual de Apetito (EAV). Los pacientes fueron clasificados en Hp positivos y Hp negativos. Para todos los análisis se consideró significativo el p<0,05 Resultados: No hubo diferencia significativa entre los grupos para el consumo de energía y de macro nutrientes por comida. La sensación subjetiva del apetito antes y después de cada comida ha sido parecida entre los grupos, excepto respecto el hambre (p=0,016) y la saciedad (p=0,008) en ayunas. Se constató de modo más evidente entre los pacientes Hp negativos que la comida anterior influye en la siguiente. Conclusión: El estudio sugiere la homogeneidad de los dos grupos evaluados respecto la ingesta de alimentos. La sensación subjetiva del apetito es distinta entre los grupos respecto el hambre y la saciedad en ayunas. La relación entre las sensaciones percibidas al final de cada comida y el inicio de la siguiente es más evidente entre los pacientes Hp negativos.

ASSOCIATION OF HELICOBACTER PYLORI INFECTION WITH NUTRITIONAL STATUS AND FOOD INTAKE.

INTRODUCTION: the H. pylori infection affects more than half of humanity, being a public health problem. Its prevalence is significantly higher in developing countries like Brazil. It has been suggested that H. pylori infection may influence the intake and caloric homeostasis. PURPOSE: to compare nutritional status and food intake of patients attended by National Health System, with and without H. pylori infection. METHODS: 140 patients were assessed. They performed upper gastrointestinal endoscopy to investigate the presence of H. pylori. Body weight and height of the patients were measured. Food intake was investigated through two 24-hour recalls, with data transformed in grams and analyzed in DietWin Professional 2.0 software. The findings were compared using the chi-square test or Student's t-test, adopting p < 0.05 as significance level. RESULTS: there was predominance of patients with excess weight for both Hp - (60.3%) and Hp + (67.7%), with no difference between them. Food intake of assessed groups was similar. CONCLUSION: no differences were found in nutritional status and food intake between the two studied groups.

Introducción: la infección por H. pylori afecta a más de la mitad de la humanidad, siendo un problema de salud pública. Su prevalencia es significativamente mayor en los países en desarrollo, como Brasil. Se ha sugerido que la infección por H. pylori puede influir en la ingesta y la homeostasis calórica. Propósito: comparar el estado nutricional y la ingesta de alimentos de los pacientes incluidos en el Sistema Nacional de Salud, con y sin infección por H. pylori. Métodos: se evaluarón 140 pacientes. Realizaron la endoscopia digestiva alta para investigar la presencia de H. pylori. Se midieron el peso corporal y la altura de los pacientes. La ingesta de alimentos se investigó a través de dos recordatorios de 24 horas, con los dados transformados en gramos y analizados en el software DietWin Professional 2.0. Los resultados se compararon mediante la prueba de chi-cuadrado o la prueba t de Student. Se adoptó de p < 0,05 como nivel de significación. Resultados: hubo predominio de pacientes con exceso de peso tanto para Hp - (60,3%) como Hp + (67,7%), sin diferencias entre ellos. La ingesta de alimentos de los grupos evaluados fue similar. Conclusiones: no hubo diferencias en el estado nutricional y la ingesta de alimentos entre los dos grupos.

Association of Helicobacter pylori infection with nutritional status and food intake / Asociación de la infección por helicobacter pylori con el estado nutricional y la ingesta de alimentos

Introduction: the H. pylori infection affects more than half of humanity, being a public health problem. Its prevalence is significantly higher in developing countries like Brazil. It has been suggested that H. pylori infection may influence the intake and caloric homeostasis. Purpose: to compare nutritional status and food intake of patients attended by National Health System, with and without H. pylori infection. Methods: 140 patients were assessed. They performed upper gastrointestinal endoscopy to investigate the presence of H. pylori. Body weight and height of the patients were measured. Food intake was investigated through two 24-hour recalls, with data transformed in grams and analyzed in DietWin Professional 2.0 software. The findings were compared using the chi-square test or Student’s t-test, adopting p < 0.05 as significance level. Results: there was predominance of patients with excess weight for both Hp - (60.3%) and Hp + (67.7%), with no difference between them. Food intake of assessed groups was similar. Conclusion: no differences were found in nutritional status and food intake between the two studied groups (AU)

Introducción: la infección por H. pylori afecta a más de la mitad de la humanidad, siendo un problema de salud pública. Su prevalencia es significativamente mayor en los países en desarrollo, como Brasil. Se ha sugerido que la infección por H. pylori puede influir en la ingesta y la homeostasis calórica. Propósito: comparar el estado nutricional y la ingesta de alimentos de los pacientes incluidos en el Sistema Nacional de Salud, con y sin infección por H. pylori. Métodos: se evaluaron 140 pacientes. Realizaron la endoscopia digestiva alta para investigar la presencia de H. pylori. Se midieron el peso corporal y la altura de los pacientes. La ingesta de alimentos se investigó a través de dos recordatorios de 24 horas, con los dados transformados en gramos y analizados en el software DietWin Professional 2.0. Los resultados se compararon mediante la prueba de chi-cuadrado o la prueba t de Student. Se adoptó de p< 0,05 como nivel de significación. Resultados: hubo predominio de pacientes con exceso de peso tanto para Hp - (60,3%) como Hp + (67,7%), sin diferencias entre ellos. La ingesta de alimentos de los grupos evaluados fue similar. Conclusiones: no hubo diferencias en el estado nutricional y la ingesta de alimentos entre los dos grupos (AU)

Influência da infecção por Helicobacter pylori e de sua erradicação sobre o consumo alimentar e estado nutricional.

Infection by Helicobacter pylori affects over half of the world's population and is a public health issue. Its prevalence is significantly higher in developing countries such as Brazil. It has been suggested that infection by H pylori can impact calorie intake and homeostasis. AIM: Analyze the influence of infection by H pylori and of its eradication on nutritional status and dietary intake. MATERIAL AND METHODS: The study included 124 patients (48 of whom H pylori positive, 45 H pylori negative, and 31 eradicated). Weight and height were measured to calculate the body mass index (BMI). Dietary intake was assessed using a 24-hour diet recall (24hR) in two occasions. RESULTS: Pre-obesity was the highest among the eradicated patients (p = 0.011). Homogenicity was found in the dietary intake for the nutrients studied, except for saccharose, whose intake was the lowest among the eradicated group (p < 0.001). CONCLUSIONS: Patients eradicated for H pylori had a higher rate of pre-obesity. The dietary intake was similar among the groups for nearly all nutrients assessed, except for saccharose, whose intake by eradicated patients was lower. This entails discussions about possibly including the investigation of nutritional status and diet in the routine procedures towards those who seek a diagnosis of infection by H pylori.

Consumo alimentar de mulheres sobreviventes de câncer de mama: análise em dois períodos de tempo / Food intake of women survivors of breast cancer: analysis in two time periods

OBJETIVO: Comparar o consumo alimentar de dois grupos de mulheres portadoras de câncer de mama atendidas em dois períodos distintos: 1999-2004 e 2005-2009. MÉTODOS: Estudo documental, com abordagem descritiva e comparativa. Foram coletados dados de identificação e de ingestão alimentar nas fichas de 154 pacientes portadoras de câncer de mama atendidas em serviços de referência de Fortaleza (CE): 66 no período de 1999-2004 e 88 no de 2005-2009. Foram considerados como integrantes do hábito os alimentos consumidos pelo menos quinzenalmente por, no mínimo, 50% das pessoas. Calculou-se a prevalência de consumo de alimentos, sendo os padrões dos dois períodos comparados pela aplicação dos testes Quiquadrado ou exato de Fisher, e adotouse p<0,05 como nível de significância. RESULTADOS: Os hábitos alimentares dos dois grupos foram semelhantes, exceto quanto ao maior consumo de leite e de cenoura e menor consumo de manga e caju, além de uma tendência ao aumento no consumo de óleo de soja, observada no grupo atendido mais recentemente. O aumento de leite e de cenoura pode configurar proteção contra a recidiva da doença, mas a redução do consumo das frutas citadas pode significar maior risco: aliás, foram baixas as prevalências de consumo de frutas e hortaliças pelos dois grupos de mulheres. CONCLUSÃO: Os achados apontam para uma lacuna na abordagem educativa das pacientes tanto no passado como na atualidade, o que comprova a necessidade de incentivar maior consumo e variedade de hortaliças e frutas e menor consumo de cereais refinados, gorduras, açúcar e refrigerantes.

OBJECTIVE: The aim of this study is to compare the dietary intake of two groups of women with breast cancer treated on different periods: 1999-2004 and 2005-2009. METHODS: This descriptive and comparative documental study collected data from the medical records of 154 patients with breast cancer treated in reference centers of Fortaleza (CE), Brazil. The following variables were studied: food intake and characterization. Sixtysix women were studied from 1999-2004 and 88 from 2005-2009. Foods consumed at least every 15 days by not less than 50% of the women were considered part of their eating habits. The prevalence of the foods consumed was calculated, and the standards of the two periods compared by the Chisquare or Fisher's exact test. The significance level was set at 5% (p<0.05). RESULTS: The dietary habits of both groups were similar but the group treated more recently consumed more milk, less carrots, mangos and cashews, and tended to consume more soybean oil. Higher intakes of milk and carrots can provide protection against recurrence, but lower consumption of fruits may increase risk. CONCLUSION: These findings indicate that patients are not being properly advised, both in the past and today. Patients need to be encouraged to consume more vegetables and fruits in volume and variety, and less refined grains, fats, sugar and soda.