Cut points of the conicity index as an indicator of abdominal obesity in individuals undergoing hemodialysis: An analysis of latent classes.

OBJECTIVES: Abdominal obesity favors the involvement of cardiometabolic complications in renal patients on hemodialysis. Thus, the aim of the study was to identify the cut-points of the conicity index in individuals undergoing hemodialysis. METHODS: This was a cross-sectional study carried out with 953 individuals undergoing hemodialysis in clinics in a metropolitan region of southeastern Brazil. The conicity index was calculated using the following mathematical equation: waist circumference/0.109 × âˆšweight/height. The receiver operating characteristic (ROC) curve was calculated from the analysis of latent classes by cross-validation through a latent variable of abdominal obesity. This latent variable was defined using the response pattern of the observed anthropometric variables considering the presence and absence of abdominal obesity: waist circumference, waist-to-height ratio, and body shape index. The cut-points identified were elucidated by the area under the curve (AUC), Youden index, sensitivity, and specificity. RESULTS: The cut-points for the conicity index found for both sexes were similar, resulting in a cut-point for men of 1.275 (AUC, 0.921; Youden index, 0.666), with a sensitivity and specificity of 83% and 83.6%, and a cut-point for women of 1.285 (AUC, 0.921; Youden index, 0.679), with a sensitivity and specificity of 78.6% and 89.3%, respectively. CONCLUSIONS: The conicity index showed high discriminatory power for the identification of abdominal obesity in hemodialysis patients, therefore it can be a simple and easily accessible tool to be incorporated into clinical practice in this population.

Quality of life and associated factors in patients with hematological cancer according to EORTCQLQ-C30 / Qualidade de vida e fatores associados em pacientes com câncer hematológico segundo o EORTC QLQ-C30

Introduction: hematological cancers account for 9% of all cancers and their progression and treatment directly affect quality of life (QoL).Objective: this study assessed QoL and associated factors in patients with hematological cancer according to the EORTC QLQ-C30.Methods: cross-sectional study carried out from August 2017 to June 2019. We included adults and the elderly of both sexes, with hematological cancer, undergoing oral or venous chemotherapy. Nutritional status was assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and QoL by EORTC QLQ-C30.Results: fifty-one patients aged in average 60.0 ± 15 years were evaluated. Of these, 51.0% were women, 80.4% were non-white, 37.3% had B lymphoid cell neoplasia, 60.8% had been diagnosed for ≤ 3 years, 77.1% were on chemotherapy, and 64.7% were well- nourished. The scores for global health status and functional scales were high and for symptoms and single items they were low, indicating good QoL and functionality and low symptomatology. After multivariate linear regression, the time of diagnosis ≤ 3 years was associated with functional performance (p <0.05) and malnutrition was associated with cognitive function (p <0.05) and with symptoms of fatigue, nausea and vomiting, and insomnia (p <0.05).Conclusions: quality of life and functionality considered adequate were observed. Time of diagnosis and malnutrition were the variables that were associated with physical and cognitive function and with the presence of fatigue, nausea and vomiting and insomnia, according to the EORTC QLQ-C30.

Introdução: os cânceres hematológicos são responsáveis por 9% de todos os cânceres e sua progressão e tratamento afetam diretamente a qualidade de vida (QV).Objetivo: avaliar a QV e fatores associados em pacientes com câncer hematológico de acordo com o EORTC QLQ-C30.Método: estudo transversal realizado de agosto de 2017 a junho de 2019. Foram incluídos adultos e idosos de ambos os sexos, com câncer hematológico, em quimioterapia oral ou venosa. O estado nutricional foi avaliado pela Avaliação Subjetiva Global Gerada pelo Paciente (PG-SGA) e a QV pelo EORTC QLQ-C30.Resultados: foram avaliados 51 pacientes com idade média de 60,0 ± 15 anos. Destes, 51,0% eram mulheres, 80,4% eram não brancos, 37,3% apresentavam neoplasia de células linfoides B, 60,8% tinham diagnóstico ≤ 3 anos, 77,1% estavam em quimioterapia e 64,7% estavam bem nutridos. As pontuações para o estado de saúde global e escalas funcionais foram altas e para sintomas e itens únicos foram baixas, indicando boa QV e funcionalidade e baixa sintomatologia. Após regressão linear multivariada, o tempo de diagnóstico ≤ 3 anos foi associado ao desempenho funcional (p <0,05) e a desnutrição foi associada à função cognitiva (p <0,05) e aos sintomas de fadiga, náuseas e vômitos e insônia (p <0,05).Conclusões: foi observada qualidade de vida e funcionalidade consideradas adequadas. O tempo de diagnóstico e a desnutrição foram as variáveis que se associaram com o comprometimento da função física e cognitiva e com a presença de fadiga, náuseas e vômitos e insônia, segundo o EORTC QLQ-C30.

Presence of dynapenia and association with anthropometric variables in cancer patients.

BACKGROUND: Dynapenia is defined as an age-related loss of muscle strength. There is little information on dynapenia in cancer patients and on how it relates to anthropometric variables. The aim of this study was to analyze the presence of dynapenia and its association with anthropometric variables in hospitalized cancer patients. METHODS: Participants comprised adult and elderly cancer patients evaluated within the first 48 h of hospital admission to a tertiary public hospital, a referral center for gastrointestinal tract surgery. Anthropometric variables were measured according to standardized protocols. Dynapenia was identified based on handgrip strength (HGS), according to the cutoff points defined by the European Working Group on Sarcopenia in Older People (EWGSOP2), with values for women < 16 kg and for men < 27 kg. Statistical analysis was performed using SPSS software, version 22.0, with a significance level of 5%. RESULTS: This study included 158 patients aged in average 59.5 ± 14.0 years; of these, 53.6% were elderly, 58.9% non-white and 59.5% had some degree of malnutrition. The most prevalent type of cancer was that of the lower gastrointestinal tract (33.5%). The presence of dynapenia was observed in 23.4% of the patients and cachexia in 36.1%. There was an association between dynapenia with age (p < 0.001), life stage (p = 0.002) and race/color (p = 0.027), and also with body mass index (BMI) (p = 0.001) and adductor pollicis muscle thickness (APMT) of both hands (p < 0.05). After logistic regression analysis, adjusted for the sociodemographic variables, the APMT of the dominant hand and the low weight determined by body mass index remained associated with the occurrence of dynapenia (p < 0.05). CONCLUSIONS: In this study we confirmed that dynapenia was present in cancer patients, being associated with APMT of the dominant hand and low weight. HSG was proven to be a reliable and complementary measure to be added to the process of assessing nutritional status, contributing to the nutritional diagnosis of these patients and to the detection of early muscle depletion.

SARC-CalF-assessed risk of sarcopenia and associated factors in cancer patients.

INTRODUCTION: Introduction: sarcopenia is considered a risk factor for cancer patients, as it increases mortality and post-surgical complications, and reduces response to treatment and quality of life. Objective: to identify the risk of sarcopenia by SARC-CalF, as well as the factors associated with this outcome in patients with cancer of the gastrointestinal tract (GIT) and adnexal glands. Methods: this cross-sectional study included patients with cancer of the GIT and adnexal glands, without edema or ascites, of both sexes and aged ≥ 20 years. Conventional anthropometric variables and handgrip strength (HGS) were measured. The risk of sarcopenia was assessed through the SARC-CalF questionnaire, and nutritional status by the Patient-Generated Subjective Global Assessment (PG-SGA). The data analysis was performed using the SPSS® software, 22.0, with a significance of 5 %. Results: seventy patients took part in the study. Of these, 55.7 % were female, 52.9 % were aged over 60 years, and 64.3 % were non-white. PG-SGA identified 50.0 % of patients as well-nourished and 50.0 % as having some degree of malnutrition. The prevalence of risk of sarcopenia was 28.6 %. There were different correlations between the SARC-CalF score and anthropometric variables (p < 0.05) according to life stage (adults and elderly). After a linear regression analysis the measures that most influenced the SARC-CalF score were arm circumference (AC) and adductor pollicis muscle thickness in the dominant hand (DAPMT) for adults, while for the elderly current weight and DAPTM (p < 0.05) were more relevant. Conclusion: SARC-CalF identified 28.6 % of patients at risk for sarcopenia and was associated with body weight and anthropometric variables indicative of muscle reserve in adults and the elderly.

INTRODUCCIÓN: Introducción: se considera la sarcopenia un factor de riesgo, especialmente para los pacientes con cáncer, ya que aumenta la mortalidad y las complicaciones posquirúrgicas, reduciendo la respuesta al tratamiento y la calidad de vida. Objetivo: identificar el riesgo de sarcopenia por el SARC-CalF y los factores asociados en pacientes con cáncer del tracto gastrointestinal (TGI) y las glándulas anexas. Métodos: estudio transversal descriptivo. Se incluyeron pacientes con cáncer del TGI y glándulas anexas, sin edema o ascitis, de ambos sexos y de edad ≥ 20 años. Se midieron las variables antropométricas convencionales y la fuerza de presión manual (FPM). El riesgo de sarcopenia se obtuvo mediante el cuestionario SARC-CalF y el estado nutricional mediante la valoración global subjetiva generada por el propio paciente (VGS-GP). El análisis de los datos se realizó con el software SPSS®, versión 22.0, con una significancia del 5 %. Resultados: Participaron 70 pacientes. De estos, el 55,7 % eran mujeres, el 52,9 % eran mayores de 60 años y el 64,3 % eran de etnia no caucásica (64,3 %). La VGS-GP identificó un 50,0 % de pacientes bien alimentados y un 50,0 % con algún grado de desnutrición. El riesgo de sarcopenia fue del 28,6 %. Hubo diferentes correlaciones entre el puntaje SARC-CalF y las variables antropométricas (p < 0,05) según la etapa de la vida (adultos y ancianos). Después del análisis de regresión lineal, las medidas que más influyeron en el puntaje SARC-CalF fueron la circunferencia muscular del brazo (CMB) y el espesor del músculo aductor del pulgar de la mano dominante (EMAPD) en los adultos, mientras que en los ancianos fueron el peso actual y elEMAPD (p < 0,05). Conclusión: el SARC-CalF identificó al 28,6 % de los pacientes con riesgo de sarcopenia y se asoció con el peso corporal y las variables antropométricas indicativas de reserva muscular en adultos y ancianos.

Ingestão de açúcar de adição por estudantes daárea da saúde em uma instituição de ensino de Viçosa, Brasil / Added sugar intake of health area students in an educationalinstitution of Viçosa, Brazil

Evidências mostram que o consumo excessivo de açúcares, pode comprometer a qualidade da alimentação impactandonegativamente na saúde. Assim, o objetivo do presente estudo foi avaliar o consumo de macronutrientes e adequaçãodo consumo de açúcar por estudantes da área da saúde da Universidade Federal de Viçosa, Brasil. Participaram desteestudo 157 mulheres e 30 homens, com faixa etária de 21,3 ± 3,4 anos, apresentando IMC e CC médios de 22,03 ±4,03 kg.m-2 e 72,95 ± 8,96 cm, respectivamente. Foram aplicados questionários semiestruturados e procedeu-se àsavaliações antropométricas e dietéticas dos indivíduos. Os resultados revelaram alta ingestão média diária de açúcarde adição (69,21 ± 5,25 g) que, consequentemente, aumentou o teor de frutose da alimentação (36,22 ± 29,78 g),além de uma baixa ingestão de fibras (15,51 ± 7,30 g). Verificou-se que a ingestão média de açúcar de adição estevesignificativamente (p<0,05) associada ao peso corporal (0,172; p=0,041), IMC (0,181; p=0,031) e consumo dosmacronutrientes e cálcio (0,247; p=0,003). Deve-se considerar a necessidade de implementação de medidas que visempromover mudanças comportamentais importantes no que diz respeito à alimentação de graduandos dos cursos desaúde.

Evidence shows that excessive sugar consumption may impair the quality of feeding affecting negatively on health. Theobjective of this study was evaluated the intake of macronutrients and adequacy of sugar consumption by healthcarestudents of Federal University of Viçosa, Brazil. The study included 157 women and 30 men, aged 21.3 ± 3.4 years,with mean body mass index (BMI) of 22.03 ± 4.03 kg m-2 and waist circumference (WC) of 72.95 ± 8.96 cm. Semistructuredquestionnaires were administered and proceeded to anthropometric and dietary assessments of individuals.The results revealed high average daily intake of added sugar (69.21 ± 5.25 g) which consequently increased the fructosecontent of feeding (36.22 ± 29.78 g), and a low intake of fiber (15.51 ± 7.30 g). It was found that the average intakeof added sugar was significantly (p <0.05) associated to body weight (0.172, p = 0.041), BMI (0.181, p = 0.031) andconsumption of macronutrients and calcium (0.247; p = 0.003). Should consider the need to implement measures topromote significant behavioral changes with regard to the supply of undergraduate health courses.

Farinha de banana verde não altera perfillipídico e inflamatório de mulheres comexcesso de peso / Green banana flour does not alter lipid and inflammatory profile of womenoverweight

A prevalência de doenças crônicas não transmissíveis, como as dislipidemias, o excesso de peso e as complicações relacionadasao estado inflamatório têm aumentado em todo o mundo. Neste cenário, produtos alimentícios com alegaçõesbenéficas no tratamento e/ou prevenção destas condições surgem como promessas, muitas vezes, sem respaldo científico.A farinha de banana verde (FBV) tem ganhado espaço na mídia como uma possível promotora de efeitos positivos àsaúde, mas não existem estudos controlados sobre seus reais efeitos em humanos. O objetivo deste trabalho foi analisaros impactos do consumo da FBV no peso corporal, perfil lipídico, parâmetros inflamatórios e no consumo alimentar demulheres adultas com excesso de peso. Foi realizado um estudo de intervenção no qual 25 mulheres adultas com excessode peso consumiram, diariamente, 20g de FBV, durante 45 dias. O protocolo do estudo incluiu avaliações antropométricas,de composição corporal, consumo alimentar, perfil lipídico e determinação de parâmetros inflamatórios séricos. A idademédia das participantes foi 34 anos, com Índice de Massa Corporal médio de 27,7 kg/m². O consumo da FBV não alterouo peso, a composição corporal, o perfil lipídico e os parâmetros inflamatórios. Houve aumento na ingestão de fibras (varia-ção no consumo mediano de 12,72g para 14,16g; p=0,031), embora a necessidade nutricional deste nutriente não tenhasido alcançada (25g/dia). O consumo isolado da FBV não promoveu alterações corporais e metabólicas significativas. Aadoção de medidas isoladas oferece efeitos limitados e deve ser desencorajada como única forma de melhora da saúde.

The prevalence of chronic diseases such as dyslipidemia, overweight and complications related to the inflammatory statehave increased worldwide. In this scenario, food products which claim to be beneficial in the treatment and/or preventionof these conditions arise as promises often having no scientific support. The green banana flour (GBF) has gained mediaattention as a possible promoter of beneficial health effects. However, there are no controlled studies on their real effectsin human studies. The objective of this study was to analyze the effects of consumption of GBF in body weight, lipid profile,inflammatory parameters and food consumption in adult overweight women. An intervention study in which 25 adultoverweight women consumed daily 20g of GBF during 45 days was carried out. The study protocol included anthropometricmeasurements, body composition, food intake, lipid profile and determination of serum inflammatory parameters. The meanage of participants was 34 years, with Body Mass Index of 27.7 kg/m². The consumption of FBV did not alter weight, bodycomposition, lipid profile and inflammatory parameters. There was an increase in fiber intake (variation in median intakeof 12,72g to 14,16g; p=0,031), although it has not achieved the needs of this nutrient (25g/day). Isolated consumption ofFBV did not cause significant bodily and metabolic changes. The adoption of individual measures offer limited effects andshould be discouraged as the only way of improving health.

Utilização de hormônios e antibióticos em produtos alimentícios de origem animal: aspectos gerais e toxicológicos / Use of hormones and antibiotics in animal food products: general and toxicological aspects

OBJECTIVE: To approach the use of hormones and antibiotics in the production of animal origin food, mechanisms of action, toxicity, regulations in Brazil and worldwide and methods for residues detection in food. Data source: For this review, articles were searched using databases indexed in MEDLINE, LILACS, PUBMED and SciELO, using the key words: residues, antibiotics, hormones, meat, milk, eggs, in addition to their translations in Portuguese and Spanish. Data synthesis: We considered publications in the last 10 years, including 28 articles. CONCLUSIONS: The consumption of foods containing antibiotics and hormones residues is a problem to be considered, therefore, it is necessary to develop better methods of compounds detection and invest in food inspection

OBJETIVO: Abordar o uso de hormônios e antibióticos na produção de alimentos de origem animal, mecanismos de ação, toxicidade, regulamentação no Brasil e no mundo e os métodos para detecção dos resíduos nos alimentos. FONTE DE DADOS: Para essa revisão, artigos foram pesquisados usando bancos de dados indexados no MEDLINE, LILACS, PubMed e SciELO, utilizando as palavras-chave: resíduos, antibióticos, hormônios, carne, leite, ovos, além das respectivas traduções em inglês e espanhol. SÍNTESE DOS DADOS: Foram consideradas publicações dos últimos 10 anos, sendo incluídos 28 artigos. CONCLUSÕES: O consumo de alimentos contendo resíduos de hormônios e antibióticos constitui um problema a ser considerado, entretanto há necessidade de desenvolver melhores metodologias de detecção dos compostos e investir em fiscalização de alimentos