Nutritionists' Health Study cohort: a web-based approach of life events, habits and health outcomes.

INTRODUCTION: Non-communicable chronic diseases (NCCDs) represent a burden for public health. Alongside the established cardiometabolic risk factors such as high blood pressure and disorders of glucose and lipid metabolism, living habits and nutritional status at different stages of life are seen as contributors to this scenario. Gut microbiota composition and subclinical inflammation have been pointed out as underlying mechanisms of NCCDs. Studies involving health professionals have brought relevant contributions to the knowledge about risk factors. Technological advances facilitate data collection and analysis for big samples. A web-based survey addressed to collect data from a cohort study, which is able to identify NCCDs risk factors, is highly desirable. The objective of the Brazilian Nutritionists' Health Study (NutriHS) is to gather online information on early life events, daily habits, emergent cardiometabolic risk factors and health outcomes of a specific subset of the Brazilian population. METHODS AND ANALYSIS: NutriHS, developed at the School of Public Health-University of Sao Paulo, Brazil, is a research initiative that enrols undergraduates of nutrition courses from Brazilian universities and graduated volunteers. A web-based self-administered system was designed to collect health-related data. After fulfilling online questionnaires (socioeconomic, early life events and lifestyle data), participants are invited to a clinical visit for physical examination and laboratory procedures (blood sampling, faeces collection and body composition). At a 3-year interval, they will be invited to repeat similar procedures. ETHICS AND DISSEMINATION: The NutriHS research protocol was approved by the Institutional Ethics Committee and is providing promising data which contribute to the understanding of pathophysiological links between early life events, body composition, gut microbiota, and inflammatory and metabolic risk profile. The combination of a friendly tool with the innovative purposes of NutriHS offers a remarkable resource for testing hypotheses about mechanisms of nutrition-related diseases and further planning of preventive programmes in public health.

Reassessing lipid metabolism and its potentialities in the prediction of cardiovascular risk.

There are numerous particles, enzymes, and mechanisms in the lipid metabolism that are involved in the genesis of cardiovascular disease (CVD). Given its prevalence in populations and its impact on mortality, it is relevant to review the lipid metabolism as it may potentially provide subsidies to better prediction. This article reviews the importance of traditional cardiovascular risk factors and comments on the potential of novel lipid biomarkers involved in the physiopathology of CVD. The Framingham cohorts proved the role of traditional risk factors (physical inactivity, smoking, blood pressure, total cholesterol, LDL-C, HDL-C, plasma glucose) in the prediction of cardiovascular events. However, a significant number of individuals that suffer from a cardiovascular event has few or none of these factors. Such finding indicates the need for new biomarkers able to identify plaques that are more susceptible to rupture. Some of bloodstream biomarkers related to lipid metabolism are modified LDL particles, apolipoprotein AI (apo AI), apolipoprotein B, lipoprotein (a) [Lp (a)], cholesteryl ester transfer protein (CETP), subtypes of LDL and HDL particles, and lipoprotein-associated phospholipase A2 (Lp-PLA2). These factors participate in the atherosclerotic process, and are abnormal in individuals at high risk, or in those who suffered from a cardiovascular event. Lp (a) determination is already employed in clinical practice and should be included as a reference parameter for CVD monitoring. Furthermore, there are expectations for wider use of apo B, non-HDL cholesterol and total cholesterol / HDL-C determination to improve cardiovascular risk assessment.

Reassessing lipid metabolism and its potentialities in the prediction of cardiovascular risk

There are numerous particles, enzymes, and mechanisms in the lipid metabolism that are involved in the genesis of cardiovascular disease (CVD). Given its prevalence in populations and its impact on mortality, it is relevant to review the lipid metabolism as it may potentially provide subsidies to better prediction. This article reviews the importance of traditional cardiovascular risk factors and comments on the potential of novel lipid biomarkers involved in the physiopathology of CVD. The Framingham cohorts proved the role of traditional risk factors (physical inactivity, smoking, blood pressure, total cholesterol, LDL-C, HDL-C, plasma glucose) in the prediction of cardiovascular events. However, a significant number of individuals that suffer from a cardiovascular event has few or none of these factors. Such finding indicates the need for new biomarkers able to identify plaques that are more susceptible to rupture. Some of bloodstream biomarkers related to lipid metabolism are modified LDL particles, apolipoprotein AI (apo AI), apolipoprotein B, lipoprotein (a) [Lp (a)], cholesteryl ester transfer protein (CETP), subtypes of LDL and HDL particles, and lipoprotein-associated phospholipase A2 (Lp-PLA2). These factors participate in the atherosclerotic process, and are abnormal in individuals at high risk, or in those who suffered from a cardiovascular event. Lp (a) determination is already employed in clinical practice and should be included as a reference parameter for CVD monitoring. Furthermore, there are expectations for wider use of apo B, non-HDL cholesterol and total cholesterol / HDL-C determination to improve cardiovascular risk assessment.

[Intestinal microbiota and cardiometabolic risk: mechanisms and diet modulation]. / Microbiota intestinal e risco cardiometabólico: mecanismos e modulação dietética.

The gut microbiota obtained after birth is composed of a large range of bacteria that play different roles in the human host, such as nutrient uptake, protection against pathogens and immune modulation. The intestinal bacterial content is not completely known, but it is influenced by internal, and mainly by external factors, which modulate its composition and function. Studies indicate that the gut microbiota differs in lean and obese individuals, and in individuals with different food habits. There is evidence that the relationship between diet, inflammation, insulin resistance, and cardiometabolic risk are, in part, mediated by the composition of intestinal bacteria. Knowledge about the gut microbiota may result in different strategies to manipulate bacterial populations and promote health. This review discusses the relevance of understanding the role of dietary factors or patterns in the composition of the microbiota, as well as pathophysiological mechanisms of chronic metabolic diseases, and the potential of prebiotics and probiotics on the cardiometabolic risk profile.

Microbiota intestinal e risco cardiometabólico: mecanismos e modulação dietética / Intestinal microbiota and cardiometabolic risk: mechanisms and diet modulation

A microbiota intestinal, adquirida no período pós-natal, é composta por grande diversidade de bactérias que desempenham diferentes funções no hospedeiro humano, entre elas a absorção de nutrientes, proteção contra patógenos e modulação do sistema imune. O conteúdo bacteriano intestinal ainda não é totalmente conhecido, mas sabe-se que é influenciado por fatores internos e principalmente externos que modulam sua composição e função. Estudos indicam que a microbiota intestinal difere em indivíduos magros e obesos e ainda naqueles que mantêm hábitos alimentares diferentes. Há evidências de que as relações entre dieta, inflamação, resistência à insulina e risco cardiometabólico são em parte mediadas pela composição de bactérias intestinais. Conhecimentos sobre a microbiota poderão reverter em diferentes estratégias para manipular as populações bacterianas e promover saúde. Esta revisão aborda a relevância do conhecimento sobre o papel de fatores ou padrões alimentares na composição da microbiota, assim como mecanismos fisiopatológicos de doenças metabólicas crônicas e as potencialidades de prebióticos e probióticos sobre o perfil de risco cardiometabólico.

The gut microbiota obtained after birth is composed of a large range of bacteria that play different roles in the human host, such as nutrient uptake, protection against pathogens and immune modulation. The intestinal bacterial content is not completely known, but it is influenced by internal, and mainly by external factors, which modulate its composition and function. Studies indicate that the gut microbiota differs in lean and obese individuals, and in individuals with different food habits. There is evidence that the relationship between diet, inflammation, insulin resistance, and cardiometabolic risk are, in part, mediated by the composition of intestinal bacteria. Knowledge about the gut microbiota may result in different strategies to manipulate bacterial populations and promote health. This review discusses the relevance of understanding the role of dietary factors or patterns in the composition of the microbiota, as well as pathophysiological mechanisms of chronic metabolic diseases, and the potential of prebiotics and probiotics on the cardiometabolic risk profile.

Is plasma alpha-tocopherol associated with electronegative LDL in obese adolescents?

Obesity has increased in children and adolescents. What is reflected in the early occurrence of cardiometabolic alterations, like hypertension and type 2 diabetes, where the oxLDL formation is stimulated. Various studies have shown that plasma α-tocopherol (α-TP) can protect LDL against oxidation. Nevertheless, the action of plasma α-TP in cardiovascular diseases remains controversial. We conducted a cross-sectional study to evaluate plasma α-TP and its impact on the concentration of LDL(-). Adolescents (n=150) of both sexes were classified into three groups: healthy weight (HW; 50%), overweight (OV; 22%), and obese (OB; 28%). Lipid profile, LDL(-), anti-oxLDL and anti-LDL(-) antibodies, CRP (ELISA) and plasma α-TP (HPLC) were analyzed. Demographic, anthropometric, and food intake data were evaluated. Crude and energy-adjusted intake of vitamin E in the OB group were higher than in the HW group (p<0.001). Crude and energy-adjusted vitamin E intakes were not correlated with plasma α-TP (r=-0.07; p=0.412 and r=-0.064; p=0.467, respectively). Subjects in the OB group had higher TC and LDL-C and lower HDL-C than in the HW and OV groups. C-reactive protein and anti-oxLDL antibodies changed as a function of BMI. The impact of obesity was reinforced by high values for LDL(-) and low content of plasma α-TP in comparison with the HW (p<0.001) and OV groups (p=0.03). This negative profile was maintained for the ratio between α-TP and TC or LDL-C. Plasma α-TP, α-TP/TC and α-TP/LDL-C were negatively associated with LDL(-) and other cardiometabolic risk factors (BMI, WC, AC and anti-oxLDL). Our results demonstrate that obesity in adolescents is associated with high levels of LDL(-) and low plasma α-TP content.

Associação da atividade da Lp-PLA2 e de antioxidantes lipossolúveis com marcadores cardiometabólicos em adolescentes / Association of Lp-PLA activity and fat-soluble antioxidants with cardiometabolic markers in adolescents

Introdução: A obesidade se caracteriza como um processo oxidativo e inflamatório, que predispõe adolescentes, de modo precoce, a eventos até recentemente pouco frequentes nessa faixa etária. Assim, a ação da enzima Fosfolipase A associada às lipoproteínas (Lp-PLA ), que reduz fosfolipídios oxidados e gera lisofosfolipídios, bem como a disponibilidade de antioxidantes plasmáticos, representam um importante tema de pesquisa no contexto cardiovascular. Objetivo: Verificar se a atividade da LP-PLA 2 2 e a concentração de antioxidantes lipossolúveis se associam com os principais marcadores de risco cardiovascular em adolescentes. Métodos: Duzentos e quarenta e dois adolescentes (10 a 19 anos), de ambos os sexos foram distribuídos, segundo o índice de massa corporal (IMC), em três grupos: Eutróficos (n=77), Sobrepeso (n=82) e Obesos (n=83). A amostra foi caracterizada através de parâmetros sócio-econômicos, estado de saúde, uso de medicamentos, antedecentes familiares de doenças crônicas e prática de atividade física. Foram avaliados ainda os dados antropométricos (peso, altura e composição corporal - bioimpedância), e o consumo alimentar por meio de três recordatórios 24 h. A partir de uma amostra de sangue coletada após jejum (12h), realizaram-se as análises da atividade da Lp-PLA , LDL(-) e seus auto-anticorpos, perfil lipídico (colesterol total, LDL-C, HDL-C e triglicerídeos), tamanho da HDL, proteína transportadora de éster de colesterol (CETP), ácidos graxos não esterificados (NEFAs), adipocitocinas, assim como antioxidantes (retinol, licopeno, -tocoferol e -caroteno) no plasma. Resultados: Artigo 1: Lp-PLA maybe an important cardiovascular biomarker in obese adolescents. Verificou-se que o perfil lipídico, insulina, HOMA-IR (resistência à insulina) e LDL(-) evidenciaram um maior risco cardiovascular nos adolescentes obesos. A atividade da enzima Lp-PLA 2 mostrou uma variação proporcional ao IMC, circunferência da cintura e porcentagem de gordura.

Impacto da proteína-C reativa no risco cardiovascular de adolescentes / Impact of C-reactive protein on cardiovascular risk in adolescents

FUNDAMENTO: Vários estudos sugerem que a proteína-C reativa (PCR) se correlaciona com doença arterial coronariana em adultos. Entretanto, essa associação ainda é pouco explorada em adolescentes. OBJETIVO: Avaliar a associação entre a PCR e os fatores de risco cardiovascular em adolescentes obesos. MÉTODOS: Oitenta e quatro adolescentes (12,6 ± 1,3 anos), ambos os sexos, foram distribuídos nos grupos Eutrófico (n = 28), Sobrepeso (n = 28) e Obeso (n = 28), segundo o índice de massa corpórea (IMC). A concentração de PCR (ELISA ultrassensível), o perfil lipídico e o conteúdo de anticorpos anti-LDLox (ELISA) foram determinados após jejum de 12h. RESULTADOS: Os grupos foram semelhantes quanto a idade (p = 0,13) e sexo (p = 0,83). Colesterol total, HDL-C, CT/HDL-C e LDL-C/HDL-C apresentaram diferenças significativas entre os grupos Eutrófico e Obeso. Não houve variação significativa no conteúdo de anticorpos anti-LDLox. Os valores de PCR foram diferentes entre os três grupos (p < 0,01). PCR apresentou associação significativa com IMC (β = 2,533), CB (β = 2,645) e CC (β = 2,945), CT (β = 0,006), LDL-C (β = 0,006) e anticorpos anti-LDLox (β = 0,383) e negativa entre HDL-C (β = -0,017). CONCLUSÃO: Os resultados indicam que a PCR se associa significativamente com marcadores de risco cardiovascular em adolescentes.

BACKGROUND: Several studies suggest that C-reactive protein (CRP) is associated with coronary artery disease in adults. However, this association has not been thoroughly explored in cases of adolescents. OBJECTIVE: To evaluate the association between CRP and cardiovascular risk factors in obese adolescents. METHODS: Eighty-four adolescents (12.6 ± 1.3 years) of both genders were divided into the following groups: Normal weight (n = 28), Overweight (n = 28), and Obese (n = 28), according to body mass index (BMI). CRP levels (ultrasensitive ELISA), the lipid profile, and anti-oxLDL antibody levels (ELISA) were determined after a 12-hour fast. RESULTS: The groups were similar in age (p = 0.13) and gender (p = 0.83). Total cholesterol, HDL-C, TC/HDL-C, and LDL-C/HDL-C showed significant differences between Normal weight and Obese groups. There was no significant variation in anti-oxLDL levels. CRP values were different among the three groups (p < 0.01). CRP levels showed a significant association with BMI (β = 2.533), AC (β = 2.645), WC (β = 2.945), TC (β = 0.006), LDL-C (β = 0.006), and anti-oxLDL antibodies (β = 0.383), and a negative association with HDL-C (β = -0.017). CONCLUSION: The results indicate that CRP is significantly associated with markers of cardiovascular risk in adolescents.

[Impact of C-reactive protein on cardiovascular risk in adolescents]. / Impacto da proteína-C reativa no risco cardiovascular de adolescentes.

BACKGROUND: Several studies suggest that C-reactive protein (CRP) is associated with coronary artery disease in adults. However, this association has not been thoroughly explored in cases of adolescents. OBJECTIVE: To evaluate the association between CRP and cardiovascular risk factors in obese adolescents. METHODS: Eighty-four adolescents (12.6 +/- 1.3 years) of both genders were divided into the following groups: Normal weight (n = 28), Overweight (n = 28), and Obese (n = 28), according to body mass index (BMI). CRP levels (ultrasensitive ELISA), the lipid profile, and anti-oxLDL antibody levels (ELISA) were determined after a 12-hour fast. RESULTS: The groups were similar in age (p = 0.13) and gender (p = 0.83). Total cholesterol, HDL-C, TC/HDL-C, and LDL-C/HDL-C showed significant differences between Normal weight and Obese groups. There was no significant variation in anti-oxLDL levels. CRP values were different among the three groups (p < 0.01). CRP levels showed a significant association with BMI (beta = 2.533), AC (beta = 2.645), WC (beta = 2.945), TC (beta = 0.006), LDL-C (beta = 0.006), and anti-oxLDL antibodies (beta = 0.383), and a negative association with HDL-C (beta = -0.017). CONCLUSION: The results indicate that CRP is significantly associated with markers of cardiovascular risk in adolescents.

Avaliação das condições microbiológicas de refeições de trabalhadores rurais do leste de Minas Gerais / Evaluation of the microbiological conditions of meals to rural workers in the east of Minas Gerais

Este trabalho avaliou a qualidade microbiológica de marmitas dos trabalhadores, conhecidos vulgarmente como bóias-frias. Das 30 amostras de marmitas analisadas, 15 (50 por cento) estavam em condições sanitárias insatisfatórias, por apresentarem nível de contaminação por Staphylococus aureus, Bacillus cereus, ou coliformes fecais acima do limite tolerável pela legislação vigente federal. Embora a contagem aeróbia mesófílica não seja considerada pela legislação brasileira, como um elemento de avaliação da qualidade microbiológica de refeições prontas ao consumo, 16 (53,33 por cento) das amostras apresentaram contagem acima de 105ufc/g. Medidas educativas com relação às boas práticas de manuseio de alimentos serão implementadas.

Qualidade microbiológica de águas minerais comercializadas em Ouro Preto, MG / Microbiological quality of mineral water commercialized in Ouro Preto, MG

Avaliou-se a qualidade microbiológica da água mineral comercializada em Ouro Preto (MG). Foi aplicado um plano de amostragem indicativa, que incluíam embalagens de 500ml, 1500ml e de 201. Coliformes totais, coliformes fecais, Pseudomonas aeruginosa, clostrídios redutores de sulfito, enterococos e a contagem padrão, foram os microrganismos analisados segundo a legislação pertinente. Do total de 50 amostras analisadas, 43 (86 por cento) apresentaram resultados microbiológicos satisfatórios. Sete amostras (14 por cento), não atenderam ao padrão vigente, devido à presença de Pseudomonas aeruginosa de 1,1 a maior que 23 (NMP/100ml). Entretanto, 25 (50 por cento) das amostras de água mineral apresentaram contagem padrão acima de 500ufc/ml, o qual é o limite tolerável para a água de abastecimento público. Comparativamente, quatro amostras de água potável tratada, foram analisadas para todos os microrganismos anteriormente relacionados. Os resultados microbiológicos encontrados foram mais satisfatórios do que os da água mineral.