Changes in weight status among "Ju/'hoansi" San hunter-gatherers between 1968/69 and 1987-The effects of nutritional transition, sex and age.

BACKGROUND: Changes in lifestyle and dietary habits that hunter-gatherer populations have undergone in recent decades have often led to rising obesity rates with disastrous consequences for their health. OBJECTIVES: The associations between dietary habits and weight status were studied in 238 "Ju/'hoansi" San (93 women and 145 men) aged between 18 and 65 years in northern Namibia in 1987. Weight status was estimated based on the World Health Organization body mass index (BMI) categories, and dietary habits were recorded using food recall methods. Anthropometrics and weight status were compared with those of a sex- and age-matched sample of "Ju/'hoansi" San people collected by Nancy Howell in 1968/69. RESULTS: Body weight had increased significantly among "Ju/'hoansi" San people from 1968/69 to 1987. The number of underweight people decreased from 1968/69 to 1987. In 1987, most participants (60.9%) were of normal weight. Overweight was found in 1.3% of the women, but not among men. No participants were obese. Less than 4% of the women and less than 2% of the men consumed exclusively traditional hunter-gatherer food. Westernized food products were significantly (p < 0.001) more common among men and younger people. Dietary patterns were significantly associated with weight status. The less traditional the diet, the higher the BMI (p < 0.001). CONCLUSION: The transition to domestic agricultural and westernized foods was positively associated with increasing BMI. Overweight, however, was still an extremely rare condition in this population in 1987.

Maternal low-protein diet alters hepatic lipid accumulation and gene expression related to glucose metabolism in young adult mouse offspring fed a postweaning high-fat diet.

Maternal consumption of low-protein (LP) diet during pregnancy has been demonstrated to increase the chances of adult offspring developing metabolic syndrome, and this risk can be exacerbated when the postnatal diets do not align with the prenatal conditions. However, in our previous study, focusing on serum parameters and gene expression patterns within adipose tissue, we discovered the presence of "healthy obesity" in young adult offspring from dams that were fed an LP, as a response to a postweaning high-fat (HF) diet. Here, we subsequently investigated the role played by the liver and skeletal muscle in alleviation of insulin resistance in male offspring that were fed either control (C/C group) or HF diet (C/HF and LP/HF groups) for 22 weeks. While a postweaning HF diet increased liver weight and hepatic triglyceride (TG) and cholesterol levels in offspring of control dams, these levels were lower in the LP/HF group compared to the C/HF group. Analysis of the liver transcriptome identified 430 differentially expressed genes (DEGs) in the LP/HF and C/HF comparison. Especially, downregulated DEGs were enriched in carbohydrate metabolism and the levels of DEGs were significantly correlated with the levels of markers for serum glucose homeostasis and hepatic lipid accumulation. In the LP/HF group compared to the C/HF group, there was a decrease in the gastrocnemius muscle weight, while no differences were observed in gene expression levels associated with muscle fiber phenotype, mitochondrial function, and inflammation. In conclusion, maternal LP diet induced changes in lipid and glucose metabolism within the liver, similar to what was observed in adipose tissue, while there were no alterations in metabolic functions in the skeletal muscle in young offspring mice fed an HF diet. Further research that investigating the enduring impact of nutritional transition on offspring is essential to gain a comprehensive grasp of developmental programming throughout their entire lifespan.

Sociodemographic determinants of eating patterns in two Latin American populations.

BACKGROUND: The present study aimed to describe the dietary patterns of a population from Brazil and another from Colombia with respect to understanding their determinants, similarities and differences. METHODS: An analytical cross-sectional study was conducted based on secondary data. The dietary patterns of the adult population of Pernambuco, Brazil, as well as those of the adult population of Antioquia, Colombia, were analysed using principal component analysis method with orthogonal varimax rotation, and a Poisson regression with robust variance was used to verify the association between eating patterns and socio-economic variables. RESULTS: In each population, three eating patterns were identified. One of them related to healthy eating, named "Prudent", was identified in the two populations analysed. In Pernambuco, a food pattern consisting exclusively of foods with some degree of processing was verified, entitled "Processed". The food culture was reflected in the pattern called "Traditional-Regional" in Pernambuco and the "Traditional" and "Regional" patterns in Antioquia. CONCLUSIONS: Income, education, age, family size, food security status and area of residence were presented as determinants of dietary patterns in both populations. Elements of the food transition were found, which seems to have happened more rapidly in Pernambuco. The food groups that make up the dietary patterns of each population are similar, but the foods that constitute them present differences due to their availability depending on aspects such as climate, soil quality, access to water, local culture and food tradition.

Risk, lifestyle and non-communicable diseases of poverty.

Common discourse in public health and preventive medicine frames non-communicable diseases, including cardiovascular and metabolic diseases, as diseases of 'lifestyle'; the choice of terminology implies that their prevention, control and management are amenable to individual action. In drawing attention to global increases in the incidence and prevalence of non-communicable disease, however, we increasingly observe that these are non-communicable diseases of poverty. In this article, we call for the reframing of discourse to emphasize the underlying social and commercial determinants of health, including poverty and the manipulation of food markets. We demonstrate this by analysing trends in disease, which indicate that diabetes- and cardiovascular-related DALYS and deaths are increasing particularly in countries categorized as low-middle to middle levels of development. In contrast, countries with very low levels of development contribute least to diabetes and document low levels of CVDs. Although this might suggest that NCDs track increased national wealth, the metrics obscure the ways in which the populations most affected by these diseases are among the poorest in many countries, and hence, disease incidence is a marker of poverty not wealth. We also illustrate variations in five countries - Mexico, Brazil, South Africa, India and Nigeria - by gender, and argue that these differences are associated with gender norms that vary by context rather than sex-specific biological pathways.We tie these trends to shifts in food consumption from whole foods to ultra-processed foods, under colonialism and with continued globalization. Industrialization and the manipulation of global food markets influence food choice in the context of limited household income, time, and household and community resources. Other factors that constitute risk factors for NCDs are likewise constrained by low household income and the poverty of the environment for people with low income, including the capacity of individuals in sedentary occupations to engage in physical activity. These contextual factors highlight extremely limited personal power over diet and exercise. In acknowledging the importance of poverty in shaping diet and activity, we argue the merit in using the term non-communicable diseases of poverty and the acronym NCDP. In doing so, we call for greater attention and interventions to address structural determinants of NCDs.

Framing poor diet quality as malnutrition: the Brazilian National Survey on Child Nutrition (ENANI-2019) / Enquadrando a má qualidade da dieta como má nutrição: Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019) / Caracterizar la mala calidad de la dieta como malnutrición: Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019)

Based on the Brazilian National Survey on Child Nutrition (ENANI-2019) results, this article reflects on the adequacy of the "malnutrition in all its forms" framework and system of classification for representing and interpreting these dietary transitions in Brazilian children. We highlight the limitations of this classification system, including the focus on health outcomes and anthropometric measures, the siloed understanding of these forms of malnutrition, the lack of relevance of the obesity category to children under 5 years old, and the failure to adequately address the various measures of poor quality diets captured by ENANI-2019. As an alternative, based on an approach developed by Gyorgy Scrinis to reframing malnutrition in all its forms, we suggest a need for frameworks that focus on describing and classifying the nature of, and changes to, dietary patterns, rather than focused on health outcomes.

Com base nos resultados do Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019), este artigo reflete sobre a adequação da estrutura e do sistema de classificação "má nutrição em todas as suas formas" para representar e interpretar essas transições alimentares em crianças brasileiras. Este estudo destaca as limitações desse sistema de classificação, incluindo o foco nos resultados de saúde e medidas antropométricas, o entendimento isolado dessas formas de má nutrição, a falta de relevância da categoria obesidade para crianças menores de 5 anos de idade e a incapacidade de abordar adequadamente as várias medidas de dietas de baixa qualidade identificadas pelo ENANI-2019. Como alternativa, com base em uma abordagem desenvolvida por Gyorgy Scrinis para reformular a abordagem da má nutrição em todas as suas formas, são necessárias estruturas que se concentrem em descrever e classificar a natureza e as mudanças nos padrões alimentares em vez de se concentrar nos resultados de saúde.

Con base en los resultados del Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019), este artículo reflexiona sobre la adecuación del marco y del sistema de clasificación de la "malnutrición en todas sus formas" para representar e interpretar estas transiciones dietéticas en los niños brasileños. Este estudio destaca las limitaciones de este sistema de clasificación, incluido el enfoque en los resultados de salud y las medidas antropométricas, la comprensión aislada de estas formas de malnutrición, la falta de relevancia de la categoría de obesidad para niños menores de 5 años y la incapacidad de abordar adecuadamente las diversas medidas de dietas de baja calidad identificadas por el ENANI-2019. Una alternativa sería, basándose en un enfoque desarrollado por Gyorgy Scrinis para reformular el enfoque de la malnutrición en todas sus formas, establecer estructuras que se centraran en describir y clasificar la naturaleza y los cambios en los patrones dietéticos en lugar de centrarse en los resultados de salud.

Food and Nutrition Public Policies in Brazil: From Malnutrition to Obesity.

"Nutrition transition" describes the shifts in dietary consumption and energy expenditure influenced by economic, demographic, and epidemiological changes at a population level. This phenomenon has been associated with rising obesity rates worldwide, especially in developed countries. In Brazil, the historical analysis of temporal trends between malnutrition and obesity characterized the nutrition transition in the country and interweaved it with the formulation and implementation of public food and nutrition policies. Such analysis is crucial for understanding certain principles in each context. Thus, this review contextualized the consolidation of obesity as a critical health and public policy issue in Brazil. Our review suggested that the country may still be at the initial stage of care for obesity, and more efforts are needed to contain the advance of the disease in Brazil.

Direct and Indirect Determinants of Body Mass Index in Both Major Ethnic Groups Experiencing the Nutritional Transition in Cameroon.

In the context of rapid nutritional transitions in Africa, few studies have analyzed the etiology of obesity by considering the driver pathways that predict body mass index (BMI). The aim of this study is to innovatively identify these driver pathways, including the main sociodemographic and socioecological drivers of BMI. We conducted a rural-urban quantitative study in Cameroon (n = 1106; balanced sex ratio) to explore this issue. We recruited participants and reported several sociodemographic characteristics (e.g., marital status, socioeconomic status (SES), and ethnicity). We then assessed three main socioecological drivers of BMI (body weight perception, dietary intake, and physical activity) and conducted bioanthropometric measurements. We identified several driver pathways predicting BMI. In Cameroon, Bamiléké ethnicity, higher SES, being married, and older age had positive effects on BMI through overweight valorization and/or dietary intake. Accordingly, we found that being Bamiléké, married, and middle-aged, as well as having a higher SES, were factors that constituted at-risk subgroups overexposed to drivers of obesity. As such, this study highlights the necessity of investigating the complex driver pathways that lead to obesity. Therefore, better identification of the subgroups at risk for obesity will help in developing more targeted population health policies in countries where this burden is a major public health issue.

Evaluating Dietary Patterns in Women from Southern Italy and Western Mexico.

Traditional diets are known to be beneficial; however, both Italian and Mexican populations are gradually moving away from the Mediterranean and traditional Mexican diets. Since women play a key role in safeguarding dietary traditions and may reflect population dietary changes, we aimed to identify Italian and Mexican women's current dietary patterns (DPs) and characterize their nutrient content. Cross-sectional analyses were separately conducted on two convenience samples of 811 women from Southern Italy and 215 women from Western Mexico. Food frequency questionnaires, 24 h recalls, and a principal component analysis (PCA) approach were used to derive a posteriori DPs. In Italian women, the first DP was characterized by the consumption of legumes, vegetables, and fish (8.8% of the total variance), while the second DP was characterized by snack foods, processed meats, and non-olive oils. In Mexican women, the first DP was characterized by the consumption of meats and processed foods (12.6% of the total variance), while the second DP by fruits, vegetables, and whole grains. In both populations, adhering to the DPs rich in healthy foods (i.e., fruits, vegetables, legumes, and fish) was associated with a higher quality of diet in terms on nutrient content. However, adherence to the Western-type DPs was more common among women of younger age (p < 0.035). Thus, more extraordinary efforts are needed in promoting each country's traditional healthy diet, especially among the new generations.

Food, energy, and nutrient supply in Mexican households from 1984 to 2018 / Disponibilidad de alimentos, energía y nutrientes en hogares mexicanos de 1984 a 2018

Introduction: information about changes in food and energy supply, macronutrient and micronutrient availability by processing level is required to understand the nutritional transition in Mexican society. Objective: to describe the food, energy, and nutrient supply in Mexican households from 1984 to 2018. Methods: five waves of a Mexican cross-sectional survey were analyzed to identify changes in food, energy, and nutrient supplies in households. Food groups were created using the NOVA classification. The content of energy and nutrients was estimated using Mexican and U.S. databases. The education and income interaction with energy and nutritional supply was analyzed. Results: in this period, the supply of fresh and processed fruits and vegetables, processed meat and dairy, fish and seafood, prepared food, and ultra-processed food and drinks increased, whereas unprocessed or minimally processed (UMP) cereals and tubers, legumes, meat, dairy, eggs, and all processed culinary ingredients decreased. These changes have implied a higher supply of protein, total fat, cholesterol, vitamins A and C, calcium and sodium. Total energy, energy density, carbohydrates, and magnesium and potassium density decreased. Across waves, UMP and processed cereals were the main supply for energy, carbohydrates, fiber, iron and potassium. Dairy was the main supply of saturated fat. UMP and processed cereals were the main source of sodium in 1984, whereas ultra-processed cereals were the main source of sodium in 2018. Conclusions: although UMP foods remain the main group in most Mexican households, their supply has decreased over the years, whereas the supply of ultra-processed foods has increased (AU)

Introducción: se requiere información sobre los cambios de la disponibilidad de alimentos, energía y nutrientes, por nivel de procesamiento, para entender la transición nutricional en México. Objetivo: describir la disponibilidad de alimentos, energía y nutrientes en los hogares mexicanos de 1984 a 2018. Métodos: se crearon grupos usando la clasificación NOVA. El contenido de energía y nutrientes se estimó usando bases de datos mexicanas y estadounidenses. Se analizó la interacción de la educación y el ingreso con la disponibilidad de energía y nutrientes. Resultados: en este periodo aumentó la disponibilidad de verduras naturales y procesadas, carnes y lácteos procesados, pescados y mariscos, comida preparada y comida y bebida ultraprocesada, mientras que los cereales sin procesar o mínimamente procesados (SPMP), las leguminosas, las carnes, los lácteos, los huevos y los ingredientes culinarios procesados disminuyeron. Estos cambios implican una mayor disponibilidad de proteína, grasa total, colesterol, vitamina A y C, calcio y sodio. La energía total, la densidad energética, los carbohidratos y la densidad de magnesio y potasio disminuyeron. A lo largo el tiempo, los cereales SPMP y procesados fueron la principal fuente de energía, carbohidratos, fibra, hierro y potasio. Los lácteos fueron la principal fuente de grasas saturadas. Los cereales SPMP y procesados fueron la principal fuente de sodio en 1984, mientras que los cereales ultraprocesados lo fueron en el 2018. Conclusiones: aunque los alimentos SPMP siguen siendo el grupo más disponible en los hogares, su disponibilidad ha disminuido a lo largo de los años, mientras que la de los ultraprocesados ha aumentado (AU)

Examination of students' willingness to change behaviour regarding meat consumption.

The aim of this study was to assess the behaviour of Swiss students regarding meat consumption by analysing their current consumption habits, attitudes and knowledge, acceptance of meat alternatives and willingness to reduce meat intake. Data were collected through an online survey conducted in universities and universities of applied sciences among German- and French-speaking students in Switzerland (n = 498). By segmenting the student population using an adapted transtheoretical model of change, four distinct clusters were identified: passive (14.7%), curious (6%), awoken (44.7%) and active consumers (34.6%). The results provide a deeper insight into Swiss students' dietary patterns, attitudes and knowledge concerning the impact of meat consumption as along with concrete practical interventions to target the different clusters and initiate and promote behaviour change regarding meat consumption. The ideal recommendations depend on the current stage of behaviour change. However, to reduce meat consumption, policy makers need to set specific, quantifiable goals within defined time frames while involving a variety of stakeholders.

Undernutrition and obesity trends in Brazilian adults from 1975 to 2019 and its associated factors / Tendências de subnutrição e obesidade em adultos brasileiros entre 1975 e 2019 e fatores associados / Tendencias de desnutrición y obesidad en adultos brasileños desde 1975 a 2019 y sus factores asociados

Nutritional status has evolved in a dual trend worldwide: underweight has become a minor or local issue while overweight or obesity has risen to play a major role in the global burden of disease. In 2014, Brazil was ranked as the third country with the highest absolute number of obese men. Our aim was to estimate trends of underweight and obesity among Brazilian adults using a comprehensive set of surveys from 1974 to 2019. The data used in the study originate from subjects aged ≥ 18 in six Brazilian national surveys, presented in chronological order: Brazilian National Survey on Household Expenses (ENDEF 1974-1975); Brazilian National Survey on Health and Nutrition (PNSN 1989); Brazilian Household Budget Survey (POF 2002-2003, 2008-2009); and Brazilian National Health Survey (PNS 2013 and 2019). All six surveys were designed to sample household complexes that were representative of the Brazilian population. Body mass index was calculated (kg/m2). The nutritional status of individuals was classified following the standards. We have modeled obesity trend according to income and education strata. The trajectories of underweight and obesity over time in Brazil draw the classical "X" of nutrition transition. From 1975 to 2019 underweight has decreased from 9.1% to 2.5% among men and 12.2% to 3.4% among women. On the other hand, obesity trajectories have scaled up from 3% to 22% among men and from 9% to 30% among women. The increase in obesity rate is directly and negatively proportional to income quintiles. Sociodemographic (income and education) improvement is associated with an increase in obesity. All public policies intending to stop the obesity spread in Brazil have been ineffective or too small to be effective.

O estado nutricional tem evoluído em duas direções no mundo: o baixo peso se tornou uma questão menor ou local, enquanto o sobrepeso ou obesidade passou a ter papel preponderante na carga global de doença. Em 2014, o Brasil ocupou terceiro lugar no mundo em número absoluto de homens obesos. O estudo teve como objetivo estimar as tendências nas taxas de baixo peso e obesidade entre adultos brasileiros, tendo como base um conjunto abrangente de inquéritos entre 1974 e 2019. Os dados utilizados no estudo se referem a indivíduos com 18 anos ou mais em seis pesquisas nacionais, apresentadas em ordem cronológica: Estudo Nacional de Despesa Familiar (ENDEF 1974-1975); Pesquisa Nacional sobre Saúde e Nutrição (PNSN 1989); Pesquisa de Orçamentos Familiares (POF 2002-2003, 2008-2009) e Pesquisa Nacional de Saúde (PNS 2013 e 2019). Todos os 6 inquéritos foram desenhados para obter amostras de complexos de domicílios que fossem representativas da população brasileira. O ídice de massa corporal foi calculado (kg/m2). O estado nutricional dos indivíduos foi classificado de acordo com as normas da Organização Mundial da Saúde. Modelamos a tendência da obesidade de acordo com as faixas de renda e escolaridade. As trajetórias de baixo peso e obesidade no Brasil ao longo do tempo mostram a forma clássica em "X" da transição nutricional. Entre 1975 e 2019, a taxa de baixo peso diminuiu de 9,1% para 2,5% entre homens e de 12,2% para 3,4% entre mulheres. Inversamente, as trajetórias da obesidade aumentaram de 3% para 22% entre homens e de 9% para 30% entre mulheres. O incremento na obesidade está relacionado diretamente e de maneira negativamente proporcional aos quintis de renda. A melhoria sociodemográfica (de renda e escolaridade) está associada ao aumento da obesidade. Todas as políticas públicas para interromper a expansão da obesidade no Brasil têm sido ineficazes, ou pequenas demais para ser eficazes.

El estatus nutricional ha evolucionado en una doble tendencia alrededor del mundo: el bajo peso se ha convertido en un problema menor o local, mientras que el sobrepeso o la obesidad ha aumentado desempeñando un papel importante en la carga global de la enfermedad. En 2014, Brasil se situó como el tercer país con la mayor carga absoluta de hombres obesos. Nuestro objetivo fue estimar las tendencias de bajo peso y obesidad entre brasileños adultos, utilizando un conjunto completo de encuestas desde 1974 a 2019. Los datos usados en el estudio procedieron de individuos con ≥18 años en 6 encuestas nacionales brasileñas, presentadas en orden cronológico: Estudio Nacional sobre Gasto Familiar (ENDEF 1974-1975); Encuesta Nacional de Salud y Nutrición (PNSN 1989); Encuestas sobre Presupuesto Familiar (POF 2002-2003, 2008-2009); y Encuesta Nacional de Salud (PNS 2013 y 2019). Las 6 encuestas se diseñaron para las muestras complejas de hogares que eran representativas de la población brasileña. Se calculó el indice de masa corporal (kg/m2). El estatus nutricional de los individuos se clasificó siguiendo los estándares de la Organización Mundial de la Salud. Hemos modelado la tendencia a la obesidad según el nivel de ingresos y educación. Las trayectorias de bajo peso y obesidad a lo largo del tiempo en Brasil dibujaron la clásica "X" de transición nutricional. Desde 1975 a 2019, ha decrecido el bajo peso de 9,1% a 2,5% entre hombres y de 12,2% a 3,4% entre mujeres. Las trayectorias de obesidad, en cambio, escalan desde el 3% al 22% entre hombres, y desde el 9% al 30% entre mujeres. El incremento en la tasa de obesidad es directamente y negativamente proporcional a los quintiles de ingresos. La mejora sociodemográfica (ingresos y educación) está asociada con un incremento en la obesidad. Todas las políticas públicas puestas en práctica para intentar detener la propagación de la obesidad en Brasil han sido inefectivas o demasiado pequeñas para ser efectivas.

Development and validation of a food frequency questionnaire for children aged 7 to 10 years / Desenvolvimento e validação de um questionário de frequência alimentar para crianças de 7 a 10 anos de idade

ABSTRACT Objective Food and nutritional evaluation of children can support public policies to combat early overweight and obesity. This study developed and validated a quantitative food frequency questionnaire for assessing the dietary intake of children. Methods This is a cross-sectional study of the development of a food frequency questionnaire for 130 children of both genders aged 7 to 10 years old. For the food frequency questionnaire list, 81 food items were selected. The validity of the food frequency questionnaire was evaluated by comparison with 24-hour recalls and reproducibility was performed by comparing two food frequency questionnaires. Results Most of the foods with 95% relative contribution were ultra-processed, such as packaged snacks and powdered juice. In validation, correlation coefficients were found between 0.45 (p<0.000) for lipids and 0.37 (p<0.000) for carbohydrates. An adjustment for energy reduced the correlations, but there was an increase in the correlation in calcium (r=0.75) and retinol (r=0.20). In terms of reproducibility, all macronutrients and calcium showed a satisfactory intraclass correlation coefficient (>0.400) and moderate correlations [proteins (0.54; p<0.000) and lipids (0.41; p<0.000)]. Conclusion The food frequency questionnaire developed was valid and able to assess the local food consumption by children from northeastern Brazil.

RESUMO Objetivo A avaliação alimentar e nutricional de crianças pode subsidiar políticas públicas de combate ao sobrepeso e à obesidade precoce. Este estudo desenvolveu e validou um questionário quantitativo de frequência alimentar para avaliação do consumo alimentar de crianças de 7 a 10 anos. Métodos Trata-se de um estudo transversal do desenvolvimento de um questionário de frequência alimentar que avaliou 130 crianças de ambos os sexos com idades entre 7 e 10 anos. Para a lista do questionário, foram selecionados 81 itens alimentares. A validade do instrumento foi avaliada por meio da comparação com recordatórios de 24 horas e a reprodutibilidade foi realizada pela comparação de dois questionários de frequência alimentar. Resultados A maioria dos alimentos com 95% de contribuição relativa foi ultraprocessada, como salgadinhos embalados e suco em pó. Na validação, foram encontrados coeficientes de correlação entre 0,45 (p<0,000) para lipídios e 0,37 (p<0,000) para carboidratos. Um ajuste para energia reduziu as correlações, mas houve um aumento na correlação de cálcio (r=0,75) e retinol (r=0,20). Em termos de reprodutibilidade, todos os macronutrientes e o cálcio apresentaram coeficiente de correlação intraclasse satisfatório (>0,400) e correlações moderadas [proteínas (0,54; p<0,000) e lipídios (0,41; p<0,000)]. Conclusão O questionário de frequência alimentar desenvolvido é válido e foi capaz de avaliar o consumo alimentar local de crianças do Nordeste do Brasil.

Biological Well-Being and Inequality in Canary Islands: Lanzarote (Cohorts 1886-1982).

Developments in anthropometric history in the Iberian Peninsula have been remarkable in recent decades. In contrast, we barely know about the behavior of insular population groups and infants' and adults' growth during the nutritional transition in the Canary Islands. This paper analyzes the height, weight and body mass index of military recruits (conscripts) in a rural municipality from the eastern Canaries during the economic modernization process throughout the 20th century. The case study (municipality of San Bartolomé (SB) in Lanzarote, the island closest to the African continent) uses anthropometric data of military recruits from 1907-2001 (cohorts from 1886 to 1982). The final sample is composed of 1921 recruits' records that were measured and weighed at the ages of 19-21 years old when adolescent growth had finished. The long-term anthropometric study is carried out using two approaches: a malnutrition and growth retardation approach and an inequality perspective. In the first one, we use the methodology recommended by the World Health Organization (WHO) that is based on z-scores. In the second one, we implement several inequality dimensions such as the coefficient of variation (CV), percentiles and an analysis for height and BMI evolution by five socioeconomic categories. The data suggest that improvements in biological well-being were due to advances in nutrition since the 1960s. They show that infant nutrition is sensitively associated with economic growth and demographic and epidemiological changes.

Associação entre anos escolares, medidas antropométricas e pressóricas: o trabalho da enfermagem / Relationship between school years and anthropometric and blood pressure measures: Nursing work

RESUMO Objetivo: O objetivo do estudo foi verificar a associação entre os anos escolares e parâmetros antropométricos e pressóricos. Metodologia: Estudo transversal e analítico, realizado em março de 2017, em escola pública brasileira com 97 alunos, por meio da coleta de dados com formulários de caracterização sociodemográfica, além da avaliação antropométrica e pressórica. Foram incluídos na pesquisa estudantes regularmente matriculados (6° ao 9° ano), de ambos os sexos. Analisaram-se os dados mediante medidas descritivas, teste exato de Fisher e ANOVA. Resultados: Verificou-se o predomínio de alunos do sexo feminino (54,6%), matriculados no 8° ano (31,5%) e com idade média de 12,91 anos ± 1,35 anos. Ademais, foi detectado que 45,8% dos estudantes foram enquadrados fora do padrão da normalidade para o peso. Essa variável também se associou (p=0,03) ao ano em curso dos estudantes e a altura apresentou diferença significativa ao longo dos anos. Na comparação de médias, não houve diferença entre peso, índice de massa corporal e pressão arterial sistêmica. Conclusão: A disparidade nutricional de crianças e adolescentes desnutridas ou com excesso de peso pode ocasionar riscos à saúde com consequências na fase adulta. Parte desse fenômeno se deve à transição nutricional. Há uma demanda por estratégias mais efetivas na redução da vulnerabilidade nutricional em conjunto dos atuais programas públicos de saúde na escola. A enfermagem assume papel importante nas ações estratégicas de promoção e prevenção à saúde em ambiente escolar, para o desenvolvimento e crescimento saudável de crianças e adolescentes.

RESUMEN Objetivo: El objetivo del estudio fue verificar la asociación entre años escolares, parámetros antropométricos y de presión arterial. Metodología: Estudio transversal y analítico, realizado en marzo de 2017, en una escuela pública brasileña con 97 estudiantes, mediante recolección de datos con formularios de caracterización sociodemográfica, de evaluación antropométrica y presión arterial. En la investigación, se incluyeron personas estudiantes matriculadas regularmente (6º a 9º grado) de ambos sexos. Los datos se analizaron mediante medidas descriptivas, prueba exacta de Fisher y ANOVA. Resultados: Predominan las alumnas (54,6 %), matriculadas en 8º grado (31,5 %) y con una edad media de 12,91 años ± 1,35 años. Además, se detectó que el 45,8 % de las personas estudiantes se clasificaron fuera del rango normal de peso. Esta variable también se asoció (p = 0.03) con el año escolar actual de los estudiantes y la altura, con la cual mostró una diferencia significativa a lo largo de los años. Al comparar las medias, no hubo diferencia entre el peso, el índice de masa corporal y la presión arterial sistémica. Conclusión: La disparidad nutricional de niñas, niños y adolescentes con desnutrición o sobrepeso puede plantear riesgos para la salud con consecuencias en la edad adulta. Parte de este fenómeno se debe a la transición nutricional. Existe una demanda de estrategias más efectivas para reducir la vulnerabilidad nutricional junto con los programas actuales de salud de las escuelas públicas. La enfermería juega un papel importante en las acciones estratégicas para promover y prevenir la salud en el ámbito escolar, para el desarrollo y crecimiento saludable de las personas durante su niñez y adolescencia.

ABSTRACT Aim: The aim of this study was to verify the relationship between school years and anthropometric and blood pressure parameters. Methods: Thisis a cross-sectional and analytical study carried out during March 2017 in a Brazilian public school with 97 students. The data were collected with sociodemographic characterization and anthropometric and blood pressure assessment forms. Regularly enrolled students (6th to 9th grade) of both sexes were included in the research. Data were analyzed using descriptive measures, Fisher's exact test, and ANOVA tests. Results: Most of the students were female (54.6%), enrolled in the 8th grade (31.5%), and with a mean age of 12.91 years ± 1.35 years. Furthermore, the researchers detected that 45.8% of the students were outside the normal range for weight. This variable was also associated (p=0.03) with the students' current year and the height, with which it showed a significant difference over the years. When comparing the average measurements, the researchers noted no difference between weight, body mass index, and systemic blood pressure. Conclusion: The nutritional disparity of malnourished or overweight children and adolescents can pose health risks with consequences in adulthood. Part of this phenomenon is due to nutritional transition. There is a demand for more effective strategies to reduce nutritional vulnerability in conjunction with the current public school health programs. Nursing plays an important role in the strategic actions to promote health in the school environment for the development and healthy growth of children and adolescents.

Children's Diet during the Early Stages of the Nutritional Transition. The Foundlings in the Hospital of Valencia (Spain), 1852-1931.

The nutritional transition brought about profound changes in the nutrition of the European population in the 19th and 20th centuries. The predominant consumption of cereals gave way to kilocalorie-, protein-, vitamin- and mineral-rich diets that involved a greater intake of animal products. However, not all population groups underwent this transition at the same pace; socio-economic conditions, sex and age led to important inequalities. This article uses institutional sources to analyse the nutrition of children during the early stages of the nutritional transition and to compare it with that of other age groups (adult psychiatric patients). The study examines the average diets and nutritional balance of foundlings in the Hospital General de Valencia from 1852 to 1931. The main conclusion of the study is that, throughout the period under study, foundlings were exposed to a poor, traditional diet, characterized by structural deficits and imbalances. This may have affected their physical growth, health and biological wellbeing in adulthood, and demonstrates that the nutritional transition was anything but a homogeneous process.

Consumption of Ultra-Processed Foods in Brazilian Children: An Analysis of Regional Trends.

PURPOSE: Childhood obesity has become a concern for the Brazilian Unified Health System, which has recently started to investigate children's eating habits in basic health units. This study examined the trends and ultra-processed foods (UPF) consumption in Brazilian children. DESIGN AND METHODS: This repeated cross-sectional study included 492,630 children (2-9 years old), from different Brazilian regions, in the years 2015 and 2019. The children's food consumption was assessed by nurses using a nationally standardized instrument. Information was provided by the Food and Nutrition Surveillance System Brazilian. RESULTS: The UPF consumption in Brazilian children is generally high and was higher among children in the South and Midwest regions. The consumption of sweetened beverages was more prevalent among all the UPF assessed and continues to increase among children in the Northeast region. Declining trends in UPF consumption were observed in children from all regions, except for the Northeast region, whose trends increased in almost all evaluated foods. PRACTICE IMPLICATIONS: Nurses, especially, have a primary role in guiding the reduction of UPF consumption, as they are the first health professionals to have access to this information. Increasing trends in UPF consumption can be mitigated by the inclusion of nutritionists in basic health units. Brazilian children need to be assisted by public policies that promote food education.

Analysis of the nutritional status of adolescents in the state of Pará, Brazil / Análisis del estado nutricional de adolescentes en el estado de Pará, Brasil

Objective: to analyze the nutritional status of adolescents in the state of Pará, Brazil, in order to observe the trends in the Height x Age and BMI x Age indexes. Material and Methods: it was a quantitative, retrospective, and cross-sectional study from 2010 to 2019. The female and male sex were evaluated in each nutritional status index "Height x Age" and "BMI x Age". The collected data were organized in Microsoft Excel 2010 software and statistics was performed in the Action Stat 3.7 program. The ethics and investigation committee's assessment was not necessary. Results: in "Height x Age", a total of 132,114 adolescents, age ≥ 10 and < 20 years, were registered and the female gender prevailed (65.8%), normality in the distribution of data was observed and no difference was noted in this category. In the "BMI x Age", 132,204 were reported, a normal distribution was found, but there was a statistical difference between sexes in the categories: "overweight", "obesity", "severe obesity" and "eutrophy", which represented the largest percentage (73.4%). Conclusion: the population is mostly female, and the distribution of records is heterogeneous. Both sexes were shown to be of adequate height for their age and eutrophic. However, it was noticed the nutritional scenario is changing, which may lead, in the future, to public health problems, such as the increase in the number of patients with chronic non-communicable diseases..(AU)

Objetivo: analizar el estado nutricional de los adolescentes en el estado de Pará, Brasil, con el fin de observar las tendencias en los índices Talla x Edad e IMC x Edad. Material y Métodos: fue un estudio cuantitativo, retrospectivo y transversal de 2010 a 2019. Se evaluó el sexo femenino y masculino en cada índice de estado nutricional "Altura x Edad" e "IMC x Edad". Los datos recopilados se organizaron en el software Microsoft Excel 2010 y las estadísticas se realizaron en el programa Action Stat 3.7. No fue necesaria la evaluación del comité de ética e investigación. Resultados: en "Talla x Edad" se registró un total de 132.114 adolescentes, edad ≥ 10 y <20 años y predominó el género femenino (65,8%), se observó normalidad en la distribución de los datos y no se notó diferencia en esta categoría. En el "IMC x Edad" se reportaron 132.204, se encontró una distribución normal, pero hubo diferencia estadística entre los sexos en las categorías: "sobrepeso", "obesidad", "obesidad severa" y "eutrofia", que representaron el mayor porcentaje (73,4%). Conclusión: la población es mayoritariamente femenina y la distribución de registros es heterogénea. Se demostró que ambos sexos tenían una estatura adecuada para su edad y eran eutróficos. Sin embargo, se advirtió que el escenario nutricional está cambiando, lo que puede generar, en el futuro, problemas de salud pública, como el aumento del número de pacientes con enfermedades crónicas no transmisibles..(AU)

Modified Mediterranean diet score adapted to a southern Mediterranean population and its relation to overweight and obesity risk.

OBJECTIVES: The current study aimed to develop a modified Mediterranean diet (MMD) score adjusted to the southern Mediterranean countries' cultural specificities and to evaluate associations between adherence to this modified score and overweight/obesity risk in Moroccan adults. DESIGN: Population-based cross-sectional study. SETTING: Rural and urban areas of the five greatest provinces of Morocco. PARTICIPANTS: In total, 1516 participants were recruited between September 2009 and February 2017. Dietary assessment was obtained using a validated Moroccan FFQ. We constructed a MMD score focusing on twelve components. The MMD score ranged from 0 (no adherence to the traditional southern Mediterranean diet (MD)) to 12 (maximal adherence) and was categorised as low (scores 0-4), moderate (scores 5-7) and high (scores 8-12). RESULTS: Among the whole population, 754 (50·5 %) were women and 738 (49·5 %) were men, and the mean age was about 55·60 ± 13·70. In total, 58 % of participants were moderately active. Regarding educational level, 50·7 % were illiterate. The prevalence of overweight and obesity was 43·3 and 8·6 %, respectively. In multivariate analyses, close adherence to MMD (scores 8-12) was associated with reduced overweight/obesity risk (OR 0·61, 95 % CI 0·44, 0·84). CONCLUSION: The prevalence of overweight and obesity was very high among Moroccan adults. Adherence to the traditional southern MD may help prevent overweight and obesity.

Perfiles de transición epidemiológica-nutricional y carga de morbi-mortalidad por COVID-19 en Argentina: un estudio ecológico / Profiles of epidemiological-nutritional transition and burden of morbimortality from COVID-19 in Argentina: an ecological study / Perfis de transição epidemiológica-nutricional e carga de morbimortalidade por COVID-19 na Argentina: um estudo ecológico

Resumen: El objetivo de este trabajo fue identificar perfiles epidemiológico-nutricionales en Argentina, y comparar su carga de morbi-mortalidad por COVID-19. Se condujo un estudio ecológico multigrupal (24 unidades geográficas de Argentina). Se estimó el porcentaje de cambio 2005-2018 de indicadores de transición epidemiológica-nutricional, y sociodemográficos por unidad geográfica. Se condujo un análisis de componentes principales y análisis de clúster jerárquico para identificar agrupamientos geográficos que definan perfiles de transición epidemiológica-nutricional. Por grupo, se calcularon medidas resumen de incidencia acumulada (IA), mortalidad y tasa de letalidad por COVID-19 (semana epidemiológica 50), estableciendo comparaciones mediante prueba t de Student. Se identificaron tres perfiles denominados: (1) reemergencia de enfermedades infecciosas, (2) persistencia de enfermedades cardiovasculares con mejoras sociosanitarias y en estilos de vida, y (3) consolidación de la tríada obesidad-sedentarismo-enfermedades cardiometabólicas. La IA y mortalidad por COVID-19 promedio fue mayor en provincias con perfil 1, en comparación con el perfil 2 (IA: p = 0,0159; mortalidad: p = 0,0187) y el perfil 3 (IA: p = 0,0205). La letalidad resultó mayor en el perfil 3, que aglomera provincias con situación socioeconómica más desfavorable, estimándose diferencias significativas respecto al perfil 2 (p = 0,0307). En conclusión, existen distintos perfiles epidemiológico-nutricionales en Argentina, que tienden a diferenciarse en su situación epidemiológica de COVID-19. Las estrategias contra COVID-19 deberían considerar las características epidemiológico-nutricionales y sociodemográficas de base.

Abstract: The study aimed to identify epidemiological-nutritional profiles in Argentina and to compare the burden of morbimortality from COVID-19. A multigroup ecological study was conducted with 24 geographic units in Argentina. We estimated the percent change from 2005 to 2018 in indicators of the epidemiological-nutritional transition and sociodemographic indicators according to geographic unit. We performed principal components analysis and hierarchical cluster analysis to identify geographic groupings to define profiles in the epidemiological-nutritional transition. By group, we calculated summary measures of COVID-19 cumulative incidence (CI), mortality, and case fatality (epidemiological week 50), establishing comparisons via Student's t test. Three profiles were identified: (1) reemergence of infectious diseases, (2) persistence of cardiovascular diseases despite social, health, and lifestyle improvements, and (3) consolidation of the triad obesity-sedentarism-cardiometabolic diseases. Mean COVID-19 cumulative incidence and mortality were higher in provinces with profile 1 compared to profile 2 (CI: p = 0.0159; mortality: p = 0.0187) and profile 3 (CI: p = 0.0205). Case-fatality was higher in profile 3, which includes provinces with more unfavorable socioeconomic conditions, showing significant differences from profile 2 (p=0.0307). In conclusion, there are distinct epidemiological-nutritional profiles in Argentina which tend to differ in terms of their COVID-19 epidemiological situation. Strategies to fight COVID-19 should consider the underlying epidemiological, nutritional, and sociodemographic characteristics.

Resumo: O objetivo deste trabalho era identificar perfis epidemiológico-nutricionais na Argentina, e comparar a sua carga de morbimortalidade por COVID-19. Foi desenvolvido um estudo ecológico multigrupal (24 unidades geográficas da Argentina). Foi avaliado o percentual de mudança 2005-2018 de indicadores de transição epidemiológica-nutricional, e sociodemográficos, por unidade geográfica. Foi feita uma análise de componentes principais e de cluster hierárquico para identificar agrupamentos geográficos, definindo perfis de transição epidemiológica-nutricional. Por grupo, foram calculadas medidas de resumo de incidência acumulada (IA), mortalidade e taxa de letalidade por COVID-19 (semana epidemiológica 50), estabelecendo comparações mediante teste t de Student. Foram identificados três perfis: (1) reemergência de doenças infecciosas, (2) persistência de doenças cardiovasculares com melhorias sociossanitárias e nos estilos de vida, e (3) consolidação da tríade obesidade-sedentarismo-doenças cardiometabólicas. A IA e a mortalidade média por COVID-19 foi maior nas províncias com perfil 1, comparado com o perfil 2 (IA: p = 0,0159; mortalidade: p = 0,0187) e o perfil 3 (IA: p = 0,0205). A letalidade resultou maior no perfil 3, que abrange províncias com situação socioeconômica mais desfavorável, sendo encontradas diferenças significativas com relação ao perfil 2 (p = 0,0307). Em conclusão, existem distintos perfis epidemiológico-nutricionais na Argentina, que tendem a diferenciar-se na sua situação epidemiológica de COVID-19. As estratégias contra a COVID-19 deveriam considerar as características epidemiológico-nutricionais e sociodemográficas de base.