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1.
BMC Public Health ; 20(1): 1240, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795294

RESUMO

BACKGROUND: Lifestyles habits such as eating unhealthy foodscommence at home and are associated with the development of obesity and comorbidities such as insulin resistance, metabolic syndrome, and chronic degenerative diseases, which are the main causes of death in adults. The present study compared changes in dietary habits, behaviors and metabolic profiles of obese children whose mothers attended at the hospital to group sessions, with those who received the usual nutritional consultation. METHODS: Randomized clinical trial, 177 mother/obese child pairs participated, 90 in the intervention group and 87 in the control group. The intervention group attended six group education sessions to promote healthy eating, being this an alternative of change of habits in children with obesity. The control group received the usual nutritional consultation; both groups were followed up for 3 months. Frequency of food consumption, behaviors during feeding in the house and metabolic profile was evaluated. Mixed effect linear regression models were used to evaluate the effect of the intervention on the variables of interest, especially in HOMA-IR. RESULTS: The intervention group reduced the filling of their dishes (p = 0.009), forcing the children to finish meals (p = 0.003) and food substitution (p <  0.001), moreover increased the consumption of roasted foods (p = 0.046), fruits (p = 0.002) and vegetables (p <  0.001). The children in the control group slightly increased HOMA-IR levels (0.51; 95% CI - 0.48 to 1.50), while the children in the intervention group significantly decreased (- 1.22; 95% CI - 2.28 to - 1.16). The difference in HOMA-IR between the control and intervention group at the end of the follow-up was - 1.67; 95% CI: - 3.11 to - 0.24. CONCLUSIONS: The educational intervention improved some eating habits at home, as well as HOMA-IR levels; why we consider that it can be an extra resource in the management of childhood obesity. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04374292 (Date assigned: May 5, 2020). Retrospectively registered.


Assuntos
Dieta Saudável , Comportamento Alimentar/psicologia , Educação em Saúde , Síndrome Metabólica/prevenção & controle , Mães/educação , Obesidade Pediátrica/prevenção & controle , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Obesidade Pediátrica/epidemiologia , Avaliação de Programas e Projetos de Saúde
3.
Rev Bras Epidemiol ; 23: e200066, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32667466

RESUMO

OBJECTIVES: To describe the occurrence of simultaneous risk factors for chronic noncommunicable diseases, and factors associated with these prevalences in rural adults of a Southern Brazilian city. METHODS: The design of this study was cross-sectional with a sample of 1,445 adults from the rural area of Pelotas, RS. Four risk factors were considered: smoking, alcohol consumption, physical inactivity and inadequate consumption of vegetables. To verify the simultaneous occurrence of the outcomes, a cluster analysis was used. The association was tested by ordinal regression resulting in odds ratios. RESULTS: Among the four risk factors evaluated, three were the most prevalent among men, and only physical inactivity was greater among women. In the cluster analysis, only the combination of alcohol consumption + smoking + inadequate vegetable consumption presented an observed prevalence that was significantly higher than the expected (O/E = 2.67, 95%CI 1.30, 5.48), and higher than another study in the south of the country. This can be justified because that study included an evaluation of urban dwellers and the consumption of fruits. After adjustment, men, single individuals, non-white people, those with less schooling, those with a worse socioeconomic status, those who reported poor perception of health, and those who do not work in specifically rural activities had a greater probability of having the simultaneity of risk factors. CONCLUSION: The results show the importance of developing priority actions regarding the health of rural populations with special attention to the subgroups with an identified higher risk.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Doenças não Transmissíveis/epidemiologia , População Rural , Comportamento Sedentário , Fumar/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Brasil/epidemiologia , Análise por Conglomerados , Estudos Transversais , Dieta Saudável , Feminino , Humanos , Masculino , Doenças não Transmissíveis/etnologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Verduras
5.
BMJ ; 370: m2206, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641435

RESUMO

OBJECTIVE: To examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes. DESIGN: Prospective cohort studies. SETTING: Nurses' Health Study (1984-2014), Nurses' Health Study II (1991-2017), and Health Professionals Follow-Up Study (1986-2016), United States. PARTICIPANTS: 158 259 women and 36 525 men who did not have type 2 diabetes, cardiovascular disease, or cancer at baseline. MAIN OUTCOME MEASURES: Self-reports of incident type 2 diabetes by participants identified through follow-up questionnaires and confirmed by a validated supplementary questionnaire. RESULTS: During 4 618 796 person years of follow-up, 18 629 participants with type 2 diabetes were identified. Total whole grain consumption was categorized into five equal groups of servings a day for the three cohorts. After adjusting for lifestyle and dietary risk factors for diabetes, participants in the highest category for total whole grain consumption had a 29% (95% confidence interval 26% to 33%) lower rate of type 2 diabetes compared with those in the lowest category. For individual whole grain foods, pooled hazard ratios (95% confidence intervals) for type 2 diabetes in participants consuming one or more servings a day compared with those consuming less than one serving a month were 0.81 (0.77 to 0.86) for whole grain cold breakfast cereal, 0.79 (0.75 to 0.83) for dark bread, and 1.08 (1.00 to 1.17) for popcorn. For other individual whole grains with lower average intake levels, comparing consumption of two or more servings a week with less than one serving a month, the pooled hazard ratios (95% confidence intervals) were 0.79 (0.75 to 0.83) for oatmeal, 0.88 (0.82 to 0.94) for brown rice, 0.85 (0.80 to 0.90) for added bran, and 0.88 (0.78 to 0.98) for wheat germ. Spline regression showed a non-linear dose-response association between total whole grain intake and the risk of type 2 diabetes where the rate reduction slightly plateaued at more than two servings a day (P<0.001 for curvature). For whole grain cold breakfast cereal and dark bread, the rate reduction plateaued at about 0.5 servings a day. For consumption of popcorn, a J shaped association was found where the rate of type 2 diabetes was not significantly raised until consumption exceeded about one serving a day. The association between higher total whole grain intake and lower risk of type 2 diabetes was stronger in individuals who were lean than in those who were overweight or obese (P=0.003 for interaction), and the associations did not vary significantly across levels of physical activity, family history of diabetes, or smoking status. CONCLUSION: Higher consumption of total whole grains and several commonly eaten whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, was significantly associated with a lower risk of type 2 diabetes. These findings provide further support for the current recommendations of increasing whole grain consumption as part of a healthy diet for the prevention of type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Dieta Saudável , Grãos Integrais , Adulto , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Estados Unidos/epidemiologia
6.
BMJ ; 370: m2322, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32669369

RESUMO

OBJECTIVE: To analyse the health and environmental implications of adopting national food based dietary guidelines (FBDGs) at a national level and compared with global health and environmental targets. DESIGN: Modelling study. SETTING: 85 countries. PARTICIPANTS: Population of 85 countries. MAIN OUTCOME MEASURES: A graded coding method was developed and used to extract quantitative recommendations from 85 FBDGs. The health and environmental impacts of these guidelines were assessed by using a comparative risk assessment of deaths from chronic diseases and a set of country specific environmental footprints for greenhouse gas emissions, freshwater use, cropland use, and fertiliser application. For comparison, the impacts of adopting the global dietary recommendations of the World Health Organization and the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems were also analysed. Each guideline's health and sustainability implications were assessed by modelling its adoption at both the national level and globally, and comparing the impacts to global health and environmental targets, including the Action Agenda on Non-Communicable Diseases, the Paris Climate Agreement, the Aichi biodiversity targets related to land use, and the sustainable development goals and planetary boundaries related to freshwater use and fertiliser application. RESULTS: Adoption of national FBDGs was associated with reductions in premature mortality of 15% on average (95% uncertainty interval 13% to 16%) and mixed changes in environmental resource demand, including a reduction in greenhouse gas emissions of 13% on average (regional range -34% to 35%). When universally adopted globally, most of the national guidelines (83, 98%) were not compatible with at least one of the global health and environmental targets. About a third of the FBDGs (29, 34%) were incompatible with the agenda on non-communicable diseases, and most (57 to 74, 67% to 87%) were incompatible with the Paris Climate Agreement and other environmental targets. In comparison, adoption of the WHO recommendations was associated with similar health and environmental changes, whereas adoption of the EAT-Lancet recommendations was associated with 34% greater reductions in premature mortality, more than three times greater reductions in greenhouse gas emissions, and general attainment of the global health and environmental targets. As an example, the FBDGs of the UK, US, and China were incompatible with the climate change, land use, freshwater, and nitrogen targets, and adopting guidelines in line with the EAT-Lancet recommendation could increase the number of avoided deaths from 78 000 (74 000 to 81 000) to 104 000 (96 000 to 112 000) in the UK, from 480 000 (445 000 to 516 000) to 585 000 (523 000 to 646 000) in the USA, and from 1 149 000 (1 095 000 to 1 204 000) to 1 802 000 (1 664 000 to 1 941 000) in China. CONCLUSIONS: This analysis suggests that national guidelines could be both healthier and more sustainable. Providing clearer advice on limiting in most contexts the consumption of animal source foods, in particular beef and dairy, was found to have the greatest potential for increasing the environmental sustainability of dietary guidelines, whereas increasing the intake of whole grains, fruits and vegetables, nuts and seeds, and legumes, reducing the intake of red and processed meat, and highlighting the importance of attaining balanced energy intake and weight levels were associated with most of the additional health benefits. The health results were based on observational data and assuming a causal relation between dietary risk factors and health outcomes. The certainty of evidence for these relations is mostly graded as moderate in existing meta-analyses.


Assuntos
Dieta/normas , Política Nutricional/legislação & jurisprudência , Desenvolvimento Sustentável/legislação & jurisprudência , Peso Corporal/fisiologia , Doença Crônica/mortalidade , Dieta/tendências , Dieta Saudável/normas , Ingestão de Alimentos/fisiologia , Ingestão de Energia/fisiologia , Saúde Ambiental/estatística & dados numéricos , Estudos de Avaliação como Assunto , Saúde Global/estatística & dados numéricos , Gases de Efeito Estufa/efeitos adversos , Nível de Saúde , Humanos , Modelos Teóricos , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/prevenção & controle , Política Nutricional/tendências , Medição de Risco , Desenvolvimento Sustentável/tendências , Organização Mundial da Saúde/organização & administração
8.
PLoS One ; 15(6): e0233876, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479544

RESUMO

Many women with Polycystic Ovary Syndrome (PCOS) report high depression rates. The relationship between PCOS and these high depression rates is unclear. Two-component lifestyle interventions have revealed short-term effects on depression scores in this group of women. In general, 3-component interventions including diet, exercise, and cognitive behavioral therapy (CBT) are more effective in the long-term to improve emotional well-being. This has not yet been studied in women with PCOS. This study examined the effect of 20 CBT lifestyle (LS) sessions combined with a healthy diet and physical therapy with or without 9 months additional feedback through Short Message Service (SMS) via mobile phone, compared to care as usual (CAU, involving advice to lose weight). In this secondary analysis, 155 women with PCOS and a BMI above 25 kg/m2 were eligible. Depression scores decreased significantly in the LS programme compared to CAU (P = 0.045). In both the LS programme without SMS (P = 0.036) and the LS programme with SMS (P = 0.011) depression scores decreased while no change was observed in CAU (P = 0.875). Self-esteem scores improved significantly in the LS programme compared to CAU (P = 0.027). No differences in body image scores were observed in LS participants compared to CAU (P = 0.087), although body image improved significantly in both the LS without SMS (P = 0.001) and with SMS (P = 0.008) study arms. We found no significant mediating role by androgens in the relationship between LS participants and emotional well-being. Only weight-loss mediated the relationship between LS and self-esteem. To conclude, a three-component lifestyle intervention programme with or without additional SMS resulted in significant improvements in depression and self-esteem compared to CAU, in women with PCOS, obesity, and a wish to achieve a pregnancy. Testosterone, androstenedione, DHEA, insulin, HOMA-IR, and cortisol did not mediate this effect. Weight loss mediated the effects on self-esteem but not on depression and body-image. This suggests that lifestyle treatment independent of weight loss can reduce depression and body-image, but both lifestyle treatment and weight loss can improve self-esteem. Thus, a three-component lifestyle intervention based on CBT could prove successful in improving mood in women with PCOS who are overweight or obese and attempting to become pregnant.


Assuntos
Terapia Cognitivo-Comportamental , Depressão/reabilitação , Dieta Saudável , Sobrepeso/reabilitação , Modalidades de Fisioterapia , Síndrome do Ovário Policístico/reabilitação , Adulto , Imagem Corporal , Terapia Combinada/métodos , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Sobrepeso/etiologia , Sobrepeso/psicologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/psicologia , Autoimagem , Resultado do Tratamento , Perda de Peso , Saúde da Mulher
10.
Cardiovasc Ther ; 2020: 2342837, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547635

RESUMO

Cardiovascular diseases (CVD) represent one of the biggest causes of death globally, and their prevalence, aetiology, and outcome are related to genetic, metabolic, and environmental factors, among which sex- and age-dependent differences may play a key role. Among CVD risk factors, platelet hyperactivity deserves particular mention, as it is involved in the pathophysiology of main cardiovascular events (including stroke, myocardial infarction, and peripheral vascular injury) and is closely related to sex/age differences. Several determinants (e.g., hormonal status and traditional cardiovascular risk factors), together with platelet-related factors (e.g., plasma membrane composition, receptor signaling, and platelet-derived microparticles) can elucidate sex-related disparity in platelet functionality and CVD onset and outcome, especially in relation to efficacy of current primary and secondary interventional strategies. Here, we examined the state of the art concerning sex differences in platelet biology and their relationship with specific cardiovascular events and responses to common antiplatelet therapies. Moreover, as healthy nutrition is widely recognized to play a key role in CVD, we also focused our attention on specific dietary components (especially polyunsaturated fatty acids and flavonoids) and patterns (such as Mediterranean diet), which also emerged to impact platelet functions in a sex-dependent manner. These results highlight that full understanding of gender-related differences will be useful for designing personalized strategies, in order to prevent and/or treat platelet-mediated vascular damage.


Assuntos
Plaquetas/efeitos dos fármacos , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/tratamento farmacológico , Dieta Saudável , Dieta Mediterrânea , Disparidades nos Níveis de Saúde , Inibidores da Agregação de Plaquetas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Plaquetas/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Valor Nutritivo , Prevenção Primária , Fatores de Risco , Comportamento de Redução do Risco , Prevenção Secundária , Fatores Sexuais , Resultado do Tratamento , Adulto Jovem
11.
PLoS One ; 15(6): e0234692, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555624

RESUMO

BACKGROUND: Obesity remains a primary threat to the health of most Americans, with over 66% considered overweight or obese with a body mass index (BMI) of 25 kg/m2 or greater. A common treatment option many believe to be effective, and therefore turn to, is exercise. However, the amount of weight loss from exercise training is often disappointingly less than expected with greater amounts of exercise not always promoting greater weight loss. Increases in energy intake have been prescribed as the primary reason for this lack of weight loss success with exercise. Research has mostly focused on alterations in hormonal mediators of appetite (e.g.: ghrelin, peptide YY, GLP-1, pancreatic polypeptide, and leptin) that may increase hunger and/or reduce satiety to promote greater energy intake with exercise training. A less understood mechanism that may be working to increase energy intake with exercise is reward-driven feeding, a strong predictor of energy intake and weight status but rarely analyzed in the context of exercise. DESIGN: Sedentary men and women (BMI: 25-35 kg/m2, N = 52) were randomized into parallel aerobic exercise training groups partaking in either two or six exercise sessions/week, or sedentary control for 12 weeks. METHODS: The reinforcing value of food was measured by an operant responding progressive ratio schedule task (the behavioral choice task) to determine how much work participants were willing to perform for access to a healthy food option relative to a less healthy food option before and after the exercise intervention. Body composition and resting energy expenditure were assessed via DXA and indirect calorimetry, respectively, at baseline and post testing. RESULTS: Changes in fat-free mass predicted the change in total amount of operant responding for food (healthy and unhealthy). There were no correlations between changes in the reinforcing value of one type of food (healthy vs unhealthy) to changes in body composition. CONCLUSION: In support of previous work, reductions in fat-free mass resulting from an aerobic exercise intervention aimed at weight loss plays an important role in energy balance regulation by increasing operant responding for food.


Assuntos
Ingestão de Energia , Metabolismo Energético , Exercício Físico , Alimentos , Obesidade/terapia , Reforço Psicológico , Perda de Peso , Adolescente , Adulto , Apetite/fisiologia , Calorimetria Indireta/métodos , Dieta Saudável , Dieta Redutora , Feminino , Humanos , Masculino , Adulto Jovem
12.
Artigo em Inglês | PAHO-IRIS | ID: phr-52281

RESUMO

[Extract]. Thanks to the strong leadership of Brazil, among others, the United Nations (UN) Decade of Action on Nutrition (“Nutrition Decade”) was proclaimed in 2016 by the UN General Assembly. The Nutrition Decade reaches its mid-term in 2020. The time has come to review the progress made so far in the six action areas of the Nutrition Decade’s Work Programme and identify areas in need of accelerated action and priority investment during the remaining period until 2025. Advocacy efforts during the first half of the Nutrition Decade on the importance of nutrition, healthy diets, and food systems for human and planetary health are showing results. The evidence of unhealthy diet and malnutrition being a key risk factor for disease and death globally is unequivocal. Global attention to the critical role of sustainable, resilient food systems for healthy diets and improved nutrition has never been as prominently present as we are observing today. Brazil is one of the first countries to recognize agroecology and biodiversity, and incorporate sustainability issues in their innovative, holistic national food-based dietary guidelines. A clear understanding of the effective interventions to be delivered by health systems has emerged. Voluntary or mandatory reformulation of processed food products is increasingly implemented by food industry stakeholders. More and more scientists break silos and work collectively across different sectors towards offering models to better predict impact of actions or inaction on nutrition, design more effective and innovative solutions to address malnutrition in all its forms and define appropriate metrics to monitor progress and ensure accountability.


Assuntos
Doenças não Transmissíveis , Obesidade , Açúcares , Dieta Saudável , Alimentos, Dieta e Nutrição
13.
PLoS One ; 15(6): e0233418, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574218

RESUMO

Common mental disorders (CMD) among mothers cause disability, negatively affect child development, and have high long-term economic costs. Little is known about how factors across multiple life dimensions, modeled together, are differentially related to maternal mental health in high poverty contexts. Further, there is limited evidence on determinants of CMD in areas where self-help groups (SHGs) exist to promote women's wellbeing. Filling this evidence gap is important given the high prevalence of CMD and the rapid expansion of SHGs in rural India. Cross-sectional data were collected from 1644 mother-infant pairs living in disadvantaged rural villages across five Indian states-Jharkhand, Madhya Pradesh, West Bengal, Odisha, and Chhattisgarh-surveyed in the Women Improving Nutrition through Group-based Strategies study. CMD were assessed using the 20-item Self Reporting Questionnaire (SRQ). We examined 31 factors across four life dimensions: work (work type, time spent in labor, domestic and caretaking activities), agency (SHG membership, decision-making, gender attitudes), health/nutrition (underweight, fertility, diet diversity, child illness), and household/environment (dependency ratio, wealth, food security, shocks, water, sanitation). Survey-adjusted multivariate logistic and ordinary least squares regression models were fit to examine predictors of CMD or SRQ score. On average, mothers were 26 (range 18-46) years old and their children were 15 (range 6-24) months old. CMD defined as ≥ 8 positive SRQ responses were reported by 262 women (16%). Protective factors included being engaged in agricultural labor as a main occupation relative to being a housewife (AOR 0.18, 95% CI 0.10-0.32), more time working (0.85, 0.77-0.93), higher decision-making (0.33, 0.16-0.69), SHG membership (0.73, 0.56-0.96), and having an improved toilet (0.49, 0.33-0.72). Risk factors included food insecurity (1.13, 1.07-1.20) and shocks to non-farm livelihoods (2.04, 1.10-3.78). Practitioners and policymakers should aim to improve food security, economic wellbeing and social capital, such as that created through SHG membership, to improve maternal mental health. Future research should aim to understand why working outside the home, albeit in agricultural work, appears to protect maternal mental health in this context.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Mães/psicologia , Adulto , Estudos Transversais/métodos , Dieta Saudável/psicologia , Feminino , Abastecimento de Alimentos , Humanos , Transtornos Mentais/metabolismo , Saúde Mental/etnologia , Pessoa de Meia-Idade , Estado Nutricional/etnologia , Pobreza , Fatores de Risco , Saúde da População Rural/etnologia , População Rural , Grupos de Autoajuda , Populações Vulneráveis/etnologia
14.
Nutr Metab Cardiovasc Dis ; 30(9): 1409-1417, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32571612

RESUMO

AIMS: CoV-19/SARS-CoV-2 is a highly pathogenic virus that is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of infection, several governments have enforced restrictions on outdoor activities or even collective quarantine on the population. The present commentary briefly analyzes the effects of quarantine on lifestyle, including nutrition and physical activity and the impact of new technologies in dealing with this situation. DATA SYNTHESIS: Quarantine is associated with stress and depression leading to unhealthy diet and reduced physical activity. A diet poor in fruit and vegetables is frequent during isolation, with a consequent low intake of antioxidants and vitamins. However, vitamins have recently been identified as a principal weapon in the fight against the Cov-19 virus. Some reports suggest that Vitamin D could exert a protective effect on such infection. During quarantine, strategies to further increase home-based physical activity and to encourage adherence to a healthy diet should be implemented. The WHO has just released guidance for people in self-quarantine, those without any symptoms or diagnosis of acute respiratory illness, which provides practical advice on how to stay active and reduce sedentary behavior while at home. CONCLUSION: Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine, a global action supporting healthy diet and physical activity is mandatory to encourage people to return to a good lifestyle routine.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/etiologia , Infecções por Coronavirus/epidemiologia , Dieta Saudável , Exercício Físico , Pneumonia Viral/epidemiologia , Quarentena , Ansiedade/complicações , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Feminino , Humanos , Estilo de Vida , Masculino , Obesidade/complicações , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Caracteres Sexuais , Estresse Psicológico/complicações , Vitamina D/administração & dosagem
17.
JAMA ; 323(17): 1642, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32369117
18.
PLoS One ; 15(5): e0232447, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32379781

RESUMO

BACKGROUND: Malnutrition linked to noncommunicable diseases presents major health problems across Europe. The World Health Organisation encourages countries to conduct national dietary surveys to obtain data to inform public health policies designed to prevent noncommunicable diseases. METHODS: Data on 27334 participants aged 19-64y were harmonised and pooled across national dietary survey datasets from 12 countries across the WHO European Region. Weighted mean nutrient intakes were age-standardised using the Eurostat 2013 European Standard Population. Associations between country-level Gross Domestic Product (GDP) and key nutrients and nutrient densities were investigated using linear regression. The potential mitigating influence of participant-level educational status was explored. FINDINGS: Higher GDP was positively associated with total sugar intake (5·0% energy for each 10% increase in GDP, 95% CI 0·6, 9·3). Scandinavian countries had the highest vitamin D intakes. Participants with higher educational status had better nutritional intakes, particularly within lower GDP countries. A 10% higher GDP was associated with lower total fat intakes (-0·2% energy, 95% CI -0·3, -0·1) and higher daily total folate intakes (14µg, 95% CI 12, 16) in higher educated individuals. INTERPRETATION: Lower income countries and lower education groups had poorer diet, particularly for micronutrients. We demonstrate for the first time that higher educational status appeared to have a mitigating effect on poorer diet in lower income countries. It illustrates the feasibility and value of harmonising national dietary survey data to inform European policy regarding access to healthy diets, particularly in disadvantaged groups. It specifically highlights the need for strong policies supporting nutritional intakes, prioritising lower education groups and lower income countries.


Assuntos
Dieta , Desnutrição/epidemiologia , Fatores Socioeconômicos , Adulto , Inquéritos sobre Dietas , Dieta Saudável , Escolaridade , Ingestão de Energia , Europa (Continente)/epidemiologia , Feminino , Humanos , Renda , Modelos Lineares , Masculino , Desnutrição/prevenção & controle , Micronutrientes/administração & dosagem , Pessoa de Meia-Idade , Análise Multivariada , Estado Nutricional , Pobreza , Adulto Jovem
19.
Cardiovasc Ther ; 2020: 6719301, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32454893

RESUMO

Noncommunicable diseases are long-lasting and slowly progressive and are the leading causes of death and disability. They include cardiovascular diseases (CVD) and diabetes mellitus (DM) that are rising worldwide, with CVD being the leading cause of death in developed countries. Thus, there is a need to find new preventive and therapeutic approaches. Polyphenols seem to have cardioprotective properties; among them, polyphenols and/or minor polar compounds of extra virgin olive oil (EVOO) are attracting special interest. In consideration of numerous sex differences present in CVD and DM, in this narrative review, we applied "gender glasses." Globally, it emerges that olive oil and its derivatives exert some anti-inflammatory and antioxidant effects, modulate glucose metabolism, and ameliorate endothelial dysfunction. However, as in prescription drugs, also in this case there is an important gender bias because the majority of the preclinical studies are performed on male animals, and the sex of donors of cells is not often known; thus a sex/gender bias characterizes preclinical research. There are numerous clinical studies that seem to suggest the benefits of EVOO and its derivatives in CVD; however, these studies have numerous limitations, presenting also a considerable heterogeneity across the interventions. Among limitations, one of the most relevant in the era of personalized medicine, is the non-attention versus women that are few and, also when they are enrolled, sex analysis is lacking. Therefore, in our opinion, it is time to perform more long, extensive and lessheterogeneous trials enrolling both women and men.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dieta Saudável , Saúde do Homem , Azeite de Oliva/administração & dosagem , Comportamento de Redução do Risco , Saúde da Mulher , Adolescente , Adulto , Animais , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Fatores Sexuais , Adulto Jovem
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