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1.
PLoS Med ; 17(8): e1003234, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32764760

RESUMO

BACKGROUND: In common with many other low- and middle-income countries (LMICs), rural to urban migrants in India are at increased risk of obesity, but it is unclear whether this is due to increased energy intake, reduced energy expenditure, or both. Knowing this and the relative contribution of specific dietary and physical activity behaviours to greater adiposity among urban migrants could inform policies for control of the obesity epidemic in India and other urbanising LMICs. In the Indian Migration Study, we previously found that urban migrants had greater prevalence of obesity and diabetes compared with their nonmigrant rural-dwelling siblings. In this study, we investigated the relative contribution of energy intake and expenditure and specific diet and activity behaviours to greater adiposity among urban migrants in India. METHODS AND FINDINGS: The Indian Migration Study was conducted between 2005 and 2007. Factory workers and their spouses from four cities in north, central, and south of India, together with their rural-dwelling siblings, were surveyed. Self-reported data on diet and physical activity was collected using validated questionnaires, and adiposity was estimated from thickness of skinfolds. The association of differences in dietary intake, physical activity, and adiposity between siblings was examined using multivariable linear regression. Data on 2,464 participants (median age 43 years) comprised of 1,232 sibling pairs (urban migrant and their rural-dwelling sibling) of the same sex (31% female) were analysed. Compared with the rural siblings, urban migrants had 18% greater adiposity, 12% (360 calories/day) more energy intake, and 18% (11 kilojoules/kg/day) less energy expenditure (P < 0.001 for all). Energy intake and expenditure were independently associated with increased adiposity of urban siblings, accounting for 4% and 6.5% of adiposity difference between siblings, respectively. Difference in dietary fat/oil (10 g/day), time spent engaged in moderate or vigorous activity (69 minutes/day), and watching television (30 minutes/day) were associated with difference in adiposity between siblings, but no clear association was observed for intake of fruits and vegetables, sugary foods and sweets, cereals, animal and dairy products, and sedentary time. The limitations of this study include a cross-sectional design, systematic differences in premigration characteristics of migrants and nonmigrants, low response rate, and measurement error in estimating diet and activity from questionnaires. CONCLUSIONS: We found that increased energy intake and reduced energy expenditure contributed equally to greater adiposity among urban migrants in India. Policies aimed at controlling the rising prevalence of obesity in India and potentially other urbanising LMICs need to be multicomponent, target both energy intake and expenditure, and focus particularly on behaviours such as dietary fat/oil intake, time spent on watching television, and time spent engaged in moderate or vigorous intensity physical activity.


Assuntos
Adiposidade/fisiologia , Dieta/tendências , Ingestão de Energia/fisiologia , Exercício Físico/fisiologia , População Rural/tendências , Migrantes , População Urbana/tendências , Adulto , Índice de Massa Corporal , Estudos Transversais , Dieta/efeitos adversos , Gorduras na Dieta/efeitos adversos , Metabolismo Energético/fisiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autorrelato
2.
PLoS Med ; 17(8): e1003256, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32853224

RESUMO

BACKGROUND: Ultra-processed food (UPF) consumption has increased drastically worldwide and already represents 50%-60% of total daily energy intake in several high-income countries. In the meantime, the prevalence of overweight and obesity has risen continuously during the last century. The objective of this study was to investigate the associations between UPF consumption and the risk of overweight and obesity, as well as change in body mass index (BMI), in a large French cohort. METHODS AND FINDINGS: A total of 110,260 adult participants (≥18 years old, mean baseline age = 43.1 [SD 14.6] years; 78.2% women) from the French prospective population-based NutriNet-Santé cohort (2009-2019) were included. Dietary intakes were collected at baseline using repeated and validated 24-hour dietary records linked to a food composition database that included >3,500 different food items, each categorized according to their degree of processing by the NOVA classification. Associations between the proportion of UPF in the diet and BMI change during follow-up were assessed using linear mixed models. Associations with risk of overweight and obesity were assessed using Cox proportional hazard models. After adjusting for age, sex, educational level, marital status, physical activity, smoking status, alcohol intake, number of 24-hour dietary records, and energy intake, we observed a positive association between UPF intake and gain in BMI (ß Time × UPF = 0.02 for an absolute increment of 10 in the percentage of UPF in the diet, P < 0.001). UPF intake was associated with a higher risk of overweight (n = 7,063 overweight participants; hazard ratio (HR) for an absolute increase of 10% of UPFs in the diet = 1.11, 95% CI: 1.08-1.14; P < 0.001) and obesity (n = 3,066 incident obese participants; HR10% = 1.09 (1.05-1.13); P < 0.001). These results remained statistically significant after adjustment for the nutritional quality of the diet and energy intake. Study limitations include possible selection bias, potential residual confounding due to the observational design, and a possible item misclassification according to the level of processing. Nonetheless, robustness was tested and verified using a large panel of sensitivity analyses. CONCLUSIONS: In this large observational prospective study, higher consumption of UPF was associated with gain in BMI and higher risks of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting UPF consumption. TRIAL REGISTRATION: ClinicalTrials.gov NCT03335644 (https://clinicaltrials.gov/ct2/show/NCT03335644).


Assuntos
Índice de Massa Corporal , Ingestão de Energia/fisiologia , Fast Foods/efeitos adversos , Inquéritos Nutricionais/tendências , Valor Nutritivo/fisiologia , Sobrepeso/epidemiologia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Sobrepeso/diagnóstico , Estudos Prospectivos , Fatores de Risco
3.
Am J Physiol Regul Integr Comp Physiol ; 319(3): R347-R357, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32755463

RESUMO

How low-level psychological stress and overnutrition interact in influencing cardiometabolic disease is unclear. Mechanistic overlaps suggest potential synergies; however, findings are contradictory. We test whether low-level stress and Western diet (WD) feeding synergistically influence homeostasis, mood, and myocardial ischemic tolerance. Male C57BL6/J mice were fed a control diet or WD (32%/57%/11% calories from fat/carbohydrates/protein) for 12 wk, with subgroups restrained for 30 min/day over the final 3 wk. Metabolism, behavior, tolerance of perfused hearts to ischemia-reperfusion (I/R), and cardiac "death proteins" were assessed. The WD resulted in insignificant trends toward increased body weight (+5%), glucose (+40%), insulin (+40%), triglycerides (+15%), and cholesterol (+20%) and reduced leptin (-20%) while significantly reducing insulin sensitivity [100% rise in homeostasis model assessment of insulin resistance (HOMA-IR), P < 0.05]. Restraint did not independently influence metabolism while increasing HOMA-IR a further 50% (and resulting in significant elevations in insulin and glucose to 60-90% above control) in WD mice (P < 0.05), despite blunting weight gain in control and WD mice. Anxiogenesis with restraint or WD was nonadditive, whereas anhedonia (reduced sucrose consumption) only arose with their combination. Neuroinflammation markers (hippocampal TNF-α, Il-1b) were unchanged. Myocardial I/R tolerance was unaltered with stress or WD alone, whereas the combination worsened dysfunction and oncosis [lactate dehydrogenase (LDH) efflux]. Apoptosis (nucleosome accumulation) and death protein expression (BAK, BAX, BCL-2, RIP-1, TNF-α, cleaved caspase-3, and PARP) were unchanged. We conclude that mild, anxiogenic yet cardio-metabolically "benign" stress interacts synergistically with a WD to disrupt homeostasis, promote anhedonia (independently of neuroinflammation), and impair myocardial ischemic tolerance (independently of apoptosis and death protein levels).


Assuntos
Dieta Hiperlipídica , Ingestão de Energia/fisiologia , Homeostase/fisiologia , Isquemia Miocárdica/fisiopatologia , Miocárdio/metabolismo , Animais , Coração/fisiopatologia , Resistência à Insulina/fisiologia , Camundongos Endogâmicos C57BL , Isquemia Miocárdica/metabolismo , Obesidade/fisiopatologia
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
7.
Nutr. hosp ; 37(3): 465-473, mayo-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193853

RESUMO

INTRODUCTION: the composition of snack foods likely influences the overall effect that snacking has on metabolism and obesity. The objective of the current study was to assess the responses to two different snacks, one of them supplemented with wakame and carobs, on cardiovascular risk factors, satiety, and subsequent food intake in obese subjects with metabolic syndrome. MATERIAL AND METHODS: forty patients were randomized in a clinical trial (NCT03420989, clinicaltrial.gov) to group I (enriched snack, n = 16) or group II (control snack, n = 16). At baseline and after 8 weeks biochemical parameters, dietary intakes, and nutritional status were assessed. The subjects also rated their feelings of satiety/hunger with a test meal. RESULTS: no differences were detected in anthropometric parameters between both snacks. Changes in other parameters were detected in patients with enriched snacks, with a significant decrease in LDL-cholesterol by 7.4 % (intervention snack, -8.9 ± 2.3 mg/dL vs control snack, -0.9 ± 3.3 mg/dL; p = 0.03), in total cholesterol by 5.8 % (intervention snack, -10.4 ± 2.9 mg/dL vs control snack, -1.4 ± 3.2 mg/dL; p = 0.02), and in resistin level by 15.9 % (intervention snack, -1.0 ± 0.2 mg/dL vs control snack, -0.1 ± 0.3 mg/dL: p = 0.03). After the test meal, satiety scores (after 20 min and 40 min) were higher than fasting levels in both groups. The same results were obtained with the 100-mm, 5-point visual satiety scale. CONCLUSION: our study indicates that a wakame- and carob-enriched snack induces a significant decrease in total cholesterol, LDL-cholesterol, and resistin levels when compared to a control snack, without effects on food consumption, other cardiovascular parameters, or anthropometric parameters


INTRODUCCIÓN: la composición de los "snacks" probablemente influya en el efecto que produce su consumo sobre los marcadores metabólicos y la obesidad. El objetivo del presente estudio fue evaluar las respuestas a dos snacks, uno de ellos suplementado con wakame y algarroba, sobre factores de riesgo cardiovascular, saciedad y posterior ingesta de alimentos, en sujetos obesos con síndrome metabólico. MATERIAL Y MÉTODOS: se aleatorizaron 40 pacientes en el ensayo clínico NCT03420989 (clinicaltrial.gov) para participar en el grupo I (snack enriquecido, n = 16) o el grupo II (snack de control, n = 16). Antes y después de 8 semanas se determinaron los parámetros bioquímicos, las ingestas dietéticas y el estado nutricional. A los sujetos también se les evaluó la saciedad y el apetito con una comida de prueba. RESULTADOS: no se detectaron diferencias en los parámetros antropométricos con ambos snacks. Se detectaron cambios en los parámetros bioquímicos de los pacientes que recibieron snacks enriquecidos, con una disminución significativa del colesterol-LDL del 7,4 % (snack de intervención, -8,9 ± 2,3 mg/dl vs. snack de control, -0,9 ± 3,3 mg/dl; p = 0,03), del colesterol total del 5,8 % (snack de intervención, -10,4 ± 2,9 mg/dl vs. snack de control, -1,4 ± 3,2 mg/dl; p = 0,02) y de los niveles de resistina del 15,9 % (snack de intervención, -1,0 ± 0,2 mg/dl vs. snack de control, -0,1 ± 0,3 mg/dl; p = 0,03). Después de la comida de prueba, las puntuaciones de saciedad (a los 20 min y 40 min) fueron más altas que el nivel de ayuno en ambos grupos. Los resultados fueron similares con la escala de saciedad visual de 5 puntos y 100 mm. CONCLUSIÓN: nuestro estudio muestra que un snack enriquecido con wakame y algarroba produce una disminución significativa de los niveles de colesterol total, colesterol-LDL y resistina frente a un snack de control, sin efectos sobre el consumo de alimentos, otros parámetros cardiovasculares y los parámetros antropométricos


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Lanches/fisiologia , Ingestão de Energia/fisiologia , Undaria , Método Duplo-Cego , Obesidade/dietoterapia , Extratos Vegetais/farmacologia , Fatores de Risco , Doenças Cardiovasculares/prevenção & controle , Síndrome Metabólica/dietoterapia , LDL-Colesterol/metabolismo , Antropometria , Receptores de Adipocina/administração & dosagem , Undaria/química , Galactanos/farmacologia , Extratos Vegetais/uso terapêutico
8.
Nutr. hosp ; 37(3): 524-533, mayo-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-193860

RESUMO

BACKGROUND: food is a powerful reinforcer that motivates people to eat. The TaqI A1 polymorphism (rs1800497; T>C) downstream of the dopamine D2 receptor (DRD2) gene has been associated with diminished DRD2 receptor density, higher food reinforcement, and impaired eating behavior in adults. OBJECTIVE: to evaluate the association between the rs1800497 polymorphism and the reinforcing value of food and eating in the absence of hunger in Chilean children. MATERIAL AND METHOD: nineteen Chilean children (aged 8-12 years) who were carriers of the A1-allele and 19 age- and gender-matched non-carriers (A2-allele) were evaluated on the reinforcing value of food and eating in the absence of hunger. Anthropometric measures were performed by standard procedures. Briefly, children received a standard pre-load lunch followed by an ad-libitum exposure to palatable foods. RESULTS: no differences were found between A1-allele carriers and non-carriers, whether obese or non-obese, in ad libitum energy intake, macronutrient consumption, or the relative reinforcing value of food (p > 0.05). In obese children, A1 carriers reported significantly lower satiety and fullness before lunch (p < 0.05). However, in children with normal weight A1 carriers were found to exhibit trends for greater satiety and fullness before lunch when compared to non-carriers, but this trend reversed after lunch such that carriers exhibited lower satiety and fullness (p = 0.06). CONCLUSIONS: although TaqI A1 may play an important role in some eating behavior-related traits such as satiety and fullness, especially in obese children, our findings indicate that this polymorphism does not appear to affect eating in the absence of hunger or food reinforcement in children


ANTECEDENTES: los alimentos son un poderoso reforzador de la alimentación. El polimorfismo TaqI A1 (rs1800497; T> C) del gen del receptor 2 de dopamina (DRD2) se ha asociado con una menor densidad de DRD2, un mayor refuerzo alimentario y un comportamiento alimentario alterado en adultos. OBJETIVO: evaluar la asociación entre el polimorfismo rs1800497, el valor reforzador del alimento y la conducta de comer en ausencia de hambre en niños chilenos. MATERIAL Y MÉTODO: treinta y ocho niños chilenos, 19 portadores del alelo A1 y 19 no portadores (alelo A2), pareados por género y edad, fueron evaluados en condiciones de laboratorio para determinar el valor reforzador del alimento y la conducta de comer en ausencia de hambre. Las mediciones antropométricas se realizaron por procedimientos estándar. Brevemente, los niños recibieron un almuerzo estándar seguido de una exposición ad-libitum a alimentos sabrosos. RESULTADOS: no hubo diferencias en la ingesta ad libitum de energía, ni en el consumo de macronutrientes, ni en el valor reforzador del alimento entre los portadores del alelo A1 frente a los no portadores (p > 0,05). Entre los niños obesos, los portadores del alelo A1 reportaron un menor nivel de saciedad y plenitud pre-almuerzo (p < 0,05). Sin embargo, entre los niños con normopeso se observó que los portadores de A1 tenían tendencia a presentar un mayor grado de saciedad y plenitud (pre-almuerzo) frente a los no portadores. Esta tendencia se invirtió post-almuerzo, de modo que los portadores exhibieron menor saciedad y plenitud (p = 0,06). CONCLUSIONES: la variante TaqI A1 podría desempeñar un papel importante en algunos rasgos relacionados con la conducta alimentaria, como la saciedad y la plenitud


Assuntos
Humanos , Masculino , Feminino , Criança , Fome/fisiologia , Variação Genética/genética , Comportamento Alimentar/fisiologia , Ingestão de Energia/genética , Obesidade/genética , Receptores de Dopamina D2/genética , Chile , Variação Genética/efeitos dos fármacos , Polimorfismo Genético/genética , Antropometria , Peso Corporal/genética , Ingestão de Energia/fisiologia , Receptores de Dopamina D2/fisiologia
10.
Am J Physiol Regul Integr Comp Physiol ; 319(2): R171-R183, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32551825

RESUMO

Exercise is often used as a strategy for weight loss maintenance. In preclinical models, we have shown that exercise may be beneficial because it counters the biological drive to regain weight. However, our studies have demonstrated sex differences in the response to exercise in this context. In the present study, we sought to better understand why females and males exhibit different compensatory food eating behaviors in response to regular exercise. Using a forced treadmill exercise paradigm, we measured weight gain, energy expenditure, food intake in real time, and the anorectic effects of leptin. The 4-wk exercise training resulted in reduced weight gain in males and sustained weight gain in females. In male rats, exercise decreased intake, whereas it increased food intake in females. Our results suggest that the anorectic effects of leptin were not responsible for these sex differences in appetite in response to exercise. If these results translate to the human condition, they may reveal important information for the use and application of regular exercise programs.


Assuntos
Apetite/fisiologia , Peso Corporal/fisiologia , Ingestão de Alimentos/fisiologia , Metabolismo Energético/fisiologia , Condicionamento Físico Animal/fisiologia , Animais , Ingestão de Energia/fisiologia , Feminino , Masculino , Ratos
11.
Chronobiol Int ; 37(6): 804-808, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32516020

RESUMO

COVID-19 and metabolic syndrome are devastating pandemics. Effective control of metabolic parameters and their dysfunction may help prevent or minimize the acute and devastating effects of SARS-CoV-2 by reducing the local inflammatory response and blocking the entry of the virus into cells. With such consideration in mind, we gathered data from dietary surveys conducted in nine European countries to explore the relationship between actual clock hour of the large dinner meal and also interval in minutes between it and sunset in the respective countries and death rate above the median rate of per one million people as an index of mortality due to COVID-19 infection. Clock time of the dinner meal varied between 16:00 and 21:00 h across the European counties sampled, and the correlation between dinner mealtime and death rate was strongly correlated, R = 0.7991 (two-tailed p = 0.0098), with R 2 explaining 63% of the variation within the data. This strong linear positive correlation indicates that the later the clock time of the dinner meal, the higher is the death rate (and vice versa). The relationship between meal timing in reference to sunset, utilized as a gross surrogate marker of the activity/rest synchronizer of circadian rhythms, and death rate was negative and even slightly stronger, R = -0.8025 (two-tailed p = 0.0092), with R 2 explaining 64% of the variation within the data. This strong linear negative correlation indicates that the shorter the interval between the dinner meal and sunset, i.e., the closer the time of the largest meal of the day to bedtime, the greater is the death rate (and vice versa). Our preliminary approach to nighttime eating, in terms of the day's largest caloric intake, as a risk factor for the predisposing conditions of obesity, metabolic syndrome, type 2 diabetes, and other commonly associated comorbidities of being overweight, and death from COVID-19 infection reveals strong correlation with the time of the dinner meal, both in terms of its actual clock and circadian time.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/etiologia , Diabetes Mellitus Tipo 2/etiologia , Refeições/fisiologia , Pneumonia Viral/etiologia , Ritmo Circadiano/fisiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Diabetes Mellitus Tipo 2/complicações , Ingestão de Alimentos/fisiologia , Ingestão de Energia/fisiologia , Comportamento Alimentar/fisiologia , Humanos , Obesidade/etiologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Tempo
12.
PLoS One ; 15(5): e0232824, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384114

RESUMO

Zambia is still facing undernutrition and micronutrient deficiencies despite fortification and supplementation programmes stressing the need for additional solutions. Fermented foods have the potential to improve nutrient intake and, therefore, could have an important role in food based recommendations (FBRs) to ensure adequate intake of nutrients for optimal health of populations. Secondary dietary intake data was used in Optifood, a linear programming software to develop FBRs, for children aged 1-3 and 4-5 years in Mkushi district of Zambia. Three scenarios per age group were modeled to determine FBRs based on: (1) FBRs based on local available foods (2) FBR and Mabisi, a fermented milk beverage, and (3) FBR with Munkoyo, a cereal fermented beverage. The scenarios were compared to assess whether addition of Mabisi or Munkoyo achieved a better nutrient intake. FBRs based on only locally available non-fermented foods did not meet ≥70% of recommended nutrient intake (RNI) for calcium, fat, iron and zinc, so-called problem nutrients. The addition of Munkoyo to the FBRs did not reduce the number of problem nutrients, but after adding Mabisi to the FBR's only iron (67% of RNI) in the 1-3 year age group and only zinc (67% of RNI) in the 4-5 year age group remained problem nutrients. Mabisi, a fermented milk product in combination with the local food pattern is a good additional source of nutrients for these age groups. However, additional nutrition sensitive and cost-effective measures would still be needed to improve nutrient intake, especially that of iron and zinc.


Assuntos
Grão Comestível/metabolismo , Alimentos e Bebidas Fermentados , Leite/metabolismo , Estado Nutricional , Animais , Cálcio na Dieta/metabolismo , Criança , Pré-Escolar , Dieta , Ingestão de Energia/fisiologia , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Ferro/metabolismo , Masculino , Micronutrientes , Nutrientes/metabolismo , Necessidades Nutricionais , Recomendações Nutricionais , Zâmbia/epidemiologia
13.
PLoS Med ; 17(5): e1003120, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32433660

RESUMO

BACKGROUND: Policymakers worldwide are considering requiring warnings for sugary drinks. A growing number of experimental studies have examined sugary drink warnings' impacts, but no research to our knowledge has synthesized this literature. To inform ongoing policy debates, this study aimed to identify the effects of sugary drink warnings compared with control conditions. METHODS AND FINDINGS: We systematically searched 7 databases on June 21, 2019, and October 25, 2019. We also searched reference lists of relevant articles. Two investigators independently screened titles, abstracts, and full texts to identify peer-reviewed articles that used an experimental protocol to examine the effects of sugary drink warnings compared to a control condition. Two investigators independently extracted study characteristics and effect sizes from all relevant full-text articles. We meta-analyzed any outcome assessed in at least 2 studies, combining effect sizes using random effects meta-analytic procedures. Twenty-three experiments with data on 16,241 individuals (mean proportion female, 58%) were included in the meta-analysis. Most studies took place in Latin America (35%) or the US or Canada (46%); 32% included children. Relative to control conditions, sugary drink warnings caused stronger negative emotional reactions (d = 0.69; 95% CI: 0.25, 1.13; p = 0.002) and elicited more thinking about the health effects of sugary drinks (d = 0.65; 95% CI: 0.29, 1.01; p < 0.001). Sugary drink warnings also led to lower healthfulness perceptions (d = -0.22; 95% CI: -0.27, -0.17; p < 0.001) and stronger disease likelihood perceptions (d = 0.15; 95% CI: 0.06, 0.24; p = 0.001). Moreover, sugary drink warnings reduced both hypothetical (d = -0.32; 95% CI: -0.44, -0.21; p < 0.001) and actual consumption and purchasing behavior (d = -0.17; 95% CI: -0.30, -0.04; p = 0.012). Statistically significant effects were not observed for perceptions of added sugar or positive sugary drink attitudes (p's > 0.10). Moderation analyses revealed that health warnings (e.g., "Beverages with added sugar contribute to obesity") led to greater reductions in hypothetical sugary drink purchases than did nutrient warnings (e.g., "High in sugar"; d = -0.35 versus -0.18; Qb = 4.04; p = 0.04). Limitations of this study include that we did not review grey literature and that we were unable to conduct moderation analyses for several prespecified moderators due to an insufficient number of studies. CONCLUSIONS: This international body of experimental literature supports sugary drink warnings as a population-level strategy for changing behavior, as well as emotions, perceptions, and intentions. PROTOCOL REGISTRY: PROSPERO ID 146405.


Assuntos
Bebidas/efeitos adversos , Comportamento do Consumidor , Ingestão de Energia/fisiologia , Rotulagem de Alimentos , Obesidade/etiologia , Canadá , Criança , Feminino , Humanos , Masculino , Adulto Jovem
14.
PLoS Med ; 17(5): e1003122, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32453739

RESUMO

BACKGROUND: Nutritional supplements may improve short-term growth of infants born small (preterm or small for gestational age), but there are few data on long-term effects and concerns that body composition may be adversely affected. Effects also may differ between girls and boys. Our systematic review and meta-analysis assessed the effects of macronutrient supplements for infants born small on later growth. METHODS AND FINDINGS: We searched OvidMedline, Embase, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from inception to January 30, 2020, and controlled-trials.com, clinicaltrials.gov, and anzctr.org.au on January 30, 2020. Randomised or quasirandomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born small and growth was assessed after discharge. Primary outcome was body mass index (BMI) in childhood. Data were pooled using random-effect models. Outcomes were evaluated in toddlers (< 3 years), childhood (3 to 8 years), adolescence (9 to 18 years), and adulthood (>18 years). Forty randomised and 2 quasirandomised trials of variable methodological quality with 4,352 infants were included. Supplementation did not alter BMI in childhood (7 trials, 1,136 children; mean difference [MD] -0.10 kg/m2, [95% confidence interval (CI) -0.37 to 0.16], p = 0.45). In toddlers, supplementation increased weight (31 trials, 2,924 toddlers; MD 0.16 kg, [0.01 to 0.30], p = 0.03) and length/height (30 trials, 2,889 toddlers; MD 0.44 cm, [0.10 to 0.77], p = 0.01), but not head circumference (29 trials, 2,797 toddlers; MD 0.15 cm, [-0.03 to 0.33], p = 0.10). In childhood, there were no significant differences between groups in height (7 trials, 1,136 children; MD 0.22 cm, [-0.48 to 0.92], p = 0.54) or lean mass (3 trials, 354 children; MD -0.07 kg, [-0.98 to 0.85], p = 0.88), although supplemented children appeared to have higher fat mass (2 trials, 201 children; MD 0.79 kg, [0.19 to 1.38], p = 0.01). In adolescence, there were no significant differences between groups in BMI (2 trials, 216 adolescents; MD -0.48 kg/m2, [-2.05 to 1.08], p = 0.60), height (2 trials, 216 adolescents; MD -0.55 cm, [-2.95 to 1.86], p = 0.65), or fat mass (2 trials, 216 adolescents; MD -1.3 5 kg, [-5.76 to 3.06], p = 0.55). In adulthood, there also were no significant differences between groups in weight z-score (2 trials, 199 adults; MD -0.11, [-0.72 to 0.50], p = 0.73) and height z-score (2 trials, 199 adults; MD -0.07, [-0.36 to 0.22], p = 0.62). In subgroup analysis, supplementation was associated with increased length/height in toddler boys (2 trials, 173 boys; MD 1.66 cm, [0.75 to 2.58], p = 0.0003), but not girls (2 trials, 159 girls; MD 0.15 cm, [-0.71 to 1.01], p = 0.74). Limitations include considerable unexplained heterogeneity, low to very low quality of evidence, and possible bias due to low or unbalanced followup. CONCLUSIONS: In this systematic review and meta-analysis, we found no evidence that early macronutrient supplementation for infants born small altered BMI in childhood. Although supplements appeared to increase weight and length in toddlers, effects were inconsistent and unlikely to be clinically significant. Limited data suggested that supplementation increased fat mass in childhood, but these effects did not persist in later life. PROSPERO registration: CRD42019126918.


Assuntos
Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recém-Nascido Pequeno para a Idade Gestacional/crescimento & desenvolvimento , Nutrientes/metabolismo , Adolescente , Adulto , Peso Corporal/fisiologia , Criança , Ingestão de Energia/fisiologia , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Parto/fisiologia , Gravidez
15.
Med Sci (Paris) ; 36(5): 472-478, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32452369

RESUMO

Substantial reviews of the most recent evidence report a strong relationship between the consumption of sugar-sweetened beverages and adverse health effects, such as the prevalence of obesity and metabolic diseases. Various public policies were recently undertaken by many countries in the hope of reducing sugar-sweetened beverage consumption amongst their population. This has led the food industries to promote low-calorie sweeteners (sugar substitutes) as a healthy alternative that would limit caloric intake without compromising the sweet taste of food and beverages. However, is the use of low-calorie sweeteners as a means of limiting or reducing energy intake without consequences for our health? This review aims to discuss the effects of low-calorie sweeteners consumption on health and to elucidate whether their use should be recommended by health professionals to their patients as part of weight management.


Assuntos
Bebidas , Ingestão de Energia/fisiologia , Edulcorantes/efeitos adversos , Edulcorantes/farmacologia , Bebidas/efeitos adversos , Restrição Calórica/efeitos adversos , Dieta com Restrição de Carboidratos/efeitos adversos , Humanos , Obesidade/terapia , Programas de Redução de Peso/métodos
16.
Obesity (Silver Spring) ; 28(6): 1129-1140, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32352645

RESUMO

OBJECTIVE: The relationship between adipocyte size and ad libitum energy intake has not been previously examined. This study hypothesized an inverse relationship between adipocyte size and daily energy intake (DEI). METHODS: Seventy healthy adults (39 men and 31 women; BMI 30.0 [SD 6.3]) underwent dual-energy x-ray absorptiometry and subcutaneous fat biopsies from the abdomen and thigh. Osmium-fixed adipocytes were sized with a Coulter counter. Volunteers self-selected food from a vending machine paradigm as the only source of energy intake over 3 days as inpatients. Volunteers also had 24-hour respiratory quotient (RQ) measured in a whole-room indirect calorimeter. RESULTS: In women, the large cell peak diameter of the thigh depot was greater than that of the abdominal depot (Δ = +15.8 µm; P < 0.0001). In women, thigh peak diameter was inversely associated with DEI (ß = -264.7 kcal/d per 10-µm difference; P = 0.03) after adjusting for demographics and body composition. The thigh peak diameter in women was associated with 24-hour RQ (r = -0.47, P = 0.04) after adjusting for demographics, body composition, and 24-hour energy balance. These associations did not extend to men or the abdominal depot. CONCLUSIONS: In women, thigh adipocyte size was associated with reduced DEI and 24-hour RQ, indicating a special role for thigh fat in women. This depot-specific sexual dimorphism indicates common regulation of energy intake and adipocyte size in the thigh region of women.


Assuntos
Adipócitos/patologia , Composição Corporal/fisiologia , Ingestão de Energia/fisiologia , Coxa da Perna/fisiopatologia , Adulto , Idoso , Metabolismo Energético/fisiologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Taxa Respiratória , Saúde da Mulher , Adulto Jovem
17.
PLoS One ; 15(4): e0232157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32324818

RESUMO

Various diets and food components have been implicated as one of the environmental factors associated with inflammatory bowel disease (IBD). Patients are often recommended nutritional guidelines to manage disease symptoms. However, the current food consumption pattern of US adults with IBD that are nationally representative is unclear. A secondary analysis of National Health Interview Survey 2015 was performed to characterize the estimated US adults with IBD and their food intake and consumption frequency using bivariate and multivariate logistic regression. Fries were consumed by a greater number of people with IBD. IBD population drank less 100% fruit juice and ate more cheese and cookies than non-IBD population. Intake of fries (OR 1.60, 95% CI 1.14-2.25) and sports and energy drinks (OR 1.46, 95% CI 1.07-1.97) and more frequent drinking of regular soda were significantly associated with the likelihood of having been told one have IBD, while popcorn (OR 0.73, 95% CI 0.548-0.971) and milk (OR 0.70, 95% CI 0.497-0.998) were associated with smaller odds, adjusting for covariates. Foods typically labeled as junk food were positively associated with IBD. Nonetheless, of the assessed 26 foods, we found eating patterns between IBD and non-IBD population to be mostly analogous. It is unclear whether the results reflect potential change in food intake in IBD population long before the survey interview. Understanding the role of food intake in IBD risk/prevalence would benefit from identifying other environmental factors (i.e. food desert), food processing (i.e. frying), and potential bioactive food components that can induce intestinal inflammation that can increase the individual's susceptibility to IBD.


Assuntos
Dieta/estatística & dados numéricos , Ingestão de Energia/fisiologia , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bebidas Gaseificadas/estatística & dados numéricos , Bebidas Energéticas/estatística & dados numéricos , Comportamento Alimentar/fisiologia , Feminino , Frutas , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais/estatística & dados numéricos , Prevalência , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
18.
Einstein (Sao Paulo) ; 18: eAO5075, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32321080

RESUMO

OBJECTIVE: To evaluate the nutritional risk factors in patients eligible for hematopoietic stem cell transplantation. METHODS: A cross-sectional, descriptive study conducted with patients recruited from an hematology outpatient clinic. Study variables included demographic and clinical data, patient-generated global subjective assessment findings, anthropometric indicators, food intake and oxidative stress levels. The level of significance was set at 5% (p<0.05). RESULTS: The sample comprised 72 patients, mean age of 48.93 years (14.5%). Multiple myeloma was the most prevalent condition (51.4%) in this sample. Most patients (55.6%) were overweight according to body mass index and at risk of cardiovascular disease according to waist circumference, conicity index and percentage of body fat. Sarcopenia was associated with risk of cardiovascular disease, hip-to-waist ratio (p=0.021), muscle strength depletion (p<0.001), food intake (p=0.023), reduced functional capacity (p=0.048), self-reported well-nourished status; p=0.044) and inadequate vitamin B6 (p=0.022) and manganese (p=0.026) intake. Elevated oxidative stress, detected in 33.3% of patients in this sample, was not associated with sarcopenia. CONCLUSION: Most patients in this sample were overweight and sarcopenic. Lean mass depletion was associated with risk of cardiovascular disease, reduced muscle strength, food intake changes, reduced functional capacity, self-reported well-nourished status and inadequate intake of vitamin B6 and manganese, but not with oxidative stress.


Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Avaliação Nutricional , Medição de Risco/métodos , Adulto , Antropometria , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Estudos Transversais , Ingestão de Alimentos/fisiologia , Ingestão de Energia/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/fisiopatologia , Mieloma Múltiplo/cirurgia , Força Muscular/fisiologia , Estado Nutricional/fisiologia , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Estresse Oxidativo/fisiologia , Fatores de Risco , Sarcopenia/complicações , Sarcopenia/fisiopatologia
19.
J Phys Act Health ; 17(4): 456-463, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32176862

RESUMO

BACKGROUND: The present study examined, among weight-stable overweight or obese adults, the effect of increasing doses of exercise energy expenditure (EEex) on changes in total daily energy expenditure (TDEE), total body energy stores, and body composition. METHODS: Healthy, sedentary overweight/obese young adults were randomized to one of 3 groups for a period of 26 weeks: moderate-exercise (EEex goal of 17.5 kcal/kg/wk), high-exercise (EEex goal of 35 kcal/kg/wk), or observation group. Individuals maintained body weight within 3% of baseline. Pre/postphysical activity between-group measurements included body composition, calculated energy intake, TDEE, energy stores, and resting metabolic rate. RESULTS: Sixty weight-stable individuals completed the protocols. Exercise groups increased EEex in a stepwise manner compared with the observation group (P < .001). There was no group effect on changes in TDEE, energy intake, fat-free mass, or resting metabolic rate. Fat mass and energy stores decreased among the females in the high-exercise group (P = .007). CONCLUSIONS: The increase in EEex did not result in an equivalent increase in TDEE. There was a sex difference in the relationship among energy balance components. These results suggest a weight-independent compensatory response to exercise training with potentially a sex-specific adjustment in body composition.


Assuntos
Composição Corporal/fisiologia , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Terapia por Exercício/métodos , Exercício Físico/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Obesity (Silver Spring) ; 28(4): 822-829, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32144892

RESUMO

OBJECTIVE: The aim of this study was to test the protein leverage hypothesis in a cohort of youth with obesity. METHODS: A retrospective study was conducted in a cohort of youth with obesity attending a tertiary weight management service. Validated food questionnaires revealed total energy intake (TEI) and percentage of energy intake from carbohydrates (%EC), fats (%EF), and proteins (%EP). Individuals with a Goldberg cutoff ≥ 1.2 of the ratio of reported TEI to basal metabolic rate from fat-free mass were included. A subgroup had accelerometer data. Statistics included modeling of percentage of energy from macronutrients and TEI, compositional data analysis to predict TEI from macronutrient ratios, and mixture models for sensitivity testing. RESULTS: A total of 137 of 203 participants were included (mean [SD] age 11.3 [2.7] years, 68 females, BMI z score 2.47 [0.27]). Mean TEI was 10,330 (2,728) kJ, mean %EC was 50.6% (6.1%), mean %EF was 31.6% (4.9%), and mean %EP was 18.4% (3.1%). The relationship between %EP and TEI followed a power function (L coefficient -0.48; P < 0.001). TEI was inversely associated with increasing %EP. In the subgroup with < 60 min/d of moderate to vigorous physical activity (n = 48), lower BMI z scores were associated with higher %EP and moderate %EC. CONCLUSIONS: In youth with obesity, protein dilution by either carbohydrates or fats increases TEI. Assessment of dietary protein may be useful to assist in reducing TEI and BMI in youth with obesity.


Assuntos
Proteínas na Dieta/efeitos adversos , Ingestão de Energia/fisiologia , Obesidade/fisiopatologia , Adolescente , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos
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