Hyperferritinemia worsens the perinatal outcomes of conceptions of pregnancies with preeclampsia.

BACKGROUND AND AIMS: To analyze the prevalence of hyperferritinemia in pregnant women with preeclampsia and its association with adverse perinatal outcomes. METHODS: A cross-sectional study carried out in 2017 with a convenience sample of pregnant women with preeclampsia attended at a high-risk maternity hospital in Alagoas, Brazil. Socioeconomic, lifestyle, clinical and biochemical data were collected through a structured questionnaire. Type of delivery, gestational age, weight and length at birth, and Apgar score were analyzed as outcome variables. Women were dichotomized according to the serum ferritin level (150 ng/mL). Poisson regression models were used to analyze the effect of hyperferritinemia on the outcome variables. Estimates were presented as prevalence ratio with 95% confidence intervals (PR [95% CI]). RESULTS: Based on the Fisher's exact statistical teste and in the proportions of the neonatal outcome (birth weight), with a statistical significance of 5%, the statistical power of the sample studied was 83%. Two hundred six pregnant women with preeclampsia were recruited, which 8.74% presented hyperferritinemia. Except for ferritin level, there were no differences in C-reactive protein (CRP), hemoglobin, Glutamate Oxaloacetate Transaminase (GOT) and Pyruvic Glutamic Transaminase (PGT) levels between women with or without hyperferritinemia. After adjusting for potential confounders, hyperferritinemia was associated with low birth weight (2.19 [2.13-3.89 95%CI]), low birth length (7.76 [2.52-23.8 95% CI]) and being born small for gestational age (3.14 [1.36-7.28 95% CI]). CONCLUSION: In the presence of hyperferritinemia, preeclampsia patients were associated with a higher rate of unfavorable neonatal outcomes.

Food Insecurity and the Negative Impact on Brazilian Children's Health-Why Does Food Security Matter for Our Future Prosperity? Brazilian National Survey (PNDS 2006/07).

BACKGROUND: Food insecurity (FI) refers to limited or uncertain access to food resulting from financial constraints. Numerous studies have shown association between FI and adverse health outcomes among adults and children around the world, but in Brazil, such information is scarce, especially if referring to nationally representative information. OBJECTIVE: To test for an independent association between FI and health outcomes. METHODS: Most recent Brazilian Demographic and Health Survey using nationally representative complex probability sampling. Participants were 3923 children <5 years of age, each representing a household. Data from the validated Brazilian Food Insecurity Scale were dichotomized as food secure (food security/mild FI) or food insecure (moderate FI/severe FI). Poisson regression was used to test for associations between FI and various health indicators. RESULTS: Models adjusted for socioeconomic and demographic variables showed that children hospitalized for pneumonia or diarrhea were 30% more prevalent in FI households (adjusted prevalence ratio [aPR]: 1.3; 1.1-1.6). Underweight children were 40% more prevalent in FI households (aPR: 1.4; 1.1-1.7). Children who didn't eat meat and fruits and vegetables every day were 20% and 70% more prevalent in FI households (aPR: 1.2; 1.1-1.4 and aPR: 1.7; 1.3-2.3), respectively. CONCLUSION: Children who grow up in food-insecure households have been shown to have worse health conditions than those in food-secure households. Consequently, their human capital accumulation and work-life productivity are likely to be reduced in the future, leading them into adulthood less capable of generating sufficient income, resulting in a cycle of intergenerational poverty and FI.

Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review.

OBJECTIVE: To evaluate the effectiveness of school-based nutrition education in reducing or preventing overweight and obesity in children and adolescents. SOURCES: Systematic search in 14 databases and five systematic reviews for randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. Body mass index and fruit and vegetable intake were used as primary and secondary measures of outcome, respectively. There was no restriction by date of publication or language, except for languages with structured logograms. We excluded studies on specific populations presenting eating disorders, dyslipidemia, diabetes, and physical or mental disabilities, as well as studies that used drugs or food supplements as components of the intervention. The assessment by title and abstract and the quality assessment were performed independently by two researchers. We used the Centre for Reviews and Dissemination's guidance for undertaking reviews in health care and the software EPPI-Reviewer 3. SUMMARY OF THE FINDINGS: From the initially retrieved 4,809 references, 24 articles met the inclusion criteria. The extracted data show that there is evidence of positive effects on anthropometry and of increase in fruit and vegetable consumption. Characteristics of the interventions that demonstrated effectiveness are: duration > 1 year, introduction into the regular activities of the school, parental involvement, introduction of nutrition education into the regular curriculum, and provision of fruits and vegetables by school food services. CONCLUSION: Interventions in schools to reduce overweight and obesity, as well as to increase fruits and vegetable consumption, have demonstrated effectiveness in the best-conducted studies.

A efetividade de intervenções de educação nutricional nas escolas para prevenção e redução do ganho excessivo de peso em crianças e adolescentes: uma revisão sistemática / Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review

OBJETIVO: Avaliar a efetividade da educação nutricional em escolas na redução ou prevenção de sobrepeso e obesidade em crianças e adolescentes. FONTES DOS DADOS: Busca sistemática em 14 bases de dados e cinco revisões sistemáticas por ensaios controlados randomizados realizados em escolas com o objetivo de reduzir ou prevenir o sobrepeso em crianças e adolescentes. O índice de massa corporal e o consumo de frutas e verduras foram utilizados como desfechos primário e secundário, respectivamente. Não houve restrição de data de publicação ou idioma, exceto para idiomas com logogramas. Excluímos estudos em populações com distúrbios alimentares, dislipidemia, diabetes e deficiência física ou mental, e que utilizassem medicamentos ou suplementos alimentares. A avaliação por título e resumo e a avaliação de qualidade foram realizadas de forma independente por dois pesquisadores. Utilizamos as orientações do Centre for Reviews and Dissemination para a elaboração de artigos de revisão em saúde e o programa EPPI-Reviewer 3. SÍNTESE DOS DADOS: Das 4.809 referências inicialmente encontradas, 24 artigos preencheram os critérios de inclusão. Os dados extraídos apresentam evidências de efeitos antropométricos positivos e de aumento no consumo de frutas e verduras. As intervenções com as seguintes características demonstraram ser efetivas: duração > 1 ano, introdução como atividade regular da escola, envolvimento dos pais, introdução da educação nutricional no currículo regular e fornecimento de frutas e verduras pelos serviços de alimentação da escola. CONCLUSÃO: As intervenções para reduzir o sobrepeso e a obesidade e aumentar o consumo de frutas e verduras foram efetivas nos estudos bem conduzidos.

OBJECTIVE: To evaluate the effectiveness of school-based nutrition education in reducing or preventing overweight and obesity in children and adolescents. SOURCES: Systematic search in 14 databases and five systematic reviews for randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. Body mass index and fruit and vegetable intake were used as primary and secondary measures of outcome, respectively. There was no restriction by date of publication or language, except for languages with structured logograms. We excluded studies on specific populations presenting eating disorders, dyslipidemia, diabetes, and physical or mental disabilities, as well as studies that used drugs or food supplements as components of the intervention. The assessment by title and abstract and the quality assessment were performed independently by two researchers. We used the Centre for Reviews and Dissemination's guidance for undertaking reviews in health care and the software EPPI-Reviewer 3. SUMMARY OF THE FINDINGS: From the initially retrieved 4,809 references, 24 articles met the inclusion criteria. The extracted data show that there is evidence of positive effects on anthropometry and of increase in fruit and vegetable consumption. Characteristics of the interventions that demonstrated effectiveness are: duration > 1 year, introduction into the regular activities of the school, parental involvement, introduction of nutrition education into the regular curriculum, and provision of fruits and vegetables by school food services. CONCLUSION: Interventions in schools to reduce overweight and obesity, as well as to increase fruits and vegetable consumption, have demonstrated effectiveness in the best-conducted studies.