Relationship between Phase Angle and Objective and Subjective Indicators of Nutritional Status in Cancer Patients: A Systematic Review.

To investigate the relationship between phase angle (PA) and objective and subjective indicators of nutritional status in cancer patients, as well as to identify cutoff points for PA, to detect malnutrition in these patients. The study was a systematic review, carried out following the guidelines of the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA). Literature search was performed for two authors, in indexed databases, including the National Library of Medicine, Bethesda, MD (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), and Scopus (Elsevier). We used the checklist from the Joanna Briggs Institute for assessing the risk of bias. The review was registered with the Systematic Review Registration (PROSPERO), number CRD42020134324. In total, nine papers were eligible. PA was correlated with several objective and subjective indicators of nutritional status in most cases. Cutoff point values for the PA, capable of detecting malnutrition, varied from 4.73° to 6°, despite the modest diagnostic accuracy. We assume that PA may be considered an indicator of nutritional status, when complementing additional data and assisting health practitioners in evaluating individuals with malignant neoplasms. However, a single cutoff point with fair and concomitant sensitivity and specificity was not identified.

Dietary inflammatory potential, cardiometabolic risk and inflammation in children and adolescents: a systematic review.

The Dietary Inflammatory Index (DII®) is a tool developed for quantifying the dietary inflammatory potential of individuals' diets, with the goal of assessing the effect of diet-associated inflammation on health outcomes. With most studies focusing on adults, little is known about the consequences for health of a more proinflammatory diet early in life. Hence, this study analyzed the available evidence on the association between the DII or the children's C-DII (C-DIITM) and cardiometabolic risk and inflammatory biomarkers in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed at the LILACS, ScienceDirect, Cochrane and PubMed databases, without any restriction regarding the dates of the publications. A total of six observational studies qualified; including three cross-sectional and three longitudinal studies focused on children and adolescents between 3 and 18 years of age representing both sexes. All papers found a positive association between the DII or C-DII with cardiometabolic markers. These included adiposity (i.e., BMI, waist and hip circumference, waist-to-height ratio and fat mass index), and/or to inflammatory biomarkers (interleukins 1, 2 and 6, tumor necrosis factor-alpha, interferon gamma, and soluble vascular cell adhesion molecule-1). In conclusion, findings currently available in the literature indicate that a proinflammatory diet is associated with a higher risk of early development of cardiometabolic and inflammatory changes during childhood. Also, the findings show the applicability of the DII and C-DII in epidemiological studies and underscore the need for strategies to encourage healthy, anti-inflammatory diets to prevent chronical illnesses. Systematic Review Registration Number (PROSPERO: CRD42019123939).

Predictive capacity of triglyceride-glucose (TyG) index for insulin resistance and cardiometabolic risk in children and adolescents: a systematic review.

Insulin resistance (IR) in childhood plays a key role in the development of metabolic changes in adulthood, therefore, it is important to diagnose it early. We aimed to investigate studies that evaluated the TyG index for prediction of IR risk and other cardiometabolic risk factors, as well as, the proposed cutoff points in childhood and adolescence. This is a systematic review elaborated according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The search was performed in Lilacs, PubMed and CAPES Journal Portal, using the terms "TyG index OR triglyceride-glucose index OR triglyceride and glucose index AND children OR adolescent*". Eight articles were included in this review. All were cross-sectional studies with individuals aged ≥2 and ≤20 years old, from the United States, Korea, Mexico, Brazil, and Iran. We concluded that the TyG index was positively associated with other IR prediction methods and appears to be advantageous for predicting IR risk and other cardiometabolic risk factors in children and adolescents (review registration: PROSPERO CRD42018100726).

Usefulness of the StrongKids Screening Tool in Detecting Anemia and Inflammation in Hospitalized Pediatric Patients.

Objective: To assess whether the nutritional risk classified by StrongKids is associated with anemia and inflammation (total leukocytes and C-reactive protein (CRP)), as well as to compare the ability of StrongKids with anthropometry in identifying these changes in hospitalized pediatric patients.Methods: Cross-sectional study with patients admitted to the pediatric ward of a public hospital in Brazil, from 2014 to 2018. The experimental protocol included: nutritional risk screening by StrongKids; weight and height measurements; and biochemical tests (complete blood count and C-reactive protein - CRP). Sensitivity, specificity, positive predictive value and negative predictive value were calculated to assess the ability of StrongKids and anthropometry to identify patients with the biochemical changes.Results: The study included 482 patients (54.2% male), with a median age of 2.7 years. The frequency of nutritional risk (medium or high) was 85.9% and the prevalence of malnutrition (acute and/or chronic) was 20.2%. Overall, of the patients evaluated, 40.2% had anemia, 28.2% leukocytosis, and 78.0% high CRP. Children and adolescents classified as at nutritional risk (moderate/high) had lower levels of hemoglobin and higher levels of CRP and total leukocytes, as well as a higher frequency of leukocytosis, high CRP and the three alterations combined when compared with individuals at low risk. No association was found between anthropometric variables and biochemical alterations. The sensitivity of nutritional screening was high to detect all biochemical alterations and was superior to the anthropometric assessment.Conclusion: StrongKids was associated with alterations in biochemical parameters with a better performance than anthropometry.

Predictive capacity and cut-off points of adiposity indices for body fat prediction according to adolescent periods.

Overweight is increasing in the adolescent population and became a public health problem in the world. This study aimed to identify the body adiposity indices (BAI) with the best capacity to predict excess fat tissue and propose cut-off points for them, according to sex and adolescence period. This is a cross-sectional study. We calculated BMI, conicity index (CI), BAI, body roundness index (BRI), waist:height ratio (WtHR) and waist:hip ratio. Predictive capacity and cut-off points of adiposity indices were established by ROC (receiver operating characteristic) curves. We determined AUC-ROC and CI, stratified by sex and adolescence period. The best index to identify excess body fat in 10-13-year-old female adolescents was the WtHR (AUC = 0·92), like the BAI in girls aged from 14 to 16 years old (AUC = 0·87) and 17 to 19 years old (AUC = 0·80). In male adolescents aged from 10 to 13 years old and 14 to 16 years old, the best index was the WtHR (AUC = 0·93 and AUC = 0·8, respectively), like the BAI in boys aged from 17 to 19 years old (AUC = 0·95). The use of indices with specific cut-off points for each period of adolescence and according to sex is important for the reliable diagnosis of excess body fat. It is advisable to use indices together to obtain a more accurate assessment. Thus, the WtHR and BAI are reproducible and reliable, with high sensitivity and specificity values, and can be used together with the BMI.

Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review.

OBJECTIVE: To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. DESIGN: The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. SETTING: School, university and population. PARTICIPANTS: Adolescents between 10 and 19 years old. RESULTS: A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. CONCLUSIONS: The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).

TAG-glucose (TyG) index in childhood: an estimate of cut-off points and the relation to cardiometabolic risk in 4- to 9-year-old children.

OBJECTIVE: To propose cut-off points for the TAG-glucose (TyG) index in Brazilian children and evaluate the link to cardiometabolic risk. DESIGN: A cross-sectional study with children from a municipality in Minas Gerais, Brazil. Anthropometric (weight, height, waist circumference and waist:height ratio), biochemical (lipid and glucose profile) and blood pressure (BP) tests were performed. Using the receiver operating characteristic curve, cut-off points for the TyG index were proposed according to sex using homoeostasis model of assessment - insulin resistance (IR) as the reference method. SETTING: Viçosa, MG, Brazil. PARTICIPANTS: Children aged 4-9 years (n 515). RESULTS: The TyG index cut-off points to identify the risk of IR were 7·9 and 8·1 for boys and girls, respectively. We observed that 48·7 % of the children had an increased TyG index. The increased TyG index was associated with overweight, total body and central fat, increased BP and altered lipid profile. Children with an increased TyG index had a higher accumulation of cardiometabolic risk factors. CONCLUSIONS: According to the cut-off points proposed by the current study, children at risk of IR estimated by the TyG index presented a higher cardiometabolic risk, including isolated risk factors, as to the higher accumulation of these.

Vitamin D is associated with the hypertriglyceridemic waist phenotype in Brazilian children.

BACKGROUND: Prevalence of cardiometabolic risk factors is increasing and vitamin D insufficiency/deficiency has become a worldwide public health problem, even in tropical countries. Therefore, we identified the prevalence of hypertriglyceridemic waist phenotype (HWP) and evaluate its relationship with vitamin D insufficiency/deficiency. METHODS: A cross-sectional study with 378 children aged 8 and 9 enrolled in all urban schools in the city of Viçosa, MG, Brazil. Anthropometric measurements, body composition (dual energy X-ray absorptiometry), biochemical tests and clinical evaluation were performed. Poisson regression was used to analyze the association between vitamin D and HWP. RESULTS: Prevalence of HWP was 16.4%. This prevalence was higher among children with vitamin D insufficiency and deficiency and in those with a greater number of other cardiometabolic risk factors. Multiple regression analysis showed that children with vitamin D insufficiency and deficiency had, respectively, prevalence 85% (95% CI: 1.03-3.30) and 121% (95% CI: 1.11-4.45) higher of HWP than the vitamin D sufficiency group. CONCLUSION: Vitamin D insuffiency and deficiency were associated with a higher prevalence of HWP among children, regardless of the presence of other cardiometabolic risk factors, indicating an additional risk of inadequate vitamin D status to cardiometabolic health in childhood.

Prevalence of processed and ultra-processed food intake in Brazilian children (6-24 months) is associated with maternal consumption and breastfeeding practices.

The aim of this study is to identify maternal consumption of processed and ultra-processed foods and to verify the factors associated with the supply of these foods to Brazilian children. This is a cross-sectional study with 231 mothers and children aged from 6 to 24 months. The mother's and children's food consumption was measured using three 24-hour recalls. The foods consumed were categorised according to the NOVA classification. The data were analysed by multinomial logistic regression. The supply of processed and ultra-processed foods to children was associated with the child's age (T2: OR = 1.17, p<.001; T3: OR = 1.23, p<.001), the absence of breast milk consumption (T3: OR = 3.82, p=.006) and the greater consumption of these foods by mothers (T2: OR = 3.15, p=.018; T3: OR = 4.59, p=.004). We conclude that mothers who consume processed and ultra-processed foods also include them in complementary feeding, and the consumption of these foods by the child increases with age, absence of breastfeeding, and with increased maternal consumption.

Nutritional Screening Tools Used and Validated for Cancer Patients: A Systematic Review.

The purpose of this systematic review was to identify validated nutritional screening tools for cancer patients. The research was conducted in the electronic databases Pubmed, Cochrane Library, Scopus, and Biblioteca Virtual de Saúde (BVS), using the descriptors "Nutrition Assessment", "Neoplasms", and "Validation studies". Initially, we identified 168 articles. After assessing eligibility, we included 21 studies. In selected studies, 14 nutritional screening tools were validation objects. The Patient-Generated Subjective Global Assessment (PG-SGA) showed better sensitivity, specificity and positive and negative predictive values (98, 82, 95, and 93%, respectively), as well as predictive of overall survival in cancer patients. In many countries, in addition to PG-SGA, the Nutrition Risk Screen (NRS-2002) is recommended for these patients. We did not identify, however, manuscripts that proposed validation. Validation studies of nutritional screening tools should be performed on patients with cancer, using representative samples of these individuals for better reliability of their results.

Association of exclusive breastfeeding duration with consumption of ultra-processed foods, fruit and vegetables in Brazilian children.

BACKGROUND: There has been little evidence of the influence of breastfeeding on childhood eating habits. AIM: To evaluate the association between duration of exclusive breastfeeding (EB) and consumption of ultra-processed foods, fruits and vegetables by Brazilian children. METHODS: This is a cross-sectional study nested in a cohort of 403 children age 4-7 years. Food consumption was evaluated by three food records and the foods were grouped by the amount of processing involved (minimal, including fruit and vegetables to ultra-processed foods). Adjusted linear and multinomial regression models were proposed to evaluate the association of EB with children's food intake. Median duration of EB was 4.0 (2.0-6.0) months and the prevalence of EB of 4 months or more was 60.9%. RESULTS: Mean energy consumption was 1536 kcal/day, 38% of energy was from ultra-processed foods. Mean intake of fruit and vegetables was 130 g/day. For each 1-month increase in duration of EB there was a 0.7% decrease in energy from ultra-processed foods (ß: - 0.7; 95% CI: - 1.3 to 0.1; p = 0.038). EB of less than 4 months was associated with the child being in the lowest tercile for consumption of fruit and vegetables (Adjusted OR: 1.8; 95% CI: 1.1-3.0; p = 0.030) and the highest for consumption of ultra-processed foods (adjusted OR: 1.7; 95% CI: 1.1-2.9; p = 0.040). CONCLUSIONS: In addition to other benefits of EB, we emphasize its importance for the formation of healthy eating habits, contributing to a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods in childhood.

Waist circumference, waist-to-height ratio and conicity index to evaluate android fat excess in Brazilian children.

OBJECTIVE: To evaluate the ability of anthropometric measurements to identify excess android fat and to propose cut-off points for excess central adiposity in children, according to age and sex. DESIGN: A cross-sectional study with children from a municipality of Minas Gerais, Brazil. Receiver-operating characteristic curve analyses were performed to evaluate waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (C-index) in estimating excess android fat by dual energy X-ray absorptiometry (DXA). SETTING: Viçosa, Minas Gerais, Brazil. SUBJECTS: Children aged 4-9 years (n 788). RESULTS: Overweight prevalence was 29·1 % and android fat percentage was higher among girls. All central fat measurements were able to discriminate excess android fat in the age groups evaluated, especially WC and WHtR, with cut-off points showing good sensitivity and specificity overall. CONCLUSIONS: Because these methods are easy to obtain and inexpensive, it is possible to use WC, WHtR and C-index in population surveys to evaluate central obesity. The proposed cut-off points showed satisfactory values of sensitivity and specificity and can be used in epidemiological studies.

Contribution of the production for self-consumption to food availability and food security in households of the rural area of a Brazilian city.

Production for self-consumption can meet the principles of food safety such as respect for food habits and diversity. The participation of production for self-consumption in food availability was compared to the purchase of food for 30 days in 79 households (272 inhabitants) of the rural area of a Brazilian city in 2012. The food security was evaluated by the method "Food energy deficiency in the domicile" that classified 12.7% of the households as insecure. In all households, staple foods (rice, pasta, corn, beans, milk, eggs, meats) were available and more than 60% had processed foods (cookies, soft drinks). Only 22.7% of the calories came from production for own consumption and the biggest expense was the purchase of carbohydrates (91.1%), mainly sugar (12.2%). Evaluating only the energy availability of food is not sufficient since the quality and origin of food is of great relevance in the food security condition.

Overweight and Body Image Perception in Adolescents with Triage of Eating Disorders.

PURPOSE: To verify the influence of overweight and alteration in the perception of the corporal image during the triage of eating disorders. METHOD: A food disorder triage was performed in adolescents with 10 to 19 years of age using the Eating Attitudes Test (EAT-26), Children's Eating Attitudes Test (ChEAT), and Bulimic Investigatory Test Edinburgh (BITE), as well as a nutritional status evaluation. The perception of body image was evaluated in a subsample of adolescents with 10 to 14 years of age, using the Brazilian Silhouette Scale. The project was approved by the Human Research Ethics Committee of the Federal University of Viçosa, Minas Gerais, Brazil. RESULTS: The prevalence of eating disorder triage was 11.4% (n = 242) for the 2,123 adolescents evaluated. Overweight was present in 21.1% (n = 447) of the students, being more prevalent in the early adolescence phase, which presented levels of distortion of 56.9% (n = 740) and dissatisfaction of 79.3% (n = 1031). Body dissatisfaction was considered as a risk factor, increasing by more than 13 times the chance of TA screening. CONCLUSION: Overweight was correlated with the ED triage and body dissatisfaction was considered as a risk factor, increasing the chances of these disorders by more than 13 times.

Dietary calcium intake is inversely associated with blood pressure in Brazilian children.

This study aimed to evaluate the dietary calcium intake and its association with blood pressure in childhood. It is a cross-sectional study with a sample of 347 Brazilian children aged 8 and 9 years. We evaluated calcium intake through three dietary records. Blood pressure was measured following the recommendations of the Brazilian Society of Cardiology. The intake of calcium was below recommendations for almost all children (96.3%). There was statistically significant difference in the means of systolic (p = .041) and diastolic (p = .047) blood pressure in the tertiles of calcium intake. After adjustment of regression model, each tertile of calcium intake showed that the systolic and diastolic blood pressure was reduced in 1.53 (95% confidence interval: -2.84 to -0.21) and 1.83 mmHg (95% confidence interval: -3.49 to -0.19), respectively. Our results showed an inverse association between dietary calcium intake and blood pressure in childhood.

Aerobic exercise did not have compensatory effects on physical activity levels in type 2 diabetes patients.

Although exercise promotes beneficial effects in diabetic patients, some studies have questioned the degree of their importance in terms of the increase in total energy expenditure. In these studies, the decrease of physical activity levels (PAL) was referred as "compensatory effect of exercise". However, our aim was to investigate whether aerobic exercise has compensatory effects on PAL in type 2 diabetes patients. Eight volunteers (51.1 ± 8.2 years) were enrolled in a supervised exercise programme for 8 weeks (3 d · wk(-1), 50-60% of VO2 peak for 30-60 min). PAL was measured using tri-axial accelerometers in the 1st, 8th and 12th weeks. Biochemical tests, cardiorespiratory fitness, anthropometric assessment and body composition were measured in the 2nd and 11th weeks. Statistical analysis was performed using non-parametric tests (Friedman and Wilcoxon, P < 0.05). We found no significant differences in PAL between intervention periods, and participants spent the majority of their awake time in sedentary activities. However, the exercise programme generated a significant 14.8% increase in VO2 peak and a 15% reduction in fructosamine. The exercise programme had no compensatory effects on PAL in type 2 diabetes patients, but improved their cardiorespiratory fitness and glycaemic control.

Influence of weight gain rate on early life nutritional status and body composition of children.

OBJECTIVE: To evaluate the influence of the weight gain rate at 4-6 months on nutritional status and body composition in children between 4 and 7 years of age. METHODS: Retrospective cohort study, sample of 257 children. Data collection was performed in two stages, with the first relating to retrospective data of weight gain from birth to the first 4-6 months of life in the patient records. Measurements of weight, height, waist circumference, and body composition in children between ages 4 and 7 years were obtained. Nutritional status was assessed by the BMI/age. Control variables, such as pregnancy, breastfeeding, lifestyle, and sociodemographics, were studied. Descriptive analysis and multiple linear regression were performed. RESULTS: In the nutritional status assessment, the prevalence of overweight observed was 24.9%. After adjusting for control variables, it was found that the increase of the WGR at 4-6 months of age explained the occurrence of higher BMI/age, percentage of total body fat, body fat percentage in the android region, and waist circumference in children between 4 and 7 years of age. CONCLUSION: The increase of the WGR in the first months of life can lead to the occurrence of higher values of parameters of nutritional status and body composition in later life.

Association between obesity and calcium:phosphorus ratio in the habitual diets of adults in a city of Northeastern Brazil: an epidemiological study.

BACKGROUND: Low calcium:phosphorus ratios (Ca:P ratio) in habitual diet have been observed worldwide, and it has been shown to be harmful to the bone health of the population. However, no study associating this ratio with obesity was found. Thus, considering that the intake of calcium and phosphorus will generate a ratio between them, which may be associated with obesity, this research seeks at evaluating the relation between obesity and the Ca:P ratio in the habitual diet of adults. METHODS: Cross-sectional population-based epidemiological study with stratified and systematic sampling. The sample was composed of 506 adults, aged between 18 and 60 years, of both genders. Information on socioeconomic and demographic conditions was obtained through questionnaires completed during home visits, where anthropometric and dietary evaluations were also conducted. RESULTS: In the habitual diet consumed by the study subjects, a Ca:P ratio above the median of 0.57 reduced the risk of central obesity based on waist-to-height ratio (WHtR) (OR: 0.61; 95% CI: 0.41 - 0.92). Habitual dietary intake of calcium (OR: 0.65; 95% CI: 0.43 - 0.97) and dairy products (OR: 0.56; 95% CI: 0.37 - 0.84) above the median value (485.4 mg and 0.9 servings, respectively) was found to be a protective factor related to central obesity based on WHtR. CONCLUSIONS: Values above the median for the Ca:P ratio found in the habitual diet were negatively associated with central obesity based on WHtR. In addition, calcium and dairy consumption were negatively associated with central obesity based on WHtR. Therefore, higher Ca:P ratios contributed to a lower prevalence of central obesity.

Proinflammatory maternal diet and early weaning are associated with the inflammatory diet index of Brazilian children (6-12 mo): A pathway analysis.

OBJECTIVE: The aim of this study was to assess the dietary inflammatory index (DII) and its association with maternal factors and excess body weight in Brazilian children aged <2 y during complementary feeding. METHODS: This was a cross-sectional study (2016-2019), conducted with 231 mothers and children ages 6 to 24 mo. The food consumption of the mother-child dyad was obtained through the mean of three 24-h recalls, as well as information on the consumption of breast milk. The DII was used to verify the quality of the diet. Children's weight and length were measured, and the weight/height index was calculated. Path analysis was used to assess the interrelationships between variables. Multiple linear regression was conducted to identify the components of the child's DII (C-DII) that contributed the most to explaining its variation. RESULTS: The children had an anti-inflammatory diet (C-DII -0.37 ± 0.91) whereas the mothers had a proinflammatory diet (M-DII +0.24 ± 0.86). Fiber was the nutrient that contributed most to the variations in the C-DII. Approximately 28% of children were overweight. In the pathway analysis, we verified a direct negative effect of education on excess body weight (standardized coefficients [SC], -0.180; P = 0.034) and C-DII (SC, -0.167; P = 0.002); negative direct effect of breastfeeding on the C-DII (SC, -0.294; P < 0.001); and positive direct effect of M-DII on C-DII (SC, 0.119; P = 0.021). CONCLUSION: Children's proinflammatory diet during the period of complementary feeding was associated with maternal proinflammatory diets, lower education, and absence of breastfeeding practice.

Metabolic syndrome and risk factors in children: a risk score proposal.

INTRODUCTION/OBJECTIVE: The lack of international consensus on the definition of Metabolic Syndrome (MS) in the pediatric population makes it difficult to estimate its prevalence. In this study, we intend to identify MS prevalence and a cutoff point based on a continuous score in children aged four to seven years. METHODS: A cross-sectional study of 402 children (4-7 years) monitored by the Lactation Support Program (PROLAC). A continuous MS risk score was assessed using Principal Component Analysis (PCA). In order to calculate the score, the following MS risk factors were considered: Waist circumference (WC), High Density Lipoprotein (HDL), Triglycerides (TG), Blood Pressure (BP) and Blood sugar. Using a Receiver Operating Characteristics (ROC) curve, the cutoff point for predicting MS risk based on continuous score was evaluated. RESULTS: A progressive increase in MS scores was observed according to increase in the number of risk factors. This increase was also observed when comparing boys and girls (p < 0.001). In the absence of MS, the median score among the children was -0.0486 (-0.2929-0.2151). For children with MS, the median score was 0.5237 (0.2286-0.7104) (p < 0.001). The best cutoff score for predicting MS in children aged four to five years was >0.09 (100% sensitivity and specificity 72.67%). For children aged six to seven years, this value was >0.14 (100% sensitivity and 64.65% specificity). CONCLUSION: The calculated continuous risk score can predict MS with good accuracy and high sensitivity and reasonable specificity.