Blood pressure variation and ultra-processed food consumption in children with obesity.

To investigate the influence of ultra-processed food (UPF) consumption on systolic (SBP) and diastolic (DBP) blood pressure in children with obesity, using dietary and urinary markers. We conducted a secondary analysis of a randomized clinical trial involving children with obesity, aged 7 to 12 years. Over a period of six months, the children and their guardians attended monthly individual consultations and educational activities aimed at promoting a reduction in UPF consumption. During each visit, measurements of blood pressure, body weight, height, and 24-h dietary recall were recorded. Additionally, spot urine samples were collected at baseline, and at the second and fifth-month follow-ups. A total of 96 children were included in the analysis. Energy intake, UPF intake and blood pressure showed a quadratic pattern of change, with a decrease in the first two months and an increase thereafter. There was an association between UPF consumption and DBP. The intake of UPF was correlated with the urinary sodium-to-potassium (Na/K) ratio (r = 0.29; p = 0.008) and the dietary Na/K ratio (r = 0.40; p < 0.001). For every 100 g increase in UPF, DBP increased by 0.28 mmHg (p-value = 0.01). After further adjustment for changes in body mass index (BMI), and physical activity, the increase in DBP was 0.22 mmHg.    Conclusion: Our findings indicate that reducing UPF consumption may have an impact on blood pressure in children with obesity. Additional adjustment for BMI and physical activity did not influence the results. Therefore, reducing UPF consumption can be considered as a strategy against hypertension. What is Known: • Ultra-processed food consumption is associated with an increased risk of cardiovascular disease; however, this evidence is still limited in children. • Intake of calories from ultra-processed food in relation to the total calories is increasing worldwide. What is New: • Ultra-processed food consumption has an effect on the diastolic blood pressure, independent of changes in weight. • The intake of ultra-processed food was correlated to the dietary sodium-to-potassium ratio (r = 0.40; p < 0.001).

[Abdominal ultrasound and magnetic resonance imaging: a comparative study on the non-alcoholic fatty liver disease diagnosis in morbidly obese patients]. / Ultrassonografia e ressonância magnética: estudo comparativo no diagnóstico da esteatose em obesos grau III.

OBJECTIVES: To evaluate the concordance between abdominal ultrasound and an MRI (Magnetic Resonance Imaging) in the diagnosis of non-alcoholic fatty liver disease (NAFLD), and concordance of these two methods with the histopathological exam. METHODS: The population studied was comprised of 145 patients with morbid obesity (BMI > or = 40 Kg/m(2)), of both genders. NAFLD diagnosis was performed by MRI and Ultrasound. Liver biopsy was performed in a sub-sample (n=40). To evaluate the concordance of these two methods, the kappa coefficient was used. RESULTS: Concordance between both methods (MRI and Ultrasound) was poor and not significant (Kappa adjusted= 0.27; CI 95%= 0.07-0.39.) Nevertheless a slight concordance was found between diagnosis of NAFLD by ultrasound and the hepatic biopsy, with 83.,3% of concordant results and Kappa adjusted= 0.67.Results of an MRI and the histopathological exam were compared and results showed 53.6% of concordant results and kappa adjusted= 0.07. CONCLUSION: The concordance found in the diagnosis performed using the ultrasound method and the hepatic biopsy, shows a need to implement and perform more research on the use of ultrasound to validate and reconsider these methods. This would minimize the need to perform biopsies to detect and diagnose such disease.

Ultrassonografia e ressonância magnética: estudo comparativo no diagnóstico da esteatose em obesos grau III / Abdominal ultrasound and magnetic resonance imaging: a comparative study on the non-alcoholic fatty liver disease diagnosis in morbidly obese patients

OBJETIVOS: Avaliar a concordância entre a ressonância magnética (RM) e a ultrassonografia abdominal (USG) no diagnóstico da doença hepática gordurosa não-alcoólica (DHGNA), bem como a concordância entre cada método com o exame padrão-ouro histopatológico. MÉTODOS: A população estudada foi constituída por 145 pacientes com obesidade grau III (IMC > 40 Kg/m²), de ambos os sexos. O diagnóstico da DHGNA foi realizado por ultrassonografia e ressonância magnética. Em uma subamostra foi realizado o diagnóstico por biópsia hepática (n=40). Para avaliar a concordância entre os diagnósticos por USG e RM, utilizou-se o coeficiente Kappa. RESULTADOS: Observou-se uma concordância fraca entre os dois métodos (Kappa ajustado= 0,27; IC 95 por cento= 0,07-0,39). Foi encontrada uma concordância moderada entre o diagnóstico da doença por USG e biópsia hepática, com 83,3 por cento de resultados concordantes e Kappa ajustado de 0,67. Já a concordância entre o diagnóstico por RM e histopatológico foi ausente, com 53,6 por cento de resultados concordantes e Kappa ajustado de 0,07. CONCLUSÃO: A boa concordância encontrada entre o diagnóstico realizado pela USG e a biópsia hepática reforça a necessidade de condução de mais estudos como os que vêm recomendando uma padronização da avaliação diagnóstica por USG como forma de minimizar a necessidade da realização da biópsia hepática para diagnóstico de formas mais graves da doença.

OBJECTIVES: To evaluate the concordance between abdominal ultrasound and an MRI (Magnetic Resonance Imaging) in the diagnosis of non-alcoholic fatty liver disease (NAFLD), and concordance of these two methods with the histopathological exam. METHODS: The population studied was comprised of 145 patients with morbid obesity (BMI > 40 Kg/m²), of both genders. NAFLD diagnosis was performed by MRI and Ultrasound. Liver biopsy was performed in a sub-sample (n=40). To evaluate the concordance of these two methods, the kappa coefficient was used. RESULTS: Concordance between both methods (MRI and Ultrasound) was poor and not significant (Kappa adjusted= 0.27; CI 95 percent= 0.07-0.39.) Nevertheless a slight concordance was found between diagnosis of NAFLD by ultrasound and the hepatic biopsy, with 83.,3 percent of concordant results and Kappa adjusted= 0.67.Results of an MRI and the histopathological exam were compared and results showed 53.6 percent of concordant results and kappa adjusted= 0.07. CONCLUSION: The concordance found in the diagnosis performed using the ultrasound method and the hepatic biopsy, shows a need to implement and perform more research on the use of ultrasound to validate and reconsider these methods. This would minimize the need to perform biopsies to detect and diagnose such disease.