Association between Ultra-Processed Food Consumption and Excess of Weight in Women with Endometrial Cancer.

Obesity is one of major risk factor for endometrial cancer, which is the eighth most incident cancer among women in Brazil. The present study aimed to assess any possible associations between ultra-processed food (UPF) consumption and clinical or sociodemographic characteristics of women diagnosed with endometrial cancer. This is a cross-sectional study with women newly diagnosed with endometrial cancer (EC). The study was conducted between December 2016 and January 2020, at a reference center for gynecological cancer treatment. The nutritional status was assessed by measuring anthropometric parameters and food consumption by the food frequency questionnaire. Multiple logistic regression was performed for the dependent variables overweight and obesity. The analyses were considered statistically significant when p < 0,05. The study population consisted of 318 women, with a mean age of 59.1 ± 6.9 years. The average daily energy intake was 2365.13 kcal/day, with 70.48% of energy consumption from fresh or minimally processed foods and 16.95% from UPF. Women above the highest tertile of UPF intake (19.27%) were more likely to be obese (OR: 1.95; 95% CI: 1.12; 3.41, p < 0.01). Having a partner and systemic arterial hypertension was associated with the outcome. The high intake of UPF was associated with obesity, which indicates the need for nutritional intervention in this population.

Effects of NO2 exposure on daily mortality in São Paulo, Brazil.

BACKGROUND: Recent reports have suggested that air pollution mixtures represented by nitrogen dioxide (NO2) may have effects on human health, which are independent from those of particulate matter mass. We evaluate the association between NO2 and daily mortality among elderly using one- and multipollutant models. METHODS: This study was a daily time series of non-accidental and cause-specific mortality among the elderly living in São Paulo, Brazil, between 2000 and 2011. Effects of NO2, particulate matter smaller than 10µm (PM10), carbon monoxide (CO) and ozone (O3) were estimated in Poisson generalized additive models. The single lag effect at lags 0 and 1 days and the cumulative effect from 0 to lag 10 days were evaluated in one-, two-, three- and four-pollutant models. The cumulative risk index (CRI) recently proposed to analyze associations with health of multiple correlated pollutants was additionally estimated for each multipollutant model. RESULTS: An association between NO2, PM10, CO and O3 exposures and non-accidental and cause-specific deaths was found in one-pollutant models. NO2 effects remained significant in multipollutant models for non-accidental and circulatory deaths. The estimated CRIs suggested that circulatory deaths were mainly associated with NO2, and respiratory deaths mainly with CO and O3, regardless the lag. For non-accidental deaths, multipollutant models were associated with the highest CRI, with the main pollutants depending on the chosen lag. CONCLUSIONS: The results suggest that air pollution mixtures represented by NO2 have an effect on non-accidental and circulatory mortality, which is independent from PM10, CO and O3. The CRI was always larger than the risks associated with single pollutants.

Predisposing factors for postoperative nausea and vomiting in gynecologic tumor patients.

PURPOSE: To evaluate the predictors of postoperative nausea and vomiting (PONV) in women with gynecologic tumor. METHODS: The analysis was based on prospectively collected data of 82 adult patients with gynecologic tumor, who were submitted to open surgical treatment and undergoing general anesthesia. The predictors included were age ≥50 years, non-smoker, use of postoperative opioids, mechanical bowel preparation, intraoperative intravenous hydration (IH) ≥10 mL/kg/h, and IH in the immediate postoperative, first and second postoperative days (PO1 and PO2) ≥30 mL/kg. A score with predictor variables was built. A multiple logistic regression was fitted. To estimate the discriminating power of the chosen model, a receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated. Statistical significance was set at p value <0.05 and the confidence interval at 95 %. RESULTS: The incidence (%) of nausea, vomiting and both, in the general population, was 36.6, 28.1, 22.0, respectively. The highest incidences of PONV were found in non-smokers and in patients who received >30 mL/kg of IH in the PO2. The results of the adjusted model showed an increased risk of PONV for each 1-point increase in the score punctuation. The relative risk was higher than 2.0 for vomiting in all period and in the PO1. The ROC curve showed great discrimination of postoperative nausea and vomiting from the proposed score (AUC >0.75). CONCLUSIONS: The study population was at high risk of PONV. Therefore, institutional guidelines abolishing modificable variables following temporal evaluation of the effectiveness should be undertaken.

Ingestão Alimentar de Mulheres com Tumores Ginecológicos em Tratamento Oncológico: Revisão Integrativa da Literatura / Food Intake of Women with Gynecological Tumors Undergoing Cancer Treatment: Integrative Literature Review / Ingestión de Alimentos de Mujeres con Tumores Ginecológicos en Tratamiento Oncológico: Revisión Integradora de la Literatura

Introdução: Pacientes com câncer apresentam uma tendência à perda ponderal e à desnutrição energético-proteica. Isso ocorre em razão das modificações que o organismo sofre pelo desenvolvimento da doença e pelos efeitos adversos do tratamento oncológico que contribuem para a redução da ingestão alimentar. Objetivo: Identificar evidências disponíveis na literatura científica sobre a ingestão alimentar de mulheres com tumores ginecológicos em tratamento oncológico. Método: Revisão integrativa da literatura cujas buscas foram realizadas nas bases de dados Embase, MEDLINE e LILACS por meio da associação de termos descritores e palavras livres. Foram incluídos nas análises estudos observacionais que avaliaram a ingestão alimentar de mulheres adultas com tumores ginecológicos durante o tratamento oncológico, redigidos em português, inglês e espanhol. Resultados: Esta revisão analisou seis estudos que investigaram a mudança na ingestão alimentar dessa população. Identificou-se uma redução da ingestão em até 31% de energia, 39,9% de proteínas, 33,7% de lipídeos, 28,7% de carboidratos e uma inadequação da ingestão de determinados micronutrientes. Conclusão: Mulheres com tumores ginecológicos durante o tratamento oncológico apresentam redução significativa da ingestão de energia, proteínas, lipídeos, carboidratos e micronutrientes. Considerando que a perda de peso e a desnutrição em pacientes com câncer está associada a desfechos clínicos negativos, a avaliação e a análise da ingestão alimentar desses indivíduos são fundamentais para possibilitar uma intervenção nutricional precoce, boa resposta ao tratamento e consequente melhoria da qualidade de vida

Introduction: Cancer patients tend to lose weight and energy-protein malnutrition because of the changes the organism undergoes caused by the progression of the disease and treatment-related adverse effects that contribute for the reduction of food intake. Objective: To identify scientific literature-based evidences on food intake of women with gynecological tumors undergoing cancer treatment. Method: Integrative literature review through searches at the Embase, MEDLINE and LILACS databases with the association of descriptive terms and free words. Observational studies in Portuguese, English and Spanish that evaluated the food intake of this population were included in the analyzes. Results: This review identified 6 studies that investigated the change in food intake of women with gynecological cancer undergoing cancer treatment. A reduction in intake was identified in until 31% of energy, 39.9% of proteins, 33.7% of lipids, 28.7% of carbohydrates and inadequate intake of certain micronutrients. Conclusion: Women with gynecological tumors during cancer treatment present significant reduction of energy, proteins, lipids, carbohydrates and micronutrients intake. Considering that weight loss and malnutrition in cancer patients are associated with negative clinical outcomes, the evaluation and analysis of the food intake of this population individuals is essential for early nutritional intervention, good response to treatment and improvement of the quality of life

Introducción: Los pacientes con cáncer tienen tendencia a la pérdida de peso y a la desnutrición calórico-proteica. Esto ocurre debido a los cambios que sufre el organismo debido al desarrollo de la enfermedad y los efectos adversos del tratamiento del cáncer que contribuyen a la reducción de la ingesta alimentaria. Objetivo: Identificar la evidencia disponible en la literatura científica sobre la ingesta alimentaria de mujeres con tumores ginecológicos en tratamiento oncológico. Método: Revisión integrativa de la literatura cuyas búsquedas se realizaron en las bases de datos Embase, MEDLINE y LILACS mediante la asociación de términos descriptivos y palabras libres. Se incluyeron en los análisis estudios observacionales que evaluaron la ingesta de alimentos de mujeres adultas con tumores ginecológicos durante el tratamiento del cáncer, escritos en portugués, inglés y español. Resultados: Esta revisión analizó seis estudios que investigaron el cambio en la ingesta de alimentos en esta población. Cuantificamos una reducción de la ingesta de hasta un 31% en energía, 39,9% en proteínas, 33,7% en lípidos, 28,7% en carbohidratos y una ingesta inadecuada de determinados micronutrientes. Conclusión: Las mujeres con tumores ginecológicos durante el tratamiento del cáncer tienen una reducción significativa en la ingesta de energía, proteínas, lípidos, carbohidratos y micronutrientes. Teniendo en cuenta que la pérdida de peso en pacientes con cáncer se asocia con resultados clínicos negativos, la evaluación de la ingesta alimentaria de estos individuos es fundamental para permitir una intervención nutricional precoz, una buena respuesta al tratamiento y la consecuente mejora de la calidad de vida

Air Pollution and Deaths among Elderly Residents of São Paulo, Brazil: An Analysis of Mortality Displacement.

BACKGROUND: Evaluation of short-term mortality displacement is essential to accurately estimate the impact of short-term air pollution exposure on public health. OBJECTIVES: We quantified mortality displacement by estimating single-day lag effects and cumulative effects of air pollutants on mortality using distributed lag models. METHODS: We performed a daily time series of nonaccidental and cause-specific mortality among elderly residents of São Paulo, Brazil, between 2000 and 2011. Effects of particulate matter smaller than 10 µm (PM10), nitrogen dioxide (NO2) and carbon monoxide (CO) were estimated in Poisson generalized additive models. Single-day lag effects of air pollutant exposure were estimated for 0-, 1- and 2-day lags. Distributed lag models with lags of 0-10, 0-20 and 0-30 days were used to assess mortality displacement and potential cumulative exposure effects. RESULTS: PM10, NO2 and CO were significantly associated with nonaccidental and cause-specific deaths in both single-day lag and cumulative lag models. Cumulative effect estimates for 0-10 days were larger than estimates for single-day lags. Cumulative effect estimates for 0-30 days were essentially zero for nonaccidental and circulatory deaths but remained elevated for respiratory and cancer deaths. CONCLUSIONS: We found evidence of mortality displacement within 30 days for nonaccidental and circulatory deaths in elderly residents of São Paulo. We did not find evidence of mortality displacement within 30 days for respiratory or cancer deaths. Citation: Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. 2017. Air pollution and deaths among elderly residents of São Paulo, Brazil: an analysis of mortality displacement. Environ Health Perspect 125:349-354; http://dx.doi.org/10.1289/EHP98.

Burden of type 2 diabetes mellitus in Brazil. / Carga do diabetes mellitus tipo 2 no Brasil.

Type 2 diabetes mellitus currently ranks high among indicators used in Global Burden of Disease Studies. The current study estimated the burden of disease attributable to type 2 diabetes mellitus and its chronic complications in Brazil, 2008. We calculated disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) stratified by gender, age bracket, and major geographic region. Type 2 diabetes mellitus accounted for 5% of the burden of disease in Brazil, ranking 3rd in women and 6th in men in the composition of DALYs. The largest share of DALYs was concentrated in the 30-59-year age bracket and consisted mainly of YLDs. The highest YLL and YLD rates were in the Northeast and South of Brazil, respectively. Chronic complications represented 80% of YLDs from type 2 diabetes mellitus. Type 2 diabetes mellitus ranked as a leading health problem in Brazil in 2008, accounting for relevant shares of mortality and morbidity.

Seasonal variation of food intake of adults from Niterói, Rio de Janeiro, Brazil.

The measurement of usual food intake (FI) is necessary to accurately establish the relationship between diet and disease. In most studies data are collected at one particular time of the year, which may influence the interpretation of the results. The purpose of this study was to investigate the effect of seasonality on FI in a sample of adults from Niterói, RJ, Brazil. A total of 102 healthy subjects (69 women) aged between 20 and 69 years were interviewed to obtain six 24-hour dietary recalls, three in summer and three in winter. In both seasons, the intake of energy (EI) and 23 nutrients was determined and the percent of subjects who met the recommendations for the nutrients were computed. The data of FI were deattenuated considering the within-person variability and adjusted for energy. The intake of energy and some nutrients were significantly different between men and women. EI did not differ between seasons, for both sexes, but the intake of macro and micronutrients was different. The results of this study suggest that the seasonality in the measurement of FI should be considered in order to improve the methods and instruments used in population dietary surveys.

Carga do diabetes mellitus tipo 2 no Brasil / Carga de la diabetes mellitus tipo 2 en Brasil / Burden of type 2 diabetes mellitus in Brazil

O diabetes mellitus tipo 2 se destaca, atualmente, na composição dos indicadores dos Estudos de Carga Global de Doença. Este estudo estimou a carga de doença atribuível ao diabetes mellitus tipo 2 e suas complicações crônicas no Brasil, 2008. Foram calculados os anos de vida perdidos ajustados por incapacidade (DALY), anos de vida perdidos por morte prematura (YLL) e os anos de vida perdidos por conta da incapacidade (YLD) estratificados por sexo, faixa etária e região. O diabetes mellitus tipo 2 representou 5% da carga de doença no Brasil, posicionando-se como a 3ª causa mais importante nas mulheres e a 6ª nos homens na construção do DALY. A maioria do DALY se concentrou na faixa etária entre 30 e 59 anos e foi representado majoritariamente pelo YLD. As maiores taxas de YLL e YLD se concentraram nas regiões Nordeste e Sul, respectivamente. As complicações crônicas do diabetes mellitus tipo 2 representaram 80% do YLD. O diabetes mellitus tipo 2 representou um dos principais agravos de saúde no Brasil em 2008, contribuindo com relevantes parcelas de mortalidade e morbidade.

La diabetes mellitus tipo 2 se destaca, actualmente, en la composición de los indicadores de los Estudios de Carga Global de Enfermedad. Este estudio estimó la carga de la enfermedad, atribuible a la diabetes mellitus tipo 2 y sus complicaciones crónicas en Brasil, 2008. Se calcularon los años de vida perdidos, ajustados por incapacidad (DALY), años de vida perdidos por muerte prematura (YLL) y los años de vida perdidos, debido a la incapacidad (YLD), estratificados por sexo, franja de edad y región. La diabetes mellitus tipo 2 representó un 5% de la carga de enfermedad en Brasil, posicionándose como la 3ª causa más importante en las mujeres y la 6ª en los hombres en la construcción del DALY. La mayoría del DALY se concentró en la franja de edad entre 30 y 59 años y fue representado mayoritariamente por el YLD. Las mayores tasas de YLL y YLD se concentraron en las regiones del nordeste y sur, respectivamente. Las complicaciones crónicas de la diabetes mellitus tipo 2 representaron un 80% del YLD. El diabetes mellitus tipo 2 representó uno de los principales agravios de salud en Brasil en 2008, contribuyendo con relevantes cuotas de mortalidad y morbilidad.

Type 2 diabetes mellitus currently ranks high among indicators used in Global Burden of Disease Studies. The current study estimated the burden of disease attributable to type 2 diabetes mellitus and its chronic complications in Brazil, 2008. We calculated disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) stratified by gender, age bracket, and major geographic region. Type 2 diabetes mellitus accounted for 5% of the burden of disease in Brazil, ranking 3rd in women and 6th in men in the composition of DALYs. The largest share of DALYs was concentrated in the 30-59-year age bracket and consisted mainly of YLDs. The highest YLL and YLD rates were in the Northeast and South of Brazil, respectively. Chronic complications represented 80% of YLDs from type 2 diabetes mellitus. Type 2 diabetes mellitus ranked as a leading health problem in Brazil in 2008, accounting for relevant shares of mortality and morbidity.

Variacao sazonal na ingestao alimentar de adultos de Niteroi, Rio de Janeiro / Seasonal variation of food intake of adults from Niteroi, Rio de Janeiro, Brazil

A aferição da ingestão alimentar (IA) usual é necessária para estabelecer, com acurácia, a relação entre a dieta e o aparecimento de doenças. Na maioria dos estudos, os dados de IA usual são coletados referentes ao período de um ano, sem considerar a estação do ano em que o estudo ocorre. O objetivo do presente estudo foi verificar o efeito da sazonalidade na IA de adultos de Niterói, RJ. Um total de 102 sujeitos (69 mulheres) saudáveis, com idade entre 20 e 69 anos, responderam a seis recordatórios dietéticos de 24 horas, três no verão e três no inverno. Em ambas as estações do ano, foi determinada a ingestão energética (IE) e de 23 nutrientes, além do percentual de indivíduos que alcançavam as recomendações dos mesmos. Os dados finais foram deatenuados pela variabilidade intraindividual e ajustados pela energia. A IE e de alguns nutrientes foram significativamente diferentes entre os homens e as mulheres. A IE não se diferenciou entre as estações, para ambos os sexos, porém a ingestão de proteínas, fibras, magnésio, tiamina, piridoxina e niacina foi diferente entre as estações para ambos os sexos. Os resultados do presente estudo sugerem que a sazonalidade seja considerada na aferição da IA, servindo de base para a adequação dos métodos e instrumentos utilizados nos inquéritos dietéticos populacionais.

The measurement of usual food intake (FI) is necessary to accurately establish the relationship between diet and disease. In most studies data are collected at one particular time of the year, which may influence the interpretation of the results. The purpose of this study was to investigate the effect of seasonality on FI in a sample of adults from Niterói, RJ, Brazil. A total of 102 healthy subjects (69 women) aged between 20 and 69 years were interviewed to obtain six 24-hour dietary recalls, three in summer and three in winter. In both seasons, the intake of energy (EI) and 23 nutrients was determined and the percent of subjects who met the recommendations for the nutrients were computed. The data of FI were deattenuated considering the within-person variability and adjusted for energy. The intake of energy and some nutrients were significantly different between men and women. EI did not differ between seasons, for both sexes, but the intake of macro and micronutrients was different. The results of this study suggest that the seasonality in the measurement of FI should be considered in order to improve the methods and instruments used in population dietary surveys.

Variação sazonal na ingestão alimentar de adultos de Niterói / Seasonal variation in food intake of adults in Niterói

A aferição da ingestão alimentar IA) é necessária para estabelecer a relação entre dieta e o aparecimento de doenças. Na maioria dos estudos, os dados de IA são coletados somente em um momento ao ano, entretanto limitar o estudo a uma única ocasião pode comprometer os seus resultados. O objetivo do presente estudo foi verificar o efeito da sazonalidade na IA, em duas estações do ano, de adultos de Niterói, RJ. Trinta e três homens e 69 mulheres, saudáveis com idade entre 20 e 69 anos, responderam a seis recordatórios de 24 horas (R24h), três no verão e três no inverno... Variações sazonais também foram encontradas nas variâncias intra e interindividuais e no número de R24h calculados, este último mais elevado quando a IA usual é estimada com mais exatidão. Os resultados do presente estudo sugerem considerar a sazonalidade na aferição da IA servindo de base para a adequação dos métodos e instrumentos utilizados nos inquéritos dietéticos populacionais