Prevalence of breastfeeding and its obstacles in patients with CHD in southern Brazil.

INTRODUCTION: Breast milk is nutritionally adequate and is related to the reduction of various health problems in childhood. Its offer is widely recommended in health guidelines. OBJECTIVE: To estimate the prevalence and obstacles to breastfeeding in patients with CHD in southern Brazil. METHODS: Cross-sectional study of patients with CHD between 2 and 18 years of age. Patients with genetic syndromes and patients whose mothers had died were excluded from the analysis. The variables on breastfeeding in the first 2 years of life were collected through a phone call to the mothers, which was conducted by trained evaluators. Prevalence was described in proportions and the continuous variables as means and standard deviation. Bivariate analyses were evaluated using a chi-square test to measure the association between the variables and the outcome. RESULTS: A total of 351 patients with CHD were analysed. There was a predominance of males (53%) and a mean age of 9.54 ± 4.52 years. Breastfeeding up to the sixth month was present in 40% of the cases. CONCLUSION: The mothers of babies with CHD face great challenges to maintain the supply of breast milk, whether inherent to the practice of breastfeeding or related to CHD.

Trends and determinants of change in compliance to dietary guidelines in a Swiss community-dwelling sample.

Adherence to dietary guidelines is associated with significantly better health outcomes. Studies across the world shows that compliance with the guidelines was low, but data in Switzerland are lacking. Hence, we aimed to assess the 5-year trends in dietary compliance regarding food guidelines in Switzerland in a prospective, population-based observational study. Data from 2882 participants (1591 women, 35-75 years), from the first (2009-2012) and second (2014-2017) follow-up. Dietary intake was assessed using a validated food frequency questionnaire. Compliance with the guidelines of the Swiss society of nutrition was assessed at baseline and 5.5 years afterwards. Prevalence rates for compliance were calculated using the exact Poisson method. Factors associated with changes in compliance (never, shifter or maintainer) were assessed by multinomial logistic regression using "Never compliers" as reference. Overall, improvements in compliance to fruits (42.4% to 45.1%) vegetables (6.9% to 8.6%) and fish (66.6% to 60.5%) were found, while compliance to meat decreased (61.1% to 58.5%). The prevalence of participants complying with at least three dietary recommendations did not change (24.1% to 25.2%). During follow-up, only 11.6% of participants maintained compliance to at least three dietary recommendations, and 62.4% never managed to comply. Female gender and older age were associated with maintaining compliance during the two study periods. In conclusion, compliance with dietary guidelines is a dynamic status, and only a small fraction of the population achieves sustained compliance with at least three guidelines. Almost two thirds of the population never achieve compliance with three guidelines.

Twenty-four-year trends and determinants of change in compliance with Swiss dietary guidelines.

BACKGROUND AND AIMS: A healthy diet is the cornerstone of disease prevention, and dietary guidelines have been issued in most countries. We aimed to assess trends in compliance with dietary guidelines in the population of Geneva, Switzerland. METHODS: Multiple cross-sectional, population-based surveys conducted between 1993 and 2016 in the canton of Geneva, Switzerland [20,310 participants (52.3% women, mean age 51.9 ± 10.7 years)]. Trends in compliance with the Swiss dietary guidelines regarding food intake were assessed using logistic regression (a) for each guideline and (b) for at least three guidelines. Compliance before and after the first and second issuing of the guidelines was assessed. RESULTS: After multivariable adjustment, compliance with fruits increased overall [odds ratio and (95% confidence interval) for 1-year increase: 1.007 (1.003-1.012), p < 0.001], in men, participants aged over 45 and with low educational level. Compliance with vegetables increased overall [1.015 (1.008-1.022), p < 0.001], in both genders, age groups [45-54 and 55-64] and participants with low educational level. Compliance with meat increased in women [1.007 (1.001-1.013), p = 0.021] and participants with a university degree. Compliance with fresh fish increased in age group [55-64] [1.009 (1.000-1.018), p = 0.041]. Compliance with dairy products decreased overall [0.979 (0.972-0.986), p < 0.001] and in all groups studied, except for age group [65-74]. Compliance with at least three guidelines increased in age group [55-64] only [1.013 (1.002-1.024), p = 0.019]. No effect of the issuing of the guidelines was found. CONCLUSION: In the Geneva adult population, compliance with the Swiss dietary guidelines improved little. Issuing of dietary guidelines did not impact trends.

Lessons learned? Changes in dietary behavior after a coronary event.

BACKGROUND AND AIMS: A healthy diet is recommended for the prevention of coronary artery disease (CAD), but whereas patients with CAD adhere to a healthy diet is unclear. We aimed to assess the impact of a CAD event on dietary intake. METHODS: Prospective, population-based, observational study conducted between 2009 and 2017. Dietary intake was assessed using a validated food frequency questionnaire. Three comparisons were performed: 1) between participants with history of CAD and gender- and age-matched controls; 2) before and after the occurrence of a CAD event, and 3) between participants with an incident CAD event and gender- and age-matched controls. RESULTS: In analysis 1), after multivariable adjustment, participants with history of CAD had a lower total energy intake than controls (adjusted mean ± standard error: 1833 ± 36 vs. 1940 ± 26 kcal/day, p = 0.022), while no difference was found for all other dietary markers. In analysis 2) (n = 87) total energy intake increased (1927 ± 593 vs. 2100 ± 700 kcal/day before and after the event, respectively, p = 0.029) and prevalence of low fat diet decreased (35.6% vs. 21.8%, p = 0.036), while no difference was found for all other dietary markers. In analysis 3), participants with incident CAD had higher vegetable protein intake (adjusted mean ± standard error 4.8 ± 0.1 vs. 4.5 ± 0.1% of total energy intake, p = 0.028), AHEI score (34 ± 1 vs. 31 ± 1, p = 0.032), and complied more frequently with vegetables guidelines [odds ratio and 95% confidence interval; 7.64 (1.06-55.2)] than controls, while no differences were found for all other dietary markers CONCLUSIONS: In Switzerland, secondary prevention of CAD by diet is seldom implemented.