Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women.

This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th-13th, 20th-26th and 30th-36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography-tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (ß=-0·12; 95 % CI -0·251, 0·009; P=0·069) and adiponectin (ß=-0·070; 95 % CI -0·150, 0·010; P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (ß=-0·253; 95 % CI -0·044, 0·550; P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.

Changes in prevalence of overweight in adolescents living in areas highly vulnerable to food insecurity. / Mudanças na prevalência de excesso de peso em adolescentes residentes em área de alta vulnerabilidade a insegurança alimentar.

This study ascertained changes, over 5 years, in the prevalence of overweight in adolescents and associations with socio-demographic variables and food insecurity. Two cross-sectional population-based studies were conducted with 511 (2005) and 314 (2010) adolescents resident in Campos Elíseos (Duque de Caxias-RJ). Overweight was evaluated by sex and age specific cut-off points of BMI (weight/height²). The prevalence of food insecurity was investigated using the Brazilian Food Insecurity Scale. Logistic regression was used to determine the association between changes in overweight over time and sex, age, skin colour, and food insecurity. Overweight was found to increase significantly, between 2005 and 2010, in boys who were younger (from 20.1% to 49.5%), black or brown (22.2% to 37.3%), those with per capita income of up to half a minimum wage (13.6% to 32.5%) and those experiencing moderate or severe food insecurity (9.2% to 36.3%). It was concluded that overweight increased significantly in adolescents living in an area of food insecurity, and that younger, black or brown, lower-income adolescents, and those living with moderate and severe food insecurity, were more exposed to that increase.

O objetivo deste estudo foi verificar as mudanças na prevalência do excesso de peso em adolescentes e sua associação com variáveis sociodemográficas e insegurança alimentar em período de 5 anos. Foram realizados dois estudos transversais com 511 (2005) e 314 (2010) adolescentes de 12 a 18,9 anos residentes de Campos Elíseos (Duque de Caxias-RJ). Excesso de peso foi avaliado por meio do IMC (peso/estatura²). A insegurança alimentar foi investigada por meio da Escala Brasileira de Insegurança Alimentar (EBIA). Utilizou-se regressão logística para verificar a associação entre as mudanças temporais de excesso de peso segundo sexo, idade, cor da pele, e insegurança alimentar. Quanto à evolução do excesso de peso pode se notar que nos meninos houve aumento significativo para os mais novos (20,1% para 49,5%), os de cor preta ou parda (22,2% para 37,3%), os que tinham renda per capita de até ½ salário mínimo (13,6% para 32,5%) e os que apresentavam insegurança alimentar moderada e grave (9,2% para 36,3%) entre 2005 e 2010. Conclui-se que o aumento do excesso de peso foi expressivo nos adolescentes residentes em área de insegurança alimentar, e os meninos mais novos, pretos ou pardos, de menor renda e residentes em lares com insegurança alimentar moderada e grave estão mais expostos a este aumento.

Association between vitamin D status during pregnancy and total gestational weight gain and postpartum weight retention: a prospective cohort.

OBJECTIVES: To evaluate the association between vitamin D status during pregnancy and total gestational weight gain (GWG), GWG rates and postpartum weight retention. METHODS: Prospective cohort of 163 women from Rio de Janeiro was followed at 5th-13th (baseline), 20th-26th, 30th-36th gestational weeks and at 30-62 days postpartum. Plasma 25-hydroxyvitamin D [25(OH)D] was evaluated during each trimester and was categorized as adequate (≥50 nmol/L) or inadequate (<50 nmol/L). GWG (kg) was calculated as the difference between the weight measured at baseline and 36th-42th gestational weeks. GWG rates (kg/week) were calculated between each visit. Postpartum weight retention (kg) was analysed as the difference between weights measured at 30-62 days postpartum and 5th-13th gestational weeks. Statistical analyses were performed using linear regression models that included interaction terms between vitamin D status and first trimester body mass index (BMI) (<25/≥25 kg/m2). Confounders were selected based on a directed acyclic graph. RESULTS: The prevalence of vitamin D inadequacy was 16.6%, 9.9% and 10.6% in the first, second and third trimesters, respectively. Overweight women with vitamin D inadequacy in the first (ß = 3.70; 95% CI 0.09; 7.31, p-value = 0.045) and third trimester (ß = 4.59, 95% CI 0.07; 9.10, p-value = 0.047) presented higher increases in total GWG than did women with vitamin D adequacy. This association was also observed between first trimester vitamin D status and GWG rates between visits 1 and 2 (ß = 0.17; 95% CI 0.13; 0.36, p-value = 0.07). CONCLUSIONS: There was an interaction effect of first trimester BMI (≥25 kg/m2) on the association between first and third trimester vitamin D status and GWG.

Temporal changes in the prevalence of disordered eating behaviors among adolescents living in the metropolitan area of Rio de Janeiro, Brazil.

To investigate temporal changes in the prevalence of disordered eating behaviors among adolescents, and their association with socio demographic factors and overweight. Using probability sampling, two population-based cross-sectional surveys were conducted: one in 2005 (n=511) and the other in 2010 (n=314). The frequency of disordered eating behaviors (binge eating, strict dieting or fasting and compensatory behaviors) was investigated using a self-administered questionnaire. The presence of binge eating increased by 18.4% in the 5 years between the two surveys. In 2005, girls were 1.95 times more likely to engage in strict dieting or fasting than boys, and this difference increased to 7.02 times in 2010. Overweight adolescents were 2.29 times more likely to undertake strict dieting than non-overweight adolescents in 2005 and 3.65 times more likely to do so in 2010. No significant associations were found for compensatory behaviors. A pronounced increase in the prevalence of binge eating was observed, and girls and overweight adolescents were more likely to engage in strict dieting or fasting.

Prepregnancy Dietary Patterns Are Associated with Blood Lipid Level Changes During Pregnancy: A Prospective Cohort Study in Rio de Janeiro, Brazil.

BACKGROUND: Physiologic adaptations lead to an increase in blood lipid levels during pregnancy, yet little is known about the influence of prepregnancy dietary patterns. AIM: To identify whether prepregnancy dietary patterns that explain the consumption of fiber, energy, and saturated fat are associated with blood lipid levels throughout pregnancy. DESIGN: Prospective cohort study, with data collection at gestational weeks 5 to 13, 20 to 26, and 30 to 36. A food frequency questionnaire was administered at baseline (gestational week 5 to 13). PARTICIPANTS/SETTING: Women with singleton pregnancy (N=299) aged 20 to 40 years, without infectious/chronic disease (except obesity) were enrolled in the study. One hundred ninety-nine women were included in the final analysis. The study took place at a prenatal service of a public health care center in Rio de Janeiro, Brazil, during the period from 2009 to 2012. MAIN OUTCOME MEASURES: Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and triglyceride levels, measured at all trimesters. STATISTICAL ANALYSES PERFORMED: Dietary patterns were derived by reduced rank regression. Fiber density, dietary energy density, and percent energy from saturated fat were response variables. Crude and adjusted longitudinal linear mixed-effects regression models were performed to account for confounders and mediators. Interaction terms between dietary pattern and gestational week were tested. RESULTS: Fast Food and Candies; Vegetables and Dairy; and Beans, Bread, and Fat patterns were derived. Our Fast Food and Candies pattern was positively associated with triglyceride level (ß=4.961, 95% CI 0.945 to 8.977; P=0.015). In the HDL-C rate of change prediction, significant interactions were observed between both the Fast Food and Candies and Vegetables and Dairy patterns and gestational week (ß=-.053, 95% CI -0.101 to -0.004; P=0.035 and ß=.055, 95% CI -0.002 to 0.112; P=0.060, respectively). The Beans, Bread, and Fat pattern was not associated with blood lipid levels. CONCLUSIONS: Prepregnancy dietary patterns were associated with gestational blood lipid levels; that is, higher scores for the Fast Food and Candies pattern were associated with higher triglyceride and slower HDL-C rates of change during pregnancy, whereas higher scores for the Vegetables and Dairy dietary patterns were associated with faster HDL-C rates of change over gestational weeks.

Mudanças na prevalência de excesso de peso em adolescentes residentes em área de alta vulnerabilidade a insegurança alimentar / Changes in prevalence of overweight in adolescents living in areas highly vulnerable to food insecurity

Resumo O objetivo deste estudo foi verificar as mudanças na prevalência do excesso de peso em adolescentes e sua associação com variáveis sociodemográficas e insegurança alimentar em período de 5 anos. Foram realizados dois estudos transversais com 511 (2005) e 314 (2010) adolescentes de 12 a 18,9 anos residentes de Campos Elíseos (Duque de Caxias-RJ). Excesso de peso foi avaliado por meio do IMC (peso/estatura²). A insegurança alimentar foi investigada por meio da Escala Brasileira de Insegurança Alimentar (EBIA). Utilizou-se regressão logística para verificar a associação entre as mudanças temporais de excesso de peso segundo sexo, idade, cor da pele, e insegurança alimentar. Quanto à evolução do excesso de peso pode se notar que nos meninos houve aumento significativo para os mais novos (20,1% para 49,5%), os de cor preta ou parda (22,2% para 37,3%), os que tinham renda per capita de até ½ salário mínimo (13,6% para 32,5%) e os que apresentavam insegurança alimentar moderada e grave (9,2% para 36,3%) entre 2005 e 2010. Conclui-se que o aumento do excesso de peso foi expressivo nos adolescentes residentes em área de insegurança alimentar, e os meninos mais novos, pretos ou pardos, de menor renda e residentes em lares com insegurança alimentar moderada e grave estão mais expostos a este aumento.

Abstract This study ascertained changes, over 5 years, in the prevalence of overweight in adolescents and associations with socio-demographic variables and food insecurity. Two cross-sectional population-based studies were conducted with 511 (2005) and 314 (2010) adolescents resident in Campos Elíseos (Duque de Caxias-RJ). Overweight was evaluated by sex and age specific cut-off points of BMI (weight/height²). The prevalence of food insecurity was investigated using the Brazilian Food Insecurity Scale. Logistic regression was used to determine the association between changes in overweight over time and sex, age, skin colour, and food insecurity. Overweight was found to increase significantly, between 2005 and 2010, in boys who were younger (from 20.1% to 49.5%), black or brown (22.2% to 37.3%), those with per capita income of up to half a minimum wage (13.6% to 32.5%) and those experiencing moderate or severe food insecurity (9.2% to 36.3%). It was concluded that overweight increased significantly in adolescents living in an area of food insecurity, and that younger, black or brown, lower-income adolescents, and those living with moderate and severe food insecurity, were more exposed to that increase.

Prevalência de síndrome metabólica em adultos referenciados para ambulatório de nutrição no Rio de Janeiro, Brasil / Prevalence of metabolic syndrome in adults referred to a nutrition out-patient clinic in Rio de Janeiro, Brazil

Fundamentos: Por ser um importante fator de risco cardiovascular, a síndrome metabólica (SM) deve ser identificada em grupos populacionais com diferentes características. Objetivos: Estimar a prevalência de SM e descrever fatores de risco associados em pacientes > ou - 18 anos, em unidade especializada de nutrição do Hospital Universitário da UNIRIO. Métodos: Estimou-se a prevalência de SM pelos critérios NCEP-ATPIII e IDF em 414 pacientes, sendo a comparação feita pelo percentual de concordância e Kappa. Na regressão de Poisson univariada, a SM foi a variável dependente enquanto sexo, idade, estado nutricional, escolaridade, renda, estado civil, etilismo e tabagismo as independentes. O modelo foi interpretado em termos de razão de prevalência, considerando um nível de significância de 5 por cento. Resultados: A prevalência elo critério IDF foi ligeiramente superior...