Diet quality index and its components have not associated with the development of breast cancer risk assessed by the diet quality index: a case-control study.

OBJECTIVE: To investigate if the diet quality and its components are associated with breast cancer risk. METHODS: A case-control study was conducted with 332 women, 114 who were diagnosed with breast cancer, and 218 control individuals. Groups were matched for age, body mass index, and menopausal status. The quality of diet was assessed using Brazilian Healthy Eating Index Revised (BHEI-R) and its components. Food consumption was measured through three 24-h dietary recalls and assessed using the NDS-R software. For statistical analyses, it was performed an adjusted logistic regression, estimation of the Odds Ratio (OR), and 95% confidence interval (95%CI), with a p-value <0.05. RESULTS: The BHEI-R score, classified into quartiles, did not differ between groups in the lowest quartile of diet quality (p=0.853). The components total cereals (p=0.038), saturated fat (p=0.039) and Gord_AA (fat, alcohol, and added sugar) (p=0.023) had higher scores among the case group. The scores for total fruits (p=0.010) and milk and dairy products (p=0.039) were higher among the control group. The BHEI-R components and the quality of diet were not associated with the outcome. CONCLUSION: Diet quality, assessed by the BHEI-R and its components, was not associated with breast cancer.

Sedentary Behavior and Alcohol Consumption Increase Breast Cancer Risk Regardless of Menopausal Status: A Case-Control Study.

Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was performed in a group of 542 women, 197 who were diagnosed with breast cancer and 344 control individuals. The groups were matched by age, body mass index, and menopausal status. Participants were evaluated for level of physical activity, alcohol consumption, smoking habit, weight, height, and waist circumference (WC). A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals (95% CI). Regular consumption of alcoholic beverages (2.91, 95% CI 1.58-5.38 and 1.86, 95% CI 1.15-3.03) and sedentary behavior (2.08; 95% CI 1.12-3.85 and 1.81; 95% CI 1.12-2.94) were associated with breast cancer risk in pre- and postmenopausal women, respectively. High WC (3.31, 95% CI 1.45-7.55) was associated with an increased risk of developing breast cancer in premenopausal women. While in postmenopausal women, current smoking (2.43, 95% CI 1.01-5.83) or previous history of smoking (1.90; 95% CI 1.14-3.14) increased the chances of developing breast cancer. Sedentary behavior and current consumption of alcoholic beverages were more likely to increase the risk of developing breast cancer regardless of menopausal status.

High Bone Mineral Density of the Lumbar Spine Is Positively Associated with Breast Cancer.

OBJECTIVE: The objective of this study was to verify possible associations between bone mineral density (BMD) and breast cancer in recently diagnosed women in the Brazilian Mid-west region, considering the menopausal status of patients. METHODS: A case-control study was conducted with 142 cases of breast cancer and 234 controls matched by for age, body mass index (BMI), and menopausal status (pre- and postmenopause), performed in a university hospital in the Brazilian Mid-west. Lumbar spine (L1-L4), femoral neck, and total femur BMD were measured by the dual-energy X-ray absorptiometry (DXA) method. For association, a logistic regression analysis was used. RESULTS: Women in the highest lumbar spine BMD quartile presented had a higher chance of developing breast cancer (OR = 2.31; 1.02-5.25; p = 0.045), after adjusting for the confounding variables. Nonetheless, there were no statistically significant differences in the association between pre- and postmenopause in that quartile and breast cancer. CONCLUSIONS: High lumbar spine BMD was positively associated with breast cancer in the total sample. In evaluating the BMD of the femoral neck and total femur, such an association was not observed.

Estado nutricional, força muscular e capacidade funcional em portadores de mieloma múltiplo / Nutritional status, muscle strength and functional capacity in patients with multiple myeloma

O mieloma múltiplo é uma neoplasia maligna caracterizada pela proliferação clonal de plasmócitos na medula óssea. O objetivo deste trabalho foi avaliar as possíveis associações entre o estado nutricional, força muscular e capacidade funcional de pacientes ambulatoriais portadores de mieloma múltiplo. Trata-se de estudo transversal realizado em amostra não probabilística de pacientes com mieloma múltiplo atendidos no Hospital das Clínicas, em Goiânia. Os dados foram coletados entre agosto e dezembro de 2015, utilizando-se de entrevistas e informações dos prontuários. O estado nutricional foi avaliado aplicando-se a Avaliação Subjetiva Global Produzida pelo Próprio Paciente; a força muscular medida por meio da Força do Aperto de Mão e a capacidade funcional, pela Escala de Performance de Karnofsky. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do referido hospital. Foram avaliados 52 pacientes, em que 48,1% estavam desnutridos, 30,8% apresentavam baixa força muscular e 73,1%, comprometimento da capacidade funcional. A força muscular e a capacidade funcional foram menores nos desnutridos. Observou-se que aqueles que utilizavam corticoides apresentaram 18% menos chance de se tornarem desnutridos (OR=0,18; IC=0,05-0,62; p=0,011) porém, é importante considerar as possíveis causas de viés; por outro lado, os pacientes com baixa força muscular ou faziam quimioterapia apresentaram, aproximadamente, quatro vezes mais chances de desnutrição, respectivamente (OR=3,46; IC=0,99-12,08; p=0,047) (OR=3,64; IC=1,13-11,69; p=0,027). Concluiu-se que a desnutrição é comum nos pacientes portadores de mieloma múltiplo, indicando a necessidade premente de intervenção nutricional apropriada e precoce.

Multiple myeloma is a malignant neoplasm characterized by the clonal proliferation of plasma cells in the bone marrow. The objective of this study was to evaluate possible associations between nutritional status, muscle strength and functional capacity of outpatients with multiple myeloma. This is a cross-sectional study carried out on a non-probabilistic sample of patients with multiple myeloma treated at Hospital das Clínicas, in Goiânia. Data were collected between August and December 2015, using interviews and information from medical records. Nutritional status was assessed using the Patient Generated Subjective Global Assessment; muscular strength measured using Hand Grip Strength and functional capacity, using the Karnofsky Performance Scale. The study was approved by the Ethics and Research Committee of that hospital. 52 patients were evaluated, of which 48.1% were malnourished, 30.8% had low muscle strength and 73.1% had impaired functional capacity. Muscle strength and functional capacity were lower in malnourished individuals. It was observed that those who used corticosteroids were 18% less likely to become malnourished (OR=0.18; CI=0.05-0.62; p=0.011), however, it is important to consider the possible causes of bias; on the other hand, patients with low muscle strength or undergoing chemotherapy were approximately four times more likely to be malnourished, respectively (OR=3.46; CI=0.99-12.08; p=0.047) (OR=3.64; CI=1.13-11.69; p=0.027). It was concluded that malnutrition is common in patients with multiple myeloma, indicating the pressing need for appropriate and early nutritional intervention.

Do Food Intake and Food Cravings Change during the Menstrual Cycle of Young Women?

OBJECTIVE: The aim of the present study was to assess the anthropometric measures, food intake and food cravings during the menstrual cycle of undergraduate students of the faculty of nutrition. METHODS: A cross-sectional study was performed with 27 students from a public university in the state of Mato Grosso do Sul, Brazil, who had their food intake evaluated through a 24-hour food recall, their nutritional status evaluated based on anthropometric measures, and food cravings evaluated using the Food Desire Questionnaire. Data were collected during an evaluation in the follicular phase (between the 5th and the 9th day of the menstrual cycle) and another in the luteal phase (LP) (between the 20th and the 25th day of the menstrual cycle). For food intake variables, the analysis of variance (ANOVA) test was used, followed by the Tukey test. The Mann-Whitney test was used for the analysis of food cravings, considering a significance level of 5% (p < 0.05). RESULTS: The desire for foods rich in sugar, salt, and fat, such as chocolate, pastries, snacks and desserts were higher (p < 0.05) during the premenstrual period, although it did not reflect neither a higher energy intake nor an alteration in the distribution of macronutrients. A higher intake of carbohydrates, proteins, fibers, and calcium was observed during the LP; however, without statistical difference between the groups. There were no differences either in the intake of any food group or in the anthropometric measurements (p > 0.05). CONCLUSION: Food cravings of nutrition students differed between the phases of the menstrual cycle; however, with no difference in food intake and in anthropometric measures.

OBJETIVO: Verificar alterações de medidas corporais, consumo e desejos alimentares durante o ciclo menstrual de acadêmicas de nutrição. MéTODOS: Estudo transversal com 27 estudantes de uma universidade pública do Mato Grosso do Sul, as quais tiveram seu consumo alimentar avaliado por meio de recordatório alimentar de 24 horas, estado nutricional avaliado com base em medidas antropométricas, e desejos alimentares avaliados utilizando-se o Questionário de Desejo Alimentar. Os dados foram coletados durante uma avaliação na fase folicular (entre o 5° e o 9° dia do ciclo menstrual) e outra na fase lútea (entre o 20° e o 25° dia do ciclo menstrual). Para as variáveis de consumo alimentar, utilizou-se o teste análise de variância (ANOVA, na sigla em inglês), seguido pelo teste de Tukey. Já para a análise dos desejos alimentares, utilizou-se o teste de Mann-Whitney. Foi considerado o nível de significância de 5% (p < 0,05). RESULTADOS: Os desejos por alimentos ricos em açúcar, sal e gordura, como chocolates, produtos de pastelaria, lanches e sobremesas foram maiores (p < 0,05) no momento pré-menstrual, apesar de não refletirem em maior consumo energético e tampouco em alteração na distribuição de macronutrientes. Observou-se maior consumo de carboidratos, proteínas, fibras e cálcio na fase lútea; no entanto, sem diferença estatística entre os grupos. Não foram encontradas diferenças no consumo de nenhum grupo alimentar, tampouco nas medidas antropométricas (p > 0,05). CONCLUSãO: Os desejos alimentares das acadêmicas de nutrição diferiram entre as fases; no entanto, sem diferença no consumo alimentar e nas medidas corporais.

Visceral adiposity increases the risk of breast cancer: a case-control study.

INTRODUCTION: in recent decades, lifestyle changes in women involving physical inactivity, insulin resistance and body fat distribution have been associated with an increase in breast cancer. OBJECTIVE: to assess whether insulin resistance, lipid profile, and visceral adiposity are associated with increased risk of breast cancer. METHODS: a hospital-based case control study was conducted with 116 women newly diagnosed with breast cancer and 226 controls. Body mass index, waist circumference, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), very-low-density lipoproteins (VLDL), triglycerides, glycated hemoglobin, HOMA-IR, HOMA-ß, lipid accumulation product (LAP), and visceral adiposity index (VAI) were assessed. Logistic regression was adjusted for body mass index and age to quantify the association between breast cancer risk and insulinresistance, dyslipidemias, and visceral adiposity. RESULTS: the case group had higher insulin resistance (p < 0.001), LAP (p = 0.012), and VAI (p = 0.004), and lower concentrations of HDL (p = 0.024) and HOMA-ß(p = 0.010) compared to the control. Insulin resistance (OR = 3.00, 95% CI: 1.75-5.17, p < 0.001) and higher VAI (OR = 1.91, 95% CI: 1.17-3.13, p = 0.01) were associated with breast cancer, whereas the highest concentration of HDL reduces the chances of cancer by 53% (95% CI: 0.32-0.86, p = 0.026). In the multivariate analysis, only LAP and VAI were associated to breast cancer. CONCLUSIONS: visceral fat accumulation increases the risk of breast cancer.

Inadequate distribution of dietary protein and muscle mass in older adults

Objective: To assess protein intake, protein distribution across meals, and a possible association between protein distribution and muscle mass in older adults. Methods: This cross-sectional study included 47 older adults attending a community center in Campo Grande, MS, Brazil. A sociodemographic questionnaire was used to characterize the population. Dietary intake data were collected using two 24-hour dietary recalls on nonconsecutive days. Anthropometric measures, such as weight, height, and body circumferences, and measures of handgrip strength were collected. Skeletal muscle mass was calculated from the anthropometric measures. Descriptive statistics were used to derive means and standard deviations. Analysis of variance and Tukey tests were performed, with a significance level of 5% (p < 0.05). Results:The older adults, mostly Caucasian, female, physically active, at risk of malnutrition, and with a low level of education, had an energy intake of 1,305.28 kcal/day. Protein intake was 65.19 g/day, with a mean of 0.93 g/kg/day. Lunch was the meal with the highest protein intake (33.85 ± 2.47 g). The lowest protein intake was observed at breakfast (8.56 ± 0.82 g). All meals were below the recommendation of 40 g of protein/meal. Protein intake at breakfast was associated with calf circumference (p = 0.04). Conclusions: The older adults consumed a low amount of total and per-meal protein. Breakfast showed the lowest protein intake, and this was associated with calf circumference in the study sample.

Objetivo: Avaliar o consumo proteico, sua distribuição nas principais refeições e sua possível associação com a massa muscular de idosos. Metodologia: Estudo transversal realizado com 47 idosos frequentadores de um centro de convivência em Campo Grande (MS). Aplicou-se um questionário sociodemográfico e dois recordatórios de 24 horas, em dias alternados, para a avaliação do consumo alimentar, e realizou-se avaliação antropométrica por meio da aferição de medidas como peso, estatura, circunferências corporais e a força de pressão palmar. Com as medidas antropométricas, foi calculada a quantidade de massa muscular esquelética. Realizou-se estatística descritiva e, para as análises de associação, aplicaram-se os testes de variância (ANOVA) e de Tukey, com significância estatística quando p < 0,05. Resultados: Os idosos, majoritariamente caucasianos, do sexo feminino, fisicamente ativos, em risco de desnutrição e com escolaridade reduzida apresentaram consumo energético de 1.305,28 kcal/dia e consumo proteico 65,19 g/dia, sendo 0,93 g de proteína/kg/dia. O almoço foi a refeição com maior aporte proteico (33,85 ± 2,47 g). O menor consumo proteico foi observado no café da manhã (8,56 ± 0,82 g). Todas as refeições ficaram abaixo da recomendação de 40 g de proteína/refeição. O consumo proteico no café da manhã associou-se à circunferência da panturrilha (p = 0.04). Conclusões: Os idosos consumiram baixa quantidade de proteínas totais e nas principais refeições. O café da manhã foi a refeição com menor aporte proteico e este associou-se à circunferência da panturrilha em idosos da amostra.

Condições higiênicossanitárias de unidades de alimentação e nutrição de escolas participantes do Programa Nacional de Alimentação Escolar: qual a realidade em Goiás? / Hygienic and sanitary conditions of "Units of food and nutrition" at schools participating in the Brazilian School Feeding Program: What is the reality in Goiás?

Introdução: Para a oferta de refeições seguras aos estudantes, preconizado pelo Programa Nacional de Alimentação Escolar, se faz necessária uma condição higiênicossanitária adequada da Unidade de Alimentação e Nutrição. Objetivo: Avaliar as condições higiênicossanitárias das Unidades de Alimentação e Nutrição de escolas participantes do Programa Nacional de Alimentação Escolar em municípios goianos, bem como verificar possíveis associações com: índices municipais, características da escola e supervisão de nutricionista. Método: Estudo transversal, realizado entre 2017 e 2019, com amostra de 395 escolas, de 103 municípios de Goiás. As condições higiênicossanitárias foram verificadas por nutricionistas, por meio de um checklist baseado na RDC nº 216, de 15 de setembro de 2004 da Agência Nacional de Vigilância Sanitária e nos índices municipais de desenvolvimento humano e da educação básica em base de dados públicas. As características da escola e o recebimento de supervisão foram perguntados aos diretores escolares. Realizou-se uma análise descritiva dos itens do checklist e testes de hipóteses e correlação. Resultados: A maioria das unidades (69,4%) foi classificada como de risco sanitário regular, de acordo com o checklist. Obteve-se diferenças significativas entre: as escolas municipais e estaduais (p = 0,02); a mesorregião Norte das outras (p = 0,00) e o baixo Índice de Desenvolvimento Humano das demais categorias (p = 0,02). Ademais, o alto Índice de Desenvolvimento da Educação Básica (5º ano) apresentou uma associação com o muito baixo risco sanitário (p = 0,04). Conclusões: Infere-se que há necessidade de medidas corretivas. Sugere-se a implementação de manuais de boas práticas; a formação de manipuladores; a supervisão contínua do nutricionista e do Conselho de Alimentação Escolar; e o investimento da gestão com vistas à Segurança Alimentar e Nutricional dos escolares.

Introduction: In order to offer safe meals to students, recommended by the Brazilian School Feeding Program (PNAE, in Portuguese), an adequate hygienic-sanitary condition of "Units of Food and Nutrition" is necessary. Objective: To evaluate the hygienic-sanitary conditions of the "Units of Food and Nutrition" at schools participating in the Brazilian School Feeding Program in municipalities in Goiás, as well as to verify possible associations with municipal indexes, school characteristics and supervision by a nutritionist. Method: Cross-sectional study, carried out between 2017 and 2019, with a sample of 395 schools, from 103 municipalities in Goiás. The hygienic-sanitary conditions were collected by nutritionists, through a checklist based on Anvisa's RDC nº 216/2004 and municipal indexes of human development and basic education in public databases. The school's characteristics and the existence of supervision by a nutritionist were asked to school directors. Descriptive analysis of the checklist items and hypothesis and correlation tests were performed. Results: Most units (69.4%) were classified as having regular health risk, according to the checklist. Significant differences were obtained between municipal and state schools (p = 0.02); difference of northern mesoregion from the others (p = 0.00) and low Human Development Index of the other categories (p = 0.02) were observed. Furthermore, the high Basic Education Development Index (5th grade) was associated with a very low health risk (p = 0.04). Conclusions: It is inferred that there is a need for corrective measures. Manuals of good practices should be implemented, along with training of handlers, ongoing supervision by the nutritionist and the School Feeding Council, and investment in management with a view to the Food and Nutritional Security of schoolchildren.

Diet quality index and its components have not associated with the development of breast cancer risk assessed by the diet quality index: a case-control study / Índice de qualidade da dieta e seus componentes não se associaram ao desenvolvimento de câncer de mama: um estudo caso-controle

ABSTRACT Objective: To investigate if the diet quality and its components are associated with breast cancer risk. Methods: A case-control study was conducted with 332 women, 114 who were diagnosed with breast cancer, and 218 control individuals. Groups were matched for age, body mass index, and menopausal status. The quality of diet was assessed using Brazilian Healthy Eating Index Revised (BHEI-R) and its components. Food consumption was measured through three 24-h dietary recalls and assessed using the NDS-R software. For statistical analyses, it was performed an adjusted logistic regression, estimation of the Odds Ratio (OR), and 95% confidence interval (95%CI), with a p-value <0.05. Results: The BHEI-R score, classified into quartiles, did not differ between groups in the lowest quartile of diet quality (p=0.853). The components total cereals (p=0.038), saturated fat (p=0.039) and Gord_AA (fat, alcohol, and added sugar) (p=0.023) had higher scores among the case group. The scores for total fruits (p=0.010) and milk and dairy products (p=0.039) were higher among the control group. The BHEI-R components and the quality of diet were not associated with the outcome. Conclusion: Diet quality, assessed by the BHEI-R and its components, was not associated with breast cancer.

RESUMO Objetivo: Avaliar se a qualidade da dieta e seus componentes estão associados ao desenvolvimento de câncer de mama. Métodos: Trata-se de estudo caso-controle com a participação de 332 mulheres, sendo 114 casos e 218 controles. Os grupos foram pareados por idade, índice de massa corporal e estado menopausal. A qualidade da dieta foi avaliada pelo Índice de Qualidade da Dieta Revisado (IQD-R) e seus componentes. O consumo alimentar foi mensurado por meio da aplicação de três recordatórios alimentares de 24 horas e analisados no software NDS-R. Foi realizada regressão logística ajustada, estimativa de odds ratio (OR) e intervalo de confiança de 95% (IC95%), com valor de p<0,05. Resultados: A pontuação do IQD-R, classificada em quartis, não diferiu entre os grupos no quartil inferior de qualidade da dieta (p=0,853). Os componentes cereais totais (p=0,038), gordura saturada (p=0,039) e Gord_AA (gordura, álcool e açúcar de adição) (p=0,023) tiveram maior pontuação no grupo caso. Já a pontuação de frutas totais (p=0,010) e leites e derivados (p=0,039) foi maior no grupo controle. Os componentes do IQD-R, assim como a qualidade da dieta, não se associaram ao desfecho investigado. Conclusão: A qualidade da dieta, avaliada pelo IQD-R e os seus componentes, não se associou ao câncer de mama.

Extra institutional food consumption and food preferences of full-time public school students / Consumo de alimentos extrainstitucionais e preferências alimentares de alunos de escolas públicas de tempo integral

ABSTRACT Objective To analyze the factors associated with the consumption of extra institutional foods and the food preferences of full-time students. Methods A cross-sectional study with students from full-time municipal schools in the city of Goiânia, Brazil, from 6 to 14 years of age, both sexes and without food restrictions. The per capita family income, maternal education, nutritional status, the consumption of extra institutional foods (meals not provided by the school) in each meal and their source, and foods with higher or lower preference in school eating habits were verified. Both a Chi-Square and a Linear Trend tests were used to analyze the data. Results Three hundred and fifty nine students participated, most of them aged between 6 and 10. More than one third consumed extra institutional foods (44.0%), with the highest frequency of consumption during the mid-morning snack (34.0%). These foods mainly originated from their own households (48.7%) and one of the main items consumed was carton juice. There was an association between adolescents and mothers with higher education levels and the consumption of these items during lunch, and between students who are non-overweight and their consumption in the afternoon snack. The preferred foods were chocolate milk and bread with butter/margarine, rice and beans, passion fruit juice, and bread with cheese/requeijão and less preferably: caramelized milk and salt biscuit, beans and beets, coconut porridge and bread with cheese. Conclusion There was a high frequency of extra institutional food consumption, associated to the age group, to a higher educational level of the mother and students who are non-overweight. Foods of higher and lower preference included dairy foods and beans.

RESUMO Objetivo O objetivo desta pesquisa é analisar os fatores associados ao consumo de alimentos extrainstitucionais e as preferências alimentares de alunos matriculados em escolas públicas de tempo integral. Métodos Trata-se de estudo transversal analítico com alunos de escolas municipais de tempo integral do município de Goiânia (GO). Participaram da pesquisa estudantes de ambos os sexos, com idade entre seis e 14 anos, que não apresentavam restrições alimentares. Verificou-se renda familiar per capita, escolaridade materna, estado nutricional, o consumo de alimentos extrainstitucionais (não provenientes da alimentação escolar) em cada refeição e seu local de origem, bem como os alimentos de maior e menor preferência na alimentação escolar. Utilizou-se teste Qui-Quadrado e Tendência Linear para análise dos dados. Resultados Participaram 359 alunos, a maioria entre seis e 10 anos. Mais de um terço consumia alimentos extrainstitucionais (44,0%), com maior frequência no lanche da manhã (34,0%). O principal local de origem desses alimentos foi o domicílio (48,7%), e um dos principais alimentos consumidos foi o suco de caixinha. Esse consumo, no almoço, associou-se com os adolescentes e as mães com maior escolaridade e, no lanche da tarde, entre os alunos sem excesso de peso. Os alimentos de maior preferência foram leite achocolatado e pão com manteiga/margarina, arroz e feijão, suco de maracujá e pão com queijo/requeijão; os de menor preferência foram leite caramelado e biscoito de sal, feijão e beterraba, mingau de coco e pão com requeijão/queijo. Conclusão Houve frequência elevada de consumo de alimentos extrainstitucionais, associado a faixa etária, maior escolaridade da mãe e alunos sem excesso de peso. Os alimentos de maior e menor preferência incluíram alimentos lácteos e feijão.

[School nutrition in 'quilombola' communities: challenges and opportunities]. / Alimentação escolar nas comunidades quilombolas: desafios e potencialidades.

The Brazilian School Nutrition Program (PNAE) is a Food and Nutritional Security (SAN) strategy for public school students. This article seeks to discuss the challenges and opportunities of school nutrition in 'quilombola'* communities and report on the experience of the Cooperation Center for Student Food and Nutrition of the Federal University of Goiás and the Midwest Region (CECANE UFG/ Centro-Oeste). It includes a report on the experience with the systematization on PNAE, SAN and other policies. Continued access and adequate social policies are a challenge for the 'quilombola'* communities. Some economic, structural and social barriers have been identified in PNAE. In this context, Law 11.947/2009 encourages local development, with the acquisition of food from the region, and it establishes differentiated values per capita, which are translated into menus including products inherent to Afro-Brazilian culture that provide at least 30% of daily nutritional requirements. In the nutrition, health and quality of life project of 'quilombola'* schoolchildren, the CECANE UFG/Midwest carry out food and nutritional security actions. The area of school nutrition has proven responsive to local needs and supports the development and promotion of quality of life.

[Venous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment]. / Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama.

PURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.

Do food intake and food cravings change during the menstrual cycle of young women? / A ingestão de alimentos e os desejos por comida mudam durante o ciclo menstrual das mulheres jovens?

Abstract Objective The aim of the present study was to assess the anthropometric measures, food intake and food cravings during the menstrual cycle of undergraduate students of the faculty of nutrition. Methods A cross-sectional study was performed with 27 students from a public university in the state of Mato Grosso do Sul, Brazil, who had their food intake evaluated through a 24-hour food recall, their nutritional status evaluated based on anthropometric measures, and food cravings evaluated using the Food Desire Questionnaire. Data were collected during an evaluation in the follicular phase (between the 5th and the 9th day of the menstrual cycle) and another in the luteal phase (LP) (between the 20th and the 25th day of the menstrual cycle). For food intake variables, the analysis of variance (ANOVA) test was used, followed by the Tukey test. The Mann-Whitney test was used for the analysis of food cravings, considering a significance level of 5% (p< 0.05). Results The desire for foods rich in sugar, salt, and fat, such as chocolate, pastries, snacks and desserts were higher (p< 0.05) during the premenstrual period, although it did not reflect neither a higher energy intake nor an alteration in the distribution of macronutrients. A higher intake of carbohydrates, proteins, fibers, and calcium was observed during the LP; however, without statistical difference between the groups. There were no differences either in the intake of any food group or in the anthropometric measurements (p> 0.05). Conclusion Food cravings of nutrition students differed between the phases of the menstrual cycle; however, with no difference in food intake and in anthropometric measures.

Resumo Objetivo Verificar alterações de medidas corporais, consumo e desejos alimentares durante o ciclo menstrual de acadêmicas de nutrição. Métodos Estudo transversal com 27 estudantes de uma universidade pública do Mato Grosso do Sul, as quais tiveram seu consumo alimentar avaliado por meio de recordatório alimentar de 24 horas, estado nutricional avaliado com base em medidas antropométricas, e desejos alimentares avaliados utilizando-se o Questionário de Desejo Alimentar. Os dados foram coletados durante uma avaliação na fase folicular (entre o 5° e o 9° dia do ciclo menstrual) e outra na fase lútea (entre o 20° e o 25° dia do ciclo menstrual). Para as variáveis de consumo alimentar, utilizou-se o teste análise de variância (ANOVA, na sigla em inglês), seguido pelo teste de Tukey. Já para a análise dos desejos alimentares, utilizou-se o teste de Mann-Whitney. Foi considerado o nível de significância de 5% (p< 0,05). Resultados Os desejos por alimentos ricos em açúcar, sal e gordura, como chocolates, produtos de pastelaria, lanches e sobremesas foram maiores (p< 0,05) no momento pré-menstrual, apesar de não refletirem em maior consumo energético e tampouco em alteração na distribuição de macronutrientes. Observou-se maior consumo de carboidratos, proteínas, fibras e cálcio na fase lútea; no entanto, sem diferença estatística entre os grupos. Não foram encontradas diferenças no consumo de nenhum grupo alimentar, tampouco nas medidas antropométricas (p> 0,05). Conclusão Os desejos alimentares das acadêmicas de nutrição diferiram entre as fases; no entanto, sem diferença no consumo alimentar e nas medidas corporais.

Anthropometry and lipid profile in women with breast cancer: a case-control study.

OBJECTIVE: To assess body composition and lipid profile of women with and without breast cancer. METHODS: We conducted a case-control study matched by age, including 62 women, 31 being newly diagnosed with breast cancer and 31 with benign breast changes. Data were collected through direct interview, with recording of sociodemographic characteristics, body composition assessment by anthropometry, including skinfolds (DC) and circumference, bioelectrical impedance (BIA) and ultrasonography (USG), as well as lipid profile evaluation. STATISTICAL ANALYSIS USED: Kolmogorov-Smirnov test (normally distributed variables), "t" test, chi-square test for trend (Mann-Whitney U), chi-square test, Fisher's exact test and Yates correction and "odds ratio". RESULTS: When compared with controls, women with breast cancer (cases) had lower height (1.56 m ± 5.68 versus 1.59 m ± 6.92), p <0.03; higher percentage of body fat, assessed by Bioelectric Impedance (39.87% ± 8.26 versus 36.00% ± 6.85), p <0.049; and higher triceps skinfold thickness (27.55 mm ± 8.37 versus 22.81 ± 5.72 mm; p <0.01), respectively. CONCLUSION: Women with breast cancer had lower height, higher body fat percentage and higher triceps skinfold thickness. There was no difference in body mass index and waist circumference. There was no association between lipid profile and the occurrence of breast cancer.

ALTERATION OF BONE MINERAL DENSITY IN BREAST CANCER FEMALE SURVIVORS ON CHEMOTHERAPY TREATMENT: AN INTEGRATIVE REVIEW / Alteração da densidade mineral óssea em mulheres sobreviventes de câncer de mama tratadas com quimioterapia: revisão integrativa da literatura

Introduction: Chemotherapy for treatment of patients with breast cancer has increased the survival of this population. However, it can significantly reduce bone mineral density (BMD). Objective: To verify bone mineral density modifications in women with breast cancer undergoing chemotherapy, as well as their clinical characteristics and risk factors. Methods: Integrative review of papers published from 2006 to 2016, carried out through specific terms in PubMed and SciELO databases. Results: In that period, 898 papers were identified (897 in PubMed and 1 in SciELO). Among the six papers recovered, there was a considerable reduction in lumbar spine and femoral bone mass. For women submitted to chemotherapy, the main regimens associated with the reduction were doxorubicin and cyclophosphamide (AC), cyclophosphamide, methotrexate and 5-fluorouracil (CMF) and cyclophosphamide, epirubicin and 5-fluorouracil (FEC). In addition, there was greater BMD reduction among women aged more than 50 years, Caucasian and who presented early ovarian failure induced by chemotherapy. Conclusion: The use of chemotherapy for breast cancer may lead to bone mass loss, especially when AC, CMF and FEC are used in women aged more than 50 years and among those with early menopause due to this treatment.

Introdução: O uso de quimioterápicos para o tratamento de pacientes com câncer de mama tem aumentado a sobrevida dessa população. Entretanto, pode reduzir significativamente a densidade mineral óssea (DMO). Objetivo: Verificar a alteração da densidade mineral óssea em mulheres com câncer de mama submetidas a quimioterapia, assim como as características clínicas e os fatores de risco. Métodos: Revisão integrativa da literatura de artigos publicados no período de 2006 a 2016, realizada por meio de termos específicos nos bancos de dados da PubMed e da SciELO. Resultados: No período selecionado, foram identificados 898 artigos (897 na base PubMed e 1 na SciELO). Entre os seis artigos recuperados para leitura na íntegra, observou-se redução considerável na massa óssea na coluna lombar e no fêmur. Os principais tipos associados à redução foram os regimes doxorrubicina e ciclofosfamida (AC), ciclofosfamida, metotrexato e 5-fluorouracil (CMF) e ciclofosfamida, epirrubicina e 5-fluorouracil (FEC). Além disso, houve maior redução da DMO entre as mulheres com idade acima de 50 anos, caucasianas e que apresentaram falência ovariana precoce induzida pela quimioterapia. Conclusão: O uso de quimioterápicos para tratamento do câncer de mama pode acarretar perda de massa óssea, principalmente quando se utilizam os regimes AC, CMF e FEC em mulheres com idade acima de 50 anos e entre aquelas que apresentam menopausa precoce decorrente desse tratamento.

Feeding in full-time public schools: Do students adhere and accept? / Alimentação em escolas públicas de tempo integral: alunos aderem e aceitam?

ABSTRACT Objective Identifying adherence to, and acceptance of school feeding, and analyzing the factors associated with non-adherence/non-acceptance in full-time public schools in Goiânia, Goiás, Brazil. Methods Cross-sectional study with students of both sexes aged 6-14 years. Issues regarding the consumption of meals, food distribution, food eaten outside the school and socioeconomic data, including nutritional assessment of students, were investigated. Adherence to meals was defined as the consumption of school meals four to five times/week, and acceptance was defined as meal approval, using the facial hedonic scale. Results A total of 359 students participated in this study and it was observed that adherence was high for lunch (95%) and afternoon snacks (78%), and low for morning snacks (44%). Acceptance did not reach the required minimum percentage of 85% for any of the meals. Factors associated with non-adherence were the presence of >4 people in a household, having meals in a refectory, the meal location being considered uncomfortable and a negative evaluation of utensils used in eating meals. Factors associated with non-acceptance were age >10 years, female sex, the negative evaluation of utensils used in eating meals and inadequate food temperature. Conclusion Lunch and afternoon snacks showed the highest adherence, but the stipulated acceptance was not reached. Non-adherence and non-acceptance were mainly associated with aspects related to school feeding. This study allowed the evaluation of feeding in full-time public schools, in order to influence its improvement.

RESUMO Objetivo Identificar a adesão e a aceitação à alimentação escolar e analisar os fatores associados à não adesão/não aceitação em escolas públicas de tempo integral de Goiânia, Goiás. Métodos Estudo transversal realizado com alunos de 6 a 14 anos de ambos os sexos. Investigou-se questões sobre o consumo das refeições e de alimentos externos à escola, distribuição de alimentos, dados socioeconômicos e avaliação nutricional. Definiu-se adesão às refeições como o consumo em 4 a 5 vezes/semana e aceitação como a aprovação das refeições, utilizando-se a escala hedônica facial. Resultados Participaram 359 alunos e observou-se que a adesão foi alta para o almoço (95%) e lanche da tarde (78%) e baixa para o lanche da manhã (44%). A aceitação não alcançou o percentual mínimo exigido de 85%. A não adesão associou-se ao número de pessoas maior que quatro no domicílio, realização da refeição no refeitório, o local de consumo considerado desconfortável e a avaliação negativa dos utensílios. A não aceitação associou-se à idade >10 anos, sexo feminino, avaliação negativa dos utensílios e inadequação da temperatura dos alimentos. Conclusão O almoço e o lanche da tarde apresentaram as maiores adesões e não se alcançou a aceitação estipulada. A não adesão e não aceitação associaram-se principalmente aos aspectos relacionados à alimentação escolar. Esse estudo permitiu avaliar a alimentação nas escolas públicas de tempo integral, com vistas a favorecer seu aprimoramento.

Comparison of methods to evaluate total body fat and its distribution.

OBJECTIVE: To compare two methods for evaluating total body fat and its distribution. METHODS: Cross-sectional, cohort-nested study. Sixty-two women received a nutritional status evaluation which included total body fat (BF) obtained through the sum of skinfolds (ΣSF) and bioimpedance (BIA). Visceral fat distribution was measured using ultrasonography (USG) (intra-abdominal fat thickness) (IAT) and waist circumference (WC). The concordance correlation coefficient (CCC) and the determination coefficient (r²) were calculated. RESULTS: Mean patient age was 48.19 (8.99) years. Thirty-six women (58.06%) had a very large WC and 42 (67.74%) had high body fat. There was moderate concordance (r² = 0.42; CCC = 0.59; p < 0.01) between the methods for determining body fat (%) and optimal concordance (r² = 0.90; CCC = 0.91; p < 0.01) for body fat (kg) determined by BIA and ΣSF. The comparison between WC and IAT (USG) showed moderate concordance (r² = 0.49; p < 0.01) between the methods. CONCLUSIONS: Moderate concordance in determining total body fat (%) and optimal concordance in determining body fat (kg) were found between the methods. Moderate concordance was found between the methods for determining body fat distribution.

Educação Alimentar e Nutricional: influência no comportamento alimentar e no estado nutricional de estudantes / Food and Nutrition Education: influence on students feeding behavior and nutritional status

A transição nutricional indica um consumo alimentar inadequado na população brasileira sendo necessária a adoção de estratégias educativas com a finalidade de favorecer comportamentos saudáveis. O objetivo deste trabalho foi avaliar a influência de um programa de intervenção nutricional educativa no hábito alimentar e indicadores antropométricos de alunos da primeira fase do ensino fundamental. Estudo quantitativo prospectivo, realizado em uma escola federal de Goiânia/Goiás, com 92 alunos. Realizou-se caracterização sociodemográfica, avaliação do peso, altura e Índice de Massa Corporal (IMC) e, para a identificação do hábito alimentar, aplicou-se o Questionário Alimentar do Dia Anterior (QUADA), previamente validado. Um programa de intervenção nutricional educativa foi implantado, sendo desenvolvidas três atividades em cada turma de alunos. A média de idade dos alunos foi de 9,61±1,17 anos, sendo que a maioria eram meninas (55,44%), da classe social "B" (54,38%); pardos (57,90%); católicos (54,39%), moravam com pais (68,42%) e tinha um a dois irmãos (71,94%). A maioria dos participantes apresentou eutrofia, antes e após a intervenção, e 20,00% apresentou excesso de peso. Após cinco meses da intervenção educativa, observou-se aumento de peso e IMC, sem significância estatística, ganho estatural significativo...

The nutritional transition indicates inadequate food intake in our population and it requires the adoption of educational strategies in order to promote healthy behaviors. This study evaluated the influence of an educational intervention program in dietary habits and anthropometric indicators in elementary school students. This was a prospective quantitative study developed in a public school in Goiânia, Goiás, with 92 students. Sociodemographic characteristics were analyzed as well as weight, height and body mass index (BMI) measurements. In order to identify the feeding habits, the already validated Previous Day Food Quiz (PDFQ) was used. An educational intervention program was implemented and three activities were developed in each classroom. The students' average age was 9.61 ± 1.17 years old, and the majority were girls (55.44%), social class "B" (54.38%); brown skin (57.90%); catholics (54.39%), living with their parents (68.42%) and they had one to two brothers (71.94%). Most participants had normal weight before and after the intervention, and 20.00% were overweight. After five months of the educational intervention, there was an increase in weight and BMI, although not statistically significant, and a significant height increase…

Excesso de peso e de gordura androide em mulheres goianas recém-diagnosticadas com câncer de mama / Overweight and android fat depot in women from Goiás newly diagnosed with breast cancer

Objetivo: Descrever a prevalência de excesso de peso e de gordura localizada na região androide avaliadas pelo método absortometria radiológica de feixe duplo (DXA) em mulheres goianas recém-diagnosticadas com câncer de mama. Métodos: Estudo transversal com 48 mulheres com câncer de mama atendidas no Programa de Mastologia do Hospital das Clínicas da Universidade Federal de Goiás. Foram coletadas características sociodemográficas, medidas antropométricas e avaliada a composição corporal por meio do DXA. Resultados: A média de idade das participantes foi de 53±11 anos, 78,00% apresentavam renda de até um salário mínimo e 69,00% referiram residir com o companheiro. Com relação à medida da circunferência da cintura, 69,00% apresentaram valores acima da recomendação máxima para esse parâmetro. Apenas 14,58% apresentaram valores de índice de massa corporal (IMC) na faixa de normalidade. Ao considerar o percentual de gordura corporal total obtido pelo DXA, nenhuma mulher foi classificada com percentual de gordura normal, além de apresentarem um elevado percentual de gordura na região androide (52,34%). Conclusão: Mulheres recém-diagnosticadas com câncer de mama apresentaram alta prevalência de excesso de peso e risco aumentado para complicações metabólicas e cardiovasculares considerando a elevada prevalência de hiperadiposidade abdominal avaliada pelas medidas de circunferência da cintura e de gordura androide.

Objective: To describe the prevalence of overweight and fat located in the android region assessed by dual x-ray absorptiometry (DXA) in women from Goiás, Brazil, newly diagnosed with breast cancer. Methods: Cross-sectional study of 48 women with breast cancer assisted in the Mastologia Program in the Clinical Hospital of the Federal University of Goiás. Socio-demographic characteristics and anthropometric measurements were collected, and body composition was evaluated by DXA. Results: The mean age of participants was 53±11 years, 78.00% had incomes up to one minimum wage and 69.00% reported living with a partner. According to waist circumference, 69.00% had values above the maximum recommendation for this parameter. Only 14.58% had body mass index (BMI) in the normal range. When the percentage of total body fat was analyzed by DXA, no woman was classified as regular body fat; in addition, they showed high percentage of the localized android fat (52.34%). Conclusion: Women newly diagnosed with breast cancer showed high prevalence of overweight and increased risk for metabolic and cardiovascular complications considering the high prevalence of abdominal adiposity assessed by waist circumference and android fat.

Práticas alimentares e fatores associados à introdução precoce da alimentação complementar entre crianças menores de seis meses na região noroeste de Goiânia / Feeding practices and factors associated with early introduction of complementary feeding of children aged under six months in the northwest region of Goiânia, Brazil / Prácticas alimenticias y factores asociados a la introducción precoz de alimentos complementarios en niños menores de seis meses en la región noroeste de Goiânia, Goiás, Brasil

OBJETIVO: analisar as práticas alimentares e fatores associados à introdução precoce da alimentação complementar entre crianças menores de seis meses, nascidas em maternidade na região noroeste de Goiânia, Goiás, Brasil. MÉTODOS: estudo transversal, realizado de agosto de 2005 a fevereiro de 2007; investigou-se a introdução precoce da alimentação complementar e fatores sociodemográficos, gestacionais, maternos, relativos à criança e consumo alimentar; foram estimadas razões de prevalência (RP) e intervalos de confiança de 95% (IC95%), por regressão de Poisson com ajuste robusto de variância. RESULTADOS: foram avaliadas 362 crianças, das quais 95,3% receberam precocemente água (77,5%), frutas (62,7%), sucos (57,2%) e comida de sal (55,1%); após análise ajustada, encontrou-se maior prevalência do desfecho nas crianças de mães fumantes (RP=1,02; IC95% 1,01;1,04), enquanto essa prevalência foi menor em primíparas (RP=0,97; IC95% 0,95;0,99). CONCLUSÃO: a prevalência da introdução precoce da alimentação complementar foi elevada, associada a fatores ambientais e gestacionais.

OBJECTIVE: to analyze feeding practices and factors associated with early introduction of complementary feeding of children aged under six months born in a maternity hospital in the northwest region of Goiânia, Goiás, Brazil. METHODS: cross-sectional study conducted between August/2005 and February/2007; early introduction of complementary feeding was investigated (outcome of interest) and possible associated factors (sociodemographic, maternal, pregnancy, child-related and food consumption variables); the prevalence ratio was determined using a Poisson regression model with robust adjustment of variance. RESULTS: 362 children aged under six months were assessed and it was found that 95.3% of children received water (77.5%), fruit (62.7%), juices (57.2%), and savoury food (55.1%) early; after adjusted analysis outcome prevalence was higher among children of mothers who smoked (PR=1.02; CI95%: 1.01;1.04) and lower in primiparous mothers (PR=0.97; CI95%: 0.95;0.99). CONCLUSION: prevalence of early introduction of complementary feeding was high and associated with environmental and gestational factors.

OBJETIVO: analizar las prácticas alimenticias y factores asociados a la introducción precoz de alimentos complementarios en niños menores de seis meses nacidos en maternidad en la región noroeste de Goiânia, Goiás, Brasil. MÉTODOS: estudio transversal realizado de agosto/2005 a febrero/2007; se investigó la introducción precoz de alimentos complementarios y factores sociodemográficas, maternos, gestacionales, relativos al niño y consumo alimenticio; se calcularon razones de prevalencia e intervalos de confianza al 95% (IC95%), usando regresión de Poisson, con ajuste robusto de varianza. RESULTADOS: se evaluaron 362 niños de los cuales 95,3% recibieron precozmente agua (77,5%), frutas (62,7%), jugos (57,2%) y comidas (55,1%); después del análisis ajustado, se encontró mayor prevalencia de la variable de desenlace en niños de madreS fumadoras (RP=1,02; IC95% 1,01;1,04), en cuanto esa prevalencia fue menor en primíparas (RP=0,97; IC95% 0,95;0,99). CONCLUSIÓN: la prevalencia de introducción precoz de alimentos complementarios fue elevada, asociada a factores ambientales y gestacionales.