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Saied S, Prokopidis K, Adenaya A, Isanejad M, Sankaranarayanan R. Is sarcopenia an associated factor of increased administration of specific medications in patients with heart failure? A systematic review and meta-analysis. Front Cardiovasc Med 2024; 11:1293537. [PMID: 38333416 PMCID: PMC10850377 DOI: 10.3389/fcvm.2024.1293537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/05/2024] [Indexed: 02/10/2024] Open
Abstract
Background There is controversy in relation to commonly used drugs in heart failure (HF) and their impact on muscle function. The aim of this study was to evaluate the odds of receiving specific medications often used in clinical practice by patients with HF and sarcopenia vs. without sarcopenia. Methods A systematic literature search of cohort studies via databases (PubMed, Web of Science, Scopus, and Cochrane Library) was conducted from inception until March 2023. To determine if sarcopenia is linked to a higher number of specific HF-related medications, a meta-analysis using a random-effects model was used to calculate the pooled effects. Results Our main analyses showed no significant association of sarcopenia with administration of higher HF-related medication count vs. those without sarcopenia. Those with lower appendicular lean mass (ALM) had significantly lower odds of receiving angiotensin converting enzyme inhibitors (ACE-Is)/angiotensin receptor blockers (ARBs) (OR: 0.68, 95%CI 0.50-0.90, I2 = 12%, P < 0.01) vs. patients with higher ALM for which age could be an important confounder based on meta-regression. No statistically significant differences were found in relation to B-blockers OR: 0.84, 95%CI 0.63-1.12, I2 = 7%, P = 0.24) and loop diuretics (OR: 1.19, 95%CI 0.87-1.63, I2 = 0%, P = 0.27). Regarding handgrip strength, gait speed, and short physical performance battery, our narrative synthesis found mixed results. Conclusion This systematic review and meta-analysis did not find a relationship of specific medication count in sarcopenia vs. without sarcopenia in patients with HF, although increased odds of ACE-I/ARB was shown in those with higher ALM. Systematic Review Registration PROSPERO (CRD42023411137).
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Affiliation(s)
- Schabnam Saied
- School of Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Konstantinos Prokopidis
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Adeoye Adenaya
- School of Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Masoud Isanejad
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Rajiv Sankaranarayanan
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
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Wang Y, Pu X, Zhu Z, Sun W, Xue L, Ye J. Handgrip strength and the prognosis of patients with heart failure: A meta-analysis. Clin Cardiol 2023; 46:1173-1184. [PMID: 37469187 PMCID: PMC10577571 DOI: 10.1002/clc.24063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Reduced muscular strength is common in patients with heart failure (HF). The aim of the systematic review and meta-analysis was to evaluate the association between handgrip strength (HGS) and prognosis of patients with HF. HYPOTHESIS Reduced HGS may be a risk factor of poor prognosis of patients with HF. METHODS Relevant observational studies with longitudinal follow-up were obtained by a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases. A random-effects model was used to pool the results. RESULTS Fifteen studies involving 7350 patients with HF were included in the meta-analysis. Pooled results showed that HF patients with lower HGS were associated with a higher risk of mortality during follow-up (risk ratio [RR]: 2.00, 95% confidence interval [CI]: 1.55-2.58, p < .001; I2 = 0%). Subgroup analysis showed that the association was not significantly affected by characteristics such as study country, design, mean age of the patients, HF status (stable or advanced/acute), HF type (reduced or preserved ejection fraction), follow-up duration, and quality score (p for subgroup difference all > 0.05). Further analysis showed that per 1 kgf decrease of HGS was associated with an 8% increased risk of mortality during follow-up (RR: 1.08, 95% CI: 1.05-1.11, p < .001; I2 = 12%). Moreover, HF patients with lower HGS were also related to a higher risk of composite outcome of HF rehospitalization or mortality (RR: 1.67, 95% CI: 1.19-2.35, p = .003; I2 = 53%). CONCLUSION A low HGS may be associated with poor clinical outcomes of patients with HF.
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Affiliation(s)
- Yu Wang
- Department of Critical Care MedicineTaizhou People's HospitalTaizhouJiangsu ProvinceChina
| | - Xuehua Pu
- Department of Critical Care MedicineTaizhou People's HospitalTaizhouJiangsu ProvinceChina
| | - Zhiyun Zhu
- Department of Critical Care MedicineTaizhou People's HospitalTaizhouJiangsu ProvinceChina
| | - Wenbin Sun
- Department of Critical Care MedicineTaizhou People's HospitalTaizhouJiangsu ProvinceChina
| | - Lu Xue
- Department of Critical Care MedicineTaizhou People's HospitalTaizhouJiangsu ProvinceChina
| | - Jilu Ye
- Department of Critical Care MedicineTaizhou People's HospitalTaizhouJiangsu ProvinceChina
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Thanapholsart J, Khan E, Lee GA. A Current Review of the Uses of Bioelectrical Impedance Analysis and Bioelectrical Impedance Vector Analysis in Acute and Chronic Heart Failure Patients: An Under-valued Resource? Biol Res Nurs 2023; 25:240-249. [PMID: 36342073 PMCID: PMC10021121 DOI: 10.1177/10998004221132838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is a need to detect and prevent fluid overload and malnutrition in heart failure. Bioelectrical impedance analysis and bioelectrical impedance vector analysis are medical instruments that can advance heart failure management by generating values of body composition and body water, assisting clinicians to detect fluid and nutritional status. However, there is a lack of evidence to summarise how they have been used among heart failure patients. METHOD A systematic search was conducted. RESULT Two hundred and four papers were screened. Forty-eight papers were reviewed, and 46 papers were included in this review. The literature shows that bioelectrical impedance analysis and bioelectrical impedance vector analysis were mostly used to assess fluid and nutritional status, together with diagnostic and prognostic values. Contraindication of using BIA and implications for practice are also demonstrated. CONCLUSION The findings suggest that bioelectrical impedance vector analysis is superior to bioelectrical impedance analysis when assessing hydration/nutritional status in heart failure. Assessing a patient using bioelectrical impedance analysis /bioelectrical impedance vector analysis, together with natriuretic peptide -heart failure biomarkers, increases the diagnostic accuracy of heart failure. Further studies are required to examine the cost effectiveness of using these instruments in clinical practice.
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Affiliation(s)
- Jenjiratchaya Thanapholsart
- Division of Applied Technologies for Clinical Care, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Ehsan Khan
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Geraldine A Lee
- Division of Applied Technologies for Clinical Care, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
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Valdiviesso R, Moreira E, Martins S, Azevedo LF, Ataíde R, Fernandes L, Silva-Cardoso J, Borges N. Frailty phenotype in heart failure: A condition that transcends age. Rev Port Cardiol 2023; 42:225-234. [PMID: 36623639 DOI: 10.1016/j.repc.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Studies on younger frail and pre-frail subjects suffering from heart failure (HF) are scarce, except for those focusing on the critically ill. This work aims to describe differences between younger (<65 years) and older (≥65 years) pre-frail and frail HF outpatients regarding their nutritional, functional and clinical statuses. METHODS In this cross-sectional study, a sample of 99 HF frail and pre-frail patients (aged 24-81 years, 38.4% women, 21.2% frail, 59.6% <65 years) was recruited from an HF outpatients' clinic in northern Portugal. Muscle mass was estimated from mid-upper arm muscle circumference. Weight status was assessed using body mass index. Hand grip strength and gait speed were measured. Medical records were reviewed. Associations between participants' characteristics and age were calculated using binary logistic regression. RESULTS Age was associated with hand grip strength (OR=0.90), gait speed (OR=0.01) and diabetes (OR=4.95). Obesity, muscle mass or heart failure functional classes were not associated with age categories. CONCLUSION There is an overall lack of differentiation between younger and older HF patients with the frailty phenotype. Therefore, frailty phenotype should be assessed in all patients, regardless of age. Hand grip strength seems to be a good predictor for older age and more studies are needed to define age-specific hand grip strength cut-offs for HF populations.
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Affiliation(s)
- Rui Valdiviesso
- FCNAUP - Faculty of Nutrition and Food Sciences of the University of Porto, Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal.
| | - Emília Moreira
- CINTESIS@RISE, Knowledge Management Unit, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Sónia Martins
- ISSSP - Instituto Superior de Serviço Social do Porto, Porto, Portugal; CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Rosário Ataíde
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Lia Fernandes
- CINTESIS@RISE, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Porto, Porto, Portugal; Psychiatry Service, University Hospital Center of São João, Porto, Portugal
| | - José Silva-Cardoso
- CINTESIS@RISE, Department of Medicine, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiology, University Hospital Center of São João, Porto, Portugal
| | - Nuno Borges
- FCNAUP - Faculty of Nutrition and Food Sciences of the University of Porto, Porto, Portugal; CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
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Harada K, Yamada S, Mamiya K, Higo S, Suzuki H, Teshima Y, Matsunaga S, Harada K, Nagao T, Shinoda N, Kato M, Marui N, Amano T, Murohara T. Cardiopulmonary exercise responses in patients with non-ischemic heart failure and a mildly reduced ejection fraction. Future Cardiol 2022; 18:627-634. [PMID: 35674279 DOI: 10.2217/fca-2021-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: The cardiopulmonary response to exercise in patients with heart failure exhibiting a mildly reduced ejection fraction (41% ≤ EF ≤ 49%) remains unclear. Materials & methods: A total of 193 consecutive patients with heart failure (excluding those with coronary artery disease) who underwent cardiopulmonary exercise (CPX) tests were examined. CPX variables were compared among patients with reduced, mildly reduced, and preserved EF. Results: The CPX test responses of patients with mildly reduced EF were similar to those of patients with reduced or preserved EF; however, increases in systolic blood pressure during exercise differed significantly (32 ± 26, 50 ± 24, and 41 ± 31 mmHg, respectively; p = 0.016). Grip strength and an increase in systolic blood pressure during exercise were independently associated with peak oxygen uptake in patients with mildly reduced EF (β = 0.41, 0.35, respectively; p < 0.05). Conclusion: Measurements of grip strength and blood pressure during exercise are useful predictors of prognoses in patients with non-ischemic and mildly reduced EF.
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Affiliation(s)
- Ken Harada
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Sumio Yamada
- Department of Physical Therapy, School of Health Sciences, Nagoya University, Nagoya, 461-8673, Japan
| | - Kumiko Mamiya
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Sayaka Higo
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Hitomi Suzuki
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Yuto Teshima
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Shun Matsunaga
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Kazuhiro Harada
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Tomoyuki Nagao
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Norihiro Shinoda
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Masataka Kato
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Nobuyuki Marui
- Department of Cardiology, Chubu Rosai Hospital, Nagoya, 455-8530, Japan
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 466-8560, Japan
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Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population. NUTR HOSP 2021; 39:82-92. [PMID: 34816725 DOI: 10.20960/nh.03732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND handgrip strength (HGS) is a health-status parameter associated with multicomorbidity in the adult population. OBJECTIVE the aim of the present study was to determine the association between HGS (i.e., absolute and relative) and abdominal obesity (AO), type-2 diabetes (T2D), and hypertension (HT), as well as to determine the association between low relative HGS with the presence of multicomorbidity (i.e., the co-occurrence of two or more comorbidities together) in a Mexican population. METHODOLOGY a cross-sectional study was carried out in 860 participants from the south of Mexico (661 women and 199 men). The age range evaluated was from 18 to 65 years. Assessments were made of sociodemographic data, clinical history, anthropometric parameters, and measurement of maximal HGS. RESULTS the regression models adjusted by age show that the presence of comorbidities (i.e., AO, HT and T2D) was linked negatively to HGS (i.e., absolute and relative). Moreover, in men, a low relative HGS in both hands reported an association with the presence of three simultaneous comorbidities (right, RR: 17.2, p < 0.001; left, RR: 11.92, p = 0.020). In women the same association was found (right, RR: 10.42, p < 0.001; left, RR: 9.90, p < 0.001). CONCLUSION lower levels of relative HGS were linked to the presence of simultaneous comorbidities (i.e., the joint presence of AO, T2D and HT). Furthermore, HGS (i.e., absolute and relative) presented an inverse association with individual anthropometric and clinical parameters related to cardiovascular risk in the Mexican population.
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Valdiviesso R, Azevedo LF, Moreira E, Ataíde R, Martins S, Fernandes L, Silva-Cardoso J, Borges N. Frailty phenotype and associated nutritional factors in a sample of Portuguese outpatients with heart failure. Nutr Metab Cardiovasc Dis 2021; 31:2391-2397. [PMID: 34112582 DOI: 10.1016/j.numecd.2021.03.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Frailty phenotype (FP) is very common in heart failure (HF) and both syndromes worsen one another. The aim of this study is to first describe FP in a sample of Portuguese patients with HF, and to analyse its association with nutritional and clinical statuses, namely, muscle mass, obesity and functional class. METHODS AND RESULTS In this cross-sectional study, a sample of 136 outpatients with HF (24-81 years, 33.8% women) were randomly selected from the appointments' listings of a HF and Transplant clinic in a Portuguese University Hospital. FP was assessed according to Fried et al. muscle mass was estimated from the mid-upper arm muscle circumference; weight status was assessed using the body mass index; HF functional classes were registered. The association between participants' characteristics and FP categories was analysed using logistic ordinal regression. The frequency of pre-frailty and frailty is 57.4% and 15.4%, respectively. Within frail individuals, 52.4% were under the age of 65. In multivariable analysis, frailty was positively associated with age 70 or older (OR = 3.44) and obesity (OR = 2.66), and negatively associated with muscle mass (OR = 0.77) and HF functional classes I (OR = 0.14) or II (OR = 0.29). CONCLUSION Muscle mass seems to be an important predictor of frailty in patients with HF and should be taken into account when designing intervention plans that allow for reverting or modifying frailty and pre-frailty. Younger patients should be monitored for the presence and evolution of FP.
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Affiliation(s)
- Rui Valdiviesso
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - Luís F Azevedo
- Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Medicina da Comunidade, Informação e Decisão em Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Emília Moreira
- Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Rosário Ataíde
- Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Sónia Martins
- Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Lia Fernandes
- Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Psiquiatria do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - José Silva-Cardoso
- Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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K P B, L L J, A L W, J B, N S, J R H, H H M H. Dietary inflammatory index and mortality in hemodialysis patients by path analysis approach (NUGE-HD study). Nutrition 2021; 89:111239. [PMID: 33930786 DOI: 10.1016/j.nut.2021.111239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the interrelationships between dietary, nutritional, and inflammatory factors in predicting all-cause mortality among individuals in hemodialysis (HD) treatment. METHODS Participating in this study were 137 patients undergoing HD (58.4% men, 61.7 ± 15.4 y of age) from the NUtrition and GEnetics on HemoDialysis outcomes (NUGE-HD study) cohort. Sociodemographic, anthropometric, and clinical data were collected. Dietary inflammatory index scores were calculated from a quantitative food frequency questionnaire. Plasma C-reactive protein was used as an inflammatory marker. Data were analyzed by path analysis. RESULTS During the 2-y follow-up, 27 patients (19.7%) died. Compared with survivors, non-survivors were older (P = 0.01) and had lower body mass index (P = 0.04). In relation to direct (unmediated) associations, dietary inflammatory index (P = 0.049) and C-reactive protein (P = 0.016) were positively associated, whereas body mass index was negatively associated with mortality (P = 0.012). There were no indirect (mediated) associations of the variables evaluated with mortality. CONCLUSION More proinflammatory diet and systemic inflammation have a direct association with mortality among patients undergoing HD therapy. Additionally, more proinflammatory diet is associated with unhealthy dietary pattern.
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Affiliation(s)
- Balbino K P
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Juvanhol L L
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Wendling A L
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Bressan J
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Shivappa N
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States; Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, United States
| | - Hebert J R
- Cancer Prevention and Control Program, University of South Carolina, Columbia, South Carolina, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States; Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, United States
| | - Hermsdorff H H M
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
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