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Amoah J, Said S, Rampal L, Manaf R, Ibrahim N, Owusu-Agyei S, Poku Asante K. Effects of a school-based intervention to reduce cardiovascular disease risk factors among secondary school students: A cluster-randomized, controlled trial. PLoS One 2021; 16:e0259581. [PMID: 34762713 PMCID: PMC8584749 DOI: 10.1371/journal.pone.0259581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are the number cause of death worldwide. In Ghana CVD has been the leading cause of death since 2001. The prevalence of CVD risk factors among adolescents in Ghana has been increasing. This study seeks to develop, implement and evaluate the effects of a behavioral modification intervention program to reduce CVD risk factors among secondary school students in Brong Ahafo, Ghana. METHODS A cluster-randomized controlled trial was conducted with schools as clusters over a period of six-months with pre and post intervention evaluations. Participants were public secondary school students (14-19 years) from four schools in Brong Ahafo, Ghana. Students in the intervention group were trained by the researchers whereas those of the control group received no intervention. The intervention included health education and physical activity modules. Follow-up data using same questionnaire were collected within two weeks after the intervention was completed. Intention-to-treat analysis was performed after replacing missing values using the multiple imputation method. The generalized linear mixed model (GLMM) was used to assess the effects of the intervention study. RESULTS The GLMM analyses showed the intervention was effective in attaining 0.77(p<0.001), 0.72(p<0.001), 0.47(p<0.001), 0.56(p<0.001), and 0.39(p = 0.045) higher total physical activity, fruits, vegetables, seafood, and water scores respectively for the intervention group over the control group. The intervention was also significant in reducing -0.15(p<0.001),-0.23(p<0.001),-0.50(p<0.001),-0.32(p<0.001),-0.90(p<0.001),-0.87(p<0.001),-0.38(p<0.001), -0.63(p<0.001), -1.63(p<0.001), 0.61(p<0.001), and -1.53(p = 0.005) carbohydrates, fats and oils, fried eggs, fried chicken, carbonated drinks, sugar, sweet snacks, salted fish, weight, BMI, and diastolic BP. The odds of quitting alcohol use in the intervention group were 1.06 times more than the control group. There was no significant effect on reducing smoking and systolic BP. CONCLUSION There is an urgent need for the intervention program to be integrated into the existing curriculum structure of secondary school schools. Implementing the intervention will allow for longer and more consistent impact on the reduction of CVD risk factors among secondary school students.
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Affiliation(s)
- John Amoah
- Kintampo Health Research Centre, Kintampo, Bono-East, Ghana
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Salmiah Said
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Lekhraj Rampal
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rosliza Manaf
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Seth Owusu-Agyei
- Department of Public Health, University of Health and Allied Science, Ho, Volta, Ghana
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Miranda VPN, Coimbra DR, Bastos RR, Miranda Júnior MV, Amorim PRDS. Use of latent class analysis as a method of assessing the physical activity level, sedentary behavior and nutritional habit in the adolescents' lifestyle: A scoping review. PLoS One 2021; 16:e0256069. [PMID: 34411143 PMCID: PMC8376087 DOI: 10.1371/journal.pone.0256069] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 07/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Currently, adolescents' lifestyle is commonly characterized by physical inactivity, sedentary behavior, and inappropriate eating habits in general. A person-oriented approach as Latent Class Analysis (LCA) can offer more insight than a variable-centered approach when investigating lifestyle practices, habits, and behaviors of adolescent population. OBJECTIVE The aim of the present study was to assess which variables are mostly used to represent the physical activity level, sedentary behavior SB) and nutritional habit in the adolescents' lifestyle in studies that used the LCA. DESIGN Scoping review. METHODS The study was a performed in accordance with the proposed criteria for systematic reviews and meta-analyses-Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered in PROSPERO (CRD42018108444). The original articles were searched in MEDLINE/PubMed, Scopus, ScienceDirect, Web of Science, PsycINFO, and SPORTdiscus. The Quality Assessment Tool analyzed the risk of bias of the included studies. RESULTS 30 original articles were selected. The physical activity level (28 studies), SB and nutritional habits (18 studies) were the most common variable used to evaluate the adolescent's lifestyle by LCA model. Specifically, physical inactivity and high SB were the manifest variables with higher frequency in the negative latent classes (LCs) in adolescent girls. On the other hand, physical exercises and sports were activities more commonly labeled as positive LCs. CONCLUSIONS The LCA models of the most of selected studies showed that physical inactivity, high SB were the most common in the LCs with negative characteristics of the adolescents' lifestyle. Better understanding the results of analyzes of clusters of multivariate behaviors such as the LCA can help to create more effective strategies that can make the lifestyle of adolescents healthier.
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Affiliation(s)
- Valter Paulo Neves Miranda
- Department of Physical Education, Federal University of Viçosa, Minas Gerais, Brazil
- Department of Sports Science and Clinic Hospital (EBSERH), Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Danilo Reis Coimbra
- Department of Physical Education, Federal University of Juiz de Fora / Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Ronaldo Rocha Bastos
- Department of Statistics, Geo-Referenced Information Lab (LINGE), Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Márcio Vidigal Miranda Júnior
- School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Ng WM, Cheung K. A feasibility study of a WhatsApp-delivered Transtheoretical Model-based intervention to promote healthy eating habits for firefighters in Hong Kong: a cluster randomized controlled trial. Trials 2020; 21:518. [PMID: 32532313 PMCID: PMC7291567 DOI: 10.1186/s13063-020-04258-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 03/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Firefighters' health is often affected by a high prevalence of obesity and cardiovascular diseases, which are common risk factors for sudden cardiac death. The aim of this study is to investigate the feasibility of enhancing healthy eating habits in firefighters through an education programme. METHODS This will be a cluster randomized control trial study. The participants will be assigned randomly into either control (health promotion pamphlet) or intervention (health promotion pamphlet and education materials through WhatsApp) groups. Changes in healthy eating habits will be assessed by a self-administered questionnaire and anthropometric measurements at three different time points. DISCUSSION More education is required in order to improve firefighters' eating habits. TRIAL REGISTRATION ISRCTN registry identifier: Registered on 8 April 2019 ISRCTN95472464.
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Affiliation(s)
- Wing Man Ng
- Division of Science, Engineering and Health Studies, College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Miranda VPN, dos Santos Amorim PR, Bastos RR, de Faria ER, de Castro Moreira ME, do Carmo Castro Franceschini S, do Carmo Gouveia Peluzio M, de Luces Fortes Ferreira CL, Priore SE. Abundance of Gut Microbiota, Concentration of Short-Chain Fatty Acids, and Inflammatory Markers Associated with Elevated Body Fat, Overweight, and Obesity in Female Adolescents. Mediators Inflamm 2019; 2019:7346863. [PMID: 31933541 PMCID: PMC6942879 DOI: 10.1155/2019/7346863] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 10/02/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS Overweight is ever more prevalent in the pediatric population, and this cardiometabolic factor can be associated with inflammatory markers, gut microbiota composition, and short-chain fatty acid (SCFA) concentrations. The aim of this study is to evaluate to what extent the abundance of gut microbiota phyla, SCFA concentrations, and inflammatory markers are associated with elevated body fat percentage (BF%), overweight, and obesity in female adolescents. METHODS An experimental and comparative study was conducted with 96 girls 14 to 19 years old. They were divided into 3 groups: G1-eutrophic (EUT) and adequate BF%; G2-EUT and high BF%; and G3-overweight (OW) or obese (OB) and high BF%. Waist circumference (WC), waist to height ratio (WtHR), and neck circumference (NC) were analyzed as indicators of central visceral adiposity. The BF% was evaluated by DEXA equipment. A food frequency questionnaire was used to evaluate the main types of food consumed in a week. The abundance of the Firmicutes, Bacteroidetes, and Proteobacteria phyla was measured by real-time polymerase chain reaction (RT-qPCR), and the SFCA concentrations (acetic, butyric, and propionic) were determined by high-performance liquid chromatography (HPLC). The inflammatory markers leptin, tumor necrosis factor-alpha, interleukin-6, and high-sensitivity C-reactive protein (hs-CRP) were assessed. RESULTS Female adolescents in groups G2 and G3 had greater central visceral adiposity and leptin concentration than those in group G1. No association was found between gut microbiota phyla abundance and SFCA concentrations in any of the groups. WC and frequency of consumption of oily and fatty foods were associated with Firmicutes abundance and SFCA concentrations. Girls with high WC also had the greatest leptin (p < 0.001) and hs-CRP (p = 0.035) concentrations. CONCLUSIONS Inflammatory markers showed association with increased BMI and high BF% in female adolescents. The abundance of Firmicutes was associated with WC and NC, but not with BMI classification or BF%. Specifically, WC and the consumption of oils and fats showed correlation with SCFA concentrations. Different anthropometric indicators, such as NC and WC, should be incorporated into the clinical evaluation of the nutritional status of individuals in the adolescent population.
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Affiliation(s)
- Valter Paulo Neves Miranda
- Department of Nutrition and Health and Department of Physical Education, Universidade Federal de Viçosa, Minas Gerais CEP 36570-900, Brazil
| | | | - Ronaldo Rocha Bastos
- Department of Statistics-ICE, Universidade Federal de Juiz de Fora, Juiz de Fora MG, Brazil CEP 36036-330
| | - Eliane Rodrigues de Faria
- Department of Nutrition, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil CEP 36036-900
| | | | | | | | | | - Silvia Eloiza Priore
- Department of Nutrition and Health, Universidade Federal de Viçosa, Minas Gerais CEP 36570-900, Brazil
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Guimarães MR, Santos AAD, Moura TFRD, Rocha MRD, Moura IHD, Silva ARVD. Alterações clínicas, metabólicas e resistência à insulina entre adolescentes. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Analisar as alterações clínicas, metabólicas e sua relação com a resistência à insulina entre adolescentes. Métodos Estudo analítico, realizado com 357 adolescentes de escolas públicas estaduais de um município do Nordeste brasileiro. O formulário aplicado continha as variáveis Índice de Massa Corporal, Circunferência da Cintura, Circunferência do Pescoço, Índice de Conicidade, Pressão Arterial Média; Triglicerídeos, Glicemia, High — Density Lipoprotein Coiesteroi, Insulina e Índice Homeostasis Model Assessment, analisadas por medidas descritivas para variáveis quantitativas; e frequências para variáveis qualitativas. Foram realizados testes de associações através do Qui-quadrado e do teste Odds Ratio. Resultados A prevalência de resistência à insulina foi de 33,9%. As médias da circunferência da cintura, circunferência do pescoço, índice de conicidade, pressão arterial sistólica média e pressão arterial diastólica média estiveram elevadas respectivamente em 4,2%; 30%; 10,9%; 4,2% e 14% dos adolescentes. Os níveis de High – Density Lipoprotein colesterol estiveram diminuídos em 30,5% da amostra, ao passo que os triglicerídeos estavam elevados em 18,8%. Não foi identificada alteração na glicemia. Aqueles que apresentaram índice de massa corporal, circunferência da cintura, circunferência do pescoço, índice de conicidade e triglicerídeos com valores alterados possuíam maiores chances de apresentar resistência à insulina (OD: 3,62; 11,54; 3,50; 4,49; 3,05, respectivamente). De maneira oposta, os adolescentes com pressão arterial sistólica média, pressão arterial diastólica média e High — Density Lipoprotein colesterol alterados não apresentaram significância estatística (p<0,05). Conclusão A resistência à insulina está presente entre os adolescentes, com associações positivas e significativas com alterações clínicas e metabólicas.
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Miranda VPN, dos Santos Amorim PR, Bastos RR, Souza VGB, de Faria ER, do Carmo Castro Franceschini S, Priore SE. Evaluation of lifestyle of female adolescents through latent class analysis approach. BMC Public Health 2019; 19:184. [PMID: 30760240 PMCID: PMC6373094 DOI: 10.1186/s12889-019-6488-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/28/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Lack of regular physical activity, high sedentary behavior and presence of unbalanced alimentary practices are attitudes associated with an inadequate lifestyle among female adolescents. OBJECTIVE to assess the lifestyle of female adolescents based on measurements of behavioral variables. METHODS Cross-sectional study with 405 female adolescents between 14 and 19 years old, resident and attending public schools in Viçosa (state of Minas Gerais). Their lifestyle was analyzed by the Physical Activity Recall, number of steps, screen time (ST), cellphone time (CT), sitting time, food frequency questionnaire (FFQ), and alcohol and tobacco consumption. With multiple correspondence analysis it was possible to observe dispersion and approximation of the variables' categories. Latent class analysis (LCA) was used for modeling the "lifestyle" variable, having been conducted in the poLCA (Polychromous Variable Latent Class Analysis) package of the R statistical software. RESULTS The mean age was 15.92 ± 1.27 years. Most of the adolescents were considered physically inactive (78%) and with low number of steps (82.57%); 41.45% reported not performing Moderate to Vigorous Physical Activities (MVPA) adequately. Sedentary behavior was found high when assessing ST (72.90%) and CT (65.31%). It was found the best fitted latent class model for the lifestyle (p-G2 = 0.055, p-χ2 = 0.066) featured three latent classes and one covariate (alcohol): Class 1, 'Inactive and Sedentary' (γ = 77.5%); Class 2, 'Inactive and Non-sedentary lifestyle (γ=16.31%); and Class 3, 'Active and sedentary' (γ=6.19%). Female adolescents that had 'never consumed alcohol' were 2.26 times as likely (log OR = 0.8174; p = 0.033) to belong to class 3 (Active & Sedentary lifestyle) than to class 1 (Inactive & Sedentary lifestyle). CONCLUSION Latent class analysis model with five manifest variable (MVPA, number of steps, ST, sitting time and number of meals) and alcohol consumption like covariate showed itself to be an accurate and objective method in the assessment of female adolescents' lifestyle. Female adolescents that had 'never consumed alcohol' were more as likely to belong to class 'Active & Sedentary lifestyle' than to class Inactive & Sedentary lifestyle. An inactive and sedentary lifestyle is coupled to other unhealthy behaviors during adolescence, possibly carrying over into adult life.
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Affiliation(s)
- Valter Paulo Neves Miranda
- Programa de Pós-Graduação em Saúde Coletiva (UFJF), Laboratório de Informações Geo-referenciadas (UFJF), Juiz de Fora, Brazil
| | | | - Ronaldo Rocha Bastos
- Programa de Pós-Graduação em Saúde Coletiva (UFJF), Laboratório de Informações Geo-referenciadas (UFJF), Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Vitor Gabriel Barra Souza
- Programa de Pós-Graduação em Saúde Coletiva (UFJF), Laboratório de Informações Geo-referenciadas (UFJF), Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
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Guerra LDDS, Espinosa MM, Bezerra ACD, Guimarães LV, Martins MSAS. [Challenges facing Food and Nutrition Security in the Amazon: availability and consumption in households with adolescents]. CIENCIA & SAUDE COLETIVA 2018; 23:4043-4054. [PMID: 30539989 DOI: 10.1590/1413-812320182312.26352016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/02/2016] [Indexed: 11/21/2022] Open
Abstract
Food and nutritional insecurity remains a challenge to the accomplishment of the right to adequate food in the Brazilian scenario. The scope of this study was to analyze the food and nutrition insecurity situation of adolescents both in households and on an individual level. A cross-sectional population-based study was conducted with 363 households and 95 adolescents in urban municipalities of the Brazilian Amazon. Food and nutrition insecurity was measured using the Brazilian Food Insecurity Scale. Linear regression was used in the analysis of the gross and adjusted effect of food and nutrition insecurity on availability and consumption. The prevalence of food and nutrition insecurity in households was 51.8%, increased availability and consumption of food sources of energy and low consumption of vegetables, fruits and legumes. The linear model analysis of variance showed dependency between food insecurity and the effect of the frequency of availability of food and food consumption. The results highlight the challenge of implementing public policies, in the light of unhealthy food consumption as an aspect of permanent nutritional, corporal and emotional impairment in adulthood.
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Affiliation(s)
- Lúcia Dias da Silva Guerra
- Programa de Pós-Graduação de Nutrição em Saúde Pública, Departamento de Nutrição em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246 -904 São Paulo SP Brasil.
| | - Mariano Martínez Espinosa
- Instituto de Saúde Coletiva, Faculdade de Ciências Exatas e da Terra, Universidade Federal de Mato Grosso (UFMT). Cuiabá MT Brasil
| | | | - Lenir Vaz Guimarães
- Instituto de Saúde Coletiva, Faculdade de Ciências Exatas e da Terra, Universidade Federal de Mato Grosso (UFMT). Cuiabá MT Brasil
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Leme ACB, Baranowski T, Thompson D, Nicklas T, Philippi ST. Sustained impact of the "Healthy Habits, Healthy Girls - Brazil" school-based randomized controlled trial for adolescents living in low-income communities. Prev Med Rep 2018; 10:346-352. [PMID: 29868390 PMCID: PMC5984243 DOI: 10.1016/j.pmedr.2018.04.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 04/03/2018] [Accepted: 04/19/2018] [Indexed: 12/14/2022] Open
Abstract
Pediatric obesity is a major public health concern in low- and middle-income countries, such as Brazil. There is an urgent need for preventive programs for adolescents and, the assessment of their sustained impact. This paper reports the longer-term (6-month post intervention) effects of the "H3G-Brazil" obesity prevention program on weight status and weight-related behaviors. A cluster randomized controlled trial starting with 10 public schools in the city of São Paulo, Brazil involved 253 adolescent girls [mean (se) age = 15.6 (0.87) years]. Body mass index (BMI), waist circumference (WC), dietary intake, physical activity (PA) and sedentary behaviors (SB) were assessed at baseline, immediate post-intervention and 6-month post-intervention (follow-up). ANCOVA was performed using intention to treat principles. There was no effect on BMI, the primary outcome. Although, meaningful increases occurred in waist circumference for both groups, the intervention group presented a lower increase (F = 3.31, p = 0.04). This effect size, however, was lower than the criterion for small (d = 0.102). Unfortunately, significant results favored the control group for time spent on TV/weekdays (F = 5.13, p = 0.01), TV/weekends (F = 5.46, p = 0.01) and sedentary behaviors/weekdays (F = 5.32, p = 0.04). No other significant results were found. This obesity prevention intervention among Brazilian adolescent girls did not have the desire effect on BMI. The significantly lower increase in waist circumference in the intervention groups is inconsistent with the adverse changes detected in sedentary time.
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Affiliation(s)
- Ana Carolina Barco Leme
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Tom Baranowski
- Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Debbe Thompson
- Department of Pediatrics, USDA/Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Theresa Nicklas
- Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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Barco Leme AC, Tucunduva Philippi S. Home food availability, parents’/caregivers’ support, and family meals influence on dietary servings of low-income urban adolescent girls from Brazil. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s41110-017-0053-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Collese TS, Nascimento-Ferreira MV, de Moraes ACF, Rendo-Urteaga T, Bel-Serrat S, Moreno LA, Carvalho HB. Role of fruits and vegetables in adolescent cardiovascular health: a systematic review. Nutr Rev 2017; 75:339-349. [PMID: 28475799 DOI: 10.1093/nutrit/nux002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Context Levels of fruit and vegetable consumption are low among adolescents, and the possible effect of this on cardiovascular health in this age group is undefined. Objective The aim of this systematic review was to investigate the potential role of fruit and vegetable consumption in adolescent cardiovascular health. Data Sources Six electronic databases (BioMed Central, MEDLINE, Web of Science, CINAHL, Scopus, PsycINFO) were searched from database inception to December 2015. Study Selection The search strategy used the following sets of descriptors: adolescents; fruits and vegetables; cardiovascular risk indicators; cross-sectional and cohort studies. Data Extraction Potentially eligible articles were selected independently by 2 reviewers. Results Eleven articles meeting the inclusion criteria were included (10 cross-sectional, 1 cohort). The main reasons for study exclusion (n = 71) were misclassification of individuals as adolescents, an unspecified outcome that was incongruent with the definitions provided, and assessment of fruits and vegetables as part of a food pattern. Articles evaluated fruit and vegetable intake (separately, together, only vegetables, or with fruit juice) in diverse units, using food frequency questionnaires, 24-hour dietary recalls, and food records. One-third of the studies showed significant inverse associations of fruit and vegetable intake with systolic blood pressure, abdominal obesity, triglycerides, high-density lipoprotein cholesterol, and metabolic syndrome. Conclusions The associations between fruit and vegetable consumption and indicators of cardiovascular risk in adolescents are inconsistent, likely because of heterogeneity in the methods used to assess and classify consumption and to define cardiovascular risk in adolescents.
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Affiliation(s)
- Tatiana Sadalla Collese
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Marcus Vinicius Nascimento-Ferreira
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Augusto César Ferreira de Moraes
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tara Rendo-Urteaga
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Silvia Bel-Serrat
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Luis A Moreno
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Heráclito Barbosa Carvalho
- T.S. Collese, M.V. Nascimento-Ferreira, A.C. Ferreira de Moraes, T. Rendo-Urteaga, and H.B. Carvalho are with the YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group, Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. T.S. Collese, A.C. Ferreira de Moraes, T. Rendo-Urteaga, S. Bel-Serrat, and L.A. Moreno are with the GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. S. Bel-Serrat is with the School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. L.A. Moreno is with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil. A.C. Ferreira de Moraes is with the Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Abstract
Purpose
This paper aims to evaluate the impact of the groups from the Brazilian Food Pyramid on macro and micronutrient content of food consumed by adolescent girls from a school-based study.
Design/methodology/approach
Baseline data from “Healthy Habits, Healthy Girls” school-based randomized control trial was used for this study. A sample of the girls aged 14 to 18 years old (n = 253) from ten schools in Brazil was evaluated. Participants completed validated food frequency questionnaire, from which, the total kilocalories and/or grams from each food groups were calculated. Descriptive statistics, t-student test and linear regression were used for the analysis with a significant level of p < 0.05.
Findings
Mean daily intake of the girls was 2,887.09 (standard error 91.50) kcal/day. There was a positive significant association between relative intake of the “Oil and Fats” group and protein (ranged from 24.95 to 96.12 kcal/d), fats (48.36 to 192.62 kcal/d), iron (56.93 to 162.85 kcal/d) and sodium (208.08 to 699.69 kcal/d) contents. In regards to the intake of “Sugars and Sweets” group, there was a positive significant association for carbohydrates (97.53 to 491.70 kcal/day), total fiber (0.56 to 2.64 kcal/d), iron (0.85 to 4.40 kcal/d) and sodium (175.59 to 838.48 kcal/d) content.
Originality/value
Findings demonstrate that girls over consumed the “Oils and Fats” and “Sugars and Sweets” groups reflecting on increased of important macro and micronutrients of their diet. Therefore, consuming up to 1 serving size of these groups is a good way to promote healthy eating among this population.
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