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Guleken Z, Ceylan Z, Çeçen S, Elgörmüş Y, Cebulski J, Depciuch J. Quantitative or qualitative biomolecular changes in blood serum composition induced by childhood obesity: A Fourier transform infrared examination. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 313:124153. [PMID: 38492465 DOI: 10.1016/j.saa.2024.124153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
Childhood obesity (CO) negatively affects one in three children and stands as the fourth most common risk factor of health and well-being. Clarifying the molecular and structural modifications that transpire during the development of obesity is crucial for understanding its progression and devising effective therapies. The study was indeed conducted as part of an ongoing CO treatment trial, where data were collected from children diagnosed with CO before the initiation of non-drug treatment interventions. Our primary aim was to analyze the biochemical changes associated with childhood obesity, specifically focusing on concentrations of lipids, lipoproteins, insulin, and glucose. By comparing these parameters between the CO group (n = 60) and a control group of healthy children (n = 43), we sought to elucidate the metabolic differences present in individuals with CO. Our biochemical analyses unveiled lower LDL (low-density lipoproteins) levels and higher HDL (high-density lipoproteins), cholesterol, triglycerides, insulin, and glucose levels in CO individuals compared to controls. To scrutinize these changes in more detail, we employed Fourier transform infrared (FTIR) spectroscopy on the serum samples. Our results indicated elevated levels of lipids and proteins in the serum of CO, compared to controls. Additionally, we noted structural changes in the vibrations of glucose, β-sheet, and lipids in CO group. The FTIR technique, coupled with principal component analysis (PCA), demonstrated a marked differentiation between CO and controls, particularly in the FTIR region corresponding to amide and lipids. The Pearson test revealed a stronger correlation between biochemical data and FTIR spectra than between 2nd derivative FTIR spectra. Overall, our study provides valuable insights into the molecular and structural changes occurring in CO.
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Affiliation(s)
- Zozan Guleken
- Gaziantep University of Science and Technology, Faculty of Medicine, Department of Physiology Gaziantep, Turkey
| | - Zeynep Ceylan
- Samsun University, Faculty of Engineering, Department of Industrial Engineering, Samsun, Turkey
| | - Serpil Çeçen
- Health Science University, Hamidiye Faculty of Medicine, Department of Physiology, İstanbul, Turkey
| | - Yusuf Elgörmüş
- Faculty of Medicine, Department of Pediatrics, İstanbul Atlas University Medicine Hospital, İstanbul 34408, Turkey
| | - Jozef Cebulski
- Institute of Physics, University of Rzeszow, 35-959 Rzeszow, Poland
| | - Joanna Depciuch
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin 20-093, Poland; Institute of Nuclear Physics, PAS, 31342 Krakow, Poland.
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Soheilipour F, Geram F. Lipid Profile and the Frequency of Dyslipidemia in Iranian Adolescents with Severe Obesity, Who Were Candidates for Bariatric Surgery. Obes Surg 2024; 34:618-624. [PMID: 38191967 DOI: 10.1007/s11695-023-07038-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Although several studies have investigated the prevalence of dyslipidemia in adults undergoing bariatric surgery, the experience is limited in adolescents. This study aimed to evaluate the serum lipid profile and prevalence of dyslipidemia in Iranian adolescents with severe obesity undergoing bariatric surgery. MATERIALS AND METHODS In this cross-sectional study, a total of 92 adolescents, aged < 20 years, with severe obesity (body mass index (BMI) ≥ 99th percentile), who were candidates for bariatric surgery were enrolled during 2016-2018. The fasting serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured in this study. Dyslipidemia was defined as TC, LDL-C, and TG ≥ 95th percentile or HDL-C < 10th percentile for age and sex. RESULTS The mean age of the participants was 17.32 ± 1.88 years (age range, 11-19 years). Overall, 60.9% of the participants were female. Based on the results, 68.48% of the adolescents had dyslipidemia. The most frequent lipid disorder was hypertriglyceridemia (48.9%), followed by low HDL-C (39.6%), hypercholesterolemia (18.5%), and high LDL-C (16.5%). The serum concentrations of lipid components were not significantly different according to sex and age. CONCLUSION The prevalence of dyslipidemia was found to be high among Iranian adolescents with severe obesity. Hypertriglyceridemia and low HDL-C were the most common types of dyslipidemia in this population. Therefore, screening for dyslipidemia may be clinically useful in adolescents with severe obesity; timely diagnosis and treatment may prevent the occurrence of coronary events in the future.
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Affiliation(s)
- Fahimeh Soheilipour
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Minimally Invasive Surgery Research Center, Department of Pediatric Endocrinology, Aliasghar Children Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Geram
- Minimally Invasive Surgery Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Zare MG, Okati-Aliabad H, Ansari-Moghaddam A, Mohammadi M, Shahraki-Sanavi F. Prevalence and risk factors of pre-hypertension and hypertension among adults in Southeastern Iran: Findings from the baseline survey of the Zahedan adult cohort study. PLoS One 2023; 18:e0295270. [PMID: 38060532 PMCID: PMC10703255 DOI: 10.1371/journal.pone.0295270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
Hypertension (HTN) stands as the leading modifiable risk factor for cardiovascular disease(CVD) and premature death globally. Understanding its prevalence and risk factors is essential for effective prevention and management of HTN. This study aimed to investigate the prevalence of Pre-hypertension (pre-HTN), HTN, and its risk factors in adults participating in the Zahedan adult cohort study (ZACS). This cross-sectional study used the baseline data of the ZACS. Ordinal logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for potential risk factors. Among the 10,016 participants in this study, 60.89% were women, with an average age of 50.44 ± 9.18 years. The prevalence of pre-HTN and HTN was 42.03% (men 45.44%, women 39.84%) and 18.47% (men 21.09%, women 16.79%), respectively. Being male, older age, having higher socioeconomic status (SES), being overweight and obese, having a family history of HTN, comorbidities such as diabetes and CVD, as well as abnormal blood lipid levels (triglycerides and HDL cholesterol) were the most significant predictors of pre-HTN and HTN. These findings highlight that more than half of the participants in this study exhibit pre-HTN or HTN, placing them at risk for CVD and stroke. Implementing comprehensive preventive strategies tailored to these identified risk factors is imperative to alleviate the disease burden, enhance disease management, and improve HTN treatment and control.
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Affiliation(s)
- Mojtaba Gholami Zare
- Department of Epidemiology, MSc Candidate of Epidemiology, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Helegbe GK, Abdullah SJ, Mohammed BS. Dyslipidemias: Prevalence and Associated Factors among Lactating Women in a Lower- and Middle-Income Country, Ghana. J Lipids 2023; 2023:6280494. [PMID: 38022868 PMCID: PMC10676279 DOI: 10.1155/2023/6280494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/21/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Dyslipidemia, an abnormally high level of lipids in the blood, has a negative impact on the health status of the individual and has lately emerged as a major public health concern, especially for low- and middle-income countries (LMIC) globally, including Ghana. However, it is still unclear what the burden and drivers of these lipid abnormalities are, especially among lactating women in the Upper West of Ghana. Thus, this study is aimed at determining the prevalence of dyslipidemia and its associated factors among lactating mothers in the Wa Municipality of Ghana. Methodology. A cross-sectional study was conducted from May to June 2020 in 8 health facilities within the Wa Municipality. Multistage and simple random sampling methods were used to select the facilities and the 200 study subjects. Sociodemographic data were collected using questionnaires, while blood samples were taken to determine the lipid profile of participants. Dietary patterns were also assessed using the Food Frequency Questionnaire (FFQ). Data were processed and analyzed using SPSS 17 software (SPSS, Inc., Chicago, IL). The chi-square test and multiple regression analysis were performed to determine the predictors associated with the various types of dyslipidemia, with statistical significance set at a p value < 0.05. Results The prevalence of hypercholesterolemia (LDL-C), hypo-HDL-cholesterolemia, and hypertriglyceridemia (TG) was 57%, 59%, and 22%, respectively. Chi-square and multinomial regression analysis revealed that duration of lactation (X2 = 3.95, p = 0.047), religion (AOR = 0.375, 95% CI 0.144-0.978, p = 0.045), low income (AOR = 0.116, 95% CI 0.026-0.514, p = 0.005), middle income (AOR = 0.163, 95% CI 0.044-0.600, p = 0.006), and alcohol intake (AOR = 6.312, 95% CI 1.108-35.949, p = 0.038) were associated with LDL-C, while age (AOR = 0.963, 95% CI 0.910-1.019, p < 0.001) and educational status (AOR = 0.365, 95% CI 0.140-0.954, p = 0.040) predicted HDL status. Conclusion Dyslipidemia is common among lactating mothers of Wa Municipality, and it is predicted by lifestyle factors. Furthermore, future research to look at a larger sample size on dyslipidemia during lactation is recommended.
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Affiliation(s)
- Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Ghana
| | - Saeed Jabactey Abdullah
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Ghana
| | - Baba Sulemana Mohammed
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, University for Development Studies, Ghana
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Doumatey AP, Bentley AR, Akinyemi R, Olanrewaju TO, Adeyemo A, Rotimi C. Genes, environment, and African ancestry in cardiometabolic disorders. Trends Endocrinol Metab 2023; 34:601-621. [PMID: 37598069 PMCID: PMC10548552 DOI: 10.1016/j.tem.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/21/2023]
Abstract
The past two decades have been characterized by a substantial global increase in cardiometabolic diseases, but the prevalence and incidence of these diseases and related traits differ across populations. African ancestry populations are among the most affected yet least included in research. Populations of African descent manifest significant genetic and environmental diversity and this under-representation is a missed opportunity for discovery and could exacerbate existing health disparities and curtail equitable implementation of precision medicine. Here, we discuss cardiometabolic diseases and traits in the context of African descent populations, including both genetic and environmental contributors and emphasizing novel discoveries. We also review new initiatives to include more individuals of African descent in genomics to address current gaps in the field.
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Affiliation(s)
- Ayo P Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training and Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Timothy O Olanrewaju
- Division of Nephrology, Department of Medicine, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Charles Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Guleken Z, Ceylan Z, Çeçen S, Jakubczyk D, Jakubczyk P, Depciuch J. Chemical changes in childhood obesity blood as a marker of the disease. A Raman-based machine learning study. J Pharm Biomed Anal 2023; 233:115445. [PMID: 37209495 DOI: 10.1016/j.jpba.2023.115445] [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: 02/27/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/22/2023]
Abstract
Obesity in children is a global problem, leading to different medical conditions that may contribute to metabolic syndrome and increase the risk of diabetes, dyslipidemia, hypertension, and cardiovascular diseases in future health. Metabolic disorders are the results of the body's chemical process. The changes in the chemical compositions could be determined by Raman spectroscopy. Therefore, in this study, we measured blood collected from children with obesity to show chemical changes caused by obesity disease. Moreover, we will also show characteristic Raman peaks/regions, which could be used as a marker of obesity, not other metabolic syndromes. Children with obesity had higher glucose levels, proteins, and lipids than the control ones. Furthermore, it was noticed that the ratio between CO and C-H is 0.23 in control patients and 0.31 in children with obesity, as well as the ratio between amide II and amide I was 0.72 in control and 1.15 in obesity, which suggests an imbalance in these two fractions in childhood obesity. PCA with discrimination analyses showed that the accuracy, selectivity, and specificity of Raman spectroscopy in differentiation between childhood obesity and healthy children was between 93% and 100%. There is an increased risk of metabolic changes in childhood obesity with higher glucose levels, lipids, and proteins in children with obesity. Also, there were differences in the ratio between proteins and lipids functional groups and glucose, amide II, and amide I vibrations as a marker of obesity. The results of the study offer valuable insights into potential alterations in protein structure and lipid composition in children with obesity, emphasizing the importance of considering metabolic changes beyond traditional anthropometric, measurements.
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Affiliation(s)
- Zozan Guleken
- Department of Physiology, Faculty of Medicine, Gaziantep University of Islam Science and Technology, 27220, Gaziantep, Turkey.
| | - Zeynep Ceylan
- Samsun University, Faculty of Engineering, Department of Industrial Engineering, Turkey
| | - Serpil Çeçen
- Health Science University, Hamidiye Faculty of Medicine, Department of Physiology, Istanbul, Turkey
| | - Dorota Jakubczyk
- Faculty of Mathematics and Applied Physics, Rzeszow University of Technology, Powstancow Warszawy 12, PL-35959 Rzeszow, Poland
| | | | - Joanna Depciuch
- Institute of Nuclear Physics, PAS, 31342 Krakow, Poland; Department of Biochemistry and Molecular Biology, Medical University of Lublin, 20-093 Lublin, Poland
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Muntean C, Sasaran MO, Crisan A, Banescu C. Effects of PPARG and PPARGC1A gene polymorphisms on obesity markers. Front Public Health 2022; 10:962852. [PMID: 36466447 PMCID: PMC9709282 DOI: 10.3389/fpubh.2022.962852] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Pediatric obesity presents a multifactorial etiology, which involves genetic traits as well, including single nucleotide polymorphisms. The aim of the study is to investigate the contribution of PPARG gene polymorphisms (namely Pro12Ala rs1801282, His447His rs3856806, and Pro115Gln rs1800571) and PPARGC1A rs8192678 SNP on the anthropometric and metabolic parameters in a population of Romanian children. We conducted a cross-sectional study of 295 Caucasian children, divided according to the body mass index (BMI) z-score into the study (obese and overweight) group of 130 children and the control (normoponderal) group of 165 children. Anthropometric parameters were greater in the obese and overweight population as opposed to controls, with significant differences (p < 0.01) found for the weight (2.77 ± 1.54 SD vs. -0.04 ± 1.15 SD), body mass index (BMI) (2.28 ± 0.97 SD vs. -0.18 ± 1.19 SD), mid-upper arm circumference (MUAC) (4.59 ± 2.28 SD vs. 0.28 ± 3.45 SD), tricipital skin-fold (TSF) (3.31 ± 3.09 SD vs. 0.62 ± 7.28 SD) and waist-to-height ratio (WHtR) (0.61 ± 1.51 SD vs. -0.35 ± 1.35 SD) z-scores. Moreover, triglyceride values were higher in the study group (118.70 ± 71.99 SD vs. 77.09 ± 37.39 SD). No significant difference in the allele and genotype distribution of investigates gene polymorphisms was observed between the studied groups (p > 0.05). PPARG (rs1801282, rs3856806, and rs1800571) were not associated with demographic, anthropometric, and laboratory parameters. However, PPARGC1A rs8192678 CC genotype was associated with TSF z-score (p = 0.03), whereas total and LDL cholesterol levels were significantly higher among TT homozygotes (p < 0.01). Our data suggest that PPARG (rs1801282, rs3856806, and rs1800571) and PPARGC1A (rs8192678) gene polymorphisms were not associated with childhood and adolescence overweight and obesity. The present study identified a significant increase in fasting glucose levels, triglyceride, albumin, and ALT levels in children with excess weight, as well as expected important upward variation of anthropometric parameters (BMI, MUAC, TSF z-scores).
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Affiliation(s)
- Carmen Muntean
- Department of Paediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania,*Correspondence: Carmen Muntean
| | - Maria Oana Sasaran
- Department of Paediatrics III, “George Emil Palade” University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Adriana Crisan
- Center for Advanced Medical and Pharmaceutical Research, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Claudia Banescu
- Center for Advanced Medical and Pharmaceutical Research, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Târgu Mureş, Romania
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Scott L, Dunn L, Oliver J. Increasing lipid screenings in children 9-11 years old at a federally qualified health center - A quality improvement project. J Pediatr Nurs 2022; 67:1-6. [PMID: 35870386 DOI: 10.1016/j.pedn.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Coronary artery disease (CAD) remains the leading cause of death in the U.S. Atherosclerotic changes leading to CAD begin in early childhood. Universal lipid screenings remain low nationwide despite the 2011 National Heart, Lung, and Blood Institute's (NHLBI) Expert Panel Guidelines. LOCAL PROBLEM The aim of this quality improvement project was to examine the benefit of an educational intervention on the implementation of universal lipid screening guidelines within a federally qualified health center tasked with providing care to a high-risk population. INTERVENTION An educational intervention was offered detailing the 2011 NHLBI guidelines. A total of seven medical providers participated in the intervention. METHOD Following the intervention, a pre- and post- knowledge survey was given to assess improvement in knowledge. A retrospective chart review was performed to evaluate application to practice. RESULTS The number of lipid screenings improved from 7.8% (n = 384) pre-intervention to 39.2% (n = 74) post intervention. There was a statistically significant increase in screenings post-intervention t (456) = 7.842, p = .000, two-tailed). CONCLUSION More studies are needed to adequately identify the impact of universal screening guidelines on the health of both children and adults alike. PRACTICE IMPLICATIONS Universal lipid screenings remain promising in early identification of CAD in the pediatric population. Interventions related to expanding the knowledge of healthcare providers, patients, and families are key to decreasing CAD morbidity and mortality.
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Affiliation(s)
- Letisha Scott
- Capstone College of Nursing, The University of Alabama, 650 University Blvd, Tuscaloosa, AL 35487, USA.
| | - Linda Dunn
- Capstone College of Nursing, The University of Alabama, 650 University Blvd, Tuscaloosa, AL 35487, USA.
| | - JoAnn Oliver
- Capstone College of Nursing, The University of Alabama, 650 University Blvd, Tuscaloosa, AL 35487, USA.
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Gildner TE, Eick GN, Schneider AL, Madimenos FC, Snodgrass JJ. After Theranos: Using point-of-care testing to advance measures of health biomarkers in human biology research. Am J Hum Biol 2022; 34:e23689. [PMID: 34669210 DOI: 10.1002/ajhb.23689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The rise and fall of the health technology startup Theranos is emblematic of the promise and peril of point-of-care testing (POCT). Instruments that deliver immediate results from minimally invasive samples at the location of collection can provide powerful tools to deliver health data in clinical and public health contexts. Yet, POCT availability is driven largely by market interests, which limits the development of inexpensive tests for diverse health conditions that can be used in resource-limited settings. These constraints, combined with complex regulatory hurdles and substantial ethical challenges, have contributed to the underutilization of POCT in human biology research. METHODS We evaluate current POCT capabilities and limitations, discuss promising applications for POCT devices in resource-limited settings, and discuss the future of POCT. RESULTS As evidenced by publication trends, POCT platforms have rapidly advanced in recent years, gaining traction among clinicians and health researchers. We highlight POCT devices of potential interest to population-based researchers and present specific examples of POCT applications in human biology research. CONCLUSIONS Several barriers can limit POCT applications, including cost, lack of regulatory approval for non-clinical use, requirements for expensive equipment, and the dearth of validation in remote field conditions. Despite these issues, we see immense potential for emerging POCT technology capable of analyzing new sample types and used in conjunction with increasingly common technology (e.g., smart phones). We argue that the fallout from Theranos may ultimately provide an opportunity to advance POCT, leading to more ethical data collection and novel opportunities in human biology research.
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Affiliation(s)
- Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Geeta N Eick
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | - Alaina L Schneider
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA.,Center for Global Health, University of Oregon, Eugene, Oregon, USA
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Mohammed O, Kassaw M, G/Egzeabher L, Fekadu E, Bikila D, Getahun T, Challa F, Abdu A, Desta K, Wolde M, Tsegaye A. Prevalence of Dyslipidemia among School-Age Children and Adolescents in Addis Ababa, Ethiopia. J Lab Physicians 2022; 14:377-383. [DOI: 10.1055/s-0042-1757229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Objective Lipid abnormalities during childhood might be associated with a higher risk of atherosclerosis development in adulthood. In Ethiopia, there were no data on this area. The present work was aimed at assessing the lipid profile abnormalities among children and adolescents aged between 5 and 17 years, in Addis Ababa, Ethiopia.
Materials and Methods The present school-based cross-sectional study was done from March 2019 to October 2019 in the capital city, Addis Ababa. A total of 504 students were randomly recruited for this study. The total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein-cholesterol levels were determined using the Cobas c501 automated chemistry analyzer. The prevalence of lipid abnormalities was described in percentages. Bivariate and multivariate analyses were performed, and data with p-value less than 0.05 was considered statistically significant.
Results Dyslipidemia in at least one of the lipid profiles was observed in 322 (63.9%) school children, whereas only one of the participants had an abnormality in all four lipid profile tests. The prevalence of total cholesterol 200 mg/dL or higher, low-density lipoprotein 130 mg/dL or higher, high-density lipoprotein less than 40 mg/dL, and triglycerides 130 mg/dL or higher was in 14 (2.8%), 16 (3.2%), 294 (58.4%), and 46 (19.1%) participants, respectively.
Conclusion In the current work, the majority of the study participants had a normal lipid profile except increased prevalence of a reduced concentration of high-density lipoprotein-cholesterol. The overall prevalence of serum lipid abnormalities was 63.9%. Serum lipid levels did not show significant differences with sex, age, fasting habits, or obesity.
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Affiliation(s)
- Ousman Mohammed
- Department of Medical Laboratory Sciences, College of Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melkitu Kassaw
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Letebrhan G/Egzeabher
- Department of Medical Laboratory Sciences, Yekatit 12 General Hospital, Addis Ababa, Ethiopia
| | - Endalkachew Fekadu
- Department of Medical Laboratory Sciences, Sent Emanuel Specialized Hospital, Addis Ababa, Ethiopia
| | - Demiraw Bikila
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health institute, Addis Ababa, Ethiopia
| | - Tigist Getahun
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health institute, Addis Ababa, Ethiopia
| | - Feyissa Challa
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health institute, Addis Ababa, Ethiopia
| | - Ahmedmenewer Abdu
- Department of Medical Laboratory Sciences, College of Health Sciences, Haramaya University, Harar, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mistire Wolde
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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AlMuhaidib S, AlBuhairan F, Tamimi W, AlDubayee M, AlAqeel A, Babiker A, AlFaraidi H, AlJuraibah F, Badri M, Al Alwan I. Prevalence and factors associated with dyslipidemia among adolescents in Saudi Arabia. Sci Rep 2022; 12:16888. [PMID: 36207522 PMCID: PMC9547070 DOI: 10.1038/s41598-022-21262-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/26/2022] [Indexed: 01/19/2023] Open
Abstract
Dyslipidemia is a major risk factor for atherosclerosis. Screening for dyslipidemia at an early age is essential to prevent and control its consequences. This study aimed to determine prevalence of dyslipidemia and its correlates among adolescents in Saudi Arabia. Data of 5854 adolescents aged 10–19 years from all 13 regions of Saudi Arabia were obtained from the Jeeluna study; a national cross-sectional, multistage stratified cluster sample survey. Dyslipidemia was defined based on the National Heart Lung and Blood Institute and National Cholesterol Education Program guidelines for adolescents. We found that a quarter of Saudi adolescents have dyslipidemia (males: 33.3%, females: 17.9%). Significant variation was observed by region (p < 0.001). Prevalence of abnormal Total Cholesterol was 6.7%, LDL-C 7.1%, HDL-C 12.8%, Non-HDL-C 8.3%, and Triglycerides 9.6%. Factors independently associated with dyslipidemia were male gender (OR = 2.19, 95% CI 1.78–2.70, p < 0.001), BMI (underweight OR = 0.80, 95% CI 0.69–0.94, overweight OR = 1.76, 95% CI 1.50–2.06, obese OR = 2.80, 95% CI 2.34–3.34, p < 0.001, vs. normal) and serum ferritin (high OR = 7.02, 95% CI 1.49–34.79, low OR = 0.82, 95% CI 0.67–1.01, p = 0.04 vs. normal) and ≥ 1 daily intake of carbonated beverage (OR = 1.10, 95% CI 1.00–1.20, p = 0.03 vs. no or not daily intake). Public health interventions for improving lipid profile of adolescents are urgently needed.
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Affiliation(s)
- Shadan AlMuhaidib
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fadia AlBuhairan
- Health Sector Transformation Program, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Waleed Tamimi
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed AlDubayee
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Pediatrics, King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Aqeel AlAqeel
- Department of Pediatrics, College of Medicine, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Amir Babiker
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Pediatrics, King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Haifa AlFaraidi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Pediatrics, King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Fahad AlJuraibah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Pediatrics, King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Motasim Badri
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. .,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.
| | - Ibrahim Al Alwan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Pediatrics, King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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12
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Changing trends of obesity and lipid profiles among Bangkok school children after comprehensive management of the bright and healthy Thai kid project. BMC Public Health 2022; 22:1323. [PMID: 35810278 PMCID: PMC9271254 DOI: 10.1186/s12889-022-13712-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 06/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background Cardiovascular diseases are the world’s leading cause of death. Children in Thailand are currently facing obesity, hyperlipidemia, and high atherogenic indices. This study aimed to assess the success of the Bright and Healthy Thai Kid project in reducing obesity and high lipid profiles among Bangkok school children. Methods A community-based, intervention (participatory action) with pre-post comparison of anthropometric and lipid profile data was conducted in five randomly selected Bangkok primary schools. The participatory action involved teachers, students, and parents. Data collection on anthropometric measurements, dietary intake, physical activity, and fasting blood samples of three generations of students was carried out during July–August (midterm months in Thailand) in the years 2004, 2017, and 2019. SPSS for Windows, version 16 was used for data analysis. Results Comparing the data from 2004, 2017, and 2019, obesity rates of 19.3 in 2004 gradually declined to 16.9 and 15.6 in 2017 and 2019 (P < 0.001). High serum total cholesterol, triglyceride, LDL-C, and atherogenic indices decreased significantly (p < 0.001). Conclusions We believe that the great time and effort expended for a campaign to reduce rates of obesity and hyperlipidemia in school children does work to prevent future cardiovascular diseases. Long-term investment in national programs is required to achieve whole societal involvement in improving knowledge and skills related to health, nutrition, and healthy food choices. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13712-w.
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13
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The determinants of lipid profiles in early adolescence in a Ugandan birth cohort. Sci Rep 2021; 11:16503. [PMID: 34389769 PMCID: PMC8363641 DOI: 10.1038/s41598-021-96035-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/02/2021] [Indexed: 12/04/2022] Open
Abstract
Dyslipidaemia in adolescence tracks into adulthood and is an important risk factor for cardiovascular disease. Little is known about the effects of environmental exposures and early-life exposure to infectious diseases common to tropical regions on lipids. In 1119 early adolescent participants in the Entebbe Mother and Baby Study, we used linear regression to examine whether prenatal, childhood or adolescent factors are associated with lipid levels. Reduced high-density lipoprotein (HDL) and elevated triglyceride levels were common (prevalence 31% and 14%, respectively), but elevated low-density lipoprotein (LDL) or total cholesterol (TC) were rare. Current malaria infection was associated with lower mean LDL (adjusted ß − 0.51; 95% CI − 0.81, − 0.21), HDL (adjusted ß − 0.40; 95% CI − 0.56, − 0.23), and TC levels (adjusted ß − 0.62; 95% CI − 0.97, − 0.27), but higher mean triglyceride levels (geometric mean ratio (GMR) 1.47; 95% CI 1.18–1.84). Early-life asymptomatic malaria was associated with modest reductions in HDL and TC. Body mass index (BMI) was positively associated with LDL, TC, and triglycerides. No associations with helminth infection were found. Our findings suggest that early-life factors have only marginal effects on the lipid profile. Current malaria infection and BMI are strongly associated with lipids and important to consider when trying to improve the lipid profile.
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Brzeziński M, Metelska P, Myśliwiec M, Szlagatys-Sidorkiewicz A. Lipid disorders in children living with overweight and obesity- large cohort study from Poland. Lipids Health Dis 2020; 19:47. [PMID: 32178670 PMCID: PMC7076982 DOI: 10.1186/s12944-020-01218-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/03/2020] [Indexed: 01/08/2023] Open
Abstract
Background While in the general paediatric population the presence of abnormal lipid values is estimated at 8–20%, depending on the population, accepted norms and age, it was shown that in the population of lean children the prevalence of dyslipidemia is lower than in obese children, in whom it ranges from 20 to over 40%. Until now, however, no results of similar studies on a large sample of children form a Central or Eastern European country have been published. The aim of this study was to evaluate the prevalence of lipid disorders in overweight and obese children and adolescents participating in an integrated weight reduction programme. Methods According to the “6-10-14 for Health” programme implementation schedule, the programme accepted patients living in Gdańsk, aged 6, 9–11 and 14 years old, with BMI above the 85th percentile for age and sex, according to the Polish percentile charts. During the first visit, each of the participants underwent basic anthropometric examinations - body weight, body height, waist and hip circumference, blood pressure and body composition by bioelectrical impedance were measured. Blood samples were taken to assess lipid, glucose and insulin levels as well as alanine transaminase (ALT) and thyroid stimulating hormone (TSH) activity. Results 1948 patients underwent full anthropomethric and blood work measurements. At least one of the lipid disorders occurred in 38.23% of girls and 40.51% of boys with overweight and obesity. The most common lipid disorderswere decreased high-density lipoprotein cholesterol (HDL-C) levels (present in 20.55% of the girls and 23.79% of the boys) and elevated low-density lipoprotein cholesterol (LDL-C) (present in 15.31% of the girls and 14.25% of the boys). There was no strong association between lipid disorders and age, sex, birth weight, gestational age at birth or body composition. Conclusions Such a frequent occurrence of lipid disorders in the population of children and adolescents should be an important warning signal both at the individual and population level. Not only effective screening methods for overweight and obese children should be implemented from an early age but also therapeutic measures are required. Trial registration The trial is registered under the Local Ethics Committee at Medical University of Gdańsk, decision No. NKBBN/228/2012 from 25 June 2012.
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Affiliation(s)
- Michał Brzeziński
- Department of Public Health and Social Medicine, Medical University of Gdańsk, al. Zwycięstwa 42a, 80-210, Gdańsk, Poland.
| | - Paulina Metelska
- "6-10-14 for Health" University Clinical Center, ul. Dębinki 7, 80-952, Gdańsk, Poland
| | - Małgorzata Myśliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, Debinki 7, 80-952, Gdańsk, Poland
| | - Agnieszka Szlagatys-Sidorkiewicz
- Department of Paediatrics, Gastroenterology, Allergology & Paediatric Nutrition, Medical University of Gdansk, ul. Nowe Ogrody 1-6, 80-803, Gdansk, Poland
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15
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Agostinis-Sobrinho C, Dias AF, Brand C, Norkiene S, Abreu S, Gaya ACA, Gaya AR, Lopes L, Moreira C, Mota J, Santos R. Adherence to Southern European Atlantic Diet and physical fitness on the atherogenic index of plasma in adolescents. CAD SAUDE PUBLICA 2019; 35:e00200418. [PMID: 31800788 DOI: 10.1590/0102-311x00200418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 06/03/2019] [Indexed: 12/22/2022] Open
Abstract
We sought (i) to evaluate the associations of cardiorespiratory fitness (CRF), muscular fitness (MF) and Southern European Atlantic Diet (SEADiet) with atherogenic index of plasma (AIP) and (ii) to investigate de combined association of MF, CRF and SEADiet on AIP in adolescents. A cross-sectional school-based study was conducted on 493 adolescents (285 girls and 208 boys) aged 15-18 years, from the Portuguese Azorean Archipelago. CRF was measured by shuttle run test and MF by curl up and push up tests. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire (FFQ). The AIP was estimated as log (TG/HDL-C). Measures of pubertal stage and socioeconomic status were assessed. Linear regression showed a significant inverse association between MF (standardized β = -0.165; p < 0.001), CRF (standardized β = -0.081; p < 0.030) and SEADiet (standardized β = -0.081; p < 0.045) with AIP, after adjustments for age, sex, pubertal stage and parental education. Furthermore, participants classified with an optimal as well as those with low adherence to a SEADiet but with LowMF/LowCRF had on average the highest AIP (F(7.482) = 3.270; p = 0.002). Moreover, optimal SEADiet with HighMF/HighCRF group showed the lowest AIP when compared with those with low adherence to a SEADiet with HighMF/HighCRF group (p = 0.03). AIP is inversely associated with MF, CRF and SEADiet. The low MF combined with a low CRF levels seems to overcome the potential healthy effect of having an optimal adherence to the SEADiet on AIP. However, an optimal adherence to SEADiet seems to improve the AIP in those adolescents with high fitness levels.
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Affiliation(s)
- César Agostinis-Sobrinho
- Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.,Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania.,Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Arieli Fernandes Dias
- Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Caroline Brand
- Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Sigute Norkiene
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Sandra Abreu
- Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Adroaldo Cezar Araujo Gaya
- Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Anelise Reis Gaya
- Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Luís Lopes
- Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Carla Moreira
- Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Jorge Mota
- Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Rute Santos
- Faculdade de Desporto, Universidade do Porto, Porto, Portugal.,School of Education, University of Wollongong, Wollongong, Australia
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16
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Quaresma FRP, da Silva Maciel E, dos Santos Figueiredo FW, Adami F. Factors associated with blood pressure disorders in Afro-descendant children and adolescents. BMC Pediatr 2019; 19:244. [PMID: 31325963 PMCID: PMC6642598 DOI: 10.1186/s12887-019-1626-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 07/12/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hypertension (AH) is an emerging disease that has rapidly increased in the last decades throughout the world. The increase in blood pressure (BP) is observed with growth and development and, although the manifestation of the disease is rare in childhood and adolescence, its occurrence is increasing and the causes are likely to be from different combinations of factors. Afrodescendants have been consistently observed in many populations, including Brazil, which has the largest population of Afrodescendants outside Africa; nevertheless, data is scarce on the disease in children and adolescents. In this study, we investigated BP disorders in children and adolescents of "Quilombola" populations of the state of Tocantins, northern Brazil, and determined the disease occurrence with some factors, namely food consumption, body composition, anthropometric measures, and biochemical data. METHODS We carried out a cross-sectional study with 67 children aged 10-17 years, comparing the variables studied between the normotensive and non-normotensive groups, using the Chi-square test for qualitative variables and the appropriate tests, according to data adherence to the Gaussian distribution for the quantitative variables. High blood pressure was defined as mean systolic or diastolic blood pressure ≥ 90 percentile for age, height, gender. RESULTS The rate of adolescents with BP disorders was 19.4% (prehypertension 14.9% and hypertension 4.5%). There were no significant differences between the sexes for high blood pressure. In the Poisson regression analysis, the high fat percentage was associated with elevated blood pressure (p = 0.021) for adolescents. Similar associations were observed for non-HDL-c (p < 0.001) and low calcium intake (p = 0.015). CONCLUSION Most children and adolescents in "Quilombola" communities had normal blood pressure. However, higher levels of dyslipidemia and low calcium intake are factors associated with prehypertension in the population studied with high BP.
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Affiliation(s)
- Fernando Rodrigues Peixoto Quaresma
- Laboratory of Epidemiology and Data Analysis, Faculdade de Medicina do ABC, Av. Lauro Gomes, 2000, Santo André, São Paulo Brazil
- Federal University of Tocantins, Campus Palmas, Quadra 109 Norte, Avenida NS15, ALCNO-14 - Plano Diretor Norte, Palmas, TO Brazil
| | - Erika da Silva Maciel
- Laboratory of Epidemiology and Data Analysis, Faculdade de Medicina do ABC, Av. Lauro Gomes, 2000, Santo André, São Paulo Brazil
- Federal University of Tocantins, Miracema Campus, Av. Lourdes Solino, 195 - St. Sussuapara, Miracema do Tocantins, TO Brazil
| | | | - Fernando Adami
- Laboratory of Epidemiology and Data Analysis, Faculdade de Medicina do ABC, Av. Lauro Gomes, 2000, Santo André, São Paulo Brazil
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Zaghi AN, Barbalho SM, Guiguer EL, Otoboni AM. Frying Process: From Conventional to Air Frying Technology. FOOD REVIEWS INTERNATIONAL 2019. [DOI: 10.1080/87559129.2019.1600541] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Aline Nalon Zaghi
- Department of Food Technology, Food Technology School, São Paulo, Brazil
| | - Sandra Maria Barbalho
- Department of Food Technology, Food Technology School, São Paulo, Brazil
- Medical School of Marília, UNIMAR, São Paulo, Brazil
| | - Elen Landgraf Guiguer
- Department of Food Technology, Food Technology School, São Paulo, Brazil
- Medical School of Marília, UNIMAR, São Paulo, Brazil
| | - Alda Maria Otoboni
- Department of Food Technology, Food Technology School, São Paulo, Brazil
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