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Aprelini CMDO, Siqueira JH, Martins HX, Pereira TSS, Urquía YJM, Molina MDCB. [Development and validation of the food quality score in ELSA-Brasil]. NUTR HOSP 2024; 41:175-185. [PMID: 38149508 DOI: 10.20960/nh.04598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
Introduction miology.Introduction: nutritional epidemiology seeks to understand the relationship between food consumption and the occurrence of diseases. During the COVID-19 pandemic, the Longitudinal Study of Adult Health (ELSA-Brasil) used a reduced Food Frequency Questionnaire (FFQ) to compare diet quality between cohort stages. Objective: to develop and validate an index created using a food quality score (FQS) using the FFQ of ELSA-Brasil. Methods: a cross-sectional study carried out between August 2020 and March 2021 with 4262 participants. For each frequency of consumption of healthy and unhealthy food markers, a score was given. Validity and reliability were tested using Pearson's correlation, principal component analysis (PCA) and Cronbach's alpha. Tests were performed to verify differences between individual characteristics and FQS. Results: the PCA indicated a total variability of 42.5 %. Women and individuals with higher age, physical activity and per capita income had a higher FQS, while those who reported higher consumption of alcohol and being smokers had a lower score. Cronbach's alpha was 0.47. Conclusion: the FQS showed a satisfactory validity and reliability and was associated with socioeconomic and lifestyle data. Therefore, it is a useful tool for comparing dietary information, thus contributing to nutritional epidemiology.
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Najibi N, Jahromi MK, Teymoori F, Farhadnejad H, Salehi-Sahlabadi A, Mirmiran P. International diet quality index and revised diet quality index relationship with non-alcoholic fatty liver disease: a case-control study. BMC Gastroenterol 2023; 23:441. [PMID: 38097953 PMCID: PMC10722782 DOI: 10.1186/s12876-023-03082-x] [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: 03/14/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND/OBJECTIVES Recent studies show the potential role of dietary quality and quantity in predicting the risk of chronic diseases, such as liver disease, therefore, in the present study, we aimed to assess the association of diet quality index International (DQI-I) and diet quality index revised (DQI-R) and their main components with the odds of non-alcoholic fatty liver disease (NAFLD) in adult populations. METHODS The current case-control study was conducted on 225 patients with NAFLD and 450 controls. Dietary intake was assessed using a validated 168-item food frequency questionnaire, and DQI-I and DQI-R were calculated in participants. Multi-variable logistic regression was used to examine the association of DQI-I and DQI-R and their components with the odds of NAFLD. RESULTS The mean (SD) age and BMI of participants (53% men) were 38.1 (8.8) years and 26.8 (4.3) kg/m2, respectively. In the final model, each one SD increment in the DQI-I score was associated with decreased odds of NAFLD (OR = 0.63; 95%CI = 0.40-0.98) (P = 0.040). Also, of DQI-I components, high adequacy score was related to lower odds of NAFLD (OR = 0.16; 95%CI = 0.06-0.40) (P < 0.001). Also, our findings showed that participants in the highest tertile of DQI-R score had lower odds of NAFLD compared to the lowest tertile of DQI-R (OR = 0.24; 95%CI = 0.10-0.53) (P < 0.001). Furthermore, of DQI-R components, high moderation score are linked to a lower risk of NAFLD (OR = 0.17;95%CI = 0.07-0.43) (P < 0.001). CONCLUSION Our findings suggested that greater adherence to diet with a higher score of DQI-I and DQI-R may be associated with lower odds of NAFLD.
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Affiliation(s)
- Narjes Najibi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Kazemi Jahromi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Farshad Teymoori
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ammar Salehi-Sahlabadi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Canhada SL, Vigo Á, Levy R, Luft VC, da Fonseca MDJM, Giatti L, Molina MDCB, Duncan BB, Schmidt MI. Association between ultra-processed food consumption and the incidence of type 2 diabetes: the ELSA-Brasil cohort. Diabetol Metab Syndr 2023; 15:233. [PMID: 37968763 PMCID: PMC10647077 DOI: 10.1186/s13098-023-01162-2] [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: 06/09/2023] [Accepted: 09/06/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption increases the risk of type 2 diabetes in various high-income countries, with some variation in the magnitude across studies. Our objective was to investigate the association of UPF consumption and specific subgroups with incident type 2 diabetes in Brazilian adults. METHODS The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a multicenter cohort study of 15,105 adults (35-74 years) enrolled in public institutions in Brazil (2008-2010). We followed participants with two clinic visits (2012-2014; 2017-2019) and annual telephone surveillance. After excluding those with diabetes at baseline, who died or were lost in the follow-up, with missing data, with implausible energy food intake, or reporting bariatric surgery, there were 10,202 participants. We used the NOVA classification to assess UPF consumption based on a food frequency questionnaire. We defined type 2 diabetes by self-report, medication use, or comprehensive laboratory tests. We estimated relative risks (RR) and 95% confidence intervals (95% CI) using robust Poisson regression. RESULTS Median UPF consumption was 372 g/day. Over 8.2 (0.7) years of follow-up, we detected 1799 (17.6%) incident cases. After adjustment for socio-demographics, family history of diabetes, and behavioral risk factors, comparing the fourth (≥ 566 g/day) with the first (< 236 g/day) quartile of UPF distribution, RR was 1.24 (1.10-1.39); every 150 g/day increments in UPF consumption resulted in a RR of 1.05 (1.03-1.07). Reclassifying natural beverages with added sweeteners as UPF increased risk (RR 1.40; 1.25-1.58). Among UPF subgroupings, consumption of processed meats and sweetened beverages increased diabetes risk, while yogurt and dairy sweets decreased the risk (p < 0.05). CONCLUSIONS UPF consumption increased the incidence of type 2 diabetes in Brazilian adults, with heterogeneity across specific food items. These findings add to previous evidence for the role of UPFs in the development of diabetes and other chronic diseases, supporting recommendations to avoid their intake in diabetes prevention and management.
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Affiliation(s)
- Scheine L Canhada
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil
| | - Álvaro Vigo
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil
| | - Renata Levy
- Department of Preventive Medicine, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vivian C Luft
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil
- Postgraduate Program in Food, Nutrition and Health, UFRGS; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Luana Giatti
- Postgraduate Program in Public Health and School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria Del Carmen B Molina
- Postgraduate Program in Nutrition and Health, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600 sala 519, Porto Alegre, RS, Brazil.
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Molina MDCB, Aprelini CMDO, Meireles AL, Griep RH, Giatti L, Almeida MDCCD, Fonseca MDJMD, Schmidt MI, Barreto SM, Matos SMAD, Vigo A, Mill JG. Impact of socioeconomic factors on lifestyle changes among employees of public higher education institutions in ELSA-Brasil during COVID-19 pandemic. CAD SAUDE PUBLICA 2023; 39:e00047123. [PMID: 37970941 PMCID: PMC10644976 DOI: 10.1590/0102-311xen047123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/06/2023] [Accepted: 08/24/2023] [Indexed: 11/19/2023] Open
Abstract
This study aimed to identify lifestyle changes and associated sociodemographic factors in women and men participating in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) cohort during the COVID-19 pandemic. Longitudinal study with 3,776 (aged 58.8 years; SD ± 8.5) employees of public higher education institutions in the second follow-up and the wave-COVID of ELSA-Brasil. Data collected using structured questionnaires. An exploratory analysis was performed using binary and multinomial logistic regression on the dependent variables with two and three categories, respectively, by obtaining crude and adjusted odds ratio estimates in SPSS 20.0, considering a p-value < 0.05. There was a reduction in physical activity of 195.5 (SD ± 1,146.4) metabolic equivalents per week in women and 240.5 (SD ± 1,474.2) in men, and in smoking by 15.2%. There was an increase in alcohol consumption in men and women (434.2 ± 5,144.0; and 366.1 ± 4,879.0, respectively), in the food quality score (0.8 ± 3.7, women; 0.5 ± 3.7, men), sleeping time (0.4 ± 1.2, women; 0.5 ± 1.1, men), screen time (1.7 ± 2.4, women; 1.4 ± 2.3, men), and sitting time (1.7 ± 2.6, women; 1.5 ± 2.4, men) (hours/day). In total, 18.6% increased the purchase of ultra-processed foods and 36% increased the purchase of natural foods. Age and work activity contributed to increase the chance of purchasing ultra-processed foods, and age and adherence to social distancing influenced the shift to a more sedentary behavior, while income and active work favored the increase in alcoholic beverage consumption. These factors should be considered when developing public policies to avoid individual behaviors that are harmful to health during pandemics.
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Affiliation(s)
| | | | - Adriana Lúcia Meireles
- Programa de Pós-graduação em Saúde e Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Brasil
| | | | - Luana Giatti
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | | | - Maria Inês Schmidt
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Sandhi Maria Barreto
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | - Alvaro Vigo
- Programa de Pós-graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - José Geraldo Mill
- Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brasil
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Scaranni PDODS, de Oliveira Cardoso L, Griep RH, Lotufo PA, Barreto SM, da Fonseca MDJM. Consumption of ultra-processed foods and incidence of dyslipidemias: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Br J Nutr 2022; 129:1-22. [PMID: 35450540 DOI: 10.1017/s0007114522001131] [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: 11/07/2022]
Abstract
Ultra-processed foods (UPF) have been associated with cardiometabolic outcomes, but the literature has still not reported their association with incidence of dyslipidemias, one of the most important risk factors for the occurrence of cardiovascular diseases. The objective of this study was to verify the association between consumption of UPF and incidence of dyslipidemia in Brazilian civil servants at a 4-year follow-up. The study used data from 5,275 participants at baseline and on the first follow-up visit in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We applied a food frequency questionnaire (FFQ) at baseline and identified UPF from NOVA, classification of foods as to the extent and purpose of processing. The proportion (in weight) of UPF in the total diet was calculated for each participant and categorized in tertiles, corresponding to low (first tertile), medium (second tertile), and high (third tertile) consumption. A mixed-effects logistic model was used to obtain the incidence of dyslipidemia associated with consumption of UPF. Individuals with medium and high consumption of UPF showed increases in the risks of development of isolated hypercholesterolemia by 12% (OR=1.12, CI:1.00-1.27) and 28% (OR=1.28, CI:1.12-1.47), of isolated hypertriglyceridemia by 14% (OR=1.14, CI:1.03-1.26) and 30% (OR=1.30, CI:1.17-1.45), of mixed hyperlipidemia by 21% (OR=1.21, CI:1.05-1.39) and 38% (OR=1.38, CI:1.18-1.62), and of low-HDL by 12% (OR=1.12, CI:1.00-1.24) and 18% (OR=1.18, CI:1.05-1.32), respectively, compared to participants that consumed less UPF. Our findings showed important cardiovascular risk associated with consumption of UPF and a gradient in the consumption´s effect, so these products should be discouraged.
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Affiliation(s)
| | | | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Foundation, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiologic Research, University of Sao Paulo, Sao Paulo, SP, Brazil
- School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Sandhi Maria Barreto
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Marchioni DM, Cacau LT, De Carli E, de Carvalho AM, Rulli MC. Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017–2018. Nutrients 2022; 14:nu14061187. [PMID: 35334839 PMCID: PMC8956109 DOI: 10.3390/nu14061187] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
Diets are simultaneously connected with population health and environment. The EAT-Lancet Commission proposed a sustainable reference diet to improve population health and respect the planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) has been developed to assess the adherence to this reference diet. In the present study, we aimed to evaluate the adherence to the EAT-Lancet diet through the PHDI in a nationwide population-based study carried out in Brazil. We used data from the National Dietary Survey conducted through the Household Budget Survey in 2017–2018, with 46,164 Brazilians aged over 10 years old. Food consumption was evaluated with a 24 h dietary recall. The average PHDI total score in the Brazilian population was 45.9 points (95% CI 45.6:46.1) on a total score that can range from 0 to 150 points. The adherence to EAT-Lancet diet was low among all Brazilian regions. Women, elderly, those overweighed/obese, with higher per capita income and living in the urban area had higher scores in the PHDI. In general, the Brazilian population presented low adherence to a healthy and sustainable dietary pattern and seems far from meeting the EAT-Lancet recommendations.
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Affiliation(s)
- Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (E.D.C.); (A.M.d.C.)
- Correspondence:
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (E.D.C.); (A.M.d.C.)
| | - Eduardo De Carli
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (E.D.C.); (A.M.d.C.)
| | - Aline Martins de Carvalho
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (E.D.C.); (A.M.d.C.)
| | - Maria Cristina Rulli
- Department of Civil and Environmental Engineering, Politecnico di Milano, 20133 Milan, Italy;
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Food Patterns of Hospitalized Patients with Heart Failure and Their Relationship with Demographic, Economic and Clinical Factors in Sergipe, Brazil. Nutrients 2022; 14:nu14050987. [PMID: 35267962 PMCID: PMC8912487 DOI: 10.3390/nu14050987] [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: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The high rates of hospitalization and mortality caused by Heart Failure (HF) have attracted the attention of health sectors around the world. Dietary patterns that involve food combinations and preparations with synergistic or antagonistic effects of different dietary components can influence the worsening and negative outcomes of this disease. Objectives: To describe the dietary patterns of patients hospitalized for HF decompensation and associate them with demographic, economic, and clinical factors, and the type of care provided in Sergipe. Materials and Methods: Cross-sectional study that is part of the Congestive Heart Failure Registry (VICTIM-CHF)” of Aracaju/SE. Prospective data collection took place with all patients hospitalized between April 2018 and February 2021 in cardiology referral hospitals, 2 public and 1 private. The data collected were sociodemographic, clinical, lifestyle, anthropometric and food consumption variables. Daily dietary intake was estimated by applying a semiquantitative food frequency questionnaire. The extraction of dietary patterns, by exploratory factor analysis, was performed after grouping the foods according to the nutritional value and form of preparation into 34 groups. To assess the association between the factorial scores for adherence to the standards and the variables studied, the Mann-Whitney U test was applied. Linear regressions were also performed, considering the dietary pattern (one for each pattern) as a dependent variable. Results: The study included 240 patients hospitalized for HF decompensation, most of them elderly (mean age 61.12 ± 1.06 years), male (52.08%) and attended by the Unified Health System—SUS (67.5%). Three dietary patterns were identified, labeled “traditional” (typical foods of the Brazilian northeastern population added to ultra-processed foods), “Mediterranean” (foods recommended by the Mediterranean diet) and “dual” (healthy foods combined with fast and easy-to-prepare foods like snacks, bread, sweets and desserts). Adherence to the “traditional” pattern was greater among men (p < 0.031) and non-diabetics (p < 0.003). The “Mediterranean” was more consumed by the elderly (p < 0.001), with partners (p = 0.001) and a lower income (p < 0.001), assisted by the SUS (p < 0.001) and without hypertension (p = 0,04). The “dual” diet pattern had greater adherence by the elderly (p < 0.001), self-declared non-black (p = 0.012), with higher income (p < 0.001), assisted in the private sector (p < 0.001) and with less impaired functional capacity (p = 0.037). It was also observed that being female (p = 0.031) and being older reduced the average scores of performing the “traditional” pattern (p = 0.002). Regarding the type of service, being from the public service reduced the average scores for adhering to the “dual” pattern (p = 0.008). Conclusions: Three dietary patterns representative of the population were found, called traditional, Mediterranean and dual, which were associated with demographic, economic and clinical factors. Thus, these standards must be considered in the development of nutritional strategies and recommendations in order to increase adherence to diets that are more protective against cardiovascular diseases.
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Alves ED, Bortolotto CC, Peter NB, Kaufmann CC, Mintem GC, Bielemann RM, Muniz LC. Qualidade da dieta de adolescentes da rede pública de ensino de um município do sul do Brasil: estudo transversal, 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2021684. [DOI: 10.1590/s1679-49742022000100024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/10/2022] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Identificar os fatores associados à qualidade da dieta de estudantes do 9º ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil. Métodos Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta foi avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial. Resultados Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92; intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65; IC95% 1,15;2,38). Conclusão Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis.
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Silva DMCE, Santos TSS, Conde WL, Slater B. Nutritional status and metabolic risk in adults: association with diet quality as assessed with ESQUADA. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210019. [PMID: 33950140 DOI: 10.1590/1980-549720210019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/05/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the association between diet quality assessed with the Diet Quality Scale (ESQUADA) and the nutritional status and metabolic risk in adults. METHODS The data included 1,147 adults aged 20 to 59, from the population-based study with complex sampling. Weight, height, tricipital (TSF) and subscapular (SSF) skinfolds, and waist (WC) and mid-arm (MAC) circumferences were measured. Body mass index (BMI) and mid-arm muscle circumference (MAMC) were calculated. Nutritional status and metabolic risk were classified considering BMI and WC values, respectively. Diet quality was assessed with ESQUADA. Data were collected at household using the Epicollect5 application. Diet quality (in scores) was analyzed as continuous data and later categorized. The confidence interval was used for comparison between groups, Fisher's exact test for an association study. Adjusted multiple linear regression models were also estimated. P < 0.05 was adopted for statistical significance. RESULTS Overweight prevailed in 60.33% of individuals, especially among women (60.73%). High or very high metabolic risk was more frequent among women with "very good or excellent" diet quality. Higher diet quality score was associated with a reduction in TSF (β = -0.07; 95%CI -0.13 - -0.01) and an increase in MAMC (β = 0.09; 95%CI 0.00 - 0,18) in men and the reduction in weight (β = -0.04; 95%CI -0.07 - -0.01), SSF (β = -0.07; 95%CI -0.13 - -0,00) and WC in women (β = -0.06; 95%CI -0.09 - -0.02). CONCLUSION A better diet quality is positively associated with lean mass in men, and negatively with fat mass in men and women.
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Affiliation(s)
| | | | - Wolney Lisboa Conde
- Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Betzabeth Slater
- Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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de Brito Gonçalves Nascimento L, Sahade V, Weber B, Pinheiro JMF, Dias LPP, Figueiredo Neto JA, Carlos Sobral Sousa A, Pinho CPS, Luna AB, Vasconcelos SML, Dantas CDF, Penafort ADM, Carlos DMDO, Daltro C. Diabetic Patients with Cardiovascular Disease Show More Metabolic Syndrome than Nondiabetic Patients: Multicentric Study in the Northeast of Brazil. Metab Syndr Relat Disord 2021; 19:233-239. [PMID: 33523760 DOI: 10.1089/met.2020.0064] [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: 11/12/2022] Open
Abstract
Background: Diabetes mellitus (DM) is associated with a higher prevalence of metabolic syndrome (MS) and cardiovascular mortality. However, few Brazilian studies evaluated MS in diabetic individuals with cardiovascular disease (CVD). Nevertheless, the objective of this study was to compare the prevalence of MS in cardiac patients with and without DM. Methods: Cross-sectional study of BALANCE Program Trial with patients with CVD, ≥45 years old, who had been attending specialized ambulatories on cardiovascular health, in eight states in the Northeast of Brazil. The components of MS were evaluated by following the criteria of National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) and Joint Interim Statement (JIS). In addition, there were investigated different indexes of abdominal obesity, variables related to lifestyle, and food intake. The statistical analysis included descriptive statistics and the Student's t-test, Mann-Whitney, and chi-squared tests for the comparison of groups. There were significant values of P < 0.05. Results: Six hundred forty-seven individuals were evaluated with average (standard deviation) age of 63.1 (9.3) years, being 50.5% females and 40.3% diabetic patients. When the groups of patients who were diabetic and the nondiabetic ones, the first showed higher percentage of obesity (38.5% vs. 23.2%, P < 0.001), of high waist circumference (84.8% vs. 71.9%; P < 0.001), higher waist-height ratio [0.6 (0.6-0.7) vs. 0.6 (0.5-0.6); P < 0.001], conicity index [1.35 (1.29-1.39) vs. 1.32 (1.27-1.38); P = 0.004], and prevalence of MS, because of the criteria of NCEP ATP III (98.8% vs. 80.4%; P < 0.001), as well as the criteria of JIS (99.2% vs. 89.3%; P < 0.001). The component of higher frequency was high blood pressure and/or hypertension (95.0%), followed by hypertriglyceridemia (93.0%). There were no differences regarding age, lifestyle, and food intake. Conclusions: Diabetic individuals with CVD showed more prevalence of MS and more abdominal obesity than nondiabetic individuals. ClinicalTrials.gov ID: NCT01620398.
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Affiliation(s)
- Luciana de Brito Gonçalves Nascimento
- University Hospital Complex Professor Edgard Santos, Federal University of Bahia, and Medicine and Health Postgraduate Program University Federal of Bahia, Salvador, Brazil
| | - Viviane Sahade
- Department of Nutrition, Nutrition School of Federal University of Bahia, Salvador, Brazil
| | | | | | | | | | | | | | | | | | - Clenise de Farias Dantas
- University Hospital Alcides Carneiro, Federal University of Campina Grande, Campina Grande, Brazil
| | | | | | - Carla Daltro
- Medicine and Health Postgraduate Program University Federal of Bahia and Department of Nutrition, Nutrition School of University Federal of Bahia, Salvador, Brazil
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