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Ued FDV, Félix PV, Nogueira-de-Almeida CA, Fisberg M. Intake of Table Sugar and Their Corresponding Food Sources in Adults from the 2017-2018 Brazilian National Dietary Survey. Nutrients 2024; 16:1085. [PMID: 38613118 PMCID: PMC11013856 DOI: 10.3390/nu16071085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Excessive intake of free sugars is associated with adverse health outcomes. Table sugar is one of the main dietary sources of free sugars; however, the amount added by Brazilian consumers in their culinary preparations is unknown. The aims were to estimate the daily intake of table sugar (g/day), its contribution to total energy intake (E%) and the main food groups that contribute to the intake of this sugar in a nationwide multi-ethnic sample of Brazilian adults (2017-2018 Brazilian National Dietary Survey). Based on two 24-h recalls adjusted for the within-person variation, the overall median table sugar intake was 14.3 g/day, corresponding to 3.2 E%. Males, individuals living in rural areas, with low income, low education and experiencing food insecurity had a higher intake of table sugar. The main food sources of table sugar were coffee (55.8%), juice (33.9%), milk-based preparations and smoothies (3.1%), powdered and processed juice (2.7%), whole milk (1.9%), and tea (1.6%). There are no recommendations regarding the limit of table sugar intake, but considering that the WHO limits the intake of free sugars to <10 E%, it is concluded that table sugar intake by Brazilians corresponds to about 30% of the upper recommended daily intake of free sugars.
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Affiliation(s)
- Fábio da Veiga Ued
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Paula Victória Félix
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | | | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01227-200, Brazil;
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Nogueira-de-Almeida CA, Weffort VRS, Ued FDV, Ferraz IS, Contini AA, Martinez EZ, Ciampo LAD. What causes obesity in children and adolescents? J Pediatr (Rio J) 2024; 100 Suppl 1:S48-S56. [PMID: 37918812 PMCID: PMC10960191 DOI: 10.1016/j.jped.2023.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents. DATA SOURCE Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023. DATA SYNTHESIS A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence. CONCLUSIONS The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.
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Affiliation(s)
| | | | - Fábio da V Ued
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
| | - Ivan S Ferraz
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Andrea A Contini
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos, SP, Brazil
| | - Edson Zangiacomi Martinez
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Medicina Social, Ribeirão Preto, SP, Brazil
| | - Luiz A Del Ciampo
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
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Reckziegel MB, Nepomuceno P, Machado T, Renner JDP, Pohl HH, Nogueira-de-Almeida CA, de Mello ED. The triglyceride-glucose index as an indicator of insulin resistance and cardiometabolic risk in Brazilian adolescents. Arch Endocrinol Metab 2023; 67:153-161. [PMID: 36651702 PMCID: PMC10689041 DOI: 10.20945/2359-3997000000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/11/2022] [Indexed: 01/19/2023]
Abstract
Objective To set cutoff points for the triglyceride and glucose index (TyG) as a marker of insulin resistance (IR) for the pediatric population. Subjects and methods This was a cross-sectional study with schoolchildren population-based data using data of 377 schoolchildren age 10 to 17 years of both sexes. We studied metabolic variables associated with IR indicators, such as fasting insulin and blood glucose, to calculate the homeostatic model assessment (HOMA-IR), and we studied triglycerides (TG) to determine the TyG index. We obtained TyG cutoff values for IR using the receiver operation characteristic (ROC), with definitions of sensitivity (Sen), specificity (Spe), and area under the ROC curve (AUC), with the HOMA-IR as reference. Results The cutoff points of the TyG index for IR in adolescents are 7.94 for both sexes, 7.91 for boys, and 7.94 for girls, indicating moderate discriminatory power. When we also considered anthropometric variables of excess weight [TyG-BMI (body mass index)] and visceral fat [TyG-WC (waist circumference)], these indexes reached AUC values higher than 0.72, enhancing their potential use for a good diagnosis. Conclusion TyG has proven to be a useful instrument for identifying IR in adolescent health screening, with high discrimination capacity when added to anthropometric variables, making it a feasible and inexpensive option.
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Affiliation(s)
- Miriam Beatrís Reckziegel
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
- Departamento de Ciências da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil,
| | - Patrik Nepomuceno
- Departamento de Ciências da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
- Institute of Health Policy, Management and Evaluation, University of Toronto (UofT), Toronto, ON, Canada
- Kite Research Institute, Lyndhurst Centre, University Health Network (UHN), Toronto, ON, Canada
| | - Tania Machado
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Jane Dagmar Pollo Renner
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
| | - Hildegard Hedwig Pohl
- Departamento de Ciências da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
- Programa de Pós-graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul (Unisc), Santa Cruz do Sul, RS, Brasil
| | | | - Elza Daniel de Mello
- Programa de Pós-graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
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Zotarelli-Filho IJ, de Quadros LG, Neto MG, Rajapaksa SW, Vidanapathirana J, Filho DR, Nogueira-de-Almeida CA. Prospective Meta-analysis of Weight Loss Regained and Success Rate of Argon Plasma Coagulation to Suture and Surgery Procedures Post-bariatric Surgery: Status of the Art of Endoscopic Treatment. Rev Recent Clin Trials 2023; 18:239-250. [PMID: 37608668 DOI: 10.2174/1574887118666230822110724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/14/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND This study performed a meta-analysis to compare the safety and efficacy of argon plasma coagulation (APC) concerning suture (SUT) and surgery (SUR). METHODS The One-Way tests were applied, with p <0.05 significant. The value of R2 was analyzed (heterogeneity), and the risk of bias of articles was evaluated. RESULTS A total of 34 studies were found, eight about APC, twenty about SUT, and six about SUR. For the percentage of Weight Loss Regained (%WLR), the means for APC, SUT, and SUR were 19.39 ± 10.94, 26.06 ± 16.71, and 17.05 ± 9.85, and for success rate (%SR), the means were 89.75 ± 16.75, 86.80 ± 11.44, and 76.00 ± 21.57, respectively with p >0.05, with R2 ≥ 50%. CONCLUSION The APC proved to be efficient and safe like the other techniques.
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Affiliation(s)
- Idiberto José Zotarelli-Filho
- Faculty of Medicine of Sao Jose do Rio Preto/SP, Brazil
- Associação Brasileira de Nutrologia/Brazilian Association of Nutrology, Catanduva, Sao Paulo, Brazil
- College of Palliative Medicine of Sri Lanka, Colombo, Sri Lanka
| | - Luiz Gustavo de Quadros
- Kaiser Day Hospital, Sao Jose do Rio Preto, Sao Paulo, Brazil
- ABC Medical School, Surgery Department, Santo Andre, Sao Paulo, Brazil
| | | | | | - Janaki Vidanapathirana
- College of Palliative Medicine of Sri Lanka, Colombo, Sri Lanka
- Director of Policy Analysis & Development, Ministry of Health, Sri Lanka
| | - Durval Ribas Filho
- Faculty of Medicine of Sao Jose do Rio Preto/SP, Brazil
- Associação Brasileira de Nutrologia/Brazilian Association of Nutrology, Catanduva, Sao Paulo, Brazil
| | - Carlos Alberto Nogueira-de-Almeida
- Associação Brasileira de Nutrologia/Brazilian Association of Nutrology, Catanduva, Sao Paulo, Brazil
- Federal University of Sao Carlos, Department of Medicine, Sao Carlos, Sao Paulo, Brazil
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Nogueira-de-Almeida CA, Prozorovscaia D, Mosquera EMB, Ued FDV, Campos VC. Low bioavailability of dietary iron among Brazilian children: Study in a representative sample from the Northeast, Southeast, and South regions. Front Public Health 2023; 11:1122363. [PMID: 36891331 PMCID: PMC9987336 DOI: 10.3389/fpubh.2023.1122363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Background Despite all efforts, iron deficiency anemia remains a serious public health problem among Brazilian children. Objective To evaluate dietary iron intake and dietary practices that interfere with the absorption of this nutrient from three regions of Brazil. Methods Brazil Kids Nutrition and Health Study is a cross-sectional dietary intake study in children aged 4-13.9 years old designed to investigate nutrient intakes and gaps of Brazilian children in a representative sample of households from Northeast, Southeast and South regions. Nutrient intake was assessed based on multiple-pass 24-h dietary recall and U.S. National Cancer Institute method was used to estimate usual micronutrients intakes and compliance with Dietary Reference Intakes. Results Five hundred sixteen individuals participated in the study (52.3% male). The top three most consumed food sources of iron were products of plant origin. Food sources of animal origin contributed with <20% of the total iron intake. Vitamin C intake was adequate, but the concomitant consumption of food sources of vitamin C with plant food sources of iron was not common. On the other hand, the concomitant intake of plant food sources of iron with food sources of iron chelators (e.g., coffee and teas) was frequent. Conclusions Adequate iron intake was observed in all three regions in Brazil. Children's diet showed low iron bioavailability and insufficient consumption of food sources of iron absorption stimulants. Frequent presence of iron chelators and inhibitors of iron absorption might help to explain the high prevalence of iron deficiency in the country.
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Affiliation(s)
| | | | - Elaine M Bento Mosquera
- Federal University of São Paulo, São Paulo, Brazil.,Medical, Scientific and Regulatory Affairs - Nestlé Nutrition/Nestlé Brazil Ltda, São Paulo, Brazil
| | - Fábio da Veiga Ued
- FMRP - Nutrition Department, University of São Paulo, São Paulo, São Paulo, Brazil
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Nogueira-de-Almeida CA, Zotarelli-Filho IJ, Nogueira-de-Almeida ME, Souza CG, Kemp VL, Ramos WS. Neuronutrients And Central Nervous System: A Systematic Review. Cent Nerv Syst Agents Med Chem 2022; 23:CNSAMC-EPUB-127708. [PMID: 36411563 DOI: 10.2174/1871524923666221121123937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/08/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The brain is the most complex organ in the human body, with a high and constant demand for inputs. Adequate nutrition is essential for the complete functioning of the brain, not only due to the energy supply, mainly from carbohydrates, but also due to the adequate supply of other macronutrients and micronutrients for the synthesis of neurotransmitters and protein components. Vitamins, minerals, and other components of the diet also constitute the so-called "neuronutrients". OBJECTIVE It was to develop a systematic review to present the main neuronutrients and the state of the art of studies that support strategies to ensure adequate nutritional status. METHODS The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from October 2021 to February 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. RESULTS A total of 234 articles were found and 167 articles were evaluated in full, and 118 were included and evaluated in the present study. According to the GRADE instrument, most studies (>50%) followed a controlled clinical study model and had a good methodological design. The overall assessment resulted in 54 studies with a high risk of bias to the small sample size. The most important macronutrients in neuro-nutrition are phosphatidylserine and tryptophan. Micronutrients are methylfolate, vitamins B6 and B12, magnesium, arginine, choline, niacin. CONCLUSION The areas of neurology and psychiatry have shown great advances regarding the deepening of knowledge in prophylaxis and pathophysiology, as well as in the treatment of established diseases. The recognition of the role of nutrition as an adjunct to these processes is currently growing. The search in scientific bases for neuronutrients reveals a great growth of publications related to this theme. In the present text, some of these nutrients were explored to verify the current state of knowledge.
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Affiliation(s)
- Carlos Alberto Nogueira-de-Almeida
- Federal University of Sao Carlos, department of medicine, Sao Carlos, Sao Paulo, Brazil
- ABRAN - Associação Brasileira de Nutrologia/Brazilian Association of Nutrology, Catanduva, Sao Paulo, Brazil
| | - Idiberto José Zotarelli-Filho
- FACERES - Faculty of Medicine of Sao Jose do Rio Preto, Sao Paulo, Brazil
- ABRAN - Associação Brasileira de Nutrologia/Brazilian Association of Nutrology, Catanduva, Sao Paulo, Brazil
| | | | | | - Vitorio Luis Kemp
- Apsen Farmacêutica, Department of Medical Affairs, Sao Paulo, Brazil
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Nogueira-de-Almeida CA, Ued FDV, Contini AA, Martinez EZ, Del Ciampo LA, Nogueira-de-Almeida ME, Ferraz IS, Silva RFB, de Mello ED, Fisberg M. Anthropometric Indicators of Body Composition Associated With Lipid and Glycemic Profiles in Overweight Brazilian Children and Adolescents From 2008 to 2020. Front Nutr 2022; 9:908562. [PMID: 35757250 PMCID: PMC9218630 DOI: 10.3389/fnut.2022.908562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Anthropometric indicators have been used to predict health problems. The objective was to determine which indicators present better correlation with dyslipidemia, hyperglycemia and peripheral insulin resistance, as well as the cutoff points capable of predicting lipid and glycemic alterations in Brazilian children and adolescents. Methods A cross-sectional study conducted with 568 overweight individuals, aged between 5 and 18 years, living in Southeast and South Brazilian regions, submitted to anthropometric and body composition evaluation by bioimpedance, in addition to fasting laboratory tests [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting glycemia, and homeostasis model assessment–insulin resistance (HOMA-IR)]. Pearson's correlation was used to evaluate the association between anthropometric indicators and serum biomarkers. The ROC curve with Youden's J index was used to suggest anthropometric cutoff points with better ability to predict or rule out lipid and glycemic changes. Results Cutoff points obtained for the z-score of body mass index (BMI), waist circumference (WC), and waist circumference for height (WC/H) showed high specificity (52 to 87%) and low sensitivity (23 to 59%), indicating greater ability to exclude changes in HDL-c, TG, and HOMA-IR levels. Cutoff points suggested for BMI ranged from +1.86 to +2.20 z-score. WC cutoff points ranged from +1.29 to +1.72, and, for the WC/H index, from +1.21 to +1.25. It was suggested the use of the following cutoff points to rule out changes in HDL-c, TG, and HOMA-IR values in clinical practice: BMI < z-score +2 and WC/H < z-score +1.29. In body fat percentage (BFP) analyses, the cutoff point < of 34% may be able to rule out changes in HDL-c (specificity of 70%), while the cutoff point > 36.6% may be able to predict changes in the HOMA-IR index (sensitivity of 76%). Conclusion It is not yet possible to state which anthropometric parameter has the best correlation with lipid and glycemic alterations in overweight children and adolescents. We suggest considering BMI, WC, and WC/H cutoff points together to rule out changes in HDL-c, TG, and HOMA-IR, and use the BFP cutoff point to predict changes in HOMA-IR.
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Affiliation(s)
| | - Fábio da Veiga Ued
- Nutrition Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | | | - Luiz Antonio Del Ciampo
- Pediatric Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Ivan Savioli Ferraz
- Pediatric Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Elza Daniel de Mello
- Pediatrics Department, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Mauro Fisberg
- Pensi Institute, Hospital Infantil Sabará, José Luiz Egídio Setúbal Foundation, São Paulo, Brazil.,Pediatrics Department, Federal University of São Paulo, São Paulo, Brazil
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de Castro MA, Fontanelli MDM, Nogueira-de-Almeida CA, Fisberg M. Food Insecurity Reduces the Chance of Following a Nutrient-Dense Dietary Pattern by Brazilian Adults: Insights from a Nationwide Cross-Sectional Survey. Nutrients 2022; 14:nu14102126. [PMID: 35631267 PMCID: PMC9143026 DOI: 10.3390/nu14102126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
Dietary patterns derived by data-driven techniques are still scarce in the food security context and may be a useful tool to inform policymakers to promote adequate and healthy diets for vulnerable populations. We investigated the association between food security status and dietary patterns among 28,127 Brazilian adults using data from the 2017–2018 Household Budget Survey. Food security status was measured by the Brazilian Food Insecurity Scale. Food items reported in two 24 h dietary recalls were combined into food groups. Dietary patterns were derived from exploratory factor analysis, and participants were grouped according to their factor scores by K-means cluster analysis. Multiple logistic regression models were fitted to investigate the association between food security status and clusters of adherence to dietary patterns. Four dietary patterns were derived: ‘Brazilian breakfast style’ (cluster 3), ‘Brazilian Traditional staple foods’ (cluster 2), ‘Beverages, ready-to-eat and convenience foods’ (cluster 4), and ‘Fruits, vegetables, and whole grains’ (cluster 1). After adjustments, food insecurity was inversely associated with adherence to the ‘Fruits vegetables, and whole grains’ pattern (OR = 0.75, 95% CI: 0.63–0.89). Findings suggest food insecurity negatively impact the adoption of a nutrient-dense dietary pattern and highlight the critical role of policy actions in a scenario of increasing food insecurity.
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Affiliation(s)
| | | | | | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, Sao Paulo 01227-200, Brazil;
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Ferraz IS, Vieira DMC, Ciampo LAD, Ued FDV, Almeida ACF, Jordão AA, Aragon DC, Martinez EZ, Martinelli CE, Nogueira-de-Almeida CA. Vitamin A deficiency and association between serum retinol and IGF-1 concentrations in Brazilian children with Down syndrome. J Pediatr (Rio J) 2022; 98:76-83. [PMID: 34000230 PMCID: PMC9432046 DOI: 10.1016/j.jped.2021.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/05/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine the prevalence of vitamin A deficiency (VAD) and serum concentrations of retinol, correlating them with IGF-1 concentrations in preschoolers with DS. METHODS Cross-sectional study was conducted on 47 children with DS aged 24 to 72 months, in Ribeirão Preto, Brazil. VAD was determined by the relative dose-response (RDR) test. Retinol serum concentration ≤ 0.70 µmol/L and IGF-1 serum concentration below the 3rd percentile for sex and age were considered to represent deficiency. C-reactive protein (CRP) was determined at the beginning of the study. Weight, height, and information about fever and/or diarrhea were obtained at the beginning of the study. RESULTS VAD prevalence was 25.5% (12/47), and 74.5% (35/47) of the children had deficient retinol before the intervention. CRP was not associated with VAD. Mean IGF-1 were 103.5 ng/mL (SD = 913) for the group with VAD and 116.3 ng/mL (SD = 54.9) for the group with no VAD (p-value = 0.85); 8.5% (4/47) of the children showed deficient IGF-1, but without VAD. No association was observed between VAD and IGF-1 deficiency. A moderate positive correlation was observed between pre-intervention retinol and IGF-1 (ρ = 0.37; p-value = 0.01). CONCLUSION a high prevalence of VAD and deficient retinol was observed and there was a positive correlation between serum retinol and IGF-1.
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Affiliation(s)
- Ivan Savioli Ferraz
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Débora Mônica Costa Vieira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Luiz Antonio Del Ciampo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil.
| | - Fábio da Veiga Ued
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
| | - Ane Cristina Fayão Almeida
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Alceu Afonso Jordão
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
| | - Davi Casale Aragon
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Edson Zangiacomi Martinez
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Medicina Social, Ribeirão Preto, SP, Brazil
| | - Carlos Eduardo Martinelli
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
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Rates SPM, Capanema FD, Amaral BD, Secundino CM, Michelli LMDS, Pereira RCM, Ued FDV, Nogueira-de-Almeida CA. Nutritional status of iodine in pregnant and non-pregnant adolescents assisted at the Family Health Strategy in Vespasiano, MG. Rev Bras Saude Mater Infant 2021. [DOI: 10.1590/1806-93042021000400005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate the nutritional status of iodine in pregnant adolescents, taking into account the increase in the demand for iodine during pregnancy and the absence of iodization strategies for this population. Methods: cross-sectional study conducted with 62 pregnant and 71 non-pregnant adolescents assisted in primary care. The nutritional status of iodine was determined by urinary samples. The iodine concentration in the consumed culinary salt was also evaluated. For the comparative analyses of categorical variables, the Chi-square test was used and for the continuous variables, the Kruskal-Wallis test, considering a 95% confidence interval (CI) and significance level of 5%. Results: the mean iodine concentration in household salt was 25.1 mg/kg (CI95%= 11.1-67.5 mg/kg), with higher mean content in culinary salt in the group of pregnant women (p<0.028). Regarding the nutritional status of iodine, 71% of pregnant adolescents were deficient and 29% iodine-sufficient, with significant difference when compared to 38% of deficiency and 62% of sufficiency in the control group (p<0.001). Conclusions: there was an iodic deficiency among pregnant adolescents, even in the face of higher concentrations of iode in household salt, exposing a paradox between higher consumption and lower sufficiency in this group. Thus, it is suggested to consider iodine supplementation during pregnancy, seeking to minimize the effects of this deficiency on maternal and child health.
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Fisberg M, Duarte Batista L, Nogueira-de-Almeida CA, Sarti FM, de Albuquerque MP, Fisberg RM. Integrative Strategies for Preventing Nutritional Problems in the Development of Children in Brazil. Front Nutr 2021; 8:662817. [PMID: 34476237 PMCID: PMC8407062 DOI: 10.3389/fnut.2021.662817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/14/2021] [Indexed: 11/28/2022] Open
Abstract
Child healthcare has been a priority subject in several programs and public policies developed over the decades. However, initiatives implemented seem insufficient to overcome the challenges regarding the integral development and improvement of the nutritional status of children in Brazil. The initial developmental stages of a child include pregnancy, breastfeeding, and complementary feeding, which are determinants in future aspects of health and nutritional status. Therefore, the strategies addressing problems during these three periods of life have the potential to positively impact the promotion of healthy eating habits and food security throughout life. Developing countries with huge dimensions and vast inequalities, like Brazil, are marked by differences in regional, cultural, and social contexts that may hinder the implementation of programs and policies with a broad scope. Extensive operational and professional costs, in addition to time-consuming activities that are necessary to apply, monitor, and evaluate interventions may jeopardize the proper assessment of programs and policy goals, generating the inefficiency and waste of resources in the health system. Thus, programs and policies aimed at creating and modifying habits should consider an intersectoral action within local contexts, involving health professionals, universities, policy managers, and the community. Therefore, this article aimed to discuss the preliminary conception of an integrated approach of decentralized strategies to promote healthy eating habits and food security of children in Brazil.
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Affiliation(s)
- Mauro Fisberg
- Feeding Difficulties Center, Institute PENSI (Pesquisa e Ensino em Saúde Infantil), Fundação Jose Luiz Setubal, Hospital Infantil Sabará (Sabara Children's Hospital), São Paulo, Brazil
| | - Lais Duarte Batista
- Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, Brazil
| | | | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of São Paulo (USP), São Paulo, Brazil
| | - Maria Paula de Albuquerque
- Section Physiology of Nutrition, Department of Physiology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo (USP), São Paulo, Brazil
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Nogueira-de-Almeida CA, Ciampo LAD, Ferraz IS, Ciampo IRLD, Contini AA, Ued FDV. Pediatric multisystem inflammatory syndrome associated with COVID-19: urgent attention required. Rev Assoc Med Bras (1992) 2021; 67Suppl 1:115-120. [PMID: 34406301 DOI: 10.1590/1806-9282.67.suppl1.20200691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To identify epidemiological and clinical characteristics of multisystemic inflammatory syndrome associated with coronavirus infection as one of the severe forms of COVID-19 involvement in children and adolescents. METHODS review was based on articles published in 2020 in the PubMed, Medline, Scopus, SciELO and Cochrane databases. SUMMARY Multisystemic inflammatory syndrome is a serious clinical disorder that affects children and adolescents and is associated with the detection of previous exposure to SARS-CoV-2. It is characterized by the installation of a shock picture, with a significant increase in inflammatory markers such as presentations of Kawasaki Disease or shock syndrome related to Kawasaki Disease, or even toxic shock syndrome, with the clinical picture being characterized by fever of difficult control, rash, conjunctivitis, peripheral edema, generalized pain in the extremities and gastrointestinal symptoms. CONCLUSIONS Although the vast majority of children with COVID-19 have mild symptoms, it is necessary to consider that some have a hyperinflammatory response. It is essential that health professionals receive information that can assist in the recognition of this clinical condition, differentiating it from other diagnoses, so that early and appropriate treatment is instituted.
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Affiliation(s)
| | - Luiz Antonio Del Ciampo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Medical School of Ribeirão Preto, Departament of Childcare and Pediatrics - São Paulo (SP), Brazil
| | - Ivan Savioli Ferraz
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Medical School of Ribeirão Preto, Departament of Childcare and Pediatrics - São Paulo (SP), Brazil
| | | | | | - Fábio da Veiga Ued
- Universidade de São Paulo, Medical School of Ribeirão Preto, Department of Health Sciences- Ribeirão Preto (SP), Brazil
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Nogueira-de-Almeida CA. Metabolic syndrome definition in adolescents should incorporate insulin resistance. Ann Pediatr Endocrinol Metab 2020; 25:287-288. [PMID: 33401885 PMCID: PMC7788337 DOI: 10.6065/apem.2040166.083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/09/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Carlos Alberto Nogueira-de-Almeida
- Medical Department, Federal University of São Carlos, Ribeirao Preto, SP, Brazil,Address for correspondence: Carlos Alberto Nogueira-deAlmeida, MD, MSc, PhD Medical Department, Federal University of São Carlos, R. Eugenio Ferrante, 170, Ribeirao Preto, SP, CEP 14027-150, Brazil Tel: +55-16-38775034 E-mail:
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Nogueira-de-Almeida CA, Del Ciampo LA, Ferraz IS, Del Ciampo IRL, Contini AA, Ued FDV. COVID-19 and obesity in childhood and adolescence: a clinical review. J Pediatr (Rio J) 2020; 96:546-558. [PMID: 32768388 PMCID: PMC7402231 DOI: 10.1016/j.jped.2020.07.001] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. SOURCES Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. SUMMARY OF FINDINGS Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. CONCLUSIONS The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.
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Affiliation(s)
| | - Luiz A Del Ciampo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Ivan S Ferraz
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Puericultura e Pediatria, Ribeirão Preto, SP, Brazil
| | - Ieda R L Del Ciampo
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos, SP, Brazil
| | - Andrea A Contini
- Universidade Federal de São Carlos, Departamento de Medicina, São Carlos, SP, Brazil
| | - Fábio da V Ued
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ciências da Saúde, Ribeirão Preto, SP, Brazil
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Nogueira-de-Almeida CA, Ferraz IS, Ued FDV, Almeida ACF, Ciampo LAD. Impact of soy consumption on human health: integrative review. Braz J Food Technol 2020. [DOI: 10.1590/1981-6723.12919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract Soy consumption is a millenary habit of populations of the eastern world and has recently increased in the western world. The risks and benefits of this practice have been extensively studied, with a current fundamental need of integration of available information. The aim of this study was to carry out an integrative review on this topic, in order to consolidate the available information. Based on the main question: “What is the impact of soy consumption on human health?”, were reviewed publications classified as original articles and reviews published from 1998 to 2020 in the databases Scopus, PubMed, SciELO, Web of Science, and Cochrane Library. A total of 97 studies were selected. In the present review were described the general impact of soy on human health and its protein quality, the effects of early exposure using soy formulas, and the effects of soy consumption on breast cancer, endometrial and ovarian cancer, prostate cancer, gastrointestinal cancer, cardiovascular disease, glucose metabolism and type 2 diabetes, obesity, reproductive health, menopause, female and male osteoporosis, microbiota, immunity and immunomodulation, thyroid function, attention-deficit hyperactivity disorder, and renal function.
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Garcia J, Benedeti ACGS, Caixe SH, Mauad F, Nogueira-de-Almeida CA. Ultrasonographic evaluation of the common carotid intima-media complex in healthy and overweight/obese children. J Vasc Bras 2019; 18:e20190003. [PMID: 31645861 PMCID: PMC6788858 DOI: 10.1590/1677-5449.190003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/28/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Obesity is a global epidemic, including among children. It is therefore necessary to identify cardiovascular changes in overweight/obese children as early as possible. Mode B ultrasonography of the common carotids can be used to precisely evaluate in real time early changes in the thickness of the intima-media complex (IMC), which can detect onset of the atherosclerosis process. OBJECTIVES This study compared IMC thickness between schoolchildren with and without overweight/obesity. METHODS A sample of 59 children of both sexes, aged 7 to 10 years, were recruited from health centers in São Paulo, Brazil. Children were classified by z scores for body mass index (BMI) into two groups, with or without overweight/obesity. These groups were then compared in terms of IMC thickness. RESULTS The groups were homogenous for age and sex. The mean IMC measurement in the group with overweight/obesity was 0.49 (± 0.07) mm, whereas in the group free from overweight/obesity it was 0.41 (± 0.05) mm (p < 0.01). These differences were maintained when groups with and without overweight/obesity were compared separately by sex and for right and left sides. The coefficient for the correlation between IMC measurement and BMI z score was 0.61 (95% confidence interval = 0.42-0.75). Within the same nutritional status group, there were no differences between sexes or between right and left sides. CONCLUSIONS Intima-media thickness was greater among children with overweight/obesity and was directly proportional to BMI z score, denoting increased cardiovascular risk in this group.
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Affiliation(s)
- Jorge Garcia
- Faculdade de Tecnologia em Saúde – FATESA, Ribeirão Preto, SP, Brasil.
| | | | | | - Francisco Mauad
- Universidade de São Paulo – USP, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
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Nogueira-de-Almeida CA, Ued FDV, Almeida CCJND, Almeida ACF, Del Ciampo LA, Ferraz IS, Silva LFDOD, Zambom CR, Oliveira AFD. Perfil nutricional e benefícios do azeite de abacate (Persea americana ): uma revisão integrativa. Braz J Food Technol 2018. [DOI: 10.1590/1981-6723.21417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Resumo O objetivo do presente estudo foi realizar uma revisão integrativa sobre a qualidade do perfil lipídico e dos compostos bioativos presentes no azeite de abacate, bem como sobre os seus potenciais benefícios para a saúde humana. Foram identificados trabalhos publicados nas bases de dados Scopus, PubMed, Lilacs, SciELO e Web of Science, além de Biblioteca Digital de Teses e Dissertações. A pesquisa encontrou dados referentes ao perfil lipídico e ao teor de substâncias bioativas presentes no azeite de abacate extraído das variedades Margarida, Quintal, Fortuna, Ouro Verde, Hass e Fuerte. O azeite de abacate caracteriza-se por apresentar, em média, teores elevados de ácidos graxos monoinsaturados (60%), teor intermediário de ácidos graxos saturados (24%) e baixo teor de ácidos graxos poli-insaturados (16%). O ácido graxo oleico (ômega-9) é o de maior concentração (aproximadamente 55%). Os principais esteróis, tocoferóis e carotenoides encontrados foram β-sitosterol, α-tocoferol e luteína, respectivamente. O azeite de abacate possui propriedades físico-químicas semelhantes às do azeite de oliva. Em modelos animais, é capaz de prevenir a disfunção mitocondrial cerebral e hepática induzida pelo diabetes, associado à diminuição de estresse oxidativo, LDL-c e peroxidação lipídica. Seus benefícios são atribuídos principalmente às concentrações de ácido oleico, por sua atividade cardioprotetora, ao β-sitosterol, por sua propriedade anti-inflamatória, e ao α-tocoferol e à luteína, pela propriedade antioxidante. Assim, o azeite de abacate se destaca pelo teor elevado de ácidos graxos monoinsaturados e de compostos bioativos, como tocoferóis, carotenoides e fitoesteróis. Análises em modelos animais, aliadas às análises de qualidade e segurança, atestam os benefícios e a possibilidade de introdução do referido azeite para uso comestível, substituindo óleos de qualidade inferior e criando nova alternativa gastronômica ao consumidor.
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Nogueira-de-Almeida CA, Mello EDD. Correlation of body mass index Z-scores with glucose and lipid profiles among overweight and obese children and adolescents. J Pediatr (Rio J) 2018; 94:308-312. [PMID: 28881179 DOI: 10.1016/j.jped.2017.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/04/2017] [Accepted: 05/04/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of abnormalities in plasma lipid and glucose profiles among overweight and obese children and adolescents, and to assess the presence of a correlation between body mass index Z-scores and indicators of comorbidities related to both profiles. METHODS This was a multicenter cross-sectional study conducted at two outpatient clinics. The study included all 417 comers for the first visit from 2008 to 2012, aged between 7 and 18 years, with BMI above the Z-score +1. Anthropometry and blood sampling were obtained. The prevalence of dyslipidemias, hyperglycemia, and insulin resistance were evaluated, together with the correlations of these variables with the increase of Z-BMI. RESULTS Dyslipidemia was observed in 43.4% of the boys and 66.1% of the girls, with no difference between genders. High glucose levels were detected in 6.2% of the individuals. Insulin resistance was present in 32.3% and 41.7% of the cases, with no statistical significance between boys and girls. Correlations between the Z-BMI were noted for triglycerides in the entire group and among girls; for HDL-c, only among girls; for glucose, a correlation was observed for the entire group, but not when stratified by gender. The indicators of insulin resistance were all correlated with Z-BMI, even when corrected for age. CONCLUSIONS Overweight and obesity give origin to a high prevalence of dyslipidemia and insulin resistance. BMI Z-scores showed a weak positive correlation with glucose and triglyceride, and negative with HDL-c. In turn, the strongest positive correlation was found with insulin resistance indicators.
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Affiliation(s)
| | - Elza Daniel de Mello
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Porto Alegre, RS, Brazil
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Almeida ACF, de Paula FJA, Monteiro JP, Nogueira-de-Almeida CA, Del Ciampo LA, Aragon DC, Ferraz IS. Do all infants need vitamin D supplementation? PLoS One 2018; 13:e0195368. [PMID: 29649273 PMCID: PMC5896946 DOI: 10.1371/journal.pone.0195368] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/23/2018] [Indexed: 01/04/2023] Open
Abstract
A high prevalence of vitamin D deficiency (VDD) in children has been observed worldwide, but there are few studies on the nutritional status of vitamin D (VD) in healthy infants. The main cause of deficiency in healthy children is breastfeeding without supplementation and lack or insufficiency of sun exposure. The aims of this study were to determine serum concentrations of 25(OH)D and verify its association with parathyroid hormone (PTH) concentrations and use of VD supplementation in healthy infants aged ≥ 6 to ≤ 24 months attended at two Primary Health Care Units in Ribeirão Preto city, São Paulo, Brazil. A cross-sectional, observational and analytical study was performed in which serum concentrations of 25(OH)D, PTH, alkaline phosphatase (AP), calcium (Ca), phosphorus (P) and albumin were determined in 155 healthy infants. Information on sun exposure, sociodemographic aspects of mothers and clinical and nutritional characteristics of infants were obtained through interviews with responsible infants’s legal representatives. Ten infants (6%) presented deficient 25(OH)D serum concentration (≤20ng/ml) and 46 (30%), insufficient (21 to 29ng/ml). No changes in serum P, Ca and albumin concentrations were detected. Only one infant had an increase in PTH serum concentrations. 35% (55/155) of infants had high AP e 40% (22/55) presented insufficient serum concentrations of 25(OH)D but none presented deficient ones. There was a weak association between serum concentrations of 25(OH)D and PTH and an association between serum concentrations of 25(OH)D and P when adjusted for sex, age and BMI. There were no associations between inadequate serum concentrations of 25(OH)D (deficient ou insufficient), sun exposure and VD supplementation. This study found a low prevalence of deficient 25(OH)D serum concentration and high prevalence of insufficient ones which was not associated with changes in serum PTH, AP, P, Ca and albumin concentrations, VD supplementation and the formula volume intake.
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Affiliation(s)
- Ane Cristina Fayão Almeida
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo—USP, Ribeirão Preto, Brazil
| | | | - Jacqueline Pontes Monteiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo—USP, Ribeirão Preto, Brazil
| | | | - Luiz Antonio Del Ciampo
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo—USP, Ribeirão Preto, Brazil
| | - Davi Casale Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo—USP, Ribeirão Preto, Brazil
| | - Ivan Savioli Ferraz
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo—USP, Ribeirão Preto, Brazil
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Deminice TMM, Ferraz IS, Monteiro JP, Jordão AA, Ambrósio LMCS, Nogueira-de-Almeida CA. Vitamin A intake of Brazilian mothers and retinol concentrations in maternal blood, human milk, and the umbilical cord. J Int Med Res 2018; 46:1555-1569. [PMID: 29436245 PMCID: PMC6091812 DOI: 10.1177/0300060518757155] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives To analyse intake of vitamin A (VA) and retinol concentrations in maternal blood, breast milk (BM), and the umbilical cord (UC) of newborns, and to determine the associations among these variables. Methods We performed a cross-sectional, epidemiological study of 180 mother-newborn dyads. Maternal and UC blood samples and BM were collected. VA intake by the mother over 30 days was assessed using a questionnaire. Results Mean retinol concentrations in maternal serum, the UC, and BM were 0.65 ± 0.27, 0.36 ± 0.18, and 2.95 ± 2.70 µmol/L, respectively. Retinol concentrations <0.70 µmol/L were found in 57.2% of maternal blood samples and in 94.9% of UC samples. A total of 27.9% of BM samples showed retinol concentrations <1.05 µmol/L. Mean VA intake by the mothers was 1041.33 ± 1187.86 µg retinol activity equivalents/day and was inadequate (<550 µg retinol activity equivalents/day) in 44.7%. Conclusions High proportions of insufficient retinol concentrations were observed in the UC, maternal blood, and BM. A high percentage of pregnant women had inadequate VA intake. Mothers with insufficient serum retinol concentrations had newborns with lower retinol concentrations in the UC. Higher retinol concentrations were observed in maternal blood and the UC with a higher VA intake.
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Affiliation(s)
- Thalia Manfrin Martins Deminice
- 1 Department of Puericulture and Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Monte Alegre, Ribeirão Preto/SP, Brazil
| | - Ivan Savioli Ferraz
- 1 Department of Puericulture and Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Monte Alegre, Ribeirão Preto/SP, Brazil
| | - Jacqueline Pontes Monteiro
- 1 Department of Puericulture and Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Monte Alegre, Ribeirão Preto/SP, Brazil
| | - Alceu Afonso Jordão
- 2 Nutrition and Metabolism Division of the Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Monte Alegre, Ribeirão Preto/SP, Brazil
| | - Lívia Maria Cordeiro Simões Ambrósio
- 3 Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Monte Alegre, Ribeirão Preto/SP, Brazil
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Abstract
OBJECTIVE To describe a case of an obese child whose weight gain was related to the Munchausen Syndrome by proxy (MSP). METHODS This is a case report including information regarding the child's clinical history and the mother's behavior. The common features of the syndrome are confronted with the description of the case, seeking to demonstrate the similarities. RESULTS The description ratifies the diagnosis based on the signs and symptoms presented by the child (<5 years old, frequent contacts with health system, symptoms witnessed only by the mother, confusing findings, not helped by treatments, emotionally distant father) and the attitude of the mother (concerned, interested in procedures, comfortable in the medical setting, higher medical knowledge, hostile when thwarted). CONCLUSION The case presented points to a new etiology, the MSP, to be considered within the set of factors currently known to cause and maintain obesity in childhood.
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Nogueira-de-Almeida CA, de Mello ED. Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents. Pediatr Gastroenterol Hepatol Nutr 2018; 21:59-67. [PMID: 29383306 PMCID: PMC5788952 DOI: 10.5223/pghn.2018.21.1.59] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 02/06/2023] Open
Abstract
PURPOSE to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. METHODS A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. RESULTS Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. CONCLUSION The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.
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Affiliation(s)
| | - Elza Daniel de Mello
- Department of Pediatric, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Nogueira-de-Almeida CA, Pires LAF, Miyasaka J, Bueno V, Khouri JMN, Ramos MLSR, Ceccato YC, Costa V, Maia Júnior FDA. Comparison of feeding habits and physical activity between eutrophic and overweight/obese children and adolescents: a cross sectional study. Rev Assoc Med Bras (1992) 2015; 61:227-33. [DOI: 10.1590/1806-9282.61.03.227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 08/26/2014] [Indexed: 01/17/2023] Open
Abstract
Summary Objective: it is broadly accepted, but little explored, that obese children practice less physical activity and eat more. This study has the objective of comparing feeding habits and physical activity between eutrophic and overweight/obese children and adolescents. Methods: 126 students with ages ranging from 6 to 18 years were evaluated. Eutrophic and overweight/obese students were compared according to calorie intake, macro and micronutrients, prevalence of physical inactivity and ingestion of micronutrients. Results: differences were observed in the amount of calories ingested per unit of BMI (eutrophic, 97.6, and overweight/obese, 70.5, p=0.0061), as well as in calcium intake (eutrophic, 546.2, and overweight/obese, 440.7, p=0.0366). Both groups presented sedentarism, as well as a high prevalence of micronutrient intake deficiency, especially calcium and vitamins A, E, and C, but with no difference observed between eutrophic and overweight/obese subjects. Conclusion: energy and macronutrients consumption, as well as physical activity, were similar between eutrophic and overweight/obese. Calcium intake was lower in the overweight/obese group and the ingestion of vitamin C was lower in the eutrophic group. These results demonstrate the importance of considering all etiologic factors that may lead to obesity, so that new strategies for prevention and control may be added to traditional interventions.
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da Costa Ribeiro H, Ribeiro TCM, de Mattos AP, Pontes M, Sarni ROS, Cruz MLS, Nogueira-de-Almeida CA, Mussi-Pinhata MM, de Carvalho Norton R, Steenhout P. Normal Growth of Healthy Infants Born from HIV+ Mothers Fed a Reduced Protein Infant Formula Containing the Prebiotics Galacto-Oligosaccharides and Fructo-Oligosaccharides: A Randomized Controlled Trial. Clin Med Insights Pediatr 2015; 9:37-47. [PMID: 25788839 PMCID: PMC4357629 DOI: 10.4137/cmped.s17841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/09/2014] [Accepted: 10/17/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of the current study was to evaluate the safety of a new reduced protein (2.1 g/100 kcal) infant formula containing 4 g/L of 90% galacto-oligosaccharides (GOS) and 10% fructo-oligosaccharides (FOS). METHODS Healthy term infants from Brazil were enrolled. Those born to human immunodeficiency virus (HIV)-positive mothers were randomized to a test (n = 65) or control (n = 63) formula group. Infants born to HIV-negative mothers were either exclusively breast-fed (n = 79) or received a mixed diet (breast milk and test formula, n = 65). Between 2 weeks and 4 months of age, infants were exclusively fed according to their assigned group. Anthropometric measurements were taken at baseline, 1, 2, 3, 4, 6, 8, 10, and 12 months. Digestive tolerance was evaluated during the first 4 months. The primary outcome was mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups. RESULTS Data from all infants (N = 272) were used in the intention-to-treat (ITT) analysis and data from 230 infants were used in the per-protocol (PP) analysis. The difference in mean daily weight gain between 2 weeks and 4 months in the test formula and breast-fed groups was 1.257 g/day (one-sided 95% confidence interval [CI]: −0.705 to inf, P < 0.001) in the PP analysis, showing that the lower bound of the 95% CI was above the −3.0 g/day non-inferiority margin. Results were similar in the ITT analysis. Symptoms of digestive tolerance and frequency of adverse events were similar in the two groups. CONCLUSIONS The formula containing 2.1 g/100 kcal protein and GOS and FOS was safe and tolerated well.
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Affiliation(s)
- Hugo da Costa Ribeiro
- Pediatrics, Federal University of Bahia School of Medicine, Salvador de Bahia, Brazil
| | | | | | - Mariana Pontes
- Fima Lifshitz Research Center, University Hospital Complex at Federal University of Bahia, Salvador de Bahia, Brazil
| | | | | | | | - Marisa M Mussi-Pinhata
- Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto de São Paulo, Brazil
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Caixe SH, Mauad Filho F, Benedetia ACGS, Garcia J, Martins WDP, Del Ciampo LA, Nogueira-de-Almeida CA. Evaluation of Echocardiography as a Marker of Cardiovascular Risk in Obese Children and Adolescents. ACTA ACUST UNITED AC 2014. [DOI: 10.14740/ijcp164w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nogueira-de-Almeida CA, Ricco RG, Del Ciampo LA, de Souza AM, Dutra-de-Oliveira JE. Growth and hematological studies on Brazilian children of low socioeconomic level. Arch Latinoam Nutr 2001; 51:230-5. [PMID: 11791475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Anemia and undernutrition are common all over the world, especially in less developed countries. The relationship between low weight, short stature and iron deficiency should be better understood so that appropriate measures might be taken to prevent these problems. A total of 115 institutionalized children aged 12 to 72 months were studied in day-care institutions in the town of Pontal, Southeastern Brazil, during the second semester of 1999. Personal data, weight, height and hematological profile were obtained from all subjects. Food intake was evaluated in 20 children by a direct food-weighing method. The prevalence of low weight for age (2.6%), low weight for height (1.7%) and low height for age (4.3%) was considered low. Anemia was observed in 68.7% of the children. Diet was found to be adequate in terms of the major nutrients evaluated, but food iron supply was of low bioavailability. In conclusion, the population studied revealed a peculiar behavior i.e., the coexistence of fairly good anthropometric nutritional status along with iron-deficiency anemia. The prevention of this kind of malnutrition cannot be limited to an adequate calorie/protein supply but should also be based on the correction of the severe iron deficiency present in this low socioeconomic level preschool children in Brazil.
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Ricco RG, Nogueira-de-Almeida CA, Del Ciampo LA, Daneluzzi JC, Ferlin ML, Muccillo G. Growth of exclusively breast-fed infants from a poor urban population. Arch Latinoam Nutr 2001; 51:122-6. [PMID: 11678043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The growth of two groups of infants were evaluated, one of them exclusively breast-fed (105 infants) and the other exclusively bottle-fed (61 infants), and compared with one another and with international standards (NCHS). All infants were evaluated by anthropometry at 1, 2, 3, 4, 5 and 6 months of age. A fourth order polynomial was adopted for each infant and for each anthropometric measurement in order to estimate individual growth, and the 5th, 50th and 95th percentiles for weight and length were obtained. For the age of 6 months, the weights of breast-fed boys and girls were always statistically equal to or higher than those of infants fed cow's milk or those of NCHS standards. Breast-fed boys presented significantly longer length than bottle-fed boys but shorter than NCHS standards, and breast-fed girls presented significantly shorter length than both bottle-fed girls and than NCHS standards. The greater weight of exclusively breast-fed infants when compared to NCHS standards at six months of age, which differentiates the present study from several other ones carried out in developing countries, was probably due to the association of the beneficial effects of breast-feeding with those of pediatric follow-up.
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Affiliation(s)
- R G Ricco
- Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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