1
|
Cacau LT, Hanley-Cook GT, Vandevijvere S, Leclercq C, De Henauw S, Santaliestra-Pasias A, Manios Y, Mourouti N, Esperanza Díaz L, Gonzalez-Gross M, Widhalm K, Molnar D, Stehle P, Kafatos A, Gottrand F, Kersting M, Castillo M, Lachat C, Marchioni DM, Huybrechts I, Moreno LA. Association between adherence to the EAT-Lancet sustainable reference diet and cardiovascular health among European adolescents: the HELENA study. Eur J Clin Nutr 2024; 78:202-208. [PMID: 38093098 DOI: 10.1038/s41430-023-01379-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health among European adolescents. METHODS Data from the HELENA study were used. Usual dietary intake was assessed using two 24-h dietary recalls and adherence to the EAT-Lancet diet was assessed using the Planetary Health Diet Index (PHDI), a 16-component index that ranges from 0 to 150 points. Cardiovascular health was assessed through the seven-component Ideal Cardiovascular Health (ICH) score: never smoked, eutrophic body mass index, moderate-to-vigorous physical activity, healthy dietary pattern, low blood pressure, low fasting plasma glucose, and low total cholesterol. Total ICH score was categorized into ideal (5-7) and non-ideal (0-4). RESULTS A 10-point increment in the PHDI was associated with a lower probability of a non-ideal ICH status (OR 0.84, [95% CI: 0.75, 0.94]) among European adolescents, after adjusting for age, sex, socio-economic status, and total energy intake. Furthermore, a 10-point increment in the PHDI was associated with lower probability of high blood pressure (OR: 0.87 [0.79, 0.96]) and a lower probability of high blood cholesterol (OR: 0.88 [0.78, 0.99]). CONCLUSION Our study suggests that a higher PHDI may be associated with a better cardiovascular health status among European adolescents.
Collapse
Affiliation(s)
- Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Catherine Leclercq
- Council for Agricultural Research and Economics - Research Center for Food and Nutrition (CREA - Food and Nutrition), Rome, Italy
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Alba Santaliestra-Pasias
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), 50013, Zaragoza, Spain
- Instituto de Investigacion Sanitaria Aragon (IIS Aragon), 50009, Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410, Heraklion, Greece
| | - Niki Mourouti
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671, Athens, Greece
- Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300, Sitia, Greece
| | - Ligia Esperanza Díaz
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN)-CSIC, 28040, Madrid, Spain
| | - Marcela Gonzalez-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Dénes Molnar
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, Crete, 71500, Heraklion, Greece
| | - Frederic Gottrand
- Institute for Translational Research in Inflammation (INFINITE), University Lille, Lille, France
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Manuel Castillo
- Department of Medical Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), 50013, Zaragoza, Spain
- Instituto de Investigacion Sanitaria Aragon (IIS Aragon), 50009, Zaragoza, Spain
| |
Collapse
|
2
|
Machado AD, Marchioni DM, Lotufo PA, Benseñor IM, Titan SM. Dietary acid load and the risk of events of mortality and kidney replacement therapy in people with chronic kidney disease: the Progredir Cohort Study. Eur J Clin Nutr 2024; 78:128-134. [PMID: 37891227 DOI: 10.1038/s41430-023-01361-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND/OBJECTIVES The association between dietary acid load (DAL) and chronic kidney disease (CKD) progression remains controversial. Also, there is a gap in the literature on the association between DAL and mortality. In this study, we evaluated the association between NEAP (net endogenous acid production) and PRAL (potential renal acid load) and the risk of events of all-cause mortality and kidney replacement therapy (KRT) in people with CKD. SUBJECTS/METHODS We included 442 patients (250 diabetics) from the Progredir Cohort Study, based in São Paulo, Brazil. We estimated NEAP and PRAL from dietary intake. Events of death before KRT and KRT were ascertained after a median follow-up of 5.8 and 5.1 years, respectively. Cox proportional hazards regression, Weibull regression, and competing risk models were performed. RESULTS Median NEAP and PRAL were 49.5 and 4.8 mEq/d. There were 200 deaths and 75 KRT events. Neither NEAP nor PRAL were associated with mortality or KRT when all participants were analyzed. After stratification for diabetes, both estimates were positively related to the risk of KRT even after adjustment for age, sex, weight status, glomerular filtration rate, serum bicarbonate, and intakes of protein, phosphorus, and energy (HR 1.31; 95% CI 1.07, 1.60 for NEAP, and HR 1.27; 95% CI 1.04, 1.57 for every 10 mEq/d increments). Competing risk analyses confirmed these findings. CONCLUSIONS DAL estimates were associated with the risk of KRT in people with CKD and diabetes but not in non-diabetics. There was no association between all-cause mortality and DAL.
Collapse
Affiliation(s)
- Alisson Diego Machado
- Division of Nephrology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Paulo Andrade Lotufo
- Epidemiological and Clinical Research Center, University Hospital of the University of São Paulo, São Paulo, SP, Brazil
| | - Isabela Martins Benseñor
- Epidemiological and Clinical Research Center, University Hospital of the University of São Paulo, São Paulo, SP, Brazil
| | - Silvia Maria Titan
- Division of Nephrology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Division of Nephrology & Hypertension, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
3
|
Teixeira CD, Marchioni DM, Motta VWDL, Chaves VM, Gomes SM, Jacob MCM. Flexitarians in Brazil: Who are they, what do they eat, and why? Appetite 2024; 192:107093. [PMID: 37923061 DOI: 10.1016/j.appet.2023.107093] [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: 06/14/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
In this study, we conducted the first scientific investigation focusing on Brazilian flexitarians, aiming to characterize their socio-economic and demographic profiles, motivations for adopting flexitarianism, the frequency of animal-based meat consumption, and the primary meat substitutes they consume. To accomplish this, we distributed an online questionnaire with the assistance of university students and researchers from various regions of the country. Data were collected from 1029 individuals in Brazil who self-identified as flexitarians. Our findings reveal that the flexitarian dietary model is primarily adopted by women, constituting 76% of the sample (n = 786). Their motivations include concerns about the environmental impact of meat consumption (n = 361, 35%), personal health (n = 344, 33%), and animal welfare (n = 219, 21%). Flexitarians exhibit varying consumption patterns, which can be categorized into three groups: light flexitarians (consuming meat 36 times a week), medium flexitarians (consuming meat 7 times a week), and heavy flexitarians (consuming meat 4 times a week). The flexitarian dietary pattern is characterized by reduced beef consumption (less than 2 times per week) and higher consumption of chicken (3 times per week). It is complemented by plant-based protein sources and eggs as the primary meat substitutes. The recognition of legumes as the principal meat substitutes opens avenues for an expanded discussion on sustainable food systems and alternative meat products in Brazil. This provides opportunities to enhance the availability and accessibility of these foods and to develop nutritional interventions that prioritize plant-based proteins.
Collapse
Affiliation(s)
- Carla D Teixeira
- Graduate Program in Social Sciences, Center for Human Sciences, Letters and Arts, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Lagoa Nova, 59078-970, Natal, RN, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av Dr Arnaldo 715, 01246-904, São Paulo, SP, Brazil.
| | - Virginia W de L Motta
- Program in Nutrition, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Lagoa Nova, 59078-970, Natal, Brazil.
| | - Viviany M Chaves
- Graduate Program in Social Sciences, Center for Human Sciences, Letters and Arts, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Lagoa Nova, 59078-970, Natal, RN, Brazil.
| | - Sávio M Gomes
- Department of Nutrition, Federal University of Paraíba, Street Tabelião Stanislau Eloy, s/n, Castelo Branco, 58050-585, João Pessoa, PB, Brazil.
| | - Michelle C M Jacob
- LabNutrir, Department, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Lagoa Nova, 59078-970, Natal, RN, Brazil.
| |
Collapse
|
4
|
Neri D, Gabe KT, Costa CDS, Martinez Steele E, Rauber F, Marchioni DM, da Costa Louzada ML, Levy RB, Monteiro CA. A novel web-based 24-h dietary recall tool in line with the Nova food processing classification: description and evaluation. Public Health Nutr 2023; 26:1997-2004. [PMID: 37548217 PMCID: PMC10564608 DOI: 10.1017/s1368980023001623] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/23/2022] [Revised: 07/04/2023] [Accepted: 07/29/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This paper describes the first web-based self-completed 24-h recall designed to categorise food intake according to Nova groups - Nova24h - and its agreement with a reference tool in estimating the dietary relative contribution of the four Nova food groups (% of total energy intake). DESIGN Comparisons of estimates of dietary relative contributions of Nova groups obtained by Nova24h and one standard interviewer-led 24-h recall. SETTING Nationwide adult cohort study in Brazil. PARTICIPANTS The subjects were 186 participants of the NutriNet Brasil Cohort Study (n 186). RESULTS No statistically significant differences were observed between the Nova24h and the reference tool mean contributions of unprocessed or minimally processed foods (52·3 % v. 52·6 %), processed culinary ingredients (11·6 % v. 11·9 %), processed foods (17·1 % v. 14·7 %) and ultra-processed foods (19·0 % v. 20·9 %). Intraclass correlation coefficients between individual estimates obtained for each Nova group showed moderate to good agreement (0·54-0·78). Substantial or almost perfect agreement between the tools was seen regarding the ability to rank participants according to quintiles of contribution of each Nova group (PABAK 0·69-0·81). CONCLUSIONS Nova24h is a suitable tool for estimating the dietary relative energy contribution of Nova food groups in the NutriNet Brasil cohort. New studies are necessary to verify its adequacy in other populations.
Collapse
Affiliation(s)
- Daniela Neri
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
| | - Kamila Tiemann Gabe
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
| | - Caroline Dos Santos Costa
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
| | - Euridice Martinez Steele
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo, Brazil
| | - Maria Laura da Costa Louzada
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Carlos Augusto Monteiro
- Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo (Nupens/USP), Sao Paulo, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo, Brazil
| |
Collapse
|
5
|
Cacau LT, Hanley-Cook GT, Huybrechts I, De Henauw S, Kersting M, Gonzalez-Gross M, Gottrand F, Ferrari M, Nova E, Castillo MJ, Molnár D, Widhalm K, Androutsos O, Manios Y, Stehle P, Lachat C, Marchioni DM, Moreno LA. Relative validity of the Planetary Health Diet Index by comparison with usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet among European adolescents: the HELENA study. Eur J Nutr 2023; 62:2527-2539. [PMID: 37171585 DOI: 10.1007/s00394-023-03171-3] [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: 08/25/2022] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be assessed. Thus, we aimed to evaluate the relative validity of the PHDI in European adolescents. METHODS We used cross-sectional data from 1804 adolescents (12.5-17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The PHDI (0-150 points) was calculated based on dietary intake data from two non-consecutive 24-h dietary recalls. Associations between the PHDI and usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet were evaluated using multivariable-adjusted mixed-effects linear regression models. RESULTS Higher PHDI score was associated with greater intakes of nutrients predominantly from plant-source foods, such as vegetable protein, vitamin E, and folate and with lower intake of nutrients predominately from animal-source foods, such as total and saturated fat, cholesterol, and animal protein. Furthermore, a higher PHDI score was also positively associated with plasma β-carotene, vitamin C, vitamin D, folate, and ferritin concentrations, while negatively associated with trans-fatty acids concentration. Moreover, higher PHDI was related to a greater adherence to the Mediterranean dietary pattern. CONCLUSIONS The PHDI showed good relative validity among adolescents in the HELENA study. Hence, future research should assess adherence to the PHDI and long-term health outcomes.
Collapse
Affiliation(s)
- Leandro Teixeira Cacau
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain.
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, 01246-904, Brazil.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Inge Huybrechts
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Marcela Gonzalez-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Frederic Gottrand
- Institute for Translational Research in Inflammation (INFINITE), University Lille, Lille, France
| | - Marika Ferrari
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Esther Nova
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Manuel J Castillo
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, 01246-904, Brazil
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), Zaragoza, Spain
- Instituto de Investigacion Sanitaria Aragon (IIS Aragon), Zaragoza, Spain
| |
Collapse
|
6
|
Yamakawa PE, Fonseca AR, Guerreiro da Silva IDC, Gonçalves MV, Marchioni DM, Carioca AAF, Michonneau D, Arrais-Rodrigues C. Biochemical phenotyping of paroxysmal nocturnal hemoglobinuria reveals solute carriers and β-oxidation deficiencies. PLoS One 2023; 18:e0289285. [PMID: 37527257 PMCID: PMC10393180 DOI: 10.1371/journal.pone.0289285] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal disease of hematopoietic cells with a variable clinical spectrum characterized by intravascular hemolysis, high risk of thrombosis, and cytopenias. To understand the biochemical shifts underlying PNH, this study aimed to search for the dysfunctional pathways involved in PNH physiopathology by comparing the systemic metabolic profiles of affected patients to healthy controls and the metabolomic profiles before and after the administration of eculizumab in PNH patients undergoing treatment. METHODS Plasma metabolic profiles, comprising 186 specific annotated metabolites, were quantified using targeted quantitative electrospray ionization tandem mass spectrometry in 23 PNH patients and 166 population-based controls. In addition, samples from 12 PNH patients on regular eculizumab maintenance therapy collected before and 24 hours after eculizumab infusion were also analyzed. RESULTS In the PNH group, levels of the long-chain acylcarnitines metabolites were significantly higher as compared to the controls, while levels of histidine, taurine, glutamate, glutamine, aspartate and phosphatidylcholines were significantly lower in the PNH group. These differences suggest altered acylcarnitine balance, reduction in the amino acids participating in the glycogenesis pathway and impaired glutaminolysis. In 12 PNH patients who were receiving regular eculizumab therapy, the concentrations of acylcarnitine C6:1, the C14:1/C6 ratio (reflecting the impaired action of the medium-chain acyl-Co A dehydrogenase), and the C4/C6 ratio (reflecting the impaired action of short-chain acyl-Co A dehydrogenase) were significantly reduced immediately before eculizumab infusion, revealing impairments in the Acyl CoA metabolism, and reached levels similar to those in the healthy controls 24 hours after infusion. CONCLUSIONS We demonstrated significant differences in the metabolomes of the PNH patients compared to healthy controls. Eculizumab infusion seemed to improve deficiencies in the acyl CoA metabolism and may have a role in the mitochondrial oxidative process of long and medium-chain fatty acids, reducing oxidative stress, and inflammation.
Collapse
Affiliation(s)
| | - Ana Rita Fonseca
- Hematology Division, Universidade Federal de São Paulo, São Paulo, Brazil
- Oncology Department, Hospital Sírio Libanês, São Paulo, Brazil
| | | | | | - Dirce Maria Marchioni
- Nutrition Department, School of Public Health, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - David Michonneau
- Hematology and Bone Marrow Transplant Department of the Saint-Louis Hospital, Paris, France
| | - Celso Arrais-Rodrigues
- Hematology Division, Universidade Federal de São Paulo, São Paulo, Brazil
- Hematology Department, Hospital Nove de Julho, DASA, São Paulo, Brazil
| |
Collapse
|
7
|
Silva VC, Gorgulho B, Marchioni DM, Alvim SM, Giatti L, de Araujo TA, Alonso AC, Santos IDS, Lotufo PA, Benseñor IM. Recommender System Based on Collaborative Filtering for Personalized Dietary Advice: A Cross-Sectional Analysis of the ELSA-Brasil Study. Int J Environ Res Public Health 2022; 19:14934. [PMID: 36429651 PMCID: PMC9690822 DOI: 10.3390/ijerph192214934] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/06/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to predict dietary recommendations and compare the performance of algorithms based on collaborative filtering for making predictions of personalized dietary recommendations. We analyzed the baseline cross-sectional data (2008-2010) of 12,667 participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The participants were public employees of teaching and research institutions, aged 35-74 years, and 59% female. A semiquantitative Food Frequency Questionnaire (FFQ) was used for dietary assessment. The predictions of dietary recommendations were based on two machine learning (ML) algorithms-user-based collaborative filtering (UBCF) and item-based collaborative filtering (IBCF). The ML algorithms had similar precision (88-91%). The error metrics were lower for UBCF than for IBCF: with a root mean square error (RMSE) of 1.49 vs. 1.67 and a mean square error (MSE) of 2.21 vs. 2.78. Although all food groups were used as input in the system, the items eligible as recommendations included whole cereals, tubers and roots, beans and other legumes, oilseeds, fruits, vegetables, white meats and fish, and low-fat dairy products and milk. The algorithms' performances were similar in making predictions for dietary recommendations. The models presented can provide support for health professionals in interventions that promote healthier habits and improve adherence to this personalized dietary advice.
Collapse
Affiliation(s)
- Vanderlei Carneiro Silva
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Bartira Gorgulho
- Department of Food and Nutrition, School of Nutrition, Federal University of Mato Grosso, Cuiaba 78060-900, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Sheila Maria Alvim
- Institute of Collective Health, Federal University of Bahia, Salvador 40110-040, Brazil
| | - Luana Giatti
- Department of Social and Preventive Medicine, Faculty of Medicine & Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil
| | - Tânia Aparecida de Araujo
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Angelica Castilho Alonso
- Laboratory of the Study of Movement, Faculty of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Itamar de Souza Santos
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Paulo Andrade Lotufo
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Isabela Martins Benseñor
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| |
Collapse
|
8
|
Levy J, Silva AM, De Carli E, Cacau LT, de Alvarenga JFR, Fiamoncini J, Benseñor IM, Lotufo PA, Marchioni DM. Biomarkers of Fruit Intake Using a Targeted Metabolomics Approach: an Observational Cross-Sectional Analysis of the ELSA-Brasil Study. J Nutr 2022; 152:2023-2030. [PMID: 35641174 DOI: 10.1093/jn/nxac115] [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: 12/06/2021] [Revised: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Advances in technology have led to the identification of a greater number of metabolites related to diet. Although fruit intake biomarkers have been reported in some studies, these findings require further replication, considering the relevance of fruits for diet quality and health. OBJECTIVES The aim of this study was to explore the associations of a set of potential urinary biomarkers of diet, assessed using a targeted metabolomics approach, with self-reported fruit intake data in participants of a computer-assisted 24-h dietary recall (GloboDiet software) validation study. METHODS A total of 93 individuals aged 43-72 y, 54% female, participated in this study. The subjects were a subsample of the Longitudinal Study of Adult Health (ELSA-Brasil). A 24-h dietary recall was obtained with the aid of GloboDiet software matching a 24-h urine sample from each participant. Candidate biomarkers were selected in a literature search and identified in urine by LC coupled to high-resolution MS. Spearman correlation analyses were performed between fruit intake and each biomarker. RESULTS Spearman correlation analysis showed that total fruits intake was significantly correlated with citric acid (ρ = 0.213, P = 0.041), ferulic acid sulfate I (ρ = 0.240, P = 0.020), hesperetin glucuronide/homoeriodictyol glucuronide (ρ = 0.303, P = 0.003), hydroxyhippuric acid (ρ = 0.239, P = 0.021), homovanillic alcohol sulfate (ρ = 0.339, P = 0.001), methylgallic acid sulfate (ρ = 0.268, P = 0.009), naringenin glucuronide (NG; ρ = 0.278, P = 0.007), proline betaine (PB; ρ = 0.305, P = 0.003), syringic acid sulfate (ρ = 0.210, P = 0.044), and sinapic acid sulfate (ρ = 0.412, P < 0.001). Among them, 3 have been described in literature as promising biomarkers for intake of total fruit, oranges, and citrus fruit: NG, hesperetin glucuronide, and PB. CONCLUSIONS Associations of total fruits intake with urinary measurements indicate the potential usefulness of dietary biomarkers in the Brazilian population as a complement to self-reported dietary assessments.
Collapse
Affiliation(s)
- Jessica Levy
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Alexsandro Macedo Silva
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Eduardo De Carli
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - José Fernando Rinaldi de Alvarenga
- Food Research Center (FoRC), Department of Food and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Jarlei Fiamoncini
- Food Research Center (FoRC), Department of Food and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Isabela Martins Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
9
|
Pequeno NPF, Cabral NLDA, Oliveira ÂGRC, Crispim SP, Rocha C, Marchioni DM, Lima SCVC, Lyra CDO. Chronic diseases and emotional disorders are associated with low perception of quality of life in food insecurity/security. Front Public Health 2022; 10:893601. [PMID: 35923966 PMCID: PMC9340216 DOI: 10.3389/fpubh.2022.893601] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Understanding individual perception of Quality of Life (QoL) can help combat social and health inequalities. We aimed to identify factors associated with Low Perceived Quality of Life (LPQoL) in 295 adults and older adults with food security and food insecurity, in the city of Natal, Brazil. A cross-sectional study was conducted from June to December 2019, with collection of data on socioeconomic demographic status, lifestyle information, non-communicable diseases (NCDs) and risk factors, emotional disorders, food (in) security and quality of life. To assess food insecurity, the Brazilian Scale of Food Insecurity—EBIA was used, and the WHOQOL-Bref questionnaire was used to assess quality of life. Poisson's Regression was used to verify associations between variables and LPQoL, stratifying the sample into food secure (FS) and food insecure (FI) groups. In the FI group, being overweight, older adult, having no partner, drinking alcoholic beverages twice a week or more, and not having daily availability of water were associated with LPQoL, and in the FS group, having diabetes, monthly family income in the 1st and 2nd tertiles, and never having studied was associated with LPQoL. Reporting emotional disorders and sleeping < 7 h/day were associated with LPQoL in both FI and FS groups. LPQoL was associated with the occurrence of NCDs and risk factors, and emotional disorders, regardless of the food security measure. However, the lack of adequate access to water highlights the social vulnerability of the FI group.
Collapse
Affiliation(s)
- Nila Patrícia Freire Pequeno
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
- *Correspondence: Nila Patrícia Freire Pequeno
| | - Natália Louise de Araújo Cabral
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Federal Institute of Education, Science and Technology of Sertão Pernambucano, Petrolina, Brazil
| | | | | | - Cecília Rocha
- School of Nutrition, Centre for Studies in Food Security, Ryerson University, Toronto, ON, Canada
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Clélia de Oliveira Lyra
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
10
|
Nunes FLDS, Lima SCVC, Lyra CDO, Marchioni DM, Pedrosa LFC, Barbosa Junior F, Sena-Evangelista KCM. The impact of essential and toxic elements on cardiometabolic risk factors in adults and older people. J Trace Elem Med Biol 2022; 72:126991. [PMID: 35597099 DOI: 10.1016/j.jtemb.2022.126991] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/23/2021] [Revised: 04/06/2022] [Accepted: 05/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Evidence suggests an association between essential and toxic elements and the worsening of cardiometabolic risk factors. This study aimed to investigate the concentrations of zinc, copper, selenium, arsenic, cadmium, and mercury and their relationship with cardiometabolic risk factors in adults and older people. METHODS This cross-sectional study was carried out with 112 adults with a mean age of 59 (sd 14) years old and a BMI of 29.30 (sd 5.11) Kg/m2. The subject's weight and height were measured for body mass index (BMI) calculation, classified according to the cut-off points recommended by the World Health Organization (WHO). We evaluated sociodemographic, clinical, lifestyle, waist circumference - WC, visceral adiposity index - VAI, glycemic lipid profile, blood pressure, and high-sensitive C-reactive protein (hs-CRP). Cardiovascular risk was defined by The Global Risk Score (GRS) score. Plasma zinc, selenium, copper levels, urinary arsenic, cadmium, and mercury levels were measured using the inductively coupled plasma mass spectrometry technique (ICP-MS). RESULTS There was a negative association between urinary arsenic and VAI (β - 0.03, p < 0.01), triglycerides (β - 1.10, p < 0.01), and VLDL cholesterol (β - 0.14, p = 0.02). Plasma copper and copper/zinc ratio were positively associated with fasting glucose and hs-CRP (β 0.38, p < 0.01; β 36.02, p = 0.01, β 0.004, p < 0.01, β 0.68, p < 0.001, respectively). Urinary arsenic (β - 0.14, p = 0.04) and cadmium (β - 36.42, p = 0.04) were negatively associated with systolic blood pressure. Also, urinary cadmium was negatively associated with diastolic blood pressure (β - 21.55, p = 0.03), and urinary mercury showed an opposite behavior (β 1.45, p = 0.03). CONCLUSION Essential and toxic elements in urine and plasma could be potential biomarkers for cardiovascular risk factors. A healthy lifestyle should be adopted; in addition, government policies should be developed to guarantee sustainable production and a safe environment.
Collapse
Affiliation(s)
- Francisca Leide da Silva Nunes
- Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000 - Lagoa Nova, 59078-900 Natal, Rio Grande do Norte, Brazil.
| | - Severina Carla Vieira Cunha Lima
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000 - Lagoa Nova, 59078-900 Natal, Rio Grande do Norte, Brazil.
| | - Clélia de Oliveira Lyra
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000 - Lagoa Nova, 59078-900 Natal, Rio Grande do Norte, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo Campus, Av. Dr. Arnaldo, 715 - Cerqueira César, 01246-904 São Paulo, SP, Brazil.
| | - Lucia Fatima Campos Pedrosa
- Department of Nutrition, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 3000 - Lagoa Nova, 59078-900 Natal, Rio Grande do Norte, Brazil.
| | - Fernando Barbosa Junior
- Laboratory of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto Campus, Av. do Café, s/n - Monte Alegre, Ribeirão Preto, 14040-903 São Paulo, SP, Brazil.
| | | |
Collapse
|
11
|
de Medeiros MFA, Silva SGB, Teixeira CD, Lima SCVC, Marchioni DM, Jacob MCM. Assessment of Biodiversity in Food Consumption Studies: A Systematic Review. Front Nutr 2022; 9:832288. [PMID: 35774537 PMCID: PMC9237621 DOI: 10.3389/fnut.2022.832288] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
The assessment of food biodiversity has gained importance in nutrition due to the positive association between the diversity of foods consumed and the quality of diets. To date, however, we do not know systematically how food consumption studies address food biodiversity. Our objective with this paper was to characterize how food consumption studies address biodiverse foods, both in terms of (i) new methods capable of overcoming the limitations of existing methods, and (ii) indicators capable of measuring the contribution of biodiversity to nutrition. We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), using four databases: Web of Science, Medline/PubMed (via National Library of Medicine), Scopus, and Google Scholar. We selected papers focused on the consumption of biodiverse foods without time constraints. In addition, we assessed the methodological quality of the studies we selected. We reviewed a total of 22 studies, and summarized the methods and indicators most used. We found that some researchers used biodiversity mapping strategies based on ethnographic approaches before the dietary assessment. Regarding dietary assessment tools, retrospective direct methods were the most used by researchers. We list 23 indicators used by the authors, among them the Dietary Species Richness (DSR), used in 18% of the studies. Studies that used biodiversity mapping strategies based on ethnographic approaches before the dietary assessment portrayed the local availability of biodiverse foods more consistently, i.e., presented lists with local edible species satisfactorily identified. We believe researchers in the future can avoid many of the limitations of current methods by ensuring that teams are interprofessional. We emphasize that most of the indicators we summarized are not sensitive enough to biodiversity since they do not measure edible resources at the species level. In this sense, the DSR is promising, because it fills information gaps, especially in the case of wild or neglected species.
Collapse
Affiliation(s)
| | | | - Carla Djaine Teixeira
- Graduate Program in Social Sciences, Center for Human Sciences, Letters and Arts, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Dirce Maria Marchioni
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | |
Collapse
|
12
|
Cacau LT, Marcadenti A, Bersch-Ferreira AC, Weber B, de Almeida JC, Rodrigues CCR, Lotufo PA, Bensenor IM, Marchioni DM. The AHA Recommendations for a Healthy Diet and Ultra-Processed Foods: Building a New Diet Quality Index. Front Nutr 2022; 9:804121. [PMID: 35479734 PMCID: PMC9036106 DOI: 10.3389/fnut.2022.804121] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
The American Heart Association (AHA) has developed the concept of “ideal cardiovascular health” (ICH), a seven-component score, which includes health dietary metrics. Higher ultra-processed foods intake is related with several cardiometabolic and cardiovascular diseases. We propose to develop and validate the Cardiovascular Health Diet Index (CHDI), a diet quality index that combines the AHA's recommendations of a healthy diet for cardiovascular health and ultra-processed foods. We used dietary data obtained through a 114-item FFQ from 14,779 participants of the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil). The CHDI had 11 components and a total score ranging from 0 to 110 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, means differences between groups (for example, smokers vs. non-smokers), Cronbach's alpha, and linear regression analyses between CHDI and overall dietary quality. The mean CHDI was 57.1 points (95% CI 47.9:66.0). The CHDI had four dimensions; in addition, it was associated with nutrients related to cardiovascular health, and the points were significantly (p < 0.001) lower in smokers (52.1) than in non-smokers (57.8). Cronbach's alpha value was 0.50. After age and sex adjustment, the CHDI score remained associated with a higher overall dietary quality (β 0.87, 95%CI 0.84:0.89, p < 0.001). The CHDI proved to be valid and reliable for use, in addition to being associated with higher overall dietary quality. The use of CHDI is expected to assess the population's compliance with dietary recommendations for promoting cardiovascular health and preventing cardiovascular disease.
Collapse
Affiliation(s)
- Leandro Teixeira Cacau
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Aline Marcadenti
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
- Instituto de Pesquisa, Hospital do Coração, São Paulo, Brazil
- Programa de Pós-Graduação em Ciências da Saúde (Cardiologia), Intituto de Cardiologia/Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Jussara Carnevale de Almeida
- Departamento de Nutrição, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cíntia Corte Real Rodrigues
- Departamento de Nutrição, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Nutrição e Dietética, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Paulo Andrade Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Martins Bensenor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
- *Correspondence: Dirce Maria Marchioni
| |
Collapse
|
13
|
Cacau LT, Marchioni DM. The Planetary Health Diet Index scores proportionally and considers the intermediate values of the EAT-Lancet reference diet. Am J Clin Nutr 2022; 115:1237. [PMID: 35362057 DOI: 10.1093/ajcn/nqac006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Leandro Teixeira Cacau
- From the Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- From the Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
14
|
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: 17] [Impact Index Per Article: 8.5] [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: 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.
Collapse
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;
| |
Collapse
|
15
|
Silva VC, Gorgulho B, Marchioni DM, Araujo TAD, Santos IDS, Lotufo PA, Benseñor IM. Clustering Analysis and Machine Learning algorithms in the prediction of dietary patterns: Cross-sectional results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Hum Nutr Diet 2022; 35:883-894. [PMID: 35043491 DOI: 10.1111/jhn.12992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 07/25/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Machine learning investigates how computers can automatically learn. This study aimed to predict dietary patterns and compare algorithm performance in making predictions of dietary patterns. METHODS We analyzed the data of public employees (n=12,667) participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The K-means clustering algorithm and six other classifiers (support vector machines, naïve Bayes, K-nearest neighbors, decision tree, random forest, and xgboost) were used to predict the dietary patterns. RESULTS K-means clustering identified two dietary patterns. Cluster 1, labeled the Western pattern, was characterized by a higher energy intake and consumption of refined cereals, beans and other legumes, tubers, pasta, processed and red meats, high-fat milk and dairy products, and sugary beverages; Cluster 2, labeled the Prudent pattern, was characterized by higher intakes of fruit, vegetables, whole cereals, white meats, and milk and reduced-fat milk derivatives. The most important predictors were age, sex, per capita income, education level, and physical activity. The accuracy of the models varied from moderate to good (69-72%). CONCLUSIONS The algorithms' performance in dietary pattern prediction was similar, and the models presented may provide support in screener tasks and guide health professionals in the analysis of dietary data. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Vanderlei Carneiro Silva
- Department of Epidemiology, School of Public Health, University of São Paulo, Brazil.,Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Bartira Gorgulho
- Department of Food and Nutrition, School of Nutrition, Federal University of Mato Grosso, Brazil
| | | | | | - Itamar de Souza Santos
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Isabela Martins Benseñor
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| |
Collapse
|
16
|
Verly E, Marchioni DM, Araujo MC, Carli ED, de Oliveira DCRS, Yokoo EM, Sichieri R, Pereira RA. Evolution of energy and nutrient intake in Brazil between 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:5s. [PMID: 34910054 PMCID: PMC9586436 DOI: 10.11606/s1518-8787.2021055003343] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess the evolution of energy and nutrient intake and the prevalence of inadequate micronutrients intakes according to sociodemographic characteristics and Brazilian regions. METHODS The food consumption of 32,749 individuals from the National Dietary Survey of the Household Budget Survey 2008-2009 was analyzed by two food registries, as well as 44,744 subjects from two 24-hour recalls in 2017-2018. Usual intake and percentage of individuals with consumption below the average recommendation for calcium, magnesium, phosphorus, copper and zinc, vitamins A, C, D, E, thiamine, riboflavin, pyridoxine and cobalamin were estimated. Sodium intake was compared to the reference value to reduce the risk of chronic diseases. Analyses were stratified by sex, age group, region and income. RESULTS Mean daily energy intake was 1,753 kcal in 2008-2009 and 1,748 kcal in 2017-2018. The highest prevalence of inadequacy (> 50%) in the two periods were calcium; magnesium; vitamins A, D and E; pyridoxine and, only among adolescents, phosphorus. There was an increase in the prevalence of inadequate vitamin A, riboflavin, cobalamin, magnesium, and zinc among women, and riboflavin among men. The prevalence of inadequacy decreased for thiamine. Sodium intake was excessive in approximately 50% of the population in both periods. The highest variations (about 50%) in the prevalence of inadequacy between the lowest and highest income (< 0.5 minimum wage and > 2 minimum wages per capita) were observed for vitamin B12 and C in both periods. The North and Northeast regions had the highest prevalence of inadequacy. CONCLUSION Both surveys found high prevalence of inadequate nutrient intake and excessive sodium intake. The inadequacy varies according to income strata, increasing in the poorest regions of the country.
Collapse
Affiliation(s)
- Eliseu Verly
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dirce Maria Marchioni
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Marina Campos Araujo
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartamento de Epidemiologia e Métodos Quantitativos em SaúdeRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
| | - Eduardo De Carli
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Dayan Carvalho Ramos Salles de Oliveira
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal FluminenseInstituto de Saúde ColetivaDepartamento de Epidemiologia e BioestatísticaNiteróiRJBrasilUniversidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroDepartamento de Nutrição Social e AplicadaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
| |
Collapse
|
17
|
Antunes ABS, Cunha DB, Baltar VT, Steluti J, Pereira RA, Yokoo EM, Sichieri R, Marchioni DM. Dietary patterns of Brazilian adults in 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:8s. [PMID: 34852165 PMCID: PMC8647980 DOI: 10.11606/s1518-8787.2021055003437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To identify dietary patterns among Brazilian adults based on the National Dietary Surveys (INA - Inquéritos Nacionais de Alimentação) in 2008-2009 and 2017-2018, and to verify in the second period the adherence to the patterns according to sociodemographic factors and Brazilian regions. METHODS We analyzed the first of two days of adults' food consumption (19-59 years) in INA data from 2008-2009 (n = 21,630) and 2017-2018 (n = 28,901). Dietary patterns were derived by exploratory factor analysis from 19 food groups, considering the complexity of the sample design. We evaluated the factor scores according to sex, age group, region, per capita income, and education for the INA data in 2017-2018. RESULTS We identified three patterns in the two surveys: (1) "traditional", characterized by rice, beans, and meat; (2) "breads and butter/margarine", characterized by breads, oils, and fats (including margarine/butter) and, coffee and teas in 2008-2009; and (3) "western", characterized by sodas, pizzas, snacks, flour, pasta, and sweets in 2017-2018. The "traditional" pattern had greater adherence among men, residents of the Midwest region and individuals with incomplete primary education. "Bread and butter/margarine" pattern had greater adherence among males, individuals aged between 40 and 59 years, from the Southeast region, and with income between 1 and 2 minimum wages per capita. Male individuals, aged between 19 and 39 years, from the South region, with per capita income greater than two minimum wages, and education level equal to or greater than primary education showed greater adherence to the "western" pattern. CONCLUSION The dietary patterns identified in 2008-2009 and 2017-2018 were similar, and we observed the maintenance of the "traditional" pattern, which includes rice, beans, and meat. Adherence to the dietary patterns varies according to sex, age group, region, per capita income, and education level.
Collapse
Affiliation(s)
- Anna Beatriz Souza Antunes
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Programa de Pós-Graduação em Saúde Coletiva. Rio de Janeiro, RJ, Brasil
| | - Diana Barbosa Cunha
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Valéria Troncoso Baltar
- Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Josiane Steluti
- Universidade Federal de São Paulo. Instituto de Saúde e Sociedade. Departamento de Políticas Públicas e Saúde Coletiva. Santos, SP, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dirce Maria Marchioni
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| |
Collapse
|
18
|
Machado AD, Bertolini AM, Brito LDS, Amorim MDS, Gonçalves MR, Santiago RDAC, Marchioni DM, Carvalho AMD. The role of the Brazilian Unified Health System in combating the global syndemic and in the development sustainable food systems. Cien Saude Colet 2021; 26:4511-4518. [PMID: 34730639 DOI: 10.1590/1413-812320212610.11702021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/28/2021] [Indexed: 11/21/2022] Open
Abstract
The undernutrition and obesity pandemics associated with climate change are a global syndemic. They have a point of convergence, which is the unsustainable current food systems. This paper aims to discuss the role of public health policies, particularly the Brazilian Unified Health System (SUS) in the context of Primary Health Care, in combating the global syndemic and in the development of sustainable food systems. In this scenario, the National Food and Nutrition Policy is a leading intersectoral tool for an adequate and healthy diet and food and nutrition security. Also, the Dietary Guidelines for the Brazilian population is a strategic tool to support food and nutrition education. We highlight the need to articulate health, agriculture, and environmental policies to achieve sustainable development. Thus, SUS can be the arena to promote the main discussions on this topic, potentiating individual, group, and institutional actions to provide a fairer, healthy, and sustainable food system.
Collapse
Affiliation(s)
- Alisson Diego Machado
- Departamento de Clínica Médica, Disciplina de Nefrologia, Faculdade de Medicina, Universidade de São Paulo. Av. Dr. Enéas de Carvalho Aguiar 255 sala 7115, Cerqueira César. 05403-000 São Paulo SP Brasil.
| | - Ana Maria Bertolini
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | | | | | - Mônica Rocha Gonçalves
- Núcleo de Apoio às Atividades de Cultura e Extensão Sustentarea, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | | | - Dirce Maria Marchioni
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Aline Martins de Carvalho
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| |
Collapse
|
19
|
Cacau LT, Benseñor IM, Goulart AC, Cardoso LO, Lotufo PA, Moreno LA, Marchioni DM. Adherence to the Planetary Health Diet Index and Obesity Indicators in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Nutrients 2021; 13:3691. [PMID: 34835947 PMCID: PMC8625681 DOI: 10.3390/nu13113691] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/23/2022] Open
Abstract
The EAT-Lancet Commission has proposed a model diet to improve the health of human beings and that of the planet. Recently, we proposed the Planetary Health Diet Index (PHDI) to assess adherence of the population to this model diet. In this study, we aimed to evaluate adherence to the PHDI and obesity outcomes using baseline data from 14,515 participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The dietary data were assessed using a 114-item FFQ. Body mass index (BMI) and waist circumference (WC) were both used continuously and categorized. Linear and multinomial regression models adjusted for potential confounding factors were performed to assess the relationship between adherence to PHDI and outcomes. An inverse association was observed between adherence to PHDI and obesity indicators. Individuals with high adherence to the PHDI had lower BMI (β-0.50 95% CI-0.73:-0.27) and WC (β-1.70 95% CI-2.28:-1.12) values. They were also 24% less likely to be overweight (OR 0.76 95% CI 0.67:0.85) or obese (OR 0.76 95% CI 0.65:0.88), and they were 14% and 27% less likely to have increased WC (OR 0.86 95% CI 0.75:0.98) or substantially increased WC (OR 0.73 95% CI 0.64:0.83) than those with lower adherence. Our results showed that higher adherence to the PHDI may decrease obesity indicators.
Collapse
Affiliation(s)
- Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (D.M.M.)
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Isabela Martins Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil; (I.M.B.); (A.C.G.); (P.A.L.)
- Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Alessandra Carvalho Goulart
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil; (I.M.B.); (A.C.G.); (P.A.L.)
| | | | - Paulo Andrade Lotufo
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil; (I.M.B.); (A.C.G.); (P.A.L.)
- Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón, 50009 Zaragoza, Spain
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (D.M.M.)
| |
Collapse
|
20
|
Gorgulho B, Alves MA, Teixeira JA, Santos RO, de Matos SA, Bittencourt MS, Benseñor I, Lotufo P, Marchioni DM. Dietary patterns associated with subclinical atherosclerosis: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) study. Public Health Nutr 2021; 24:5006-5014. [PMID: 33413712 PMCID: PMC11082815 DOI: 10.1017/s1368980020005340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 02/07/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify dietary patterns associated with subclinical atherosclerosis measured as coronary artery calcification (CAC). DESIGN Cross-sectional analysis of data from the Brazilian Longitudinal Study of Adult Health. Dietary data were assessed using a FFQ, and a principal component factor analysis was used to derive the dietary patterns. Scree plot, eigenvalues > 1 and interpretability were considered to retain the factors. CAC was measured using a computed tomography scanner and an electrocardiography-gated prospective Ca score examination and was categorised into three groups based on the CAC score: 0, 1-100 and >100 Agatston units. Multinomial regression models were conducted for dietary patterns and CAC severity categories. SETTING Brazil, São Paulo, 2008-2010. PARTICIPANTS Active and retired civil servants who lived in São Paulo and underwent a CAC exam were included (n 4025). RESULTS Around 10 % of participants (294 men, 97 women) had a detectable CAC (>0), 6·5 % (182 men, 73 women) had a CAC of 1-100 and 3·5 % (110 men, 23 women) had a CAC > 100. Three dietary patterns were identified: convenience food, which was positively associated with atherosclerotic calcification; plant-based and dairy food, which showed no association with CAC; and the traditional Brazilian food pattern (rice, legumes and meats), which was inversely associated with atherosclerotic calcification. CONCLUSIONS Our results showed that a dietary pattern consisting of traditional Brazilian foods could be important to reducing the risk of atherosclerotic calcification and prevent future cardiovascular events, whereas a convenience dietary pattern was positively associated with this outcome.
Collapse
Affiliation(s)
- Bartira Gorgulho
- Department of Food and Nutrition, School of Nutrition, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | - Mariane A Alves
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| | - Juliana A Teixeira
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| | - Roberta O Santos
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| | | | - Marcio Sommer Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Isabela Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Paulo Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 – Cerqueira César, São Paulo – SP, CEP 01246-904, Brazil
| |
Collapse
|
21
|
Miranda AM, Goulart AC, Benseñor IM, Lotufo PA, Marchioni DM. Moderate coffee consumption is associated with lower risk of mortality in prior Acute Coronary Syndrome patients: a prospective analysis in the ERICO cohort. Int J Food Sci Nutr 2020; 72:794-804. [PMID: 33349068 DOI: 10.1080/09637486.2020.1862069] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined the association between coffee consumption and all-cause mortality in patients with a prior acute myocardial infarction or unstable angina. Data were from the prospective study ERICO, totalising 928 patients with Acute Coronary Syndrome (ACS). During 4 years' follow-up, a total of 111 deaths occurred. Moderate coffee consumption (1-2 and 2-3 cups/day) was inversely associated with total mortality (HR 0.13, 95% CI: 0.06-0.29 and 0.22, 95% CI: 0.13-0.39, respectively). For patients with higher coffee consumption (>3 cups/day), there was a positive association with mortality (HR 2.12, 95% CI: 1.06-4.24). After stratification by smoking status, the analysis revealed lower risk of mortality in never and former smokers, drinking 1-2 and 2-3 cups/day. Among current smokers there was a positive association between >3 cups/day and mortality. The moderate consumption of coffee was associated with lower risk of all-cause mortality in patients with a prior ACS, particularly in non-smokers.
Collapse
Affiliation(s)
| | | | - Isabela Martins Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, SP, Brazil.,School of Medicine, University of São Paulo, SP, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, SP, Brazil.,School of Medicine, University of São Paulo, SP, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil
| |
Collapse
|
22
|
Carioca AAF, Steluti J, Carvalho AMD, Silva AM, Silva IDCGD, Fisberg RM, Marchioni DM. Plasma metabolomics are associated with metabolic syndrome: A targeted approach. Nutrition 2020; 83:111082. [PMID: 33360505 DOI: 10.1016/j.nut.2020.111082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/28/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Advances in metabolomic tools have allowed us to gain a more comprehensive understanding of metabolic syndrome (MetS). The aim of this study was to evaluate the association between plasma metabolomic profiles and MetS. METHODS For this study, adults without diabetes, chronic kidney disease, stroke, heart disease, or cancer and with full metabolomics, biochemical, and dietetic data available, representing a subsample of the Health Survey of Sao Paulo study (ISA-Capital; N = 130), were included. The joint interim statement consensus criteria were used for diagnosing MetS. Absolute quantification (µmol/L) of blood metabolites was achieved by targeted quantitative profiling of annotated metabolites by electrospray ionization tandem mass spectrometry in plasma samples. Mean differences in the compounds for MetS were evaluated by linear regression adjusted for confounding factors. RESULTS Serine was inversely associated with MetS (β = -15.04; P = 0.014). In glycerophospholipids with acyl-alkyl bonds, there was an inverse association with MetS, including phosphatidylcholine (PC) ae C42:5 (β = -0.15; P = 0.040), PC ae C44:5 (β = -0.15; P = 0.046), PC ae C40:4 (β = -0.21; P = 0.014) and PC ae C44:4 (β = -0.04; P = 0.032). CONCLUSION Plasma metabolomic profiles were associated with MetS, especially the amino acid serine and some acyl-alkyl PCs.
Collapse
Affiliation(s)
- Antonio Augusto Ferreira Carioca
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil; University of Fortaleza (UNIFOR), Nutrition Course, Fortaleza, Brazil.
| | - Josiane Steluti
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil
| | | | | | | | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil
| |
Collapse
|
23
|
Silva DFO, Lima SCVC, Sena-Evangelista KCM, Marchioni DM, Cobucci RN, de Andrade FB. Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review. Nutrients 2020; 12:E2956. [PMID: 32992538 PMCID: PMC7599513 DOI: 10.3390/nu12102956] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/17/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants' ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19.
Collapse
Affiliation(s)
| | | | | | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo—USP, São Paulo 05410-020, Brazil;
| | - Ricardo Ney Cobucci
- Postgraduate Program in Biotechnology, Potiguar University—UnP, Natal 59056-000, Brazil;
| | - Fábia Barbosa de Andrade
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte—UFRN, Natal 59056-000, Brazil
| |
Collapse
|
24
|
Pequeno NPF, Cabral NLDA, Marchioni DM, Lima SCVC, Lyra CDO. Quality of life assessment instruments for adults: a systematic review of population-based studies. Health Qual Life Outcomes 2020; 18:208. [PMID: 32605649 PMCID: PMC7329518 DOI: 10.1186/s12955-020-01347-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 04/01/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Against a backdrop of population aging and improving survival rates for chronic noncommunicable diseases (CNCD), researchers are placing growing emphasis on health-related quality of life (HRQoL). The aim of this study was to identify the QoL assessment instruments used in population-based studies with adults conducted around the world. METHODS A systematic review of original research published in all languages between 2008 and 2018 was conducted. Systematic reviews and meta-analyses were excluded. RESULTS Sixty-three articles (38.1% conducted in the Americas) fitted the eligibility criteria. Based on the AHRQ checklist for cross-sectional studies and the Newcastle-Ottawa scale for cohort studies, methodological quality was shown to be fair in the majority of studies (55.6%) and good in 44.4%. The country with the highest number of publications was Brazil (20.6%). Twelve types of generic instruments and 11 specific instruments were identified. The generic instrument SF-36 was the most frequently used measure (33.3% of studies). In-home interviewing was exclusively used by 47.6% of the studies, while 39 studies (61.9%) reported the use of self-administered questionnaires. Over two-thirds of the studies (34.9%) used questionnaires to investigate the association between chronic diseases and/or associated factors. CONCLUSIONS It was concluded that the wide range of instruments and modes of questionnaire administration used by the studies may hinder comparisons between population groups with the same characteristics or needs. There is a lack of research on QoL and the factors affecting productive capacity. Studies of QoL in older persons should focus not only on the effects of disease and treatment, but also on the determinants of active aging and actions designed to promote it. Further research is recommended to determine which QoL instruments are best suited for population-based studies.
Collapse
Affiliation(s)
- Nila Patrícia Freire Pequeno
- Postgraduate Program in Public Health at the Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, Brazil.
- Department of Nutrition at the Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, CEP 59078-970, Brazil.
| | - Natália Louise de Araújo Cabral
- Postgraduate Program in Public Health at the Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition of the School of Public Health at the University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, Brazil
| | - Severina Carla Vieira Cunha Lima
- Department of Nutrition at the Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, CEP 59078-970, Brazil
| | - Clélia de Oliveira Lyra
- Department of Nutrition at the Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, CEP 59078-970, Brazil
| |
Collapse
|
25
|
Miranda AM, Goulart AC, Benseñor IM, Lotufo PA, Marchioni DM. Coffee consumption and risk of hypertension: A prospective analysis in the cohort study. Clin Nutr 2020; 40:542-549. [PMID: 32576389 DOI: 10.1016/j.clnu.2020.05.052] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 02/05/2020] [Revised: 05/20/2020] [Accepted: 05/28/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Coffee is one of the most widely consumed beverages around the world. Dietary habits, specifically, coffee consumption has long been a suspected cause of hypertension. However, previous findings on coffee consumption and its association with the incidence of hypertension are not homogeneous and still inconsistent. PURPOSE To examine the association of habitual coffee consumption with the risk of developing hypertension in a middle-aged Brazilian cohort. METHODS Data were from the multicenter prospective cohort "Brazilian Longitudinal Study for Adult Health - ELSA-Brasil". The cohort comprises 15,105 civil servants, aged 35-74 years at baseline, who were sampled from universities located in six Brazilian cities. For the present study, we analyzed data from 8780 participants initially free of hypertension during a mean follow-up of 3.9 years. The consumption of coffee was obtained at baseline using a previously validated semi-quantitative food frequency questionnaire (FFQ). Subsequently coffee intake was categorized into four categories (cups/day): never/almost never, ≤1, 1-3, and >3. Hypertension status was defined as a systolic blood pressure ≥140 mmHg or a diastolic blood pressure ≥90 mmHg, use of antihypertensive drug treatment, or both. Poisson regression model with a robust variance was performed to estimate relative risk (RR) and confidence interval (95% CI) for hypertension according to baseline coffee consumption. The effect of interaction between coffee consumption and smoking status was assessed. RESULTS Most participants (90%) drank coffee, and the median total coffee intake was 150 mL/day. A total of 1285 participants developed hypertension. Compared to participants who never or almost never drink coffee, the risk of hypertension was lower for individuals consuming 1-3 cups/day (RR 0.82, 95% CI: 0.68-0.97) (P for interaction=0.018). After stratification by smoking status the analysis revealed a decreased risk of hypertension in never smokers drinking 1-3 cups of coffee per day (RR 0.79, 95% CI: 0.64-0.98), whereas the hypertension risk among former and current smokers was not associated with coffee consumption significantly. Moreover, upper category of coffee drinking (>3 cups/day) the association was not significant for risk of hypertension. CONCLUSION The association between coffee consumption and incidence of hypertension was related to smoking status. The beneficial effect of moderate coffee intake (1-3 cups/day) on risk of hypertension was observed only in never smokers.
Collapse
Affiliation(s)
| | - Alessandra C Goulart
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, SP, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, SP, Brazil; School of Medicine, University of São Paulo, SP, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, SP, Brazil; School of Medicine, University of São Paulo, SP, Brazil
| | | |
Collapse
|
26
|
Steluti J, Crispim SP, Araujo MC, Peralta AM, Pereira RA, Sichieri R, Yokoo EM, Marchioni DM. Technology in Health: Brazilian version of the GloboDiet program for dietary intake assessment in epidemiological studies. Rev Bras Epidemiol 2020; 23:e200013. [PMID: 32159624 DOI: 10.1590/1980-549720200013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/10/2019] [Indexed: 11/22/2022] Open
Abstract
The 24-hour recall (R24h) has been the method for dietary assessment in surveys. Technological advances have allowed the development of a program for the collection of R24h data. International Agency for Research on Cancer-World Health Organization (IARC-WHO) developed a standardized interview and computer-based 24-hour dietary recall program called GloboDiet, aimed at using it in research and nutrition surveillance. Brazil was included in a project for the global expansion of this methodology for developing and adapting a version for national use. The adaptation followed the procedures established by the IARC-WHO that considered the translation and adaptation of approximately 70 databases. For the development of the food list, national databases of food consumption from national surveys were consulted obtaining a final list of 2113 foods and recipes. GloboDiet program guides an interview in five steps: general information of the participant; quick list of foods and recipes; details of food / recipes and quantities consumed using mainly a picture book; control of the amount of food and nutrients; and information on dietary supplements. The Brazilian version of the GloboDiet program will provide a more accurate assessment of food intake based on a standardized method for nutrition surveillance and investigation of the relationship between diet and health outcomes, as well as comparisons of dietary intakes within and between countries.
Collapse
Affiliation(s)
- Josiane Steluti
- Instituto de Saúde e Sociedade, Universidade Federal de São Paulo - Santos (SP), Brasil.,Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Marina Campos Araujo
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Ministério da Saúde - Rio de Janeiro (RJ), Brasil
| | - Aline Mendes Peralta
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Rosangela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Rosely Sichieri
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Edna Massae Yokoo
- Departamento de Saúde da Comunidade, Faculdade de Medicina, Universidade Federal Fluminense - Niterói (RJ), Brasil
| | - Dirce Maria Marchioni
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| |
Collapse
|
27
|
Fontes AS, Pallottini AC, Vieira DADS, Fontanelli MDM, Marchioni DM, Cesar CLG, Alves MCGP, Goldbaum M, Fisberg RM. Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study. Rev bras epidemiol 2020; 23:e200003. [DOI: 10.1590/1980-549720200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT: Introduction: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. Objective: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. Methods: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. Results: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. Conclusion: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.
Collapse
|
28
|
Levy J, Miranda AAM, De Carli E, Bittencourt MS, Benseñor IJ, Lotufo PA, Marchioni DM. Ingestion of magnesium was not associated with coronary calcium score in a cross-sectional study. INT J VITAM NUTR RES 2019; 91:217-223. [PMID: 31711405 DOI: 10.1024/0300-9831/a000618] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background and aims: Magnesium plays a key role in glucose metabolism, vascular tone, and inflammation. Therefore, it might be a dietary risk factor for cardiovascular diseases. In vitro and animal studies have suggested a decrease in vascular calcification with an increase in the magnesium intake. The objective of the present study was to investigate the association between magnesium intake and coronary artery calcium (CAC) score among participants of the ELSA-Brasil. Methods: This is an observational, cross-sectional study undertaken with a sub-sample from the ELSA-Brasil baseline data. In this sub-sample, only participants with CAC examination data were included (n = 4,306). Dietary intake was assessed by a validated food frequency questionnaire. The association between magnesium intake and presence of CAC (0 versus > 0) was investigated using multiple logistic regression models. Results: The participants were predominantly female (54.4 %), with self-reported white skin color (59.1 %), no smoking habit (53.7 %) and undergraduate or postgraduate education (44.4 %). The range of magnesium consumption was 37.24 - 1266.31 mg/day. CAC prevalence was 28.4 %. No significant association was found between magnesium intake and CAC after adjustments for diet, lifestyle, and clinical characteristics. In a first univariate model, the fifth quintile of magnesium intake, in comparison to the first quintile (lowest intake), resulted in an OR = 1.25, 95 % CI: 1.01 - 1.54 (P-linear trend = 0.005). However, in the last fully adjusted model, the fifth quintile of magnesium intake resulted in OR = 0.86, 95 % CI: 0.64 - 1.17 (P-linear trend = 0.239). Conclusions: In ELSA-Brasil, the intake of magnesium was not associated with the presence of coronary artery calcification.
Collapse
Affiliation(s)
- Jéssica Levy
- School of Public Health/University of São Paulo, Brazil
| | | | | | - Marcio Sommer Bittencourt
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Isabela Judith Benseñor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, Brazil
| | | |
Collapse
|
29
|
Machado AD, Andrade GRG, Levy J, Ferreira SS, Marchioni DM. Association between Vitamins and Minerals with Antioxidant Effects and Coronary Artery Calcification in Adults and Older Adults: A Systematic Review. Curr Pharm Des 2019; 25:2474-2479. [DOI: 10.2174/1381612825666190722101954] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/20/2019] [Indexed: 12/19/2022]
Abstract
Background:
Coronary Artery Calcification (CAC) is considered an important cardiovascular risk
factor. There is evidence that CAC is associated with an increased risk of atherosclerosis, coronary events and
cardiovascular mortality. Inflammation is one of the factors associated with CAC and despite the interest in antioxidant
compounds that can prevent CAC, its association with antioxidants remains unclear.
Objective:
This study aimed to systematically review the association between vitamins and minerals with antioxidant
effects and CAC in adults and older adults.
Methods:
We conducted a systematic review using PubMed for articles published until October 2018. We included
studies conducted in subjects aged 18 years and older with no previous cardiovascular disease. Studies
involving animal or in vitro experiments and the ones that did not use reference methods to assess the CAC, dietary
intake or serum levels of vitamin or mineral were excluded.
Results:
The search yielded 390 articles. After removal of duplicates, articles not related to the review, review
articles, editorials, hypothesis articles and application of the inclusion and exclusion criteria, 9 articles remained.
The results of the studies included in this systematic review suggest that magnesium is inversely associated with
CAC and results on the association between CAC and vitamin E have been conflicting.
Conclusion:
Additional prospective studies are needed to elucidate the role of these micronutrients on CAC.
Collapse
Affiliation(s)
- Alisson Diego Machado
- Department of Nephrology, Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Jéssica Levy
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Sara Silva Ferreira
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
30
|
Leroux IN, Ferreira APSDS, Paniz FP, Silva FFD, Luz MS, Batista BL, Marchioni DM, Olympio KPK. Brazilian preschool children attending day care centers show an inadequate micronutrient intake through 24-h duplicate diet. J Trace Elem Med Biol 2019; 54:175-182. [PMID: 31109609 DOI: 10.1016/j.jtemb.2019.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 09/14/2018] [Revised: 03/29/2019] [Accepted: 04/08/2019] [Indexed: 11/30/2022]
Abstract
Inadequate micronutrient intake in childhood harms growth and development, and it is related to increased rates of morbidity and mortality. The aim of this study is to evaluate the dietary intake and prevalence of inadequate micronutrient intake in preschool children (1-4 years old) attending two-day care centers. To assess children's dietary micronutrient intake, 24-h duplicate diets (n = 64) were collected for one week-day, including everything the children ate and drank both at home and in kindergarten. Anthropometric measurements were carried out to evaluate the children's nutritional status. The micronutrients copper, iron, calcium, magnesium, selenium, zinc, potassium, sodium, and manganese were determined by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry. Calcium and selenium were found with high inadequate intake rates: 50% and 42%, respectively, for children aged 1-3 years old, and 93% and 90% for children aged 4 years. Potassium was consumed in very low amounts, 13% and 5% of children aged 1-3 and 4 years old, respectively, achieved the adequate intake for the nutrient. Sodium intakes were excessive: 23% of the 1-3-year old and 42% of the 4-year-old children, respectively, had an intake higher than the tolerable upper levels. Regarding the nutritional status, overweight and obesity prevalence was 17%. Therefore, considering the damaging health effects for children of micronutrient deficiency and overweight and obesity status, it is necessary that government authorities be aware and update public policies and educational programs in order to promote healthy eating habits in early childhood.
Collapse
Affiliation(s)
- Isabelle Nogueira Leroux
- Laboratório de Análises da Exposição Humana a Contaminantes Ambientais, Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Ana Paula Sacone da Silva Ferreira
- Laboratório de Análises da Exposição Humana a Contaminantes Ambientais, Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Fernanda Pollo Paniz
- Laboratório de Análises da Exposição Humana a Contaminantes Ambientais, Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Fábio Ferreira da Silva
- EnvironMetals, Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Avenida dos Estados, 5001, Bairro Santa Terezinha, Santo André, SP, CEP 09210-580, Brazil; Agilent Technologies, Alameda Araguaia, 1142, Alphaville Industrial, CEP: 6455000, Barueri, São Paulo, SP, Brazil.
| | - Maciel Santos Luz
- Laboratório de Processos Metalúrgicos, Centro de Tecnologia em Metalurgia e Materiais, Instituto de Pesquisas Tecnológicas do Estado de São Paulo (IPT), Av. Prof. Almeida Prado, 532, Cidade Universitária, Butantã, CEP 05508-901, São Paulo, SP, Brazil.
| | - Bruno Lemos Batista
- EnvironMetals, Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Avenida dos Estados, 5001, Bairro Santa Terezinha, Santo André, SP, CEP 09210-580, Brazil.
| | - Dirce Maria Marchioni
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Kelly Polido Kaneshiro Olympio
- Laboratório de Análises da Exposição Humana a Contaminantes Ambientais, Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| |
Collapse
|
31
|
Marchioni DM, de Oliveira MF, Carioca AAF, Miranda AAM, Carvalho AM, Oki E, Norde MM, Rogero MM, Damasceno NRT, Fisberg RM. Plasma fatty acids: Biomarkers of dietary intake? Nutrition 2019; 59:77-82. [DOI: 10.1016/j.nut.2018.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/16/2018] [Accepted: 08/11/2018] [Indexed: 01/19/2023]
|
32
|
Teixeira JA, Steluti J, Gorgulho BM, Carioca AAF, Alencar GP, Fisberg RM, Marchioni DM. Prudent dietary pattern influences homocysteine level more than folate, vitamin B12, and docosahexaenoic acid: a structural equation model approach. Eur J Nutr 2019; 59:81-91. [DOI: 10.1007/s00394-018-1886-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 12/19/2018] [Indexed: 12/20/2022]
|
33
|
Santos RDO, Gorgulho BM, Castro MAD, Fisberg RM, Marchioni DM, Baltar VT. Principal Component Analysis and Factor Analysis: differences and similarities in Nutritional Epidemiology application. Rev bras epidemiol 2019; 22:e190041. [DOI: 10.1590/1980-549720190041] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/15/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT: Introduction: Statistical methods such as Principal Component Analysis (PCA) and Factor Analysis (FA) are increasingly popular in Nutritional Epidemiology studies. However, misunderstandings regarding the choice and application of these methods have been observed. Objectives: This study aims to compare and present the main differences and similarities between FA and PCA, focusing on their applicability to nutritional studies. Methods: PCA and FA were applied on a matrix of 34 variables expressing the mean food intake of 1,102 individuals from a population-based study. Results: Two factors were extracted and, together, they explained 57.66% of the common variance of food group variables, while five components were extracted, explaining 26.25% of the total variance of food group variables. Among the main differences of these two methods are: normality assumption, matrices of variance-covariance/correlation and its explained variance, factorial scores, and associated error. The similarities are: both analyses are used for data reduction, the sample size usually needs to be big, correlated data, and they are based on matrices of variance-covariance. Conclusion: PCA and FA should not be treated as equal statistical methods, given that the theoretical rationale and assumptions for using these methods as well as the interpretation of results are different.
Collapse
|
34
|
Baltar VT, Cunha DB, Santos RDO, Marchioni DM, Sichieri R. Breakfast patterns and their association with body mass index in Brazilian adults. CAD SAUDE PUBLICA 2018; 34:e00111917. [PMID: 29952402 DOI: 10.1590/0102-311x00111917] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 12/18/2017] [Indexed: 11/22/2022] Open
Abstract
The objective was to investigate the relationships between body mass index (BMI), skipping breakfast, and breakfast patterns in Brazilian adults. We analyzed data of 21,003 individuals aged between 20 to 59 from the Brazilian National Dietary Survey 2008-2009. Breakfast was defined as the eating occasion between 5 and 10a.m. with the highest usual food consumption (exceeding 50Kcal/209.2kJ). Dietary patterns were derived by the factor analysis of 18 food groups (usual intake). Controlling for confounders linear regressions of BMI were used to verify the associations considering the survey design. Skipping breakfast was not associated with BMI. Three breakfast patterns were observed (48% variability): Brazilian Northern (positive loading for meats, preparations with corn, eggs, tubers/roots/potatoes, dairy products, savory snacks/crackers, fruit juices/fruit drinks/soy-based drinks); Western (positive for fruit juices/fruit drinks/soy-based drinks, sandwiches/pizza, baked/deep-fried snacks, chocolate/desserts, cakes/cookies) and Brazilian Southeastern (cold cut meat, milk, cheese, coffee/tea, bread). The Brazilian Southeastern pattern was inversely associated with BMI, while the Brazilian Northern pattern was directly associated with it. Therefore, the results suggest a role for breakfast quality in the association with BMI. Thus, a Brazilian Southeastern breakfast usual intake may be inversely associated with BMI.
Collapse
Affiliation(s)
- Valéria Troncoso Baltar
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, Brasil
| | - Diana Barbosa Cunha
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | | | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| |
Collapse
|
35
|
Gorgulho BM, Santos RDO, Teixeira JA, Baltar VT, Marchioni DM. Lunch quality and sociodemographic conditions between Brazilian regions. CAD SAUDE PUBLICA 2018; 34:e00067417. [PMID: 29846406 DOI: 10.1590/0102-311x00067417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 10/02/2017] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to assess the quality of lunch consumed by adults in Brazil and its sociodemographic determinants in each Brazilian region. A cross-sectional study was carried out and a representative sample of regional populations was used. The sample comprised of 16,096 adults from the Brazilian National Dietary Survey, part of the Brazilian Household Budget Survey (POF). The lunch quality was evaluated by applying the main meal quality index (MMQI), comprised of 10 items of equal weights that resulted in a score that ranged from zero to 100 points. Linear regression models measured the association between lunch quality and sociodemographic factors. The average energy consumption at lunch was 704kcal (SD = 300), and the meal quality score mean was 57 points (SE = 0.30). The North Region had the worst MMQI score (56 points, SE = 0.07), while the Central had the best MMQI adjusted score (59 points, SE = 0.05). The MMQI final score was positively associated with male gender and ages between 20-39 years, and was inversely associated with having eight years or more of education, per capita income of at least three minimum wages, and with the consumption of meals prepared away from home. Despite differences among sociodemographic factors, all Brazilian regions had a lunch composed of foods rich in sugars and fats, with insufficient portions of fruits and vegetables, resulting in a low meal quality.
Collapse
Affiliation(s)
| | | | - Juliana A Teixeira
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Valeria T Baltar
- Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brazil
| | | |
Collapse
|
36
|
Dos Santos Vieira DA, Hermes Sales C, Galvão Cesar CL, Marchioni DM, Fisberg RM. Influence of Haem, Non-Haem, and Total Iron Intake on Metabolic Syndrome and Its Components: A Population-Based Study. Nutrients 2018. [PMID: 29518910 PMCID: PMC5872732 DOI: 10.3390/nu10030314] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Studies suggest that haem, non-haem iron and total iron intake may be related to non-communicable diseases, especially metabolic syndrome. This study was undertaken to investigate the association of haem, non-haem iron and total iron intake with metabolic syndrome and its components. A cross-sectional population-based survey was performed in 2008, enrolling 591 adults and elderly adults living in São Paulo, Brazil. Dietary intake was measured by two 24 h dietary recalls. Metabolic syndrome was defined as the presence of at least three of the following: hypertension, hyperglycaemia, dyslipidaemia and central obesity. The association between different types of dietary iron and metabolic syndrome was evaluated using multiple logistic regression. After adjustment for potential confounders, a higher haem iron intake was positively associated with metabolic syndrome and with elevated triglyceride levels. A higher total iron intake was positively associated with hyperglycaemia. Non-haem iron intake was positively associated with hyperglycaemia in the fourth quintile. In conclusion, this study suggests that the different types of dietary iron are associated with metabolic syndrome, elevated triglyceride levels and hyperglycaemia. In addition, it emphasises the importance of investigating the roles of dietary iron in health outcomes, since its consumption may have different impacts on health.
Collapse
Affiliation(s)
- Diva Aliete Dos Santos Vieira
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP 01246-904, Brazil.
| | - Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP 01246-904, Brazil.
| | - Chester Luiz Galvão Cesar
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP 01246-904, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP 01246-904, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP 01246-904, Brazil.
| |
Collapse
|
37
|
Teixeira JA, Castro TG, Grant CC, Wall CR, Castro ALDS, Francisco RPV, Vieira SE, Saldiva SRDM, Marchioni DM. Dietary patterns are influenced by socio-demographic conditions of women in childbearing age: a cohort study of pregnant women. BMC Public Health 2018; 18:301. [PMID: 29490638 PMCID: PMC5831579 DOI: 10.1186/s12889-018-5184-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women's health during their reproductive years and whilst pregnant has implications for their children's health, both in utero and during childhood. Associations of women's pre-pregnancy dietary patterns (DP) with maternal socio-demographic characteristics and nutrient intake were investigated in ProcriAr cohort study in São Paulo/Brazil, 2012. METHODS The DPs of 454 women were investigated by principal component factor analysis, using dietary information from a validated 110-item food frequency questionnaire. Multiple linear regression models identified independent associations between DPs and maternal socio-demographic characteristics and Spearman's correlation determined associations between DPs and nutrients intake. RESULTS Participants' mean age was 26.1 years (standard deviation = 6.3), 10.3% had more than 8 years of formal education, 30% were migrants from outside of the Southeast of Brazil, 48% were employed, 13% were smokers, and 51% were overweight/obese. Four DPs were derived: 'Lentils, whole grains and soups,' 'Snacks, sandwiches, sweets and soft drinks,' 'Seasoned vegetables and lean meats,' and 'Sweetened juices, bread and butter, rice and beans'. The 'Lentils, whole grains and soups' score was positively related to maternal age, being non-smoker and born in the South, North or Midwest of Brazil. The 'Snacks, sandwiches, sweets and soft drinks' score was positively related to higher maternal education, and negatively related to age, lack of formal work and being born in the Northeast region. The 'Seasoned vegetables and lean meats' score was positively related to higher maternal education. The 'Sweetened juices, bread and butter, rice and beans' score was positively related to unemployment and to no family history of hypertension, and negatively related to maternal overweight and obesity. Dietary intake of fruits and vegetables, foods that require preparation, nutrients from one-carbon metabolism, protein, iron, calcium and vitamin D were correlated with the 'Seasoned vegetables and lean meats'. Dietary intake of sugar-sweetened and alcoholic beverages, industrialized and takeaway foods, and foods rich in sugar, energy, fat, and synthetic folate were correlated with the 'Snacks, sandwiches, sweets and soft drinks'. CONCLUSIONS Findings from this study add perspectives to be considered in the implementation of health interventions, which could improve women's nutritional status and provide an adequate environment for the developing fetus.
Collapse
Affiliation(s)
- Juliana Araujo Teixeira
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904 Brazil
| | - Teresa Gontijo Castro
- The Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, 1072 New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, 1142 New Zealand
| | - Cameron C. Grant
- The Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, 1072 New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, 1142 New Zealand
- Starship Children’s Hospital, Auckland District Health Board, Auckland, 1023 New Zealand
| | - Clare R. Wall
- The Centre for Longitudinal Research – He Ara ki Mua, University of Auckland, Auckland, 1072 New Zealand
- Discipline of Nutrition and Dietetics, School of Medical Sciences, University of Auckland, Auckland, 1023 New Zealand
| | - Ana Lúcia da Silva Castro
- Department of Obstetrics and Gynecology, School of Medicine, University of Sao Paulo, Sao Paulo, 05403-000 Brazil
| | | | - Sandra Elisabete Vieira
- Department of Pediatrics, School of Medicine, University of Sao Paulo, Sao Paulo, 05403-000 Brazil
| | | | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, 01246-904 Brazil
| |
Collapse
|
38
|
Carioca AAF, Gorgulho B, Teixeira JA, Fisberg RM, Marchioni DM. Dietary patterns in internal migrants in a continental country: A population-based study. PLoS One 2017; 12:e0185882. [PMID: 29036177 PMCID: PMC5642885 DOI: 10.1371/journal.pone.0185882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/26/2016] [Accepted: 09/21/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the differences and similarities in dietary patterns among migrants and natives. METHODS A population-based, cross-sectional study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 999) was divided into three groups: natives of São Paulo (n = 354), migrants from the Southeast (n = 349) and migrants from the Northeast (n = 296). Factor and principal component analysis was employed to derive dietary patterns. The standardized scores were compared among groups using linear regression. RESULTS Differences in income per capita, years of education, self-reported race, smoking habits, alcohol consumption, nutritional status and prevalence of hypertension were found for place of birth. Three dietary patterns were identified: prudent (salad dressings, vegetables, natural flavorings, fruits, whole-grain bread, white cheeses and juices), traditional (rice, beans, bread/toast/crackers, butter/margarine, whole milk, coffee/teas, sugar), and modern (sodas, pastries/sandwiches/pizzas, yellow cheeses, pastas, sauces, alcoholic beverages, sweets, processed meats). Compared to natives, migrants from the Southeast had an inversely proportional adherence to the modern pattern whereas migrants from the Northeast had an inverse association with the prudent and modern patterns and a positive association with the traditional pattern. CONCLUSIONS São Paulo natives and internal migrants from other regions of Brazil exhibited different dietary patterns. The results presented here add perspectives to be considered in the study of non-communicable diseases and its different incidences among migrants and natives.
Collapse
Affiliation(s)
| | - Bartira Gorgulho
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Juliana Araujo Teixeira
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
39
|
de Oliveira Santos R, Vieira DADS, Miranda AAM, Fisberg RM, Marchioni DM, Baltar VT. The traditional lunch pattern is inversely correlated with body mass index in a population-based study in Brazil. BMC Public Health 2017; 18:33. [PMID: 28724424 PMCID: PMC5518136 DOI: 10.1186/s12889-017-4582-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 04/21/2017] [Accepted: 07/10/2017] [Indexed: 11/17/2022] Open
Abstract
Background The association of obesity and dietary patterns has been well documented in scientific literature; however, information on the impact of meal patterns on obesity is scarce. The objective of this study was to investigate the association of adherence to lunch patterns and body mass index (BMI) in a representative sample of individuals aged 20 years or older in Sao Paulo. Methods Data for 933 participants were retrieved from the Health Survey of São Paulo (ISA-Capital 2008), a cross-sectional population-based survey. The usual dietary intake of individuals with at least one 24-h recall was estimated by the Multiple Source Method. The definition of lunch was self-reported by the participant. Five lunch patterns were derived from twenty-two food groups by exploratory factor analysis: Traditional, Western, Sweetened juice, Salad, and Meats. To estimate the effect of lunch patterns on BMI, we used a generalized linear model with link identity and inverse Gaussian distribution. Analyses were adjusted by age, gender, household income per capita, physical activity levels, smoking status, alcohol consumption, total energy intake, and misreporting status. Results The greater adherence to the traditional pattern at the lunch meal was associated with lower BMI, only in insufficiently active individuals (ß = −0.78; 95% CI -1.57; −0.02). Conclusions The traditional Brazilian lunch pattern might protect the insufficiently active individuals against obesity.
Collapse
Affiliation(s)
- Roberta de Oliveira Santos
- Department of Nutrition, School of Public Health, University of Sao Paulo, Avenida Dr. Arnaldo, 715 - Cerqueira César. CEP, São Paulo, SP, 01246-904, Brazil.
| | - Diva Aliete Dos Santos Vieira
- Department of Nutrition, School of Public Health, University of Sao Paulo, Avenida Dr. Arnaldo, 715 - Cerqueira César. CEP, São Paulo, SP, 01246-904, Brazil
| | - Andreia Alexandra Machado Miranda
- Department of Nutrition, School of Public Health, University of Sao Paulo, Avenida Dr. Arnaldo, 715 - Cerqueira César. CEP, São Paulo, SP, 01246-904, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, Avenida Dr. Arnaldo, 715 - Cerqueira César. CEP, São Paulo, SP, 01246-904, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Avenida Dr. Arnaldo, 715 - Cerqueira César. CEP, São Paulo, SP, 01246-904, Brazil
| | - Valéria Troncoso Baltar
- Department of Epidemiology and Biostatistics, Institute of Collective Health, Federal Fluminense University, Travessa Marquês de Paraná, 303 - Centro. CEP, Niterói, RJ, 24030-210, Brazil
| |
Collapse
|
40
|
Pallottini AC, Sales CH, Vieira DADS, Marchioni DM, Fisberg RM. Dietary BCAA Intake Is Associated with Demographic, Socioeconomic and Lifestyle Factors in Residents of São Paulo, Brazil. Nutrients 2017; 9:E449. [PMID: 28468321 PMCID: PMC5452179 DOI: 10.3390/nu9050449] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/21/2017] [Accepted: 04/26/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Identifying which risk groups have a higher intake of branched chain amino acids (BCAA) is important for the planning of public policies. This study was undertaken to investigate BCAA consumption, the foods contributing to that consumption and their association with demographic, socioeconomic and lifestyle factors. METHODS Data from the Health Survey of São Paulo, a cross-sectional population-based survey (n = 1662; age range 12-97 years), were used. Dietary intake was measured using 24-h dietary recalls. Baseline characteristics were collected. Associations between BCAA intake and demographic, socioeconomic and lifestyle factors were determined using linear regression. RESULTS Total BCAA intake was 217.14 mg/kg·day (Leu: 97.16 mg/kg·day; Ile: 56.44 mg/kg·day; Val: 63.54 mg/kg·day). BCAA intake was negatively associated with female sex in adolescents and adult groups, with no white race in adolescents, and with former smoker status in adults. Conversely, BCAA was positively associated with household per capita income in adolescents and adults. No associations were observed in the older adults group. Main food contributors to BCAA were unprocessed red meat, unprocessed poultry, bread and toast, beans and rice. CONCLUSIONS Adolescents and adults were the most vulnerable to having their BCCA intake influenced by demographic, socioeconomic and lifestyle factors.
Collapse
Affiliation(s)
- Ana Carolina Pallottini
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo CEP 01246-904, Brazil.
| | - Cristiane Hermes Sales
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo CEP 01246-904, Brazil.
| | - Diva Aliete Dos Santos Vieira
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo CEP 01246-904, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo CEP 01246-904, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo CEP 01246-904, Brazil.
| |
Collapse
|
41
|
Gorgulho BM, Pot GK, Sarti FM, Marchioni DM. Main meal quality in Brazil and United Kingdom: Similarities and differences. Appetite 2017; 111:151-157. [DOI: 10.1016/j.appet.2016.12.038] [Citation(s) in RCA: 5] [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] [Received: 07/14/2016] [Revised: 11/29/2016] [Accepted: 12/28/2016] [Indexed: 10/20/2022]
|
42
|
Fontanelli MDM, Teixeira JA, Sales CH, de Castro MA, Cesar CLG, Alves MCGP, Goldbaum M, Marchioni DM, Fisberg RM. Validation of self-reported diabetes in a representative sample of São Paulo city. Rev Saude Publica 2017; 51:20. [PMID: 28355348 PMCID: PMC5344074 DOI: 10.1590/s1518-8787.2017051006378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 02/14/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To validate the self-reported diabetes mellitus in adults and older adults living in the city of São Paulo, Brazil. METHODS We have used data of 569 subjects (284 adults and 285 older adults), participants of the population-based cross-sectional study Inquérito de Saúde do Município de São Paulo (Health Survey of São Paulo). Fasting glucose ≥ 7.0 mmol/L (126 mg/dL) and/or use of drugs (oral hypoglycemic and/or insulin) defined the diagnosis of diabetes mellitus. We have validated the self-reported diabetes mellitus by calculating the sensitivity, specificity, positive predictive values, and negative predictive values. We have used Poisson regression with robust variance to verify the factors associated with the sensitivity of the self-reported datum. For all analyses, we have considered the sample design of the study. RESULTS The sensitivity of self-reported diabetes mellitus was 63.8% (95%CI 49.2-76.3), specificity was 99.7% (95%CI 99.1-99.9), positive predictive value was 95.5% (95%CI 84.4-98.8), and negative predictive value was 96.9% (95%CI 94.9-98.2). The correct reporting of diabetes mellitus was more prevalent among older adults (PR = 2.0; 95%CI 1.2-3.5) than among adults. CONCLUSIONS The use of the datum of self-reported diabetes mellitus is valid, especially among older adults living in the city of São Paulo. The results highlight the need to track diabetes mellitus in asymptomatic subjects who have one or more risk factors for it, mainly in the adult population of this city.
Collapse
Affiliation(s)
| | - Juliana Araújo Teixeira
- Programa de Pós-Graduação de Nutrição em Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Cristiane Hermes Sales
- Programa de Pós-Graduação de Nutrição em Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | | | - Chester Luiz Galvão Cesar
- Departamento do Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | | | - Moisés Goldbaum
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Dirce Maria Marchioni
- Departamento de Nutrição. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Regina Mara Fisberg
- Departamento de Nutrição. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| |
Collapse
|
43
|
Miranda AM, Steluti J, Fisberg RM, Marchioni DM. Association between Coffee Consumption and Its Polyphenols with Cardiovascular Risk Factors: A Population-Based Study. Nutrients 2017; 9:nu9030276. [PMID: 28335422 PMCID: PMC5372939 DOI: 10.3390/nu9030276] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 01/08/2023] Open
Abstract
Epidemiological studies have examined the effect of coffee intake on cardiovascular disease, but the benefits and risks for the cardiovascular system remain controversial. Our objective was to evaluate the association between coffee consumption and its polyphenols on cardiovascular risk factors. Data came from the “Health Survey of São Paulo (ISA-Capital)” among 557 individuals, in São Paulo, Brazil. Diet was assessed by two 24-h dietary recalls. Coffee consumption was categorized into <1, 1–3, and ≥3 cups/day. Polyphenol intake was calculated by matching food consumption data with the Phenol-Explorer database. Multiple logistic regression models were used to assess the associations between cardiovascular risk factors (blood pressure, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, fasting glucose, and homocysteine) and usual coffee intake. The odds were lower among individuals who drank 1–3 cups of coffee/day to elevated systolic blood pressure (SBP) (Odds Ratio (OR) = 0.45; 95% Confidence Interval (95% CI): 0.26, 0.78), elevated diastolic blood pressure (DBP) (OR = 0.44; 95% CI: 0.20, 0.98), and hyperhomocysteinemia (OR = 0.32; 95% CI: 0.11, 0.93). Furthermore, significant inverse associations were also observed between moderate intake of coffee polyphenols and elevated SBP (OR = 0.46; 95% CI: 0.24, 0.87), elevated DBP (OR = 0.51; 95% CI: 0.26, 0.98), and hyperhomocysteinemia (OR = 0.29; 95% CI: 0.11, 0.78). In conclusion, coffee intake of 1–3 cups/day and its polyphenols were associated with lower odds of elevated SBP, DBP, and hyperhomocysteinemia. Thus, the moderate consumption of coffee, a polyphenol-rich beverage, could exert a protective effect against some cardiovascular risk factors.
Collapse
Affiliation(s)
- Andreia Machado Miranda
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | - Josiane Steluti
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
| |
Collapse
|
44
|
de Mello Fontanelli M, Sales CH, Carioca AAF, Marchioni DM, Fisberg RM. The relationship between carbohydrate quality and the prevalence of metabolic syndrome: challenges of glycemic index and glycemic load. Eur J Nutr 2017; 57:1197-1205. [DOI: 10.1007/s00394-017-1402-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/10/2017] [Indexed: 12/11/2022]
|
45
|
Miranda AM, Steluti J, Fisberg RM, Marchioni DM. Association between Polyphenol Intake and Hypertension in Adults and Older Adults: A Population-Based Study in Brazil. PLoS One 2016; 11:e0165791. [PMID: 27792767 PMCID: PMC5085083 DOI: 10.1371/journal.pone.0165791] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [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: 02/26/2016] [Accepted: 10/18/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/OBJECTIVE Hypertension is an important risk factor for cardiovascular disease, and diet has been identified as a modifiable factor for preventing and controlling hypertension. Besides, epidemiological studies have suggested an inverse association between polyphenol intake and cardiovascular diseases. The aim of this study was to evaluate the association between the intake of polyphenols and hypertension in a general population of Sao Paulo. METHODS Data came from the 'Health Survey of Sao Paulo (ISA-Capital)' among 550 adults and older adults in Sao Paulo, Brazil. Diet was assessed by two 24-hour dietary recalls (24HR). Usual intakes were calculated using the Multiple Source Method. Polyphenol intake was calculated by matching food consumption data from the 24HR with the Phenol-Explorer database. The associations between the hypertension and tertiles of the total and classes of polyphenols intake were tested by multivariate logistic regression analysis. RESULTS After multivariate adjustment for potential confounding factors the findings showed an inverse and linearly association between the hypertension and highest tertiles of tyrosols (OR = 0.33; 95%CI 0.18, 0.64), alkylphenols (OR = 0.45; 95%CI 0.23, 0.87), lignans (OR = 0.49; 95%CI 0.25, 0.98), as well as stilbenes (OR = 0.60; 95%CI 0.36, 0.98), and other polyphenols (OR = 0.33; 95%CI 0.14, 0.74). However, total polyphenol intake, and phenolic acids were significantly associated only in the middle tertile with hypertension and flavonoids were not significant associated. CONCLUSION There is an inverse and linearly association between the highest tertile of some classes of polyphenols, such as, tyrosols, alkylphenols, lignans, stilbenes, other polyphenols and hypertension.
Collapse
Affiliation(s)
- Andreia Machado Miranda
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
- * E-mail:
| | - Josiane Steluti
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
| |
Collapse
|
46
|
Giudici KV, Fisberg RM, Marchioni DM, Martini LA. Comparisons of physical activity, adipokines, vitamin D status and dietary vitamin D intake among adolescents. J Hum Nutr Diet 2016; 30:369-377. [PMID: 27779331 DOI: 10.1111/jhn.12434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Considering that lifestyle and diet are key factors responsible for the increases in adiposity in youth, it is important to understand how vitamin D, adipokines and markers of glucose metabolism are related to physical activity level (PAL) during growth. The present study aimed to investigate associations between physical activity level, adiponectin/leptin ratio, vitamin D status and dietary vitamin D intake among adolescents. METHODS A cross-sectional study was conducted with adolescents aged 14-18 years old who were living in São Paulo, Brazil. Serum 25 hydroxyvitamin D [25(OH)D], adiponectin (A), leptin (L), glucose and insulin were obtained after 12 h of fasting. Dietary calcium and vitamin D intake were measured by 24-h food record, as repeated in 62.6% of the sample. PAL was measured by the International Physical Activity Questionnaire (IPAQ). Pearson's chi-square test, Pearson correlation and linear regression analysis were performed. RESULTS A total of 198 subjects, mean (SD) age 16.3 (1.4) years, 51% male, were enrolled in the study. Some 9% of participants were sedentary, 22% were insufficiently active (IA), 51% were active and 18% were very active (VA). The A/L ratio was lower among sedentary/IA subjects [2.2 (4.0) versus 5.6 (12.3); P = 0.01] compared to active/VA subjects. PAL was not associated with vitamin D status or markers of glucose metabolism. Serum 25(OH)D positively associated with vitamin D intake, after adjusting for sex, sun exposure and season of the year in regression analysis (partial r2 =0.026, P = 0.02). CONCLUSIONS Low PAL was associated with a lower A/L ratio. Vitamin D status was not associated with sun exposure habits, although it was positively correlated with vitamin D intake.
Collapse
Affiliation(s)
- K V Giudici
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - R M Fisberg
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - D M Marchioni
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - L A Martini
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
47
|
Miranda AM, Carioca AAF, Steluti J, da Silva IDCG, Fisberg RM, Marchioni DM. The effect of coffee intake on lysophosphatidylcholines: A targeted metabolomic approach. Clin Nutr 2016; 36:1635-1641. [PMID: 28029506 DOI: 10.1016/j.clnu.2016.10.012] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/06/2016] [Accepted: 10/12/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIM Lysophosphatidylcholines (lysoPC) are known to be a pathological component of oxidized-LDL, and several studies demonstrate its pro-inflammatory properties in vitro. Nevertheless, bioactive compounds found in coffee, such as phenolic acids might inhibit LDL oxidation. The relationship between coffee consumption and lysoPC has not been described previously in humans. The aim of the present study was to assess the association between coffee intake and plasma lysoPC levels in adults. METHODS Data was from the "Health Survey of Sao Paulo (ISA-Capital)", a cross-sectional population-based survey in Sao Paulo, among 169 individuals aged 20 years or older. This population was categorized into three groups: non-coffee consumers (0 mL/day-G1), low coffee consumers (≤100 mL/day-G2), and high coffee consumers (>100 mL/day-G3). Usual coffee intake was estimated by two 24HR and one FFQ, using Multiple Source Method. Quantification of the metabolites was performed by mass spectrometry (FIA-MS/MS and HPLC-MS/MS) and 14 lysoPC species were identified. The association between coffee intake and lysoPC was analyzed by multiple linear regression adjusted for age, sex, household per capita income, smoking, physical activity, body mass index, total energy intake, use of drugs, vegetables and fruit consumption and caffeine intake. RESULTS LysoPC levels were significantly lower in G3 than in G1, for the lysoPC a C16:1 (β = -0.56; p = 0.014), lysoPC a C18:1 (β = -2.57; p = 0.018), and lysoPC a C20:4 (β = -1.14; p = 0.037). In opposition, the ratios of C16:0/C16:1 and C18:0/18:1 was higher in G3 (β = 5.04; p = 0.025 and β = 0.28; p = 0.003, respectively). CONCLUSION LysoPC profile differed according to coffee intake, showing a possible beneficial health effect of this beverage on inflammatory and oxidative processes.
Collapse
Affiliation(s)
| | | | - Josiane Steluti
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil
| | | | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of Sao Paulo, SP, Brazil.
| |
Collapse
|
48
|
Pereira JL, Mendes A, Crispim SP, Marchioni DM, Fisberg RM. Association of Overweight with Food Portion Size among Adults of São Paulo - Brazil. PLoS One 2016; 11:e0164127. [PMID: 27706222 PMCID: PMC5051931 DOI: 10.1371/journal.pone.0164127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 03/01/2016] [Accepted: 09/20/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Although studies show that portion size affects energy intake, few have demonstrated a link between portion size and weight status, especially in free-living populations. The objective of the present study was to assess the relationship between food portion sizes and overweight in a representative population of adults of São Paulo, Brazil. METHODS Cross-sectional population-based study with 1005 adults from São Paulo, Brazil. Dietary data were obtained from two 24-hour recalls. Reported foods were classified into groups and energy contribution, prevalence of consumers and portion sizes were calculated. Individuals were classified according to BMI in with and without overweight. Logistic regression models were used to evaluate the association between food portion sizes and being overweight. RESULTS The most consumed food groups were: beans, breads/rolls, coffee/tea, milk, rice, and sugar. Rice, red meat, breads/rolls, and white meat were the groups with the highest percentage of contribution to total energy intake. Butter/margarine, toasts/biscuits, sugar, and cakes were the groups with the highest energy density. After adjustment for confounding variables, overweight was associated with larger portions of pizza (OR = 1.052; p = 0.048), red meat (OR = 1.025; p = 0.043), rice (OR = 1.033; p<0.001), salted snacks (OR = 1.078; p = 0.022), and soft drinks (OR = 1.016; p = 0.007). CONCLUSIONS Larger portions of few food groups with different energy densities were associated with being overweight, suggesting that overweight may be related to the consumption of larger portion sizes of a series of food groups, not a food group alone. Additionally, we highlight the importance of considering underreporting as a confounding factor in these associations.
Collapse
Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Aline Mendes
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
49
|
Previdelli ÁN, de Andrade SC, Fisberg RM, Marchioni DM. Using Two Different Approaches to Assess Dietary Patterns: Hypothesis-Driven and Data-Driven Analysis. Nutrients 2016; 8:nu8100593. [PMID: 27669289 PMCID: PMC5083981 DOI: 10.3390/nu8100593] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/29/2016] [Accepted: 09/01/2016] [Indexed: 01/07/2023] Open
Abstract
The use of dietary patterns to assess dietary intake has become increasingly common in nutritional epidemiology studies due to the complexity and multidimensionality of the diet. Currently, two main approaches have been widely used to assess dietary patterns: data-driven and hypothesis-driven analysis. Since the methods explore different angles of dietary intake, using both approaches simultaneously might yield complementary and useful information; thus, we aimed to use both approaches to gain knowledge of adolescents’ dietary patterns. Food intake from a cross-sectional survey with 295 adolescents was assessed by 24 h dietary recall (24HR). In hypothesis-driven analysis, based on the American National Cancer Institute method, the usual intake of Brazilian Healthy Eating Index Revised components were estimated. In the data-driven approach, the usual intake of foods/food groups was estimated by the Multiple Source Method. In the results, hypothesis-driven analysis showed low scores for Whole grains, Total vegetables, Total fruit and Whole fruits), while, in data-driven analysis, fruits and whole grains were not presented in any pattern. High intakes of sodium, fats and sugars were observed in hypothesis-driven analysis with low total scores for Sodium, Saturated fat and SoFAA (calories from solid fat, alcohol and added sugar) components in agreement, while the data-driven approach showed the intake of several foods/food groups rich in these nutrients, such as butter/margarine, cookies, chocolate powder, whole milk, cheese, processed meat/cold cuts and candies. In this study, using both approaches at the same time provided consistent and complementary information with regard to assessing the overall dietary habits that will be important in order to drive public health programs, and improve their efficiency to monitor and evaluate the dietary patterns of populations.
Collapse
Affiliation(s)
- Ágatha Nogueira Previdelli
- Department of Nutrition, School of Public Health, University of São Paulo-USP, São Paulo 01246-904, Brazil.
| | - Samantha Caesar de Andrade
- Department of Nutrition, School of Public Health, University of São Paulo-USP, São Paulo 01246-904, Brazil.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo-USP, São Paulo 01246-904, Brazil.
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo-USP, São Paulo 01246-904, Brazil.
| |
Collapse
|
50
|
Santos PVFD, Sales CH, Vieira DAS, de Mello Fontanelli M, Marchioni DM, Fisberg RM. Family income per capita, age, and smoking status are predictors of low fiber intake in residents of São Paulo, Brazil. Nutr Res 2016; 36:478-87. [DOI: 10.1016/j.nutres.2015.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 01/11/2023]
|