RESUMO Objetivo: Analisar a associação entre a participação em exercícios físicos relacionados ao fitness (EFRF) e a insatisfação com a imagem corporal (IIC) em adolescentes e avaliar a interação entre os exercícios físicos e o estado nutricional nesta associação. Métodos: Estudo transversal realizado em 2015 com 799 adolescentes (10 a 16 anos) de 14 escolas públicas de Curitiba (PR), Brasil. A IIC foi avaliada por meio do Body Shape Questionnaire e da Escala de Silhuetas. A participação em EFRF foi avaliada pelo Questionário de Atividade Física para Adolescentes e classificada em “não pratica”, “pratica ≤300 minutos/semana” e “pratica >300 minutos/semana”. As regressões de Poisson e logística multinomial, ajustadas por sexo, maturação sexual e estado nutricional, analisaram a associação entre EFRF e IIC. Resultados: A prevalência de IIC foi de 28,3%; 52,4% dos adolescentes queriam reduzir a silhueta e 48,7% não praticavam a EFRF. Adolescentes que praticavam EFRF >300 minutos/semana tiveram prevalência 28% maior para algum nível de IIC (razão de prevalência — RP 1,28; intervalo de confiança de 95% — IC95% 1,08–1,52) e chance 46% menor de querer reduzir silhuetas (OR 0,54; 95IC% 0,35–0,82), comparados aos não praticantes. Não houve interação entre os EFRF e o estado nutricional na associação com IIC. Conclusões: Os adolescentes que praticam EFRF >300 minutos/semana estão mais propensos a apresentar algum nível de IIC e têm menores chances de reportar o desejo de aumentar silhuetas, independentemente do estado nutricional. Objetivo (EFRF (IIC Métodos 201 79 10 (1 1 anos PR, PR , (PR) Brasil Silhuetas pratica, pratica pratica” 300 ≤30 minutossemana minutos semana >30 minutos/semana. . multinomial sexo Resultados 28,3% 283 28 3 524 52 4 52,4 487 48 7 48,7 razão 1,28 128 95 IC95 IC 1,08–1,52 108152 08 46 OR 0,54 054 0 54 95IC 0,35–0,82, 035082 0,35–0,82 35 82 0,35–0,82) praticantes Conclusões 20 ( (PR 30 ≤3 >3 28,3 2 5 52, 48, 1,2 12 9 IC9 1,08–1,5 10815 0,5 05 03508 0,35–0,8 8 ≤ > 28, 1, 1,08–1, 1081 0, 0350 0,35–0, 1,08–1 108 035 0,35–0 1,08– 03 0,35– 1,08 0,35 1,0 0,3

ABSTRACT Objective: The aim of this study was to analyze the association between participation in fitness-related exercises (FRE) and body image dissatisfaction (BID) in adolescents and evaluate the interaction between physical exercise and nutritional status in this association. Methods: A cross-sectional study was conducted in 2015 involving 799 adolescents (10–16 years old) from 14 public schools in Curitiba (PR), Brazil. BID was assessed using the Body Shape Questionnaire and the Silhouette Scale. The FRE was classified as “does not practice,” “practices ≤300 min/week,” and “practices >300 min/week” by the Physical Activity Questionnaire for Adolescents. Poisson and multinomial logistic regressions, adjusted for sex, sexual maturation, and nutritional status analyzed the association of FRE and BID. Results: The BID prevalence was 28.3%; 52.4% of the adolescents wanted to reduce their silhouettes; and 48.7% did not practice FRE. Adolescents who practiced FRE >300 min/week had a 28% higher prevalence for some level of BID (PR 1.28; 95%CI 1.08–1.52) and a 46% lower chance of wanting to reduce silhouettes (OR 0.54; 95%CI 0.35–0.82), compared to nonpractitioners. There was no interaction between FRE and nutritional status in association with BID. Conclusions: The adolescents who practice FRE >300 min/week are likely to have some level of BID and are less likely to report the desire to increase their silhouettes, regardless of their nutritional status. Objective fitnessrelated fitness related (FRE (BID Methods crosssectional cross sectional 201 79 10–16 1016 10 16 (10–1 old 1 PR, PR , (PR) Brazil Scale does practice, practices 300 ≤30 min/week, minweek min week >30 regressions sex maturation Results 28.3% 283 28 3 524 52 4 52.4 487 48 7 48.7 1.28 128 95CI CI 95 1.08–1.52 108152 08 46 OR 0.54 054 0 54 0.35–0.82, 035082 0.35–0.82 35 82 0.35–0.82) nonpractitioners Conclusions 20 10–1 101 (10– 30 ≤3 >3 28.3 2 5 52. 48. 1.2 12 9 1.08–1.5 10815 0.5 05 03508 0.35–0.8 8 10– (10 ≤ > 28. 1. 1.08–1. 1081 0. 0350 0.35–0. (1 1.08–1 108 035 0.35–0 ( 1.08– 03 0.35– 1.08 0.35 1.0 0.3

ABSTRACT Objective: To evaluate the predictive validity and cut-off point of heart rate and blood pressure on heart rate variability (HRV) changes in children with and without obesity. Methods: This study included 125 children, of whom 41 were normal weight and 84 were obese. Anthropometry, blood pressure, heart rate, and HRV were measured using an electronic scale and stadiometer, a sphygmomanometer, and HRV monitor. In addition, the receiver operating characteristic (ROC) curve was obtained by statistical analysis of the data. Results: Heart rate proved to be a good predictor for changes in the square root of the mean of the square of the differences between consecutive NN intervals (RMSSD) parameter in students of both sexes for the normal-weight group (ROC 0.89; 95%CI 0.77–1.00) and obesity (ROC 0.90; 95%CI 0.83–0.97). In addition, the heart rate cut-off point for alterations in the RMSSD parameter for normal-weight boys was 93 bpm (sensitivity 100.00% and specificity 87.50%) and for boys with obesity, the established cut-off point was 91 bpm (sensitivity 94.74% and specificity 63.64%). Heart rate also proved to be a good predictor considering low-frequency/high-frequency ratio (LF/HF) and standard deviation of long-term continuous NN intervals /standard deviation of the instantaneous variability of continuous NN intervals in the Poincaré graph ratio (SD2/SD1). Systolic and diastolic blood pressures were good predictors in more specific stratifications and, therefore, can be used in some cases. Conclusions: The predictive validity of heart rate was shown to be at a good level, with high sensitivity and acceptable specificity for the cut-off points according to the different analyses stratified by gender and nutritional status. In this sense, health professionals will be able to use heart rate to estimate cardiovascular risk in children of different sexes and nutritional status. Objective cutoff cut off (HRV Methods 12 4 8 obese Anthropometry stadiometer sphygmomanometer monitor addition ROC data Results (RMSSD normalweight 0.89 089 0 89 95CI CI 95 0.77–1.00 077100 77 1 00 0.90 090 90 0.83–0.97. 083097 0.83–0.97 . 83 97 0.83–0.97) 9 10000 100 100.00 87.50% 8750 87 50 9474 94 74 94.74 63.64%. 6364 63.64% 63 64 63.64%) lowfrequency/highfrequency lowfrequencyhighfrequency low frequency/high frequency LF/HF LFHF LF HF (LF/HF longterm long term SD2/SD1. SD2SD1 SDSD SD2/SD1 SD2 SD1 SD (SD2/SD1) therefore cases Conclusions level status sense 0.8 08 0.77–1.0 07710 7 0.9 09 08309 0.83–0.9 1000 10 100.0 87.50 875 5 947 94.7 636 63.64 6 lowfrequency highfrequency frequencyhigh SD2SD SD2/SD (SD2/SD1 0. 0.77–1. 0771 0830 0.83–0. 100. 87.5 94. 63.6 (SD2/SD 0.77–1 077 083 0.83–0 87. 63. 0.77– 07 0.83– 0.77 0.83 0.7

RESUMO Objetivo: Avaliar a validade preditiva e o ponto de corte da frequência cardíaca e da pressão arterial nas alterações da variabilidade da frequência cardíaca (VFC) em crianças com e sem obesidade. Métodos: Foram incluídas 125 crianças neste estudo, sendo 41 com peso normal e 84 com obesidade. Antropometria, pressão arterial, frequência cardíaca e VFC foram medidas por meio de balança eletrônica e estadiômetro, esfigmomanômetro e monitor de VFC. Além disso, a curva característica de operação do receptor (ROC) foi obtida pela análise estatística dos dados. Resultados: A frequência cardíaca mostrou-se um bom preditor de alterações no parâmetro de raiz quadrada da média do quadrado das diferenças entre os intervalos NN consecutivos (RMSSD) em escolares de ambos os sexos para o grupo de peso normal (ROC 0,89; IC95% 0,77–1,00) e obesidade (ROC 0,90; IC95% 0,83–0,97). Além disso, o ponto de corte da frequência cardíaca para alterações no parâmetro RMSSD para meninos com peso normal foi de 93 bpm (sensibilidade 100,00% e especificidade 87,50%), e para meninos com obesidade, o ponto de corte estabelecido foi de 91 bpm (sensibilidade 94,74% e especificidade 63,64%). A frequência cardíaca também se mostrou um bom preditor considerando os índices da relação baixa frequência/alta frequência (LF/HF) e razão desvio padrão de intervalos NN contínuos de longo prazo/desvio padrão da variabilidade instantânea de intervalos NN contínuos na relação gráfica de Poincaré (SD2/SD1). As pressões arteriais sistólicas e diastólicas foram bons preditores em estratificações mais específicas e, portanto, podem ser utilizadas em alguns casos. Conclusões: A validade preditiva da frequência cardíaca mostrou-se em bom nível, com alta sensibilidade e especificidade aceitável para os pontos de corte, conforme as diferentes análises estratificadas por sexo e estado nutricional. Desta forma, os profissionais de saúde poderão utilizar a frequência cardíaca para estimar o risco cardiovascular em crianças de diferentes sexos e estado nutricional. Objetivo (VFC Métodos 12 estudo 4 8 Antropometria estadiômetro disso ROC dados Resultados mostrouse (RMSSD 0,89 089 0 89 IC95 IC 0,77–1,00 077100 77 1 00 0,90 090 90 0,83–0,97. 083097 0,83–0,97 . 83 97 0,83–0,97) 9 10000 100 100,00 87,50%, 8750 87,50% , 87 50 87,50%) 9474 94 74 94,74 63,64%. 6364 63,64% 63 64 63,64%) frequênciaalta LF/HF LFHF LF HF (LF/HF prazodesvio prazo SD2/SD1. SD2SD1 SDSD SD2/SD1 SD2 SD1 SD (SD2/SD1) portanto casos Conclusões nível nutricional forma 0,8 08 IC9 0,77–1,0 07710 7 0,9 09 08309 0,83–0,9 1000 10 100,0 875 87,50 5 947 94,7 636 63,64 6 SD2SD SD2/SD (SD2/SD1 0, 0,77–1, 0771 0830 0,83–0, 100, 87,5 94, 63,6 (SD2/SD 0,77–1 077 083 0,83–0 87, 63, 0,77– 07 0,83– 0,77 0,83 0,7

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Resumo Introdução: A deficiência de crescimento na doença renal crônica está relacionada à elevada morbidade e mortalidade. O retardo do crescimento nessa doença é multifatorial. É fundamental conhecer os fatores modificáveis e estabelecer estratégias para melhorar o atendimento às crianças afetadas. Objetivos: Descrever padrões de crescimento em crianças com DRC e fatores de risco associados à baixa estatura. Métodos: Analisamos retrospectivamente dados antropométricos e epidemiológicos, peso ao nascer, prematuridade e níveis de bicarbonato, hemoglobina, cálcio, fosfato, fosfatase alcalina e paratormônio de crianças com DRC estágios 3–5, não submetidas a diálise, acompanhadas por pelo menos um ano. Resultados: Incluímos 43 crianças, a maioria meninos (65%). O escore z médio de altura/comprimento/idade das crianças no início e no acompanhamento foi de –1,89 ± 1,84 e –2,4 ± 1,67, respectivamente (p = 0,011). Cinquenta e um por cento das crianças apresentaram baixa estatura, e essas crianças eram mais jovens que aquelas com estatura adequada (p = 0,027). Níveis de PTH no início do acompanhamento correlacionados com escore z de altura/comprimento/idade. Uma subanálise com crianças menores de cinco anos (n = 17) mostrou que 10 (58,8%) delas apresentaram déficit de desenvolvimento e escore z de peso/idade mais baixo (0,031) e escore z de IMC/idade mais baixo (p = 0,047). Conclusão: Crianças, especialmente mais jovens, com DRC, que não estavam em diálise, apresentaram elevada prevalência de baixa estatura. Níveis de PTH foram correlacionados com escore z de altura, e deficiência de crescimento foi associada a pior estado nutricional. Portanto, é essencial monitorar o crescimento dessas crianças, controlar o hiperparatireoidismo e fornecer suporte nutricional. Introdução mortalidade multifatorial afetadas Objetivos Métodos epidemiológicos nascer bicarbonato hemoglobina cálcio fosfato 35 3 5 3–5 diálise ano Resultados 4 65%. 65 65% . (65%) alturacomprimentoidade altura comprimento idade 189 1 89 –1,8 184 84 1,8 24 2 –2, 167 67 1,67 p 0,011. 0011 0,011 0 011 0,011) 0,027. 0027 0,027 027 0,027) n 17 58,8% 588 58 8 (58,8% pesoidade 0,031 0031 031 (0,031 IMCidade IMC 0,047. 0047 0,047 047 0,047) Conclusão Crianças nutricional Portanto 3– 6 (65% 18 –1, 1, –2 16 1,6 001 0,01 01 002 0,02 02 58,8 (58,8 0,03 003 03 (0,03 004 0,04 04 (65 –1 – 00 0,0 58, (58, (0,0 (6 0, (58 (0, ( (5 (0

Abstract Introduction: Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount. Objectives: To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature. Methods: We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3–5 CKD not on dialysis, followed for at least one year. Results: We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was –1.89 ± 1.84 and –2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047). Conclusion: Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support. Introduction mortality multifactorial paramount Objectives Methods data weight prematurity bicarbonate hemoglobin calcium phosphate phosphatase 35 3 5 3– year Results 4 65%. 65 65% . (65%) heightlength length age zscore z score followup follow up 189 1 89 –1.8 184 84 1.8 24 2 –2. 167 67 1.67 p 0.011. 0011 0.011 0 011 0.011) Fiftyone Fifty 0.027. 0027 0.027 027 0.027) heightlengthage zscore. score. subanalysis sub analysis n 17 58.8% 588 58 8 (58.8% weightage 0.031 0031 031 (0.031 BMIage BMI 0.047. 0047 0.047 047 0.047) Conclusion Children ones zscore, score, status Therefore hyperparathyroidism support 6 (65% 18 –1. 1. –2 16 1.6 001 0.01 01 002 0.02 02 58.8 (58.8 0.03 003 03 (0.03 004 0.04 04 (65 –1 – 00 0.0 58. (58. (0.0 (6 0. (58 (0. ( (5 (0

Abstract Introduction: The malnutrition-inflammation process is one of the main causes of morbidity and mortality in patients with chronic kidney disease (CKD), influencing quality of life. The aim of this study was to identify the inflammatory and nutritional status of elderly hemodialysis (HD) and its association with quality of life. Methods: This study was carried out in health services in three different cities. The Malnutrition-Inflammation Score (MIS) was used to assess the inflammatory and nutritional status, with anthropometric measurements, protein status, lean mass and function. The quality of life was assessed using KDQOL-SFTM. Data were analyzed using multivariate analysis and the Poisson model to evaluate the factors that increased the risk of developing malnutrition and inflammation. Results: The MIS identified a 52.2% prevalence of malnutrition and inflammation in the population. In univariate analysis, most KDQOL-SFTM domains presented higher scores for nourished elderly. Anthropometric measures associated with muscle mass and functionality were lower in the malnourished elderly. Multivariate modeling revealed a higher nutritional risk of 50.6% for women and older age, since with each additional year of life the risk of malnutrition increased by 2.4% and by 0.4% with each additional month on HD. Greater arm muscle circumference (AMC) and higher serum albumin were factors for reducing malnutrition by 4.6% and 34.7%, respectively. Conclusion: Higher serum albumin and preserved AMC have been shown to be good indicators of better nutritional status. Higher MIS was associated with poorer quality of life, older age, lower income and education, longer time on dialysis, and presence of comorbidities. Introduction malnutritioninflammation CKD, CKD , (CKD) HD (HD Methods cities MalnutritionInflammation Malnutrition Inflammation (MIS measurements function KDQOLSFTM. KDQOLSFTM KDQOL SFTM. SFTM Results 522 52 2 52.2 population 506 50 6 50.6 age 24 4 2.4 04 0 0.4 (AMC 46 4.6 347 34 7 34.7% respectively Conclusion education dialysis comorbidities (CKD 5 52. 50. 2. 0. 4. 3 34.7 34.

Resumo Introdução: O processo de desnutrição-inflamação é uma das principais causas de morbimortalidade em pacientes com DRC, influenciando a qualidade de vida. O objetivo deste estudo foi identificar o estado inflamatório e nutricional de idosos em hemodiálise (HD) e sua associação com qualidade de vida. Métodos: Estudo realizado em serviços de saúde de três cidades diferentes. O Escore de Desnutrição-Inflamação (MIS, por sua sigla em inglês) foi utilizado para avaliar estado inflamatório e nutricional, com medidas antropométricas, estado proteico, massa magra e funcionalidade. A qualidade de vida foi avaliada com KDQOL-SFTM. Os dados foram analisados utilizando análise multivariada e modelo de Poisson para avaliar fatores que aumentaram o risco de desenvolver desnutrição e inflamação. Resultados: O MIS identificou prevalência de 52,2% de desnutrição e inflamação na população. Na análise univariada, a maioria dos domínios do KDQOL-SFTM apresentou escores maiores para idosos nutridos. Medidas antropométricas associadas à massa muscular e funcionalidade foram menores em idosos desnutridos. A modelagem multivariada revelou maior risco nutricional de 50,6% para mulheres e idosos pois o risco de desnutrição aumentou em 2,4% para cada ano adicional de vida e em 0,4% para cada mês adicional de HD. Maior circunferência muscular do braço (CMB) e maior albumina sérica foram fatores de redução da desnutrição em 4,6% e 34,7%, respectivamente. Conclusão: Demonstrou-se que albumina sérica mais elevada e CMB preservada são bons indicadores de melhor estado nutricional. Maior MIS foi associado a pior qualidade de vida, idade mais avançada, menor renda e escolaridade, maior tempo em diálise e presença de comorbidades. Introdução desnutriçãoinflamação DRC HD (HD Métodos diferentes DesnutriçãoInflamação Desnutrição Inflamação MIS, (MIS inglês proteico KDQOLSFTM. KDQOLSFTM KDQOL SFTM. SFTM Resultados 522 52 2 52,2 população univariada nutridos desnutridos 506 50 6 50,6 24 4 2,4 04 0 0,4 (CMB 46 4,6 347 34 7 34,7% respectivamente Conclusão Demonstrouse Demonstrou se avançada escolaridade comorbidades 5 52, 50, 2, 0, 4, 3 34,7 34,

Abstract Introduction: The nursing process is the method that allows us to administer care to people with chronic diseases through the disease stages, that is, assessment, diagnostic reasoning, nursing care plan and evaluation. Objective: Evaluate a nursing care plan for an older adult with type 2 diabetes mellitus and osteoporosis with a focus on therapeutic health education. Methodology: Observational, descriptive, and longitudinal clinical case study of a 63-year-old patient with diabetes mellitus and osteoporosis; the Marjory Gordon instrument was used for assessment, and standardized language was used for diagnostic reasoning, planning, execution and evaluation. Under bioethical principles, this is a minimal risk research, and the privacy and data of the elderly are protected. Results: Alteration was found in the pattern of perception/maintenance of health, nutritional/metabolic, exercise activity and coping with stress; with the establishment of activities to control glucose, priority was given to prescribed diet, exercise, adherence to treatment and coping with stress. Acceptance of the disease, learning to take capillary glucose and glycemic control was achieved, as well as adherence to the prescribed diet and exercise. Conclusions: Therapeutic health education achieved adherence to pharmacological and non-pharmacological treatment, as well as the acceptance of the health status, which allows acquiring self-control of the disease. Continuous and long-term follow-up is important due to the pathological progress, age and general deterioration of the patient.

Abstrato Introdução. O processo de enfermagem é o método que nos permite administrar a assistência a pessoas com doenças crônicas por meio dos estágios da doença, ou seja, avaliação, raciocínio diagnóstico, plano de assistência de enfermagem e avaliação. Objetivo: Avaliar um plano de cuidados de enfermagem para um adulto mais velho com diabetes mellitus tipo 2 e osteoporose com foco na educação terapêutica em saúde. Metodologia: Estudo de caso clínico observacional, descritivo e longitudinal de uma paciente de 63 anos com diabetes mellitus e osteoporose; para a avaliação foi utilizado o instrumento Marjory Gordon para raciocínio diagnóstico, planejamento, execução e avaliação, para raciocínio diagnóstico, planejamento, execução e avaliação, foi utilizada a linguagem padronizada. De acordo com os princípios bioéticos, essa é uma pesquisa de risco mínimo, e a privacidade e os dados dos idosos são protegidos. Resultados: Foi encontrada alteração no padrão de percepção/manutenção da saúde, nutricional/metabólico, atividade física e enfrentamento do estresse; com o estabelecimento de atividades para controlar a glicose, a prioridade foi dada à dieta prescrita, aos exercícios, à adesão ao tratamento e ao enfrentamento do estresse. Houve aceitação da doença, aprendizado da medição da glicose capilar e controle glicêmico, além de adesão à dieta e aos exercícios prescritos. Conclusões: A educação terapêutica em saúde conseguiu a adesão ao tratamento farmacológico e não farmacológico, bem como a aceitação do estado de saúde, que permite adquirir o autocontrolo da doença, sendo importante a monitorização contínua e a longo prazo da evolução patológica, da idade e da deterioração geral do paciente.

Resumen Introducción: El proceso de enfermería es el método que nos permite administrar los cuidados a personas con enfermedades crónicas a través de sus etapas: valoración, razonamiento diagnóstico, plan de cuidados de enfermería y evaluación. Objetivo: Evaluar un plan de cuidados de enfermería a una adulta mayor con diabetes mellitus tipo 2 y osteoporosis con enfoque a la educación para la salud terapéutica. Metodología: Estudio de caso clínico, observacional, descriptivo y longitudinal, a paciente de 63 años con diabetes mellitus y osteoporosis; para la valoración se empleó el instrumento de Marjory Gordon, para el razonamiento diagnóstico, planeación, ejecución y evaluación se utilizó el lenguaje estandarizado de enfermería. Bajo los principios bioéticos es una investigación de riesgo mínimo, se protege la privacidad y datos del adulto mayor. Resultados: Se encontró alteración en el patrón percepción / mantenimiento de la salud, nutricional / metabólico, actividad ejercicio y afrontamiento del estrés; estableciendo actividades para el control de su glucosa, se priorizó en dieta prescrita, ejercicio, adherencia al tratamiento y afrontamiento al estrés. Se logró aceptación de la enfermedad, aprendizaje de toma de glucosa capilar y control glucémico, además del apego a dieta y ejercicio prescrito. Conclusiones: La educación para la salud terapéutica logró el apego al tratamiento farmacológico y no farmacológico, así como la aceptación del estado de salud le permite adquirir el autocontrol de su enfermedad, es importante el seguimiento continuo y a largo plazo por el avance patológico, edad y deterioro general de la paciente.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Abstract Objective Platelet to albumin ratio (PAR) and prognostic nutritional index (PNI) are potential indicators for evaluating nutritional and inflammatory status. This study aimed to examine the relationship between PAR and PNI and the acute complicated course of acute hematogenous osteomyelitis (AHO). Methods AHO patients were divided into the simple course group and the acute complicated course group. The patient's gender, age, site of infection, body temperature, laboratory results, and pathogen culture results were collected and compared. Multivariate logistic regression analysis was used to determine the independent risk factors of the acute complicated course group. The receiver operating characteristic curve was applied to determine the optimal cut-off value. Results In total, 101 AHO patients with a median age of 7.58 years were included. There were 63 cases (62.4 %) in the simple course group and 38 cases (37.6 %) in the complicated course group. Binary logistic regression analysis revealed that PAR and PNI were independent risk factors for predicting the acute complicated course of AHO (p = 0.004 and p < 0.001, respectively). Receiver operating characteristic curve analysis demonstrated that the combination of PAR and PNI had an area under the curve of 0.777 (95 % CI: 0.680-0.873, p < 0.001) with a cut-off value of 0.51. Conclusions The incidence of acute complicated courses was significantly higher in patients with high PAR and low PNI. A combined factor greater than 0.51, derived from PAR and PNI measurements within 24 h of admission, may be useful for predicting AHO patients who are likely to develop severe disease. (PAR (PNI status AHO. . (AHO) patient s gender infection temperature compared cutoff cut off total 10 758 7 58 7.5 included 6 62.4 624 62 4 (62. 3 37.6 376 37 (37. 0004 0 004 0.00 0001 001 0.001 respectively. respectively respectively) 0777 777 0.77 95 (9 CI 0.6800.873, 06800873 0.680 0.873, 680 873 0.680-0.873 051 51 0.51 2 admission disease (AHO 1 75 5 7. 62. (62 37. (37 000 00 0.0 077 77 0.7 9 ( 6800 0.6800.873 0680087 0680 0.68 0873 0.873 68 87 0.680-0.87 05 0.5 (6 (3 0. 07 0.6800.87 068008 068 0.6 087 0.87 8 0.680-0.8 0.6800.8 06800 06 08 0.8 0.680-0. 0.6800. 0.680-0 0.6800 0.680-

Abstract Objective To compare the phase angle (PhA) through bioelectrical impedance (BIA) of children with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by an Intestinal Rehabilitation Program, with a control group. Methods Children under 10 years of age with IF using prolonged PN for >60 days (study group) were included. The control group consisted of healthy children without chronic pathologies, matched by sex and age. Anthropometric parameters evaluated were: weight, height, weight/age z-score (W/A), height/age z-score (H/A), BMI, BMI/A z-score, arm circumference, triceps skinfold, subscapular skinfold, mid-arm muscle circumference. BIA parameters were resistance (R), reactance (Xc), and phase angle (PhA). Results Twenty-eight children were included in the study group, median (IQR) age was 11 (8-27) months, 53.6 % were male. In the control group, 28 children were included, median (IQR) age was 12.5 (8-24.7) months, 50 % were male. Children from the study group had W/A z-scores and H/A z-scores significantly lower than controls. There was no significant difference between PhA in the study group and controls, [median (IQR) 4.3° (3.8;4.6) vs 4.0° (3.8;5.4) respectively, p = 0.980]. Prematurity was significantly higher in the study group than in the controls, but there was no significant correlation between gestational age at birth and PhA of the children from the study group. Conclusion Children with IF using prolonged PN showed lower W/A and H/A compared to the control group, but without significant difference between the PhA of children with IF compared to controls. (PhA (BIA (IF (PN Program 1 60 >6 pathologies weight height weightage zscore z score W/A, WA , W A (W/A) heightage H/A, HA H (H/A) BMI BMIA zscore, score, circumference skinfold midarm mid R, R (R) Xc, Xc (Xc) PhA. . Twentyeight Twenty eight IQR (IQR 827 8 27 (8-27 months 536 53 6 53. male 2 125 12 5 12. 824.7 8247 24.7 24 7 (8-24.7 zscores scores controls 43 4 3 4.3 3.84.6 3846 3.8 4.6 (3.8;4.6 40 0 4.0 3.85.4 3854 5.4 (3.8;5.4 respectively 0.980. 0980 0.980 980 0.980] > (W/A (H/A (R (Xc 82 (8-2 824 824. 247 24. (8-24. 4. 84 3.84. 384 38 3. 46 (3.8;4. 85 3.85. 385 54 5. (3.8;5. 098 0.98 98 (8- (8-24 3.84 (3.8;4 3.85 (3.8;5 09 0.9 9 (8 (3.8; 0. ( (3.8 (3. (3

Abstract Objectives: Age at menarche (MA) is a proxy for biological maturation and a parameter of socioeconomic changes. Worldwide, anticipation of menarche is associated with nutritional transition and excess weight. The objective of this study was to evaluate the MA in Amazonian students and its association with nutritional status, ethnicity, and socioeconomic level. Methods: Cross-sectional study with 1,017 students aged 6 to 17 living in the city of Manaus, Brazil. MA was analyzed by status quo and recall; its association with body mass index (BMI), race, socioeconomic status, and adult height was examined. Results: 559 (51.9%) participants had already experienced menarche. In 91.7%, menarche occurred between 10 and 14 years of age; the mean age at the onset of menarche was 11.9 years. Overweight (11.6 years) and obese (11.4 years) participants reached menarche earlier than those with normal weight (12 years) and lean (12.7 years) participants. The associations between MA and nutritional status showed that overweight and obesity are risk factors for the early occurrence of menarche. MA was not associated with socioeconomic status/parental education or race. However, excess weight was associated with earlier MA in all races and social classes. The adult height was slightly lower in girls with menarche before 12 years old (157.9 vs 159.4 cm). Conclusion: Regardless of socioeconomic level or ethnicity, excess weight was associated with earlier menarche in Amazonian students. Objectives (MA changes Worldwide ethnicity Methods Crosssectional Cross sectional 1017 1 017 1,01 Manaus Brazil recall BMI, BMI , (BMI) race examined Results 55 51.9% 519 51 9 (51.9% 917 91 7 91.7% 119 11 11. 11.6 116 (11. 11.4 114 4 (1 12.7 127 (12. statusparental parental However classes 157.9 1579 157 (157. 1594 159 159. cm. cm . cm) Conclusion 101 01 1,0 (BMI 5 51.9 (51.9 91.7 (11 ( 12. 157. 15 (157 0 1, 51. (51. 91. (15 (51 (5

The South African food system is facing severe challenges as increasing hunger, rising food costs, lack of dietary diversity, child stunting, foodborne illnesses, food waste and an obesity epidemic coupled with malnutrition are observed. In this study, we aimed to establish the application of science and technology advances in the food and beverage industry in South Africa in response to food consumption pattern changes since 1994 and how they could be used to address food security challenges. We found that food consumption shifts have been towards sugar-sweetened beverages, processed and packaged food, animal-source foods and added caloric sweeteners, and away from vegetables. These dietary shifts are concerning as they relate to public health. Most commitments to improve the nutritional status of South Africans have been limited to corporate social investment strategies and should be extended into core business strategies. Furthermore, although the South African food and beverage industry has kept pace with developments in food manufacturing practices, there has been little experimentation with non-commercial novel technologies. The expert survey revealed that indigenous African crops and food waste recovery are the two most promising emerging food sources that could be available to South Africans in the shortest time frame. South Africa has many enabling drivers to become a global leader in food technology advances. However, many barriers need to be overcome for industry, academia and government to collaborate to advance novel food science and technologies to reach commercialisation. SIGNIFICANCE: • Drivers and consequences of food consumption changes in South Africa were modelled and broad food consumption trends between 1994 and 2009/2012 were identified. • For the first time, the Access to Nutrition Index methodology was applied to South African owned food companies to identify strategies to enhance nutrition practices. Companies need to do more to deliver affordable and accessible products. • Drivers and barriers in adopting advanced food science and technology were modelled. A collective ecosystem approach with industry, academia and government mobilisation around critical areas like hunger, malnutrition and poverty could be a way to tackle the failing food system.

Resumen La desnutrición infantil constituye un desafío de gran importancia en el ámbito de la salud pública. El objetivo de la investigación fue evaluar la influencia de los factores sociales y culturales en el estado nutricional en niños menores ecuatorianos de 2 años, en la ciudad de Portoviejo, Provincia de Manabí, durante el año 2023. Se realizó una investigación prospectiva, descriptiva, transversal y observacional. La población pediátrica incluyó 169 menores de dos años, cuyas madres proporcionaron los datos pertinentes. Los factores sociales predominantes fue el nivel educativo del cuidador del niño comprendida entre 7 a 12 años de estudios con la presencia de casos de desnutrición crónica en un 83,9%; además, la limitada contribución financiera del progenitor para la alimentación del infante con casos de desnutrición aguda en un 88,6%. Dentro de los factores culturales, se encontró que los niños con esquema de vacunación incompleto presentaban desnutrición crónica con un 88,7%, la falta de los controles prenatales, al igual que la inasistencia al primer control prenatal antes del quinto mes con casos de desnutrición aguda en un 95,5%; además, se evidenció que la estimulación para la ingesta de alimentos y la falta de práctica de la lactancia materna exclusiva con la presencia de desnutrición crónica en los menores, con un 98,4% y un 96,8%, respectivamente. En este entorno, el estado nutricional de mayor tendencia fue la desnutrición crónica con un 34,3%. Además, se identificó una asociación significativa de relación de dependencia (p<0,05) entre los factores sociales, culturales y el estado nutricional.

Abstract Child malnutrition constitutes a challenge of great importance in the field of public health. The objective of the research was to evaluate the influence of social and cultural factors on the nutritional status in Ecuadorian children under 2 years of age in the city of Portoviejo, Province of Manabí, during the year 2023. A prospective, descriptive, crooss-sectional and observational research was carried. The pediatric population included 169 children under two years of age, whose mothers provided the relevant data. The predominant social factors were the educational level of the child's caregiver, ranging from 7 to 12 years of education, with the presence of cases of chronic malnutrition in 83.9%; in addition, the limited financial contribution of the parent to feeding the infant with cases of acute malnutrition in 88.6%. Within the cultural factors, it was found that children with an incomplete vaccination presented chronic malnutrition with 88.7%, the lack of prenatal check-ups, as well as non-attendance at the first prenatal check-up before the fifth month with cases of malnutrition acute in 95.5%; Furthermore, it was evidenced that the stimulation of food intake and the lack of practice of exclusive breastfeeding with the presence of chronic malnutrition in minors, with 98.4% and 96.8%, respectively. In this environment, the most trending nutritional status was chronic malnutrition with 34.3%. In addition, a significant association of dependency relationship (p<0.05) was identified between social and cultural factors and nutritional status.

ABSTRACT Introduction: Although the cause of childhood obesity is multifactorial, it is known that breastfeeding (BF) could be a protective element. Objective: To determine the association of obesity in children with the duration of BF, parental educational levels and types of employment and family formation in a group of children from Encarnación, Paraguay. Methodology: This was a longitudinal, retrospective and descriptive study with an analytical component carried out in 200 children of both sexes. Nutritional status was evaluated at 2, 4 and 6 years, duration of BF. Families were grouped according to parental education levels and types of employment (Group A: up to 6th grade of Elementary Education [EE] and informal economy work; Group B: up to 12th grade of EE and public/commercial employment; Group C: tertiary education and managerial employment positions or business ownership. A value of p <0.05 was considered significant. Results: 50% (n=100) were men, 96.5% (n=193) from urban areas, 70% (n=140) came from nuclear families, 73% (n=146) were families from group B. BF duration was ≤4 months 5.5% (n=11), up to 6 months 9% (n=18), 7 to 11 months 20.5% (n=41), continued BF (≥1 year) 63 .5%(n=127). 14.5%, 18% and 18.5% were obese at 2, 4 and 6 years respectively. There was greater obesity at 4 years with BF <6 months (42.9% vs 16.1% Chi2 p=0.02), but not at 2 or 6 years. No significant association of obesity with parental employment or educational level or with the presence of a partner (Chi2 p≥0.05). Conclusion: Breastfeeding duration of less than 6 months is associated with a higher frequency of obesity at 4 years of age.

RESUMEN Introducción: Aunque la causa de la obesidad infantil es multifactorial, se sabe que la lactancia materna (LM) podría ser un elemento protector. Objetivo: Determinar la asociación de obesidad en los niños con la duración de la LM, escolaridad y tipo de empleo de padres y conformación familiar en un grupo de niños de Encarnación-Paraguay. Metodología: estudio longitudinal, retrospectivo y descriptivo con componente analítico realizado con 200 niños de ambos sexos. Se evaluó estado nutricional a los 2, 4 y 6 años, duración de LM, agrupación familiar según nivel de escolaridad y tipo de empleo (Grupo A: hasta 6° grado de la Educación Escolar Básica (EEB) y trabajo informa; 2)Grupo B: hasta 3° de EEB y empleados públicos/comerciales; 3)Grupo C: educación terciaria y cargos jerárquicos o dueños de corporaciones.Se consideró valor de p<0,05 como significativo. Resultados: 50%(n=100) fueron varones, 96,5%(n=193) del área urbana, 70%(n=140) con familia nuclear, 73%(n=146) fueron familias del grupo B. Tuvo LM ≤4 meses el 5,5%(n=11), hasta 6 meses 9%(n=18), 7 a 11 meses el 20,5%(n=41), LM continuada (≥1 año) el 63,5%(n=127). Presentaron obesidad el 14,5%, 18% y 18,5% a los 2, 4 y 6 años respectivamente. Hubo mayor obesidad a los 4 años con LM <6 meses (42,9% vs 16,1% Chi2 p=0,02), no así a los 2 o 6 años. Sin asociación significativa de obesidad con tipo de empleo y escolaridad de los padres o con presencia de pareja (Chi2 p≥0,05). Conclusión: La duración de lactancia materna menor a 6 meses se asocia con mayor frecuencia de obesidad a los 4 años.

Abstract Objective: To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD). Methods: Cross-sectional study involving 161 adolescents with a body mass index ≥ + 1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %. Results: It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL. Conclusion: The adolescent at higher risk is younger with higher fasting glycemia levels. Objective SAD. SAD . (SAD) Methods Crosssectional Cross sectional 16 zScore, zScore z Score, Score z-Score years intimamedia intima media (IMT status adiposity pressure profile sex dispersion frequency outcome variable independent correlation software Results 237 23 7 23. thickening lowest increase 024 0 24 0.2 mgdL mg dL mg/dL Conclusion levels (SAD 2 02 0.

Abstract In Argentina, obesity has been on the rise since 2005. The factors shown to be associated with obesity are of a socio-environmental and genetic nature. Among the latter, the FTO gene has been the most extensively studied. The aim of the present work was to analyze the relationship between two markers of the FTO gene, namely rs9939609 and rs11075997, and socio-environmental variables with nutritional status in a sample of 155 individuals from Puerto Madryn, Chubut. Body mass index (BMI) and waist-to-height index (WHtR) were calculated, and multiple linear models were tested to determine the influence of genetic and non-genetic variables on these anthropometric indices. Nutritional status was significantly and negatively associated with educational level and physical activity. The allele reported in the literature as risk allele of the marker rs11075997 was significantly associated with an increase in anthropometric indices in an additive model, more so with WHtR than with BMI. It is necessary to carry out work on a larger scale that will allow us to determine the frequency of the genetic markers of predisposition to obesity studied here and their distribution in our country. Rev Arg Antrop Biol 26(1), 073, 2024. https://doi.org/10.24215/18536387e073

Resumen En Argentina, el exceso de peso aumentó continuamente desde el 2005 hasta el presente. Los factores con probada relación con el exceso de peso son socio-ambientales y genéticos. Entre estos últimos, el gen FTO es el más estudiado. El objetivo de este trabajo fue analizar la relación entre dos marcadores del gen FTO (rs9939609 y rs11075997) y variables socio-ambientales con el estado nutricional en una muestra de 155 personas de Puerto Madryn, Chubut. Se calcularon los índices de masa corporal (IMC) y de cintura-talla (ICT), y se probaron modelos lineales múltiples para conocer la influencia de las variables genéticas y no genéticas sobre dichos índices antropométricos. El nivel educativo y la actividad física estuvieron asociados significativamente y de manera negativa con el estado nutricional. El alelo reportado en la literatura como de riesgo del marcador rs11075997 estuvo significativamente asociado con el aumento de los índices antropométricos bajo un modelo aditivo, en mayor medida con el ICT que con el IMC. Es necesario realizar trabajos a mayor escala que permitan identificar la frecuencia de los marcadores genéticos de predisposición a obesidad aquí estudiados y su distribución en nuestro país. Rev Arg Antrop Biol 26(1), 073, 2024. https://doi.org/10.24215/18536387e073