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Repercussions of SARS-CoV-2 infection and the pandemic on birth routes: a cross-sectional study
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Oliveira, Isabela Carolina de Paula

; Geraldo, Letícia Marcella Cordeiro Soares

; Faria, Ana Paula Vieira

; Silva, Thales Philipe Rodrigues da

; Amorim, Torcata

; Pereira, Patricia Feliciano

; Souza, Kleyde Ventura de

; Matozinhos, Fernanda Penido

Revista Gaúcha de Enfermagem

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2023, Volume 44 elocation e20220320

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

ABSTRACT Objective: To assess the repercussions of SARS-CoV-2 infection (suspected or confirmed) and the context of the pandemic on the birth route and humanized assistance during childbirth. Method: Cross-sectional epidemiological study, nested within a cohort and comparative with the research “Birth in Belo Horizonte: Survey on Childbirth and Delivery”.The medical records of three reference maternity hospitals in Belo Horizonte were assessed, with a final sample of 1,682 pregnant women, in the months of May, June and July 2020. A descriptive analysis was carried out, with absolute and relative frequency, and a comparative one, with a Pearson’s chi-square test. Results: It was observed that 2.02% of pregnant women were infected with SARS-CoV-2.Before the pandemic, out of a total of 390 pregnant women, 74.10% gave birth vaginally.During a pandemic, among infected women, 51.61% gave birth via cesarean section and 48,39% via vaginal delivery;among uninfected, 26.99% cesarean sections and 73.01% vaginaldeliveries. Conclusion: There was an increase in the percentage of cesarean sections and a possible influence of the pandemic on the rates of indication of cesarean sections at the time of admission to the maternity ward.

RESUMO Objetivo: Avaliar as repercussões da infecção por SARS-CoV-2 (suspeita ou confirmada) e do contexto da pandemia na via de nascimento e na assistência humanizada ao parto. Método: Estudo epidemiológico transversal, aninhado a uma coorte e comparativo com a pesquisa “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento”. Avaliou-se prontuários de três maternidades-referência em Belo Horizonte, com amostra final de 1.682 parturientes, nos meses de maio, junho e julho de 2020. Realizou-se análise descritiva, com frequência absoluta e relativa, e comparativa, com teste Qui-quadrado de Pearson. Resultados: Observou-se que, 2,02% das gestantes estavam infectadas por SARS-CoV-2. Antes da pandemia, em um total de 390 gestantes, 74,10% pariram via vaginal. Durante a pandemia, nas mulheres infectadas, 51,61% pariram pela via cesariana e 48,39% pela vaginal; nas não infectadas, 26,99% cesarianas e 73,01% vaginais. Conclusão: Observou-se aumento percentual de cesarianas e possível influência da pandemia nas taxas de indicação de cesarianas no momento da admissão na maternidade.

RESUMEN Objetivo: Evaluar las repercusiones de la infección por SARS-CoV-2 (sospechosa o confirmada) y el contexto de la pandemia en la vía del parto y la asistencia humanizada durante el parto. Método: Estudio epidemiológico transversal, anidado en una cohorte y comparativo con la investigación “Nacimiento en Belo Horizonte: Encuesta sobre Parto y Parto”.Se enviaron los prontuarios de tres maternidades de referencia en Belo Horizonte, con una muestra final de 1.682 gestantes, en los meses de mayo, junio y julio de 2020. Se realizó un análisis descriptivo, con frecuencia absoluta y relativa, y comparativo. uno, con una prueba de Chi, cuadrado de Pearson. Resultados: Tenga en cuenta que el 2,02% de las mujeres embarazadas estaban infectadas con SARS-CoV-2.Antes de la pandemia, en un total de 390 gestantes, el 74,10% daba a luz por vía vaginal.Durante una pandemia, entre las mujeres infectadas, el 51,61% dio a luz por cesárea y el 48,39% por parto vaginal;en las no infectadas, 26,99% cesáreas y 73,01% vaginales. Conclusión: Hubo un aumento en el porcentaje de cesáreas y una posible influencia de la pandemia en las tasas de indicación de cesáreas al momento del ingreso a la sala de maternidad.

https://doi.org/10.1590/1983-1447.2023.20220320.en

Association between food consumption and the Quality of Diet Index Adapted for pregnant women
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Gotine, Ana Raquel Ernesto Manuel

; Filgueiras, Mariana De Santis

; Ribeiro, Sarah Aparecida Vieira

; Araújo, Raquel Maria Amaral

; Pereira, Patrícia Feliciano

Revista Brasileira de Saúde Materno Infantil

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2023, Volume 23 elocation e20210361

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Objectives: to investigate the association between the Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) (Quality of Diet Index Adapted for Pregnant Women) with food consumption, lifestyle and health information. Methods: cross-sectional study with 110 pregnant women assisted at a public health service. Sociodemographic, nutritional and health data were collected from medical records. Food consumption was investigated through the usual intake, for a nutritional analysis, DietPro® program version 6.1 was used. Quality ofdiet was assessed using the IQDAG. Multinomial logistic regression was used to investigate an association between food consumption and IQDAG. Results: the average total score of the IQDAG was 61.3 (±26.1), this is the best quality of the diet. After adjusting for age, schooling and physical activity, the highest consumption of vitamin A (OR=1.04; CI95% = 1.02-1.07) and B2 (OR=2.63; CI95% = 1.19-5.70) was associated with a greater chance of having a better quality of diet (3rdtertile of the IQDAG). Conclusions: pregnant women with better quality of diet had higher intakes of vitamins A and B2. However, other population-based studies are suggested to more broadly in verify its association with food consumption and its ability to identify adherence to nutritional recommendations.

Resumo Objetivos: investigar a associação entre o Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) com o consumo alimentar e hábitos de vida e informações de saúde. Métodos: estudo transversal com 110 gestantes atendidas em um serviço público de saúde. Os dados sociodemográficos, nutricionais e de saúde foram coletados a partir dos prontuários de atendimento. O consumo alimentar foi investigado por meio do recordatório de ingestão habitual, para a análise nutricional foi utilizado o Programa DietPro® versão 6.1. A qualidade da dieta foi avaliada utilizando o IQDAG. A regressão logística multinomial foi usada para investigar a associação entre o consumo alimentar e IQDAG. Resultados: a média da pontuação total do IQDAG foi 61,3 (±26,1), isto é uma melhor qualidade da dieta. Após ajuste por idade, escolaridade e atividade física, o maior consumo de vitamina A (OR=1,04; IC95%= 1,02-1,07) e B2 (OR= 2,63; IC95%= 1,19-5,70) esteve associado a maior chance da gestante apresentar uma melhor qualidade da dieta (3º tercil do IQDAG). Conclusões: gestantes com melhor qualidade da dieta tiveram maior ingestão das vitaminas A e B2. Entretanto, sugere-se outros estudos de base populacional para verificar de forma mais ampla sua associação com o consumo alimentar e sua capacidade de identificar a adesão as recomendações nutricionais.

https://doi.org/10.1590/1806-9304202320210361-en

Maternal and child characteristics correlated with frequency of consuming ultra-processed food by children aged 6 to 24 months old
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Soares, Marcela Martins

; Ribeiro, Andreia Queiroz

; Pereira, Patrícia Feliciano

; Franceschini, Sylvia Carmo Castro

; Araújo, Raquel Maria Amaral

Revista Brasileira de Saúde Materno Infantil

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jun 2022, Volume 22 N. 2 Pages 365 - 373

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivos: verificar a correlação do consumo de alimentos ultraprocessados de mães e filhos menores de dois anos de idade e as principais características relacionadas a este consumo. Métodos: estudo transversal conduzido nos serviços públicos de saúde. Aplicaram-se três recordatórios de 24 horas para avaliar o consumo alimentar. Os alimentos ultraprocessados foram agrupados em: bebidas açucaradas; carnes; molhos e cremes; lácteos; lanches; massas; e mucilagens. Calculou-se o Índice de Massa Corporal e a relação cintura/quadril da mãe, índice peso/estatura, estatura/idade, peso/idade e índice de massa corporal/idade da criança. Correlacionou-se a frequência de ultraprocessados na alimentação das crianças com: variáveis antropométricas da díade; frequência de ultraprocessados na alimentação materna. Comparou-se a média do consumo de ultraprocessados das crianças com uso de chupeta, mamadeira, aleitamento materno e condição socioeconômica. Modelos de regressão linear foram conduzidos. Resultados: avaliou-se 172 pares. Foi verificada semelhança no consumo de ultraprocessados de mães e filhos. A maior frequência de ultraprocessados correlacionou-se a maior idade da criança e ao maior índice de massa corporal/idade e índice peso/idade. Dos 39 alimentos ultraprocessados presentes na alimentação das mães, 22 correlacionaram com os da criança. Conclusão: o consumo de ultraprocessados pelas crianças se assemelha ao das mães e correlacionase com maiores valores dos índices peso/idade e índice de massa corporal/idade.

Abstract Objectives: to verify the correlation between the consumption of ultra-processed food among mothers and children under two years of age and the main characteristics related to this consumption. Methods: cross-sectional study conducted in public health services. Three 24-hour recalls were applied to assess food intake. The ultra-processed food was grouped into: sugary drinks; meat; sauces and creams; dairy products; snacks; pastas; and mucilage. Themother’s body mass index and waist/hip ratio, and the child’s weight/height, height/age, weight/age and body mass index/age were calculated. The children’s ultra-process frequency as correlated with: anthropometric dyadic variables; ultra-process frequency on breastfeeding. The children’s average ultra-process intake was compared to pacifier, bottle, breastfeeding and socioeconomic status. Linear regression models were conducted. Results: 172 pairs were evaluated. Similarity was found in the mothers and children’s consumption of ultra-processed products. The higher frequency of ultra-processed products was correlated with older child and the higher body mass/age index and weight/age index. Of the 39 ultra-processed food present in the mothers’ diet, 22 were correlated to child’s Conclusion: the consumption of ultra-processed food by children is similar to their mothers and correlates with higher z-score values of weight/age and body mass/age index.

https://doi.org/10.1590/1806-9304202200020010

Maternal overweight and its relation with child’s anthropometric indices
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Soares, Marcela Martins

; Juvanhol, Leidjaira Lopes

; Ribeiro, Andreia Queiroz

; Pereira, Patrícia Feliciano

; Franceschini, Sylvia C. C.

; Araújo, Raquel Maria Amaral

Revista Brasileira de Saúde Materno Infantil

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jun 2021, Volume 21 N. 2 Pages 379 - 388

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivos: investigar a relação do excesso de peso materno com índices antropométricosinfantis, identificando a interação da idade da criança. Métodos: estudo transversal com mães e seus filhos menores de 2 anos. Calculou-se o índice de massa corporal (IMC), relação cintura quadril e relação cintura estaturadas mães. Nas crianças, calculou-se os índices estatura/idade (E/I), índice de massa corporal/idade (IMC/I), peso/estatura (P/E) e peso/idade (P/I). Comparou-se as médias dos índices antropométricos das crianças com excesso de peso e risco cardiometabólico materno. Correlacionou-se índices antropométricos infantis e maternos. Modelos de regressão linear foram propostos. Foi investigada interação da idade da criança com variáveis antropométricas da díade. Resultados: as médias do IMC/I e P/E foram maiores em filhos de mães com excesso de peso e as médias do IMC/I, P/E e P/I foram maiores quando mães apresentaram risco aumentado para doenças cardiometabólicas. Verificou-se associação do peso e estatura materna com o índice P/I; do IMC materno com P/E; da estatura materna com E/I; do peso, IMC e perímetro da cintura materna com IMC/I. A idade das crianças não interagiu com os parâmetros avaliados. Conclusão: crianças menores de 2 anos, cujas mães têm excesso de peso, tendem a apresentar alteração no peso, independente da idade.

Abstract Objectives: to investigate the relation between maternal overweight and child’s anthropometric indices, identifying the interaction with the child's age. Methods: a cross-sectional study with mothers and their children under 2 years old. The mothers’ body mass index (BMI), waist-to-hip ratio and waist-to-height ratio was calculated. In children, we calculated height/age (H/A), body mass index/age (BMI/A), weight/height (W/H) and weight/age (W/A) indices. The means of the anthropometric indices of children with excess weight and maternal cardiometabolic risk were compared. Mothers and children’s anthropometric indices were correlated. Linear regression models were proposed. We investigated the child's age interaction with anthropometric variables of the dyad. Results: the means of BMI/A and W/H were higher in children of overweight mothers and the means of BMI/A, W/H and W/A were higher when mothers had increased risk for cardiometabolic diseases. There was an association of maternal weight and height with the W/A index; maternal BMI with W/H; maternal height with H/A; maternal weight, BMI and waist circumference with BMI/A. The children's age did not interact with the assessed parameters. Conclusion: children under 2 years of age, whose mothers are overweight, tend to show changes in weight, regardless of age.

https://doi.org/10.1590/1806-93042021000200003 106 downloads

Diretriz Brasileira de Cardio-oncologia – 2020
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Hajjar, Ludhmila Abrahão

; Costa, Isabela Bispo Santos da Silva da

; Lopes, Marcelo Antônio Cartaxo Queiroga

; Hoff, Paulo Marcelo Gehm

; Diz, Maria Del Pilar Estevez

; Fonseca, Silvia Moulin Ribeiro

; Bittar, Cristina Salvadori

; Rehder, Marília Harumi Higuchi dos Santos

; Rizk, Stephanie Itala

; Almeida, Dirceu Rodrigues

; Fernandes, Gustavo dos Santos

; Beck-da-Silva, Luís

; Campos, Carlos Augusto Homem de Magalhães

; Montera, Marcelo Westerlund

; Alves, Sílvia Marinho Martins

; Fukushima, Júlia Tizue

; Santos, Maria Verônica Câmara dos

; Negrão, Carlos Eduardo

; Silva, Thiago Liguori Feliciano da

; Ferreira, Silvia Moreira Ayub

; Malachias, Marcus Vinicius Bolivar

; Moreira, Maria da Consolação Vieira

; Valente Neto, Manuel Maria Ramos

; Fonseca, Veronica Cristina Quiroga Soeiro, Maria Carolina Feres de Almeida Alves, Juliana Barbosa Sobral Silva, Carolina Maria Pinto Domingues Carvalho Sbano, João Pavanello, Ricardo Pinto, Ibraim Masciarelli F. Simão, Antônio Felipe Dracoulakis, Marianna Deway Andrade Hoff, Ana Oliveira Assunção, Bruna Morhy Borges Leal Novis, Yana Testa, Laura Alencar Filho, Aristóteles Comte de Cruz, Cecília Beatriz Bittencourt Viana Pereira, Juliana Garcia, Diego Ribeiro Nomura, Cesar Higa Rochitte, Carlos Eduardo Macedo, Ariane Vieira Scarlatelli Marcatti, Patricia Tavares Felipe Mathias Junior, Wilson Wiermann, Evanius Garcia Val, Renata do Freitas, Helano Coutinho, Anelisa Mathias, Clarissa Maria de Cerqueira Vieira, Fernando Meton de Alencar Camara Sasse, André Deeke Rocha, Vanderson Ramires, José Antônio Franchini Kalil Filho, Roberto

Arquivos Brasileiros de Cardiologia

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nov 2020, Volume 115 N. 5 Pages 1006 - 1043

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20201006 4180 downloads

Body composition indices in Brazilian adults: age-specific and sex-specific percentile curves
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Carvalho, Cristiane Junqueira de Longo, Giana Zarbato Juvanhol, Leidjaira Lopes Kakehasi, Adriana Maria Pereira, Patrícia Feliciano Segheto, Kátia Josiany Freitas, Brunnella Alcântara Chagas de Ribeiro, Andréia Queiroz

Archives of Endocrinology and Metabolism

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aug 2019, Volume 63 N. 4 Pages 358 - 368

Abstract: En | Text: En | PDF: En

ABSTRACT Objective To establish percentile curves for measures and indices of body composition by age and sex and compare them with data from other ethnic groups. Subjects and methods Cross-sectional, population-based study with adults aged 20-59 years (n = 689). Percentile curves adjusted by a third degree polynomial function were constructed for skeletal mass index (SMI), fat mass index, body fat, and load-capacity metabolic indices (LCMI) based on dual-energy X-ray absorptiometry (DXA). Results SMIweight and SMIBMI showed decline from the third decade of life in both sexes, whereas SMIheight was not able to identify lean mass loss over the ages studied. There was a slight drop at the end of the fifth decade (50-59 years) in men. Among Americans and Chinese, the 50th percentile curve of SMIheight showed an earlier decline. The estimates of adiposity and LCMI curves peaked between 40-49 years and Americans and Chinese maintained an upward curve throughout adulthood. Conclusion The data and curves showed that the SMI adjusted for BMI and body weight were more adequate in detecting the decline of lean mass in adults due to aging. In contrast, SMIheight had a positive correlation with age and its curve increased throughout the evaluated age groups. The results contribute to the evaluation to the nutritional status of adults and to the prevention and treatment of outcomes related to adiposity and deficit lean mass.

https://doi.org/10.20945/2359-3997000000124 1329 downloads

ÍNDICE RELAÇÃO CINTURA-ESTATURA PARA PREDIÇÃO DO EXCESSO DE PESO EM CRIANÇAS
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Vieira, Sarah Aparecida Ribeiro, Andréia Queiroz Hermsdorff, Helen Hermana Miranda Pereira, Patrícia Feliciano Priore, Silvia Eloiza Franceschini, Sylvia do Carmo Castro

Revista Paulista de Pediatria

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mar 2018, Volume 36 N. 1 Pages 52 - 58

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Identificar um indicador de adiposidade abdominal de baixo custo e com maior acurácia para predizer o excesso de peso em crianças de quatro a sete anos idade. Métodos: Estudo transversal com amostra de 257 crianças de 4 a 7 anos. Os indicadores de adiposidade abdominal avaliados foram: perímetro da cintura (PC), relação cintura-estatura (RCE) e percentual de gordura central (avaliado pela técnica dual energy X-ray absorptiometry - DEXA). O excesso de peso foi classificado pelo índice de massa corporal por idade (IMC/I). Nas análises, estimou-se a razão de prevalência (RP) pela regressão de Poisson com variância robusta e utilizou-se a curva (receiver operating characteristics - ROC), considerando como significância estatística p<0,05. Resultados: A prevalência de excesso de peso foi de 24,9%, e observou-se maior mediana dos indicadores de adiposidade abdominal no grupo de crianças com excesso de peso. As crianças com valores aumentados de PC (RP=4,1; IC95% 2,86-5,86), RCE (RP=5,76; IC95% 4,14-8,02) e percentual de gordura central (RP=2,48; IC95% 1,65-3,73) apresentaram maior prevalência de excesso de peso. Verificou-se, na análise de curva ROC, que o índice RCE apresentou maior área sob a curva, comparado ao PC e ao percentual de gordura central estimada pelo DEXA, na predição do excesso de peso. Conclusões: Diante dos resultados, sugere-se a utilização da RCE para triagem de crianças com excesso de peso.

ABSTRACT Objective: To identify a low-cost abdominal adiposity index that has a higher accuracy in predicting excess weight in children aged four to seven years old. Methods: A cross-sectional study with a sample of 257 children aged 4 to 7 years old. Indicators of abdominal adiposity assessed were: waist circumference (WC), waist-to-height ratio (WHR) and central fat percentage (measured by dual energy X-ray absorptiometry - DEXA). Overweight children were classified using body mass index by age (BMI/age). In the analysis, the prevalence ratio (PR) using Poisson regression with a robust variance was estimated, and a receiver operating characteristic (ROC) curve was built, with a statistical significance of p<0.05. Results: The prevalence of overweight children was 24.9% and a higher median of all abdominal adiposity indicators was observed in the overweight group. Children with increased values of WC (PR=4.1; 95%CI 2.86-5.86), WHR (PR=5.76; 95%CI 4.14-8.02) and a central fat percentage (PR=2.48; 95%CI 1.65-3.73) had a higher prevalence of being overweight. Using the ROC curve analysis, the WHR index showed a higher area under the curve, when compared to the WC and to the central fat percentage estimated by DEXA for predicting the classification of being overweight. Conclusions: Given the results, WHR is suggested for the screening of overweight children.

https://doi.org/10.1590/1984-0462/;2018;36;1;00002 5273 downloads

Neck circumference, cardiometabolic risk, and Framingham risk score: Population-based study
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ZANUNCIO, Virgínia Vinha PESSOA, Milene Cristine PEREIRA, Patrícia Feliciano LONGO, Giana Zarbato

Revista de Nutrição

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dec 2017, Volume 30 N. 6 Pages 771 - 781

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Investigar a associação da circunferência do pescoço com fatores de risco cardiometabólico e escore de risco de Framinghan. Métodos Estudo transversal de base populacional com 948 adultos (522 mulheres), de 20 a 59 anos. Fatores sociodemográficos, antropométricos, de composição corporal, comportamentais, bioquímicos e hemodinâmicos foram mensurados. Associação entre circunferência do pescoço, variáveis antropométricas, de composição corporal e fatores de risco cardiometabólico foi avaliada por regressão linear múltipla, ajustada por fatores sociodemográficos e comportamentais. Resultados Foram apresentados como coeficientes β, erros-padrão e intervalos de confiança de 95% com nível de significância de 0,05. Circunferência do pescoço associou-se positivamente com triglicerídeos, índice de resistência a insulina, ácido úrico, pressão arterial sistólica e diastólica, proteína C-reativa, circunferência da cintura, índice de massa corporal e gordura corporal total estimada pela absorciometria por dupla emissão de raios-X. Circunferência do pescoço e lipoproteinas de alta densidade colesterol apresentaram associação negativa. Estas associações permaneceram significativas mesmo após ajuste por fatores sociodemográficos e comportamentais. Indivíduos com circunferência do pescoço abaixo do ponto de corte para predição de risco cardiometabólico (39,5cm para homens e 33,3cm para mulheres), apresentaram menor probabilidade de evento coronariano em 10 anos que aqueles com circunferência do pescoço acima do ponto de corte. Conclusão A circunferência do pescoço é uma alternativa para estimar a gordura corporal, podendo ser usado como instrumento adicional de triagem durante a avaliação de pacientes assintomáticos com risco cardiovascular.

ABSTRACT Objective To investigate the association of the neck circumference with cardiometabolic risk factors and the Framingham risk score. Methods The study was a cross-sectional population-based one with 948 adults (522 women) aged 20–59 years. Sociodemographic, anthropometric, body composition, behavioral, biochemical, and hemodynamic factors were evaluated. The association between neck circumference, anthropometric variables, body composition and cardiometabolic risk factors was evaluated by multiple linear regression, adjusted for sociodemographic and behavioral factors. Results Are presented as β coefficients, standard errors, and 95% confidence intervals with a 0.05 significance level. The neck circumference was positively associated with triglycerides, insulin resistance index, uric acid, systolic and diastolic blood pressure, C-reactive protein, waist circumference, body mass index and total body fat estimated by dual energy X-ray absorptiometry. The neck circumference and high-density lipoprotein cholesterol were negatively associated, even after adjustment for sociodemographic and behavioral factors. Individuals with a neck circumference below the cut-off point to predicting cardiometabolic risks, 39.5cm for men and 33.3cm for women, had lower probability of having a coronary event in 10 years compared to those with a neck circumference above the cut-off point. Conclusion Neck circumference is an alternative measure to estimate body fat and as an additional marker to screen for cardiovascular risk diseases.

https://doi.org/10.1590/1678-98652017000600009 1840 downloads

Association of inflammation, dyslipidemia, obesity and physical activity status in children
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Guedes, Juliano Magalhães Mamêde Neto, José Bontempo Andaki, Alynne Christian Ribeiro Pereira, Patrícia Feliciano Oliveira, Michelle Dias de Dias, Roberto Sousa Paula, Sérgio Oliveira de Natali, Antônio José Rogério, Alexandre de Paula Mendes, Edmar Lacerda

Motriz: Revista de Educação Física

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jun 2016, Volume 22 N. 2 Pages 18 - 26

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to verify the association between inflammatory biomarkers, dyslipidemia, obesity and physical activity status in 10-years old children. Ninety-four children participated in this study and were classified into eutrophic (n=36), overweight (n=34) or obese (n=24) according to their body mass index (BMI). The genic expression of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and chemokine C-C motif ligand 2 (CCL-2) mRNA; the serum concentration of high-density lipoprotein cholesterol (HDL-c) and triglycerides; BMI, percentage of body fat (% BF) and waist circumference; and the number of steps per day were determined. The expression of IL-6, TNF-α and CCL-2 were associated (p < 0.05) positively with serum triglycerides, BMI, % BF and waist circumference, and negatively with serum HDL-c. No association (p > 0.05) between pro-inflammatory biomarkers and number of steps per day was found.

https://doi.org/10.1590/S1980-6574201600020003 1834 downloads

10.

Hypertriglyceridemic waist phenotype and cardiometabolic alterations in Brazilian adults
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Rocha, Anna Ligia Cabral da Pereira, Patricia Feliciano Pessoa, Milene Cristine Alfenas, Rita de Cássia Gonçalves Segheto, Wellington Silva, Danielle Cristina Guimarães da Andrade, Márcio Pacheco de Longo, Giana Zarbato

Nutrición Hospitalaria

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sep 2015, Volume 32 N. 3 Pages 1099 - 1106

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Aims: the present study aims to evaluate the prevalence of cardiometabolic changes according to the hypertriglyceridemic waist (HW) phenotype in Brazilian adults. Methods: it is a population based transversal study with 976 adults (n = 533 women) 20-59 years old. Phenotype was defined by triglycerides concentration (TGL) ≥150 mg/dl and waist circumference (WC) ≥80 cm in females and ≥90 cm in males. All the analyses were adjusted according to the study design and pondered by gender, age and schooling. A descriptive analysis was performed through averages and ratios; their respective confidence intervals were herein presented (CI 95%). The prevalence of cardiometabolic changes due to the presence of HW and to gender was calculated and compared by means of Pearson�fs chi-square test. Statistic significance level was 0.05. The probability of coronary event risk was estimated in 10 years and calculated from Framinghan score, using Kernel density graph. Results: no difference in phenotype prevalence between genders was observed. Higher averages in all the cardiometabolic risk factors analyzed and higher probability of evolving to a cardiovascular event in 10 years were observed in individuals with the HW phenotype. Lower HDL values were only verified in this group. Conclusion: the HW phenotype is an important cardiovascular risk sign and allows the premature identification of individuals with higher risk, so that its use in clinical practice must be encouraged, mainly because it is a simple low cost asset.

Objetivos: evaluar la prevalencia de alteraciones cardiometabólicas según el fenotipo cintura hipertrigliceridémica (CH) en adultos brasileños. Métodos: estudio transversal, de base poblacional, con 976 (n = 533 mujeres) individuos de 20 a 59 años. El CH fue definido por un aumento en las concentraciones de triglicéridos y en la circunferencia de la cintura (CC). Todos los análisis fueron ajustados por el efecto del diseño del estudio y ponderados por género, edad y escolaridad. Fue realizado un anaìlisis descriptivo de promedio y presentados sus respectivos intervalos de confianza (IC 95%). La prevalencia de las alteraciones cardiometabólicas según la presencia o no del fenotipo CH y según el sexo fue calculada y comparada a través del test chi-cuadrado de Pearson. El nivel de significancia estadística adoptado fue de 0,05. Se estimó la probabilidad de riesgo de evento coronario en 10 años, a partir del score de Framinghan a través del gráfico de densidad de Kernel. Resultados: la prevalencia del fenotipo CH en la muestra fue de 17,32% (IC 95% 13,54-21,89), no se observó diferencia entre sexos. Se observaron mayores promedios para todos los factores de riesgo cardiometabólico analizados en aquellos con CH. Sólo Se verificaron menores valores medianos para el HDL en este grupo. Los individuos con CH presentaban mayor probabilidad de evolucionar hacia un evento cardiovascular en 10 años que aquellos sin el fenotipo. Conclusión: el fenotipo CH constituye un importante marcador precoz del riesgo cardiovascular. Su utilización en la práctica clínica debe ser incentivada, ya que se trata de una herramienta sencilla y de bajo coste.

https://doi.org/10.3305/nh.2015.32.3.9305

11.

Anthropometric indices to identify metabolic syndrome and hypertriglyceridemic waist phenotype: a comparison between the three stages of adolescence
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Pereira, Patrícia Feliciano Faria, Franciane Rocha de Faria, Eliane Rodrigues de Hermsdorff, Helen Hermana Miranda Peluzio, Maria do Carmo Gouveia Franceschini, Sylvia do Carmo Castro Priore, Silvia Eloiza

Revista Paulista de Pediatria

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jun 2015, Volume 33 N. 2 Pages 194 - 203

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Determinar a ocorrência de síndrome metabólica (SM) e do fenótipo cintura hipertrigliceridêmica (CH) em amostra de adolescentes e estabelecer qual indicador antropométrico melhor identifica SM e CH, de acordo com gênero e fase da adolescência. MÉTODOS: Estudo transversal com 800 adolescentes (414 meninas) de 10-19 anos. Indicadores antropométricos (índice de massa corporal, perímetro da cintura, relação cintura/estatura, relação cintura/quadril e relação pregas cutâneas centrais/periféricas) foram determinados por protocolos padronizados. Para diagnóstico da SM, foi usada a proposta de Ferranti et al. (2004). A CH foi definida pela presença simultânea de perímetro da cintura aumentado (>75 percentil por idade e sexo) e triglicerídeos elevados (>100 mg/dL). O desempenho dos indicadores antropométricos foi avaliado por meio da curva Receiver Operating Characteristic. RESULTADOS: A prevalência de SM foi idêntica à de CH (6,4%), sem diferenças entre os gêneros e entre as fases da adolescência. O perímetro da cintura apresentou maior área abaixo da curva no diagnóstico da SM, exceto para meninos entre 17-19 anos, para os quais a relação cintura/estatura exibiu melhor desempenho. No diagnóstico da CH, a cintura isolada apresentou maior área abaixo da curva, exceto para os meninos nas fases inicial e final da adolescência, nos quais a relação cintura/estatura obteve maior área. A relação entre as pregas cutâneas apresentou pior desempenho para identificar SM e CH. CONCLUSÕES: O perímetro da cintura e a relação cintura/estatura mostraram o melhor desempenho para identificar SM e CH em ambos os sexos e nas três fases da adolescência.

OBJECTIVE: To determine the prevalence of metabolic syndrome (MS) and the hypertriglyceridemic waist phenotype (HW) in a representative adolescent sample; as well as to establish which anthropometric indicator better identifies MS and HW, according to gender and adolescent age. METHODS: This cross sectional study had the participation of 800 adolescents (414 girls) from 10-19 years old. Anthropometric indicators (body mass index, waist perimeter, waist/stature ratio, waist/hip ratio, and central/peripheral skinfolds) were determined by standard protocols. For diagnosis of MS, the criteria proposed by de Ferranti et al. (2004) were used. HW was defined by the simultaneous presence of increased waist perimeter (>75th percentile for age and sex) and high triglycerides (>100 mg/dL). The ability of anthropometric indicators was evaluated by Receiver Operating Characteristic curve. RESULTS: The prevalence of MS was identical to HW (6.4%), without differences between genders and the adolescence phases. The waist perimeter showed higher area under the curve for the diagnosis of MS, except for boys with 17-19 years old, for whom the waist/stature ratio exhibited better performance. For diagnosing HW, waist perimeter also showed higher area under the curve, except for boys in initial and final phases, in which the waist/stature ratio obtained larger area under the curve. The central/peripheral skinfolds had the lowest area under the curve for the presence of both MS and HW phenotype. CONCLUSIONS: The waist perimeter and the waist/stature showed a better performance to identify MS and HW in both genders and in all three phases of adolescence.

https://doi.org/10.1016/j.rpped.2014.10.001 3747 downloads

12.

Measurements of body fat distribution: assessment of collinearity with body mass, adiposity and height in female adolescents
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Pereira, Patrícia Feliciano Serrano, Hiara Miguel Stanciola Carvalho, Gisele Queiroz Ribeiro, Sônia Machado Rocha Peluzio, Maria do Carmo Gouveia Franceschini, Sylvia do Carmo Castro Priore, Silvia Eloiza

Revista Paulista de Pediatria

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mar 2015, Volume 33 N. 1 Pages 63 - 71

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Verificar a correlação entre medidas de localização da gordura corporal com índice de massa corporal (IMC), percentual de gordura corporal (%GC) e estatura, de acordo com o estado nutricional em adolescentes do sexo feminino. MÉTODOS: Realizou-se estudo transversal controlado, com 113 adolescentes (G1: 38 eutróficas mas com gordura corporal elevada; G2: 40 eutróficas e G3: 35 com excesso de peso), de 14 a 19 anos, de escolas públicas de Viçosa-MG. Aferiu-se peso, estatura, circunferência da cintura (CC), circunferência umbilical (CUm), circunferência do quadril (CQ), circunferência da coxa, relação cintura/quadril (RCQ), relação cintura/estatura (RCE), relação cintura/coxa (RCC), índice de conicidade (IC), diâmetro abdominal sagital (DAS), diâmetro coronal (DC), pregas cutâneas centrais (PCC) e periféricas (PCP). Avaliou-se o %GC por bioimpedância elétrica tetrapolar. RESULTADOS: O aumento da gordura central, representada pela CC, CUm, RCE, DAS, DC e PCC, e o aumento da gordura periférica indicado pela CQ e da coxa foram proporcionais ao aumento do IMC e %GC. A CC e principalmente CUm apresentaram as correlações mais fortes com a adiposidade, enquanto RCQ, RCC, IC e PCC/PCP as mais fracas. A estatura apresentou correlação com praticamente todas as medidas de localização de gordura, sendo de fraca a regular com as medidas da cintura. CONCLUSÕES: Os resultados indicam colinearidade entre massa corporal e adiposidade total com tecido adiposo central e periférico. Recomenda-se o emprego da CUm na avaliação do estado nutricional de adolescentes, pois ela apresentou maior capacidade para predizer adiposidade em cada grupo, além de correlação fraca a regular com a estatura.

OBJECTIVE : To verify the correlation between body fat location measurements with the body mass index (BMI), body fat percentage (BF%) and height, according to the nutritional status in female adolescents. METHODS : A controlled cross-sectional study was carried out with 113 adolescents (G1: 38 with normal weight, but with high body fat level, G2: 40 with normal weight and G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following measures were assessed: weight, height, waist circumference (WC), umbilical circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), conicity index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central (CS) and peripheral skinfolds (PS). The BF% was assessed by tetrapolar electric bioimpedance. RESULTS : The increase in central fat, represented by WC, UC, WHtR, SAD, CD and CS, and the increase in peripheral fat indicated by HC and thigh circumference were proportional to the increase in BMI and BF%. WC and especially the UC showed the strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and CS/PS with adiposity were observed. The height showed correlation with almost all the fat location measures, being fair or weak with waist measurements. CONCLUSIONS : The results indicate colinearity between body mass and total adiposity with central and peripheral adipose tissue. We recommend the use of UC for assessing nutritional status of adolescents, as it showed the highest capacity to predict adiposity in each group, and also showed fair or weak correlation with height.

https://doi.org/10.1016/j.rpped.2014.11.011 13861 downloads

13.

Nutritional status, metabolic changes and white blood cells in adolescents
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Oliveira, Thatianne Moreira Silva Faria, Franciane Rocha de Faria, Eliane Rodrigues de Pereira, Patrícia Feliciano Franceschini, Sylvia C.C. Priore, Silvia Eloiza

Revista Paulista de Pediatria

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dec 2014, Volume 32 N. 4 Pages 351 - 359

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Analisar a relação entre as células brancas do sangue periférico e as alterações metabólicas e estado nutricional de adolescentes com e sem excesso de peso e gordura corporal.MÉTODOS: Avaliou-se, em estudo transversal, o Índice de Massa Corporal (IMC) e o percentual de gordura corporal (%GC) em 362 adolescentes de 15 a 19 anos de idade, de ambos os sexos. Os critérios gerais de inclusão foram: ter aceitado participar da pesquisa e assinado o termo de consentimento livre e esclarecido. Os critérios de exclusão foram: relatar a presença de doenças crônicas ou infecciosas; usar medicamentos que pudessem causar alteração nos exames bioquímicos; ter engravidado; ter participado de programas de redução e controle de peso; usar diuréticos/laxantes ou usar marcapasso. Realizou-se leucograma, contagem de plaquetas, ácido úrico, glicemia de jejum, insulina e perfil lipídico. Utilizaram-se os testes Kolmogorov-Smirnov, t de Student ou Mann Whitney, correlação de Pearson ou de Spearman e qui-quadrado, considerando significante p<0,05.RESULTADOS: Excesso de peso foi verificado em 20,7% dos adolescentes. O colesterol total(CT) apresentou maior porcentagem de inadequação (52,2%), seguido da lipoproteína de alta densidade (HDL) (38,4%). Encontraram-se correlações positivas entre células brancas e lipídeos séricos, insulina, gordura corporal e IMC. Os monócitos apresentaram correlação negativa com IMC e os bastonetes com IMC, gordura corporal e insulina.CONCLUSÕES: O estado nutricional está relacionado com um quadro inflamatório, sendo que adolescentes com excesso de peso e/ou de gordura corporal apresentaram maiores quantidades de células brancas.

OBJECTIVE: To analyze the relationship between the peripheral blood white cells, metabolic changes, and nutritional status of adolescents with and without excess weight and body fat.METHODS: This cross-sectional study evaluated the body mass index (BMI) and percentage body fat (%BF) in 362 adolescents from 15 to 19 years of age, of both sexes. White blood cell count, platelet count, uric acid, fasting glucose, insulin, and lipid profile were measured. The inclusion criteria were agreement to participate in the study and signature of the informed consent. Exclusion criteria were: presence of chronic or infectious disease; use of medications that could cause changes in biochemical tests; pregnancy; participation in weight reduction and weight control programs; use of diuretics and laxatives; or the presence of a pacemaker. The following statistical tests were applied: Kolmogorov-Smirnov test, Student's t or Mann-Whitney test, Pearson or Spearman correlation tests, and chi-squared test, considering p<0.05.RESULTS: Overweight was observed in 20.7% of adolescents. The total cholesterol (TC) had a higher percentage of inadequacy (52.2%), followed by high-density lipoprotein (HDL) (38.4%). There was a positive correlation between white cells and serum lipids, insulin, body fat, and BMI. Monocytes were negatively correlated with BMI, and rods with BMI, body fat, and insulin.CONCLUSIONS: Nutritional status is related to an inflammatory process, and adolescents with excess weight or body fat presented higher amounts of white blood cells.

https://doi.org/10.1590/S0103-05822014000400011 5514 downloads

14.

Aldosterone: a cardiometabolic risk hormone?
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Feliciano Pereira, Patricia Eloiza Priore, Silvia Bressan, Josefina

Nutrición Hospitalaria

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dec 2014, Volume 30 N. 6 Pages 1191 - 1202

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Introduction: A aldosterone is a component of the renin-angiotensin-aldosterone system, classically known for its role in sodium and water retention. Besides its effects, has been shown that the aldosterone is associated with the pathogenesis and progression of metabolic syndrome components. A better understanding of this system and interfering factors could help develop pharmacotherapeutic alternatives for several disorders. Objectives: Investigate the relationship between diet and aldosterone, and its influence on cardiometabolic risk factors. Results and Discussion: Diet can affect plasma aldosterone levels; high fructose and fat intake can lead to increased aldosterone levels, whereas the effect of sodium intake remains controversial. Adipose tissue, particularly visceral tissue, appears to produce a lipid-soluble factor that increases aldosterone production. Patients with metabolic syndrome have higher aldosterone levels; moreover, an increased cardiometabolic risk associated with insulin resistance could be partially mediated by the action of aldosterone via mineralocorticoid receptors. Even a subtle activation of this hormonal system may have deleterious effects on the glucose and lipid metabolism related to metabolic syndrome. Nevertheless, additional studies are required to better understand the interactions among adipose tissue, aldosterone, and cardiovascular risk as well as the possible role of diet.

Introducción: La aldosterona es un componente del sistema renina-angiotensina-aldosterona, clasicamente conocida por su papel en la retención de sodio y agua. Además de estos efectos, ha sido demostrado que la aldosterona está asociada a la patogénesis y progresión de componentes del síndrome metabólico. Una mejor comprensión de este sistema y de los factores interferentes podría ayudar a desarrollar alternativas farmacoterapéuticas para varias enfermedades. Objetivos: Investigar la relación entre dieta y aldosterona, y su influencia sobre factores de riesgo cardiometabólico. Resultados y Discusión: La dieta es capaz de modular las concentraciones plasmáticas de aldosterona; alto contenido de fructosa y la ingestión de grasa pueden llevar al aumento de los niveles de aldosterona, mientras que el efecto de la ingestión de sodio permanece polémico. El tejido adiposo, particularmente el visceral, parece producir un factor liposoluble que aumenta la producción de aldosterona. Pacientes con síndrome metabólico tienen concentraciones más elevadas de aldosterona; Además de eso, un aumento del riesgo cardiometabólico asociado con la resistencia a la insulina puede ser parcialmente mediada por la acción de la aldosterona a través de los receptores mineralocorticoides. Aunque la activación sutil de este sistema hormonal parece ejercer efectos deleterios en el metabolismo glicémico y lipídico, asociado con el síndrome metabólico. Sin embargo, otros estudios son necesarios para el entendimento de las interaciones entre tejido adiposo, aldosterona y riesgo cardiovascular, así como el posible papel de la dieta.

https://doi.org/10.3305/nh.2014.30.6.7725

15.

Glycemic index role on visceral obesity, subclinical inflammation and associated chronic diseases
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Feliciano Pereira, Patricia Almeida, Crislaine das Graças de Gonçalves Alfenas, Rita de Cassia

Nutrición Hospitalaria

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aug 2014, Volume 30 N. 2 Pages 237 - 243

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: It is believed that the glycemic index (GI) may be used as a strategy to prevent and control noncommunicable diseases (NCD). Obesity is a multifactorial condition, a risk factor for development of other NCDs. Among the different types, abdominal obesity is highlighted, which is essential for the diagnosis of metabolic syndrome, and it is related to insulin resistance, dyslipi-demia, hypertension and changes in levels of inflammatory markers. Such indicators are closely related to the development of Type 2 Diabetes and cardiovascular disease. Objectives: Discuss the role of GI as a strategy for the prevention and/or treatment of visceral obesity, subclinical inflammation and chronic diseases. Results and discussion: The intake of low GI diets is associated with glycemic decreases, and lower and more consistent postprandial insulin release, avoiding the occurrence of hypoglycemia. Moreover, consumption of a low GI diet has been indicated as beneficial for reducing body weight, total body fat and visceral fat, levels of proinflammatory markers and the occurrence of dyslipidemia and hypertension. The intake of low GI foods should be encouraged in order to prevent and control non-communicable diseases.

Introducción: Se cree que es posible emplear el índice glucémico (IG) como estrategia para prevenir y controlar enfermedades no-comunicables (ENC). La obesidad es un estado multifactorial, un factor de riesgo para el desarrollo de otras ENC. Entre las distintas manifestaciones de la obesidad, destaca la obesidad abdominal, que es fundamental para el diagnóstico del síndrome metabólico y está relacionada con resistencia a la insulina, dislipidemia, hipertensión y cambios en los niveles de marcadores inflamatorios. Estos indicadores están estrechamente relacionados con el desarrollo de diabetes de tipo 2, así como de enfermedad cardiovascular. Objetivos: Debatir el papel del IG como estrategia para la prevención y/o tratamiento de obesidad visceral, inflamación subclínica y enfermedades crónicas. Resultados y debate: La ingesta de dietas con bajo IG está asociada a incrementos glucémicos, así como una insulina postprandial más baja y más consistente, evitando la aparición de hipoglucemia. Además, el consumo de una dieta de bajo IG ha sido identificado como beneficioso para la reducción del peso corporal, la grasa corporal total y la grasa visceral, los niveles de marcadores pro-inflamatorios y la aparición de dislipidemia e hipertensión. Se debería fomentar la ingesta de alimentos con bajo IG para prevenir y controlar enfermedades no-comunicables.

https://doi.org/10.3305/nh.2014.30.2.7506

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