Abstract BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide. Neck circumference (NC) is a simple anthropometric adiposity parameter that has been correlated with cardiometabolic disorders like NAFLD. OBJECTIVES: To investigate the association between NC and NAFLD, considering their obesity-modifying effect, among participants from the Longitudinal Study of Adult Health (ELSA-Brasil) baseline study. DESIGN AND SETTINGS: Cross-sectional study at the ELSA-Brasil centers of six public research institutions. METHODS: This analysis was conducted on 5,187 women and 4,270 men of mean age 51.8 (± 9.2) years. Anthropometric indexes (NC, waist circumference [WC] and body mass index [BMI]), biochemical and clinical parameters (diabetes, hypertension and dyslipidemia) and hepatic ultrasound were measured. The association between NC and NAFLD was estimated using multinomial logistic regression, considering potential confounding effects (age, WC, diabetes, hypertension and dyslipidemia). Effect modification was investigated by including the interaction term NC x BMI in the final model. RESULTS: The frequency of NAFLD and mean value of NC were 33.6% and 33.9 (± 2.5) cm in women, and 45.8% and 39.4 (± 2.8) cm in men, respectively. Even after all adjustments, larger NC was associated with a greater chance of moderate/severe NAFLD (1.16; 95% confidence interval [CI] for women; 1.05, 95% CI for men; P < 0.001). Presence of multiplicative interaction between NC and BMI (P < 0.001) was also observed. CONCLUSION: NC was positively associated with NAFLD in both sexes, regardless of traditional adiposity indexes such as BMI and WC. The magnitude of the association was more pronounced among women.

Resumo A fortificação de alimentos constitui importante estratégia para o controle da deficiência de micronutrientes e apresenta como vantagens a alta cobertura populacional e o fato de não alterar hábitos alimentares. O presente estudo teve como objetivo avaliar o impacto do uso de arroz fortificado (Ultra Rice® - UR®) sobre o estado nutricional de pré-escolares. Noventa e nove crianças matriculadas em duas creches filantrópicas participaram do estudo. Para crianças de uma creche foi oferecido UR® misturado com arroz polido, como parte das refeições escolares (grupo teste) e para as da outra foi oferecido somente arroz polido (grupo controle). Avaliações bioquímicas foram realizadas antes e após 4 meses de intervenção. Avaliações dietética e sensorial do UR® misturado com arroz polido foram realizadas durante o estudo. O arroz fortificado melhorou as concentrações de zinco (p < 0,001), tiamina (p < 0 ,001), ácido fólico (p = 0,003), hemoglobina corpuscular média (p < 0,001) e hemoglobina corpuscular média (p < 0,001). O arroz fortificado mostrou boa aceitação entre os pré-escolares. Este estudo demonstrou a eficácia do uso de arroz fortificado com ferro, zinco, tiamina e ácido fólico sobre o estado nutricional das crianças.

Abstract Fortification of food constitutes an important strategy for the control of micronutrient deficiency and has advantages such as high population coverage and maintenance of eating habits. This study aimed to assess the impact of using fortified rice (Ultra Rice® - UR®) on the nutritional status of preschoolers. Ninety-nine children enrolled in two philanthropic preschools participated of the study. Children of one of the preschools were offered UR® mixed with polished rice, as part of school meals (test group) and the children of another preschool were offered pure polished rice (control group). Biochemical evaluations were performed before and after 4 months of intervention. Dietary assessment and sensory evaluation of UR® mixed with polished rice were performed during the study. The fortified rice improved the concentrations of zinc (p < 0.001), thiamine (p < 0.001), folic acid (p = 0.003), mean corpuscular hemoglobin (p < 0.001) and mean corpuscular hemoglobin concentration (p < 0.001). The fortified rice showed good acceptability among preschoolers. This study demonstrated the effectiveness of using rice fortified with iron, zinc, thiamine and folic acid on the nutritional status of children.

Resumo A fortificação de alimentos constitui importante estratégia para o controle da deficiência de micronutrientes e apresenta como vantagens a alta cobertura populacional e o fato de não alterar hábitos alimentares. O presente estudo teve como objetivo avaliar o impacto do uso de arroz fortificado (Ultra Rice® - UR®) sobre o estado nutricional de pré-escolares. Noventa e nove crianças matriculadas em duas creches filantrópicas participaram do estudo. Para crianças de uma creche foi oferecido UR® misturado com arroz polido, como parte das refeições escolares (grupo teste) e para as da outra foi oferecido somente arroz polido (grupo controle). Avaliações bioquímicas foram realizadas antes e após 4 meses de intervenção. Avaliações dietética e sensorial do UR® misturado com arroz polido foram realizadas durante o estudo. O arroz fortificado melhorou as concentrações de zinco (p < 0,001), tiamina (p < 0 ,001), ácido fólico (p = 0,003), hemoglobina corpuscular média (p < 0,001) e hemoglobina corpuscular média (p < 0,001). O arroz fortificado mostrou boa aceitação entre os pré-escolares. Este estudo demonstrou a eficácia do uso de arroz fortificado com ferro, zinco, tiamina e ácido fólico sobre o estado nutricional das crianças.

Abstract Fortification of food constitutes an important strategy for the control of micronutrient deficiency and has advantages such as high population coverage and maintenance of eating habits. This study aimed to assess the impact of using fortified rice (Ultra Rice® - UR®) on the nutritional status of preschoolers. Ninety-nine children enrolled in two philanthropic preschools participated of the study. Children of one of the preschools were offered UR® mixed with polished rice, as part of school meals (test group) and the children of another preschool were offered pure polished rice (control group). Biochemical evaluations were performed before and after 4 months of intervention. Dietary assessment and sensory evaluation of UR® mixed with polished rice were performed during the study. The fortified rice improved the concentrations of zinc (p < 0.001), thiamine (p < 0.001), folic acid (p = 0.003), mean corpuscular hemoglobin (p < 0.001) and mean corpuscular hemoglobin concentration (p < 0.001). The fortified rice showed good acceptability among preschoolers. This study demonstrated the effectiveness of using rice fortified with iron, zinc, thiamine and folic acid on the nutritional status of children.