Abstract Objective: to analyze the relationship of age at menarche and leptin with the metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes in adolescent girls in different body mass index (BMI) categories. Method: an observational and cross-sectional study consisting of 139 female adolescents attended to at the Adolescent Reference Center in Macaé, Rio de Janeiro.: Menarche was classified as early (EM) when the first menstruation occurred at or before 11 years of age; normal menarche (NM) was categorized at ages 12 to 14; menarche was considered late (LM) when it occurred at age 15 or older. The factors required to ascertain the subjects' phenotype, as well as their leptin levels, weight, and height, were measured and their BMIs were calculated. The girls were classified as MH or MUH based on the NCEP-ATP III criteria as adapted for children and adolescents. Results: 82 % (n = 114) of the girls were classified as MH and 18 % (n = 25) as MUH. Mean age at menarche was 11.79 ± 1.39 years. There was a higher prevalence of MUH amongst the girls who had EM (p = 0.04). A higher inadequacy of serum leptin concentrations was found in girls who had EM (p = 0.05) and in those classified as MUH (p = 0.01). The adolescents who were severely obese exhibited inadequate leptin levels (p < 0.01) and had gone through EM (p = 0.02). A total of 8.1 % (n = 7) of the normal-weight girls were classified as MUH, and 29.4 % (n = 5) of those who were severely obese were classified as MH (p < 0.01). Conclusion: early menarche and high serum leptin concentrations are related with the MUH phenotype in adolescent girls in different BMI categories.

Resumen Objetivo: analizar la relacion de la edad de la menarquia y los niveles de leptina con los fenotipos metabolicamente saludables (MS) y metabolicamente no saludables (MNS) en adolescentes de diferentes categorias de indice de masa corporal (IMC). Método: estudio observacional y transversal compuesto por 139 adolescentes de sexo feminino, atendidas en el Centro de Referencia para Adolescentes de Macae, Rio de Janeiro. La menarquia se clasifico como precoz (MP) cuando se produjo la primera menstruacion a o antes de los 11 anos de edad; la menarquia normal (MN) se clasifico como aquella sucedida a la edad de 12 a 14 anos; la menarquia se consider tardia (MT) cuando ocurrio a los 15 anos o mas. Se midieron los factores necesarios para determinar el fenotipo de los sujetos, y se midieron sus niveles de leptina, peso y altura, y se calculo su IMC. Las adolescentes se clasificaron como MS y MNS segun los criterios de NCEP-ATP III, adaptados para ninos y adolescentes. Resultados: el 82 % (n = 114) de las adolescentes se clasificaron como MH y el 18 % (n = 25) como MUH. La edad media de la menarquia fue de 11,79 ± 1,39 anos. Hubo una mayor prevalencia de MUH entre las adolescentes que tenian MP (p = 0,04). Se encontro una mayor insuficiencia de las concentraciones sericas de leptina en las adolescentes que tenian MP (p = 0,05) y en aquellas clasificadas como MNS (p = 0,01). Las adolescentes que eran severamente obesas exhibieron niveles inadecuados de leptina (p < 0,01) y habian pasado por una MP (p = 0,02). El 8,1 % (n = 7) de las adolescentes de peso normal se clasificaron como MNS y el 29,4 % (n = 5) de las que eran severamente obesas se clasificaron como MS (p < 0,01). Conclusión: la menarquia temprana y las altas concentraciones sericas de leptina estan relacionadas con el fenotipo MNS en las adolescents de diferentes categorias de IMC.

Abstract Introduction: increased vitamin D deficiency occurs together with obesity and the association between these conditions has been observed. Objective: to assess the nutritional status of vitamin D and metabolic profile in adolescents and adults with obesity, and the relationship between complications arising from severe class of obesity with vitamin D nutritional status, and to compare the differences between these groups. Methods: observational comparative study. Population comprises adolescents and adults with severe obesity. Waist circumference (WC) and body mass index (BMI) were measured. Analysis of vitamin D (25(OH)D), lipid profile, C-reactive protein (CRP), blood glucose, fasting insulinemia, insulin sensitivity, blood pressure and diagnoses of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) were performed. Results: a total of 60 adolescents (G1) and 68 adults (G2) were evaluated. The percentage of vitamin D inadequacy was observed in 90% in G1 and 79.4% in G2. There was a negative and significant correlation of BMI with the values of 25(OH)D in the group of adults (r = -0.244; p = 0.045). Individuals with inadequacy of vitamin D showed higher values of CRP in both groups (p = 0.000). HOMA-IR showed a negative correlation with 25(OH)D in G1 (r = -0.832; p = 0.000) and G2 (r = -0.589; p = 0.000). The inadequacy of this vitamin showed association with high total cholesterol in G1 (p = 0.029) and higher values of LDL-c in G2 (p = 0.003). Conclusion: high prevalence of deficiency and insufficiency of vitamin D were observed, associated with metabolic changes both in obese adults and adolescents. It is necessary to develop strategies for the prevention and control of obesity and vitamin D deficiency.

Resumen Introducción: el aumento de la deficiencia de vitamina D se produce junto con la obesidad y se ha observado la asociación entre estas condiciones. Objetivo: evaluar el estado nutricional de la vitamina D y el perfil metabólico en adolescentes y adultos con obesidad, así como la relación entre las complicaciones derivadas de una clase severa de obesidad con el estado nutricional de vitamina D, y comparar las diferencias entre estos grupos. Métodos: estudio comparativo observacional. La población comprende adolescentes y adultos con obesidad severa. Se midieron la circunferencia de la cintura (CC) y el índice de masa corporal (IMC). Se realizaron análisis de vitamina D (25(OH)D), perfil lipídico, proteína C-reactiva (PCR), glucosa en sangre, insulinemia en ayunas, sensibilidad a la insulina, presión arterial y diagnósticos de enfermedad del hígado graso no alcohólico y síndrome metabólico (MS). Resultados: se evaluaron 60 adolescentes (G1) y 68 adultos (G2). El porcentaje de insuficiencia de vitamina D se observó en un 90% en G1 y un 79,4% en G2. Hubo una correlación negativa y significativa del IMC con los valores de 25(OH)D en el grupo de adultos (r = -0,244, p = 0,045). Las personas con insuficiencia de vitamina D mostraron valores más altos de PCR en ambos grupos (p = 0,000). HOMA-IR mostró una correlación negativa con 25(OH)D en G1 (r = -0,832, p = 0,000) y G2 (r = -0,589, p = 0,000). La insuficiencia de esta vitamina mostró asociación con colesterol total alto en G1 (p = 0,029) y valores más altos de c-LDL en G2 (p = 0,003). Conclusión: se observó alta prevalencia de deficiencia e insuficiencia de vitamina D, asociada a cambios metabólicos tanto en adultos obesos como en adolescentes. Es necesario desarrollar estrategias para la prevención y el control de la obesidad y la deficiencia de vitamina D.

OBJETIVO: Avaliar a ingestão de energia, de macro e de micronutrientes por adolescentes no primeiro e no segundo trimestres de gestação e estimar sua associação com o peso do concepto ao nascer. MÉTODOS: Estudo longitudinal, incluindo 139 gestantes adolescentes atendidas em serviço de pré-natal de maternidade pública, acompanhadas desde o primeiro trimestre gestacional até o puerpério imediato. Aplicou-se um questionário de frequência de consumo alimentar no primeiro e no segundo trimestres de gestação. O peso e a idade gestacional ao nascer dos recém-nascidos foram coletados dos prontuários hospitalares. Foram estimados médias e intervalo de confiança de 95%. O método dos resíduos foi utilizado para ajustar o consumo de nutrientes pelo consumo energético total. Modelos de regressão linear múltipla foram desenvolvidos para identificar os fatores associados ao peso ao nascer. RESULTADOS: O consumo médio de proteínas (p=0,02), lipídeos (p=0,02), ácidos graxos saturados (p=0,02) e monoinsaturados (p=0,05), colesterol (p=0,01), cálcio (p<0,01), potássio (p=0,01) e fósforo (p<0,01) foi mais elevado entre gestantes que tiveram filhos com peso ao nascer acima de 2500g. Idade gestacional ao parto (β=105,8; p<0,01), número de consultas de pré-natal (β=34,1; p=0,04), consumo de ácidos graxos poli-insaturados (β=7,5; p=0,04) e de ômega-3 (β=74,3; p=0,05) e de colesterol (β=0,4; p=0,04) foram variáveis preditoras do peso ao nascer em modelos de regressão linear múltipla. CONCLUSÃO: O perfil lipídico da dieta da mãe foi o principal preditor do peso do concepto ao nascer, e os resultados sugerem que o acompanhamento nutricional deva ser incluído na rotina dos serviços de atenção pré-natal.

OBJECTIVE: This study assessed energy, macronutrient, and micronutrient intakes of adolescents in the first and second trimesters of pregnancy and investigated their association with the infant's birth weight. METHODS: This longitudinal study included 139 pregnant adolescents seen at the prenatal care clinic of a public maternity hospital. They were followed from the first trimester of pregnancy until hospital discharge after delivery. The participants answered a food frequency questionnaire in the first and second trimesters of pregnancy. Birth weight and gestational age were collected from the mothers' hospital records. The means and 95% confidence intervals were calculated. The residual method was used for adjusting nutrient intake according to total energy intake. The factors associated with birth weight were identified by multiple linear regression models. RESULTS: The mothers of infants with birth weight higher than 2500 grams had higher mean intakes of protein (p=0.02), lipids (p=0.02), saturated fatty acids (p=0.02) monounsaturated fatty acids (p=0.05), cholesterol (p=0.01), calcium (p<0.01), potassium (p=0.01), and phosphorus (p<0.01). According to the multiple linear regression models, gestational age at delivery (β=105.8; p<0.01), number of prenatal care visits (β=34.1; p=0.04), intake of polyunsaturated fatty acids (β=7.5; p=0.04), intake of omega-3 fatty acids (β=74.3; p=0.05), and cholesterol intake (β=0.4; p=0.04) were predictors of birth weight. CONCLUSION: The mother's dietary lipid profile was the main predictor of the infant's birth weight and the results suggest that nutritional follow-up should be included in the prenatal care routine.

The objective of this study was to analyze retinol equivalent and iron content in different food composition tables and nutritional evaluation software programs. A literature search was conduct to identify tables and software available in Brazil containing information about retinol equivalent and iron content that are currently used by nutritionists. Ten tables and five software programs were selected for this study. The methodology used to present the retinol equivalent and iron content was evaluated and no pattern to obtain such content was found in the tables and software programs analyzed. Only one of the tables had enough information for the calculation of retinol equivalents; this table is recommended to all Latin America As for the iron content, three of the tables analyzed stand out and therefore should be used; two of them are based on national foods and the other is recommended for use in all Latin America countries. None of the software programs evaluated use the conversion factors suggested by IVACG to assess the vitamin A content in foods. Special attention should be given to the content of iron provided in the software programs since they use tables as international sources and fortified foods.