ABSTRACT Objective: There is no consensus as to the best criterion for the evaluation of metabolic syndrome (MS), impairing the estimation of its prevalence. This study aims to compare MS estimates using three recommended definitions for adolescents based on a cross-sectional study nested in the Consortium of Brazilian Birth Cohorts in São Luís, Maranhão. Subjects and methods: A total of 2,515 adolescents aged between 18 and 19 years were evaluated. The criteria of International Diabetes Federation (IDF) and National Cholesterol Education Program Panel III (NCEP-ATP) modified by Cook and cols. (2003) and De Ferranti and cols. (2004) defined SM. To compare the estimates of MS prevalence, the chi-square, Fisher’s exact and Cohen’s Kappa index tests were used. Results: Among the 2,064 participants evaluated in the final sample. The prevalence of MS ranged from 4.2% (95% CI: 3.3-5.1) to 10.2% (95% CI: 8.8-11.4). When comparing the estimates of MS prevalence in the total sample and by sex, a statistically significant difference was observed. The agreement between the criteria ranged from 0.42 (CI 95%: 0.35-0.49) to 0.55 (CI 95%: 0.48-0.62) in the total sample, 0.33 (CI 95%: 0.24-0.42) to 0.59 (95%CI: 0.47-0.71) among boys and 0.39 (95% CI: 0.26-0.52) to 0.54 (95% CI: 0.44-0.64) among girls. Conclusion: Different criteria provide different estimates for the prevalence of MS in adolescents, reflecting the importance of establishing a consensus.

Resumo O uso de gorduras com baixo ponto de fusão é atraente para a indústria de alimentos, pois contribui para melhorar as características de textura, cor e estabilidade dos alimentos. Essas gorduras são obtidas a partir de óleos vegetais por meio de processos como hidrogenação ou interesterificação. No entanto, o processo de hidrogenação parcial leva à formação de gordura trans. Em diversos países, vêm ocorrendo ações no sentido de eliminar a presença do ácido graxo elaídico (C18:1t) dos alimentos industrializados. Esse ácido graxo trans e o ácido graxo saturado palmítico (C16:0) são comprovadamente aterogênicos. O objetivo deste trabalho foi avaliar a composição de ácidos graxos de 39 tipos de alimentos comercializados no Brasil, incluindo biscoitos, salgadinhos, bolachas, macarrão instantâneo, sanduíches e pizzas congeladas, mistura para preparo de alimentos, pipoca de micro-ondas, margarinas, requeijões e massa de pastel. Os lipídios foram extraídos, e seus FAMES- Fatty Acid Methyl Esters, identificados por cromatografia gasosa. Os ácidos graxos encontrados em maior quantidade foram oleico, linoleico e palmítico, enquanto os ácidos graxos trans foram detectados em 51,3% das amostras. Por outro lado, em alguns alimentos a gordura trans foi reduzida, mas foram observados aumentos no teor de ácido palmítico (C16:0), justificáveis pela adição de óleo de palma e de seus derivados, que podem ser usados em misturas interesterificadas ou podem compor diretamente formulações de alimentos industrializados, mesmo sem interesterificação. Governos e organizações em prol da saúde humana devem atentar para o fato de que o uso de ácidos graxos aterogênicos não é uma alternativa saudável. Os consumidores devem, portanto, ser alertados para o risco do consumo de alimentos contendo essas gorduras, até que as indústrias de alimentos sejam proibidas de utilizá-las ou encontrem alternativas mais saudáveis para a fabricação dos alimentos.

Abstract The use of fats with a low melting point is attractive to the food industry, as it contributes to improving the texture, color and stability characteristics of the food. These fats are obtained from vegetable oils through some processes such as hydrogenation or interesterification. However, the partial hydrogenation process leads to the formation of trans fat. In several countries, actions have been taken to eliminate the presence of elaidic acid, a trans fatty acid (C18: 1t) from processed foods. This trans fatty acid and palmitic acid, a common saturated fatty acid (C16: 0) are proven to be atherogenic. The aim of this work was to evaluate the composition of fatty acids of 39 types of commercialized foods in Brazil, including cookies, snacks, wafers, instant noodles, frozen sandwiches and pizzas, mixtures for food preparation, microwave popcorn, margarines, spreadable cheeses and pastry dough. The lipids were extracted and their Fatty Acid Methyl Esters (FAMEs) identified by Gas-Chromatography (GC). The fatty acids found in greater quantity were oleic, linoleic and palmitic acids; whereas the trans fatty acids were detected in 51.3% of the samples. On the other hand, when trans fast were reduced in some foods, it could be observed increases in the palmitic acid (C16:0) content. This high content of palmitic acid is justified by the addition of palm oil and its derivatives, which can be used in interesterified oil mixtures or can be directly used in industrialized food formulations, even without interesterification. Governments and organizations in favor of human health should be aware that the use of dietary fatty acids which compromise the atherogenic index is not a healthy alternative. Consumers should therefore be alerted to the risk of consuming foods containing these fats until the food industry is banned from using them or finds healthier alternatives for making food.

Abstract Background: studies have shown an association between obesity and a reduction in estimated glomerular filtration rate (eGFR). However, little is known regarding whether this association is related to total fat or, more specifically, to central or visceral fat. Objective: this study evaluated the correlations among the nutritional indices that measure total, central and visceral obesity with eGFR. Methods: a cross-sectional study, involving 288 hypertensive patients. Kidney function was estimated by GFR, using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Explanatory variables included body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist stature ratio (WSR), estimated visceral adipose tissue (eVAT) and body fat percentage (BF%). Results: the mean BMI was 27.8 ± 4.7 kg/m². Most of the patients (68.1%) were in the normal range of BF%, but regarding WC and eVAT, they were at very high risk (58.3% and 64.6%, respectively). In men, there were no correlations between nutritional indices and eGFR. In women, only eVAT remained negatively correlated with eGFR, estimated by MDRD and CKD-EPI equations, independent of BMI, smoking, physical inactivity, blood pressure, glycated hemoglobin, LDL and HDL cholesterol, uric acid and microalbuminuria. Conclusions: the majority of obesity indices were not associated with eGFR. Only eVAT was negatively associated with eGFR by MDRD and CKD-EPI equations in hypertensive women. In primary health care, visceral adipose tissue estimation could support the identification of hypertensive women at increased risk for developing chronic kidney disease.

Resumen Antecedentes: los estudios han demostrado una asociación entre la obesidad y una reducción en la tasa de filtración glomerular estimada (eGFR). Sin embargo, poco se sabe sobre si esta asociación está relacionada con la grasa total o, más específicamente, con la grasa central o visceral. Objetivo: este estudio evaluó las correlaciones entre los índices nutricionales que miden la obesidad total, central y visceral con eGFR. Métodos: estudio transversal con 288 pacientes hipertensos. La función renal se estimó mediante TFG, utilizando las ecuaciones de Modificación de la Dieta en la Enfermedad Renal (MDRD) y la Colaboración en Epidemiología de la Enfermedad Renal Crónica (CKD-EPI). Las variables explicativas incluyeron el índice de masa corporal (IMC), la circunferencia de cintura (WC), la relación cintura-cadera (WHR), la proporción cintura-estatura (WSR), el tejido adiposo visceral estimado (eVAT) y el porcentaje de grasa corporal (% BF). Resultados: el IMC medio fue de 27,8 ± 4,7 kg/m². La mayoría de los pacientes (68,1%) se encontraban en el rango normal de BF%, pero en cuanto a WC y eVAT, presentaban un riesgo muy alto (58,3% y 64,6%, respectivamente). En los hombres, no hubo correlaciones entre los índices nutricionales y eGFR. En las mujeres, solo el eVAT permaneció correlacionado negativamente con el eGFR, estimado por las ecuaciones MDRD y CKD-EPI, independiente del IMC, el tabaquismo, la inactividad física, la presión arterial, la hemoglobina glicosilada, el colesterol LDL y HDL, el ácido úrico y la microalbuminuria. Conclusiones: la mayoría de los índices de obesidad no se asociaron con el eGFR. Solo eVAT se asoció negativamente con eGFR por las ecuaciones MDRD y CKD-EPI en mujeres hipertensas. En la Atención Primaria, la estimación del tejido adiposo visceral podría apoyar la identificación de las mujeres hipertensas con mayor riesgo de desarrollar enfermedad renal crónica.