RESUMEN Objetivo El objetivo de este estudio fue evaluar los principales patrones de adherencia a las pautas de prevención del cáncer propuestas por el World Cancer Research Fund/ American Institute for Cancer Research (WCRF/AICR) de 2018 por sobrevivientes de cáncer de mama. Métodos Estudio transversal que utilizó el Análisis Factorial de Componentes Principales para identificar los patrones de adherencia y los cuartiles más alto (Q4) y más bajo (Q1) de cada patrón. Resultados Se identificaron dos patrones principales de adherencia: ‘granos/frutas/ fibra’ -adherencia a un índice de masa corporal saludable (IMC), una dieta rica en granos, verduras, frutas y frijoles y fibra total-; una segunda, ‘comida rápida/azúcar’ -adherencia al IMC, limitando el consumo de comida rápida, alimentos procesados, azúcar y fécula y el consumo de bebidas azucaradas-. El patrón ‘comida rápida/azúcar’ tiene la mayor influencia en el IMC (0,4672). Se observa menor peso (p=0,005; p=0,001) e IMC (p=0,001; p<0,001) en mujeres en el Q4 de los dos patrones, respectivamente. Conclusiones Las sobrevivientes de cáncer de mama tienen un patrón de adherencia a las guías caracterizado por un mayor consumo de granos, verduras, frutas, frijoles y fibra y otro caracterizado por un consumo limitado de alimentos procesados y bebidas azucaradas, con mayor impacto en el IMC.

ABSTRACT Objective The aim of this study was to assess the main patterns of adherence to the cancer prevention guidelines proposed by the 2018 World Cancer Research Fund/ American Institute for Cancer Research (WCRF/AICR) by breast cancer survivors. Methods Cross-sectional study that used the Principal Component Factor Analysis to identify the adherence patterns and the highest (Q4) and lowest (Q1) quartiles of each pattern. Results Two main adherence patterns were identified: ‘grains/fruits/fiber’ -adherence to a healthy body mass index (BMI), a diet rich in grains, vegetables, fruits and beans and total fiber-; a second, ‘fast-food/sugar’ -adherence to the BMI, limiting the consumption of fast food, processed foods, sugar and starch and the consumption of sugary drinks-. The ‘fast-food/sugar’ pattern has the greatest influence on BMI (0.4672). Lower weight (p=0.005; p=0.001) and BMI (p=0.001; p<0.001) are observed in women at the Q4 of the two patterns, respectively. Conclusions Breast cancer survivors have a pattern of adherence to the guidelines characterized by greater consumption of grains, vegetables, fruits, beans, and fiber; and another characterized by a limited consumption of processed foods and sugary drinks, with a greater impact on BMI.

Abstract Introduction: cell integrity and fat mass had been studied as a prognostic marker for cancer survival. Objective: our aim was to evaluate the association between tumor aggressiveness and cell integrity changes and adiposity in breast cancer (BC) survivors. Methods: women with BC (n = 114) were evaluated at diagnosis and 5 years later. Percentage of lean mass, fat mass, phase angle (PA), resistance (R) and reactance (Xc) were obtained by bioimpedance (450-50 kHz). Plasma leptin was assessed by immunoassay. Changes in body composition were assessed by the paired t-test or Wilcoxon's test. The disease effect associated with the time of diagnosis was assessed by a generalized linear model. Regression models were structured to assess the prevalence ratio between tumor aggressiveness and body composition changes adjusted for age, income, and level of schooling. Results: patients with N+ (p = 0.02) and % Ki67 > 14 (p = 0.00) show a reduction in Xc. Patients with advanced clinical staging (CS) (p = 0.02), tumors > 2 cm (p = 0.01), N+ (p = 0.01), non-luminal tumors (p = 0.02), ER- (p = 0, 00) and PR- (p = 0.02) show a PA reduction, and N+ patients (p = 0.01) show a reduction in leptin during follow-up. Tumors ≤ 2 cm (CI: 0.33-0.95; p = 0.03), initial CS (CI: 0.20-0.93; p = .0.03), and luminal tumors (CI: 0.01-0.95; p = 0.04) are related to a lower reduction in PA. Initial CS (CI: 0.00-0.00; p = 0.00) are related to increased leptin. Conclusion: tumor aggressiveness is associated with cell integrity changes in women who are BC survivors.

Resumen Introducción: se han estudiado la integridad celular y la masa grasa como marcadores pronósticos de supervivencia al cáncer. Objetivo: nuestro objetivo fue evaluar la asociación entre la agresividad del tumor y los cambios en la integridad celular y la adiposidad en supervivientes de cáncer de mama (CM). Métodos: las mujeres con CM (n = 114) se evaluaron al diagnóstico y 5 años después. El porcentaje de masa magra, masa grasa, ángulo de fase (PA), resistencia (R) y reactancia (Xc) se obtuvo mediante bioimpedancia (450-50 kHz). La leptina plasmática se evaluó mediante inmunoensayo. Los cambios en la composición corporal se evaluaron mediante la prueba de la t pareada o la prueba de Wilcoxon. El efecto de la enfermedad asociado con el momento del diagnóstico se evaluó mediante un modelo lineal generalizado. Los modelos de regresión se estructuraron para evaluar la razón de prevalencia entre la agresividad del tumor y los cambios en la composición corporal ajustados por edad, ingresos y nivel de escolaridad. Resultados: las pacientes con N+ (p = 0,02) y % Ki67 > 14 (p = 0,00) muestran una reducción de Xc. Las pacientes con estadificación clínica (EC) avanzada (p = 0,02), tumores > 2 cm (p = 0,01), N+ (p = 0,01), tumores no luminales (p = 0,02), ER- (p = 0, 00) y PR- (p = 0,02) muestran una reducción de la AP, y los pacientes N+ (p = 0,01) muestran una reducción de la leptina durante el seguimiento. Los tumores ≤ 2 cm (IC: 0,33-0,95; p = 0,03), el EC inicial (IC: 0,20-0,93; p = 0,03) y los tumores luminales (IC: 0,01-0,95; p = 0,04) se relacionan con un menor reducción de la PA. Los EC iniciales (IC: 0,00-0,00; p = 0,00) están relacionados con un aumento de leptina. Conclusión: la agresividad del tumor se asocia con cambios en la integridad celular en las mujeres que sobreviven al CM.

Abstract Hypertriglyceridemia is associated with several metabolic diseases. The triglycerides (TG) disrupt the cholesterol reverse transport and contribute to increased levels of low-density lipoprotein (LDL). High-density lipoprotein (HDL) acts in cholesterol reverse transport as an anti-inflammatory and antioxidant. This study aims to investigate the role of hypertriglyceridemia in the functionality of HDL. Individuals were divided into 4 groups based on high or low HDL-c and triglycerides levels. Biochemical and anthropometric analysis were performed. This study demonstrated that triglycerides promote dysfunctions on HDL, increasing the cardiovascular risk. Blood pressure was higher in subjects with low HDL. Women presented higher levels of HDL-c and low percentage of fat mass. The highest levels of triglycerides were observed in older age. In addition, high levels of triglycerides were associated with higher total cholesterol and LDL-c levels, non-HDL-c, non-esterified fatty acids, and blood glucose, increasing in the ratio of non-HDL-c/HDL-c and ApoB/ApoA-I. The increase of triglycerides levels progressively impairs the antioxidant capacity of HDL, probably due to a higher occurrence of fatty acid peroxidation in individuals with hypertriglyceridemia. Patients with high HDL and low TG levels increased the Lag Time. Furthermore, a positive correlation was found between TG versus HDL particle size, variables that depend on age and anthropometric parameters.

Resumo O Programa Nacional de Alimentação Escolar garante por meio da transferência de recursos financeiros a alimentação de alunos em escolas públicas e filantrópicas. Na adolescência, a boa nutrição é influenciada pelas taxas de crescimento físico e de alterações na composição corporal, sendo um período importante de vulnerabilidade nutricional. Objetivou-se analisar a adequação de macro e micronutrientes oferecidos aos adolescentes de escolas públicas de tempo integral no Nordeste do Brasil. Os cardápios foram avaliados utilizando os parâmetros para o atendimento de 70% das necessidades nutricionais diárias de macronutrientes e micronutrientes dos alunos beneficiários. Nota-se que, na maioria das faixas etárias, não houve o atendimento das necessidades energéticas, atingindo o percentual máximo de adequação de 86,2%. Houve adequação de proteínas em quatro dias apenas. O valor médio de carboidratos e lipídios estiveram abaixo do recomendado para todos os grupos etários. Os teores de Vitamina C, zinco e cálcio estiveram abaixo na maioria das preparações oferecidas. A quantidade de ferro foi alcançada em todas as faixas etárias. Conclui-se que deve haver um melhor planejamento na elaboração dos cardápios para tentar alcançar as necessidades previstas pelo Programa.

Abstract The National School Food Program guarantees the food of students in public and philanthropic schools by means of the transfer of funds. During adolescence, which is an important period of nutritional vulnerability, a healthy diet is responsible for the rates of physical growth and changes in body composition. The objective was to analyze the adequacy of macro- and micronutrients provided to adolescents in full-time public schools in northeastern Brazil. The menus were evaluated using the parameters to meet 70% of the daily nutritional needs in terms of macronutrients and micronutrients of the students involved. It was found that, for most age groups, energy requirements were not met, attaining the maximum adequacy of 86.2%, and protein ingestion was only sufficient on four days. The average amount of carbohydrates and lipids was below the recommended dose for all age groups. The levels of Vitamin C, zinc and calcium were insufficient in most of the meals on offer, though the iron quota was adequate for all age groups. The conclusion drawn is that enhanced planning needs to be incorporated in the preparation of menus to attempt to attain the requirements stipulated in the Program.

Resumo O Programa Nacional de Alimentação Escolar garante por meio da transferência de recursos financeiros a alimentação de alunos em escolas públicas e filantrópicas. Na adolescência, a boa nutrição é influenciada pelas taxas de crescimento físico e de alterações na composição corporal, sendo um período importante de vulnerabilidade nutricional. Objetivou-se analisar a adequação de macro e micronutrientes oferecidos aos adolescentes de escolas públicas de tempo integral no Nordeste do Brasil. Os cardápios foram avaliados utilizando os parâmetros para o atendimento de 70% das necessidades nutricionais diárias de macronutrientes e micronutrientes dos alunos beneficiários. Nota-se que, na maioria das faixas etárias, não houve o atendimento das necessidades energéticas, atingindo o percentual máximo de adequação de 86,2%. Houve adequação de proteínas em quatro dias apenas. O valor médio de carboidratos e lipídios estiveram abaixo do recomendado para todos os grupos etários. Os teores de Vitamina C, zinco e cálcio estiveram abaixo na maioria das preparações oferecidas. A quantidade de ferro foi alcançada em todas as faixas etárias. Conclui-se que deve haver um melhor planejamento na elaboração dos cardápios para tentar alcançar as necessidades previstas pelo Programa.

Abstract The National School Food Program guarantees the food of students in public and philanthropic schools by means of the transfer of funds. During adolescence, which is an important period of nutritional vulnerability, a healthy diet is responsible for the rates of physical growth and changes in body composition. The objective was to analyze the adequacy of macro- and micronutrients provided to adolescents in full-time public schools in northeastern Brazil. The menus were evaluated using the parameters to meet 70% of the daily nutritional needs in terms of macronutrients and micronutrients of the students involved. It was found that, for most age groups, energy requirements were not met, attaining the maximum adequacy of 86.2%, and protein ingestion was only sufficient on four days. The average amount of carbohydrates and lipids was below the recommended dose for all age groups. The levels of Vitamin C, zinc and calcium were insufficient in most of the meals on offer, though the iron quota was adequate for all age groups. The conclusion drawn is that enhanced planning needs to be incorporated in the preparation of menus to attempt to attain the requirements stipulated in the Program.

OBJETIVO: Avaliar o comportamento alimentar de mulheres com câncer de mama submetidas à quimioterapia, e sua relação com a qualidade de vida destas pacientes. MÉTODOS: A partir de um ensaio clínico do tipo antes e depois, selecionou-se 25 mulheres do Hospital AC Camargo (São Paulo, Brasil) durante o período de outubro de 2005 a abril de 2006. As pacientes inclusas no estudo apresentavam diagnóstico de câncer de mama, com estadiamento I e II e indicação de tratamento quimioterápico adjuvante. Nos momentos T0 (antes) e T1 (após o tratamento quimioterápico), o comportamento alimentar (consumo e aversão alimentar) foi avaliado por três recordatórios 24 horas e um questionário Food Action, respectivamente. A qualidade de vida foi monitorada por meio do questionário Functional Assessment of Cancer Therapy-Breast. RESULTADOS: Após o tratamento quimioterápico (T1), o consumo de macro e micronutrientes não apresentou alterações significantes, mas o consumo de frutas e sucos aumentou (p=0,03). Perfil inverso foi observado em relação à preferência por café preto (p=0,01) e pelo grupo de bebidas (p<0,001). Alimentos gordurosos (38%), laticínios (23%), café preto (15%), chá (15%), chocolate (7%) e carne vermelha (7%) foram os principais alimentos associados ao desconforto das pacientes. Análises de qualidade de vida mostraram que o tratamento quimioterápico promoveu significante redução no bem estar físico (p<0,01). Após o mesmo, algumas variáveis do comportamento alimentar foram significantemente correlacionadas com os parâmetros de qualidade de vida. CONCLUSÃO: A relação bilateral entre comportamento alimentar e qualidade de vida foi modificada negativamente pelo tratamento quimioterápico.

OBJECTIVE: The objective of this paper was to assess the eating behavior of women with breast cancer subjected to chemotherapy and its relation with the quality of life of these patients. METHODS: A total of 25 women receiving care at the Hospital AC Camargo (SP, Brazil) from October 2005 to April 2006 were selected based on a clinical assay of the before and after type. The patients included in the study were diagnosed with breast cancer, stages I and II and had indication of adjuvant chemotherapy. At the times T0 (before) and T1 (after chemotherapy), the eating behavior (food intake and aversion) was assessed by three 24-hour recalls and the Food Action questionnaire, respectively. Quality of life was monitored through the use of the Functional Assessment of Cancer Therapy - Breast questionnaire. RESULTS: After chemotherapy (T1), the intake of macro and micronutrients did not change significantly, but the intake of fruits and juices increased (p=0.03). The opposite was observed regarding the preference for black coffee (p=0.01) and for the beverages group (p<0.001). Fat-rich foods (38%), dairy (23%), black coffee (15%), tea (15%), chocolate (7%) and red meats (7%) were the main foods associated with patient discomfort. Analyses of the quality of life showed that chemotherapy caused a significant reduction of physical well-being (p<0.01). After chemotherapy, some eating behavior variables were significantly correlated with quality of life parameters. CONCLUSION: Chemotherapy caused the bilateral relationship between eating behavior and quality of life to change in a negative manner.