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RATIONALE/OBJECTIVE: The phase angle (PhA) is a measurement obtained from the resistance and reactance found in the bioelectrical impedance examination and is useful in assessing nutritional status and in assessing cardiometabolic diseases. Therefore, the objective was to correlate the phase angle to the anthropometric variables of cardiometabolic risk (CMR) in children and adolescents. SUBJECTS/METHODS: Weight, height, body mass index (BMI), waist circumference (WC) and neck circumference (NC), waist-to-height ratio (WHtR), and PhA of 1231 children and adolescents aged between 5 and 18 years were assessed. PhA was assessed in tertiles and CMR was identified using the anthropometric variables BMI, WC, NC, and WHtR. Linear regression models were used to verify the association between PhA tertiles and CMR anthropometric variables, stratified by sex. RESULTS: No relationship was found between PhA and CMR variables in children. In adolescents, lower values of NC (ß = -0.019, p = 0.005) and BMI (ß = -0.025, p = 0.023) were found in boys, WC (ß = -0.017, p = 0.020), WHtR (ß = -0.017, p = 0.020), NC (ß = -0.011, p = 0.027) and BMI (ß = -0.026, p = 0.009) in girls when they were in tertile 1 when compared to tertile 3 of the PhA, even after adjusting for age. CONCLUSION: The PhA was directly associated with CMR in the assessed adolescents.

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BACKGROUND AND AIMS: Recently, new indices combining routine and low-cost anthropometric and biochemical measurements have emerged. Among them, the visceral adiposity index (VAI) and lipid accumulation product (LAP) are being investigated for the prediction of altered blood pressure (BP) and insulin resistance (IR). Therefore, this study aimed to evaluate whether visceral adiposity index (VAI) and height-corrected lipid accumulation product (HLAP) are predictors of cardiometabolic risk in Brazilian adolescents. METHODS AND RESULTS: Data were obtained from the Cardiovascular Risk in Adolescents (ERICA) study, a cross-sectional, national, multicenter, school-based survey conducted between 2013 and 2014 in Brazil. The sample consisted of 37,815 adolescents aged 12-17 years of both genders attending the last 3 years of elementary or secondary school from public and private schools located in 273 municipalities with more than 100,000 inhabitants. A Poisson regression was performed to verify associations between VAI and HLAP indices and the presence of altered BP and IR according to sex. In addition, receiver operating characteristic curve (ROC) analysis was applied to compare the predictive ability and determine the cut-off points of the VAI and HLAP indices in identifying cardiometabolic risk obtained by altered BP and IR. The prevalences of altered BP and IR were 24.49 % (95 % confidence interval [CI]: 23.14-25.87) and 24.22 % (95 % CI: 22.70-25.80), respectively. CONCLUSIONS: The VAI and HLAP indices are good predictors of cardiometabolic risk in Brazilian adolescents. HLAP showed better performance in identifying insulin resistance in males.

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BACKGROUND: Multiple sclerosis (MS) is an autoimmune neurodegenerative disease. Nutritional status influences the course of the disease, however, its relationship with sarcopenia needs further investigation. The aim of the study was to identify patients with sarcopenia and assess its association with nutritional status and the clinical course of the disease. METHODS: The study assessed 110 patients submitted to evaluation of sociodemographic characteristics, level of physical activity, nutritional status, and presence of sarcopenia. The clinical course of the disease, age at onset, disease duration, disease-modifying therapy, and expanded scale of disability status (EDSS) were investigated. RESULTS: Mean age was 37.17 (SD = 10.60) years, disease duration was 6.29 years (SD = 4.65), with a predominance of female gender (80.90 %), relapsing-remitting clinical form (RRMS) (89.10 %) and mild level of disability (EDSS median = 1.92). The group had excess weight (53.6 %) according to body mass index (BMI) and abdominal fat accumulation measured by waist circumference (WC) (53.6 %). High percentage of fat mass ( % FM) was observed in 54.5 % and 38.2 % of the patients according to bioimpedance (BIA) and ultrasound (US), respectively. It was observed that 15.5 % were at risk for sarcopenia, which was associated with excess weight, and high % FM (p<0.05). CONCLUSION: These findings highlight the importance of including nutritional status indicators, and sarcopenia assessment in the care of patients with MS.

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BACKGROUND: Oxidative stress (OS) is an important process related to the pathophysiology of rheumatoid arthritis and can be increased by the low intake of antioxidants. Zinc (Zn) is an important antioxidant trace-element for human health and the assessment of the nutritional status of this micronutrient in these patients is of relevance. AIM: This study aimed to evaluate Zn nutritional status in rheumatoid arthritis patients and its relation to OS. METHODS: A case-control study was carried out with 51 patients diagnosed with rheumatoid arthritis (RA group) recruited in Hospital São Paulo (São Paulo, Brazil) and 55 healthy women (CO group) from the campus of the University of São Paulo. Blood and 24-hour urine collection were used for biochemical parameters related to Zn status and OS. The assessment of dietary Zn was performed by three 24-hour dietary recalls. RESULTS: The RA group presented significative low Zn intake (p < 0.001) and plasma concentration (p = 0.040) of this mineral compared to the CO group. However, both groups were Zn deficient and the disease activity (DAS28 score) for RA patients did not influence Zn biomarkers. In addition, the antioxidant enzymes (superoxide dismutase and glutathione peroxidase) activity and the urinary 8-isoprostanes were reduced in RA patients. CONCLUSION: The evaluation of dietary intake and biochemical biomarkers indicates that rheumatoid arthritis patients are zinc deficient and have increased OS.

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OBJECTIVE: To analyze association between patterns of food intake markers and high blood pressure levels among Brazilians. METHODS: This was a cross-sectional study using National Health Survey data. Its outcome was high blood pressure levels, measured during interviews between August and November 2013. Food intake marker patterns were identified. These were the exposure variables. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated using multivariate Poisson regression. RESULTS: High blood pressure prevalence was 16.0% (95%CI - 15.3;16.7) in the sample of 37,216 participants. It was higher in those with a diet that included meat and alcoholic beverages (PR=1.21 - 95%CI 1.08;1.35). The pattern with greater presence of greens and vegetables did not show statistically significant association with high blood pressure levels (PR=0.94 - 95%CI 0.84;1.06). CONCLUSION: The pattern marked by meat and alcoholic beverages was associated with high blood pressure levels.

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Objetivo: Analisar a associação entre padrões de marcadores do consumo alimentar com níveis pressóricos elevados em brasileiros. Métodos: Estudo transversal, com dados da Pesquisa Nacional de Saúde, tendo como desfecho níveis pressóricos elevados, aferidos durante entrevistas realizadas entre agosto e novembro de 2013. Foram identificados padrões de marcadores do consumo alimentar, as variáveis de exposição. Calculou-se razão de prevalências (RP) e intervalo de confiança de 95% (IC95%) por regressão de Poisson multivariável. Resultados: A prevalência de níveis pressóricos elevados foi de 16,0% (IC95% 15,3;16,7) na amostra de 37.216 participantes, sendo maior naqueles com dieta que incluía carne e bebidas alcoólicas (RP=1,21 - IC95% 1,08;1,35). O padrão com maior presença de verduras e legumes não apresentou associação estatisticamente significante com níveis pressóricos elevados (RP=0,94 - IC95% 0,84;1,06). Conclusão: O padrão marcado pelo consumo de carne e bebidas alcoólicas mostrou-se associado com níveis pressóricos elevados.

Objetivo: Analizar la asociación entre patrones de marcadores de consumo de alimentos con niveles presóricos elevados en brasileños. Métodos: Estudio transversal con datos de la Encuesta Nacional de Salud, con resultado los niveles de presión arterial alta, medidos durante entrevista, entre agosto y noviembre de 2013. Se identificaron patrones de consumo de alimentos, las variables de exposición. La razón de prevalencia (PR) y el intervalo de confianza del 95% (IC95%) se calcularon mediante la regresión de Poisson multivariable. Resultados: La prevalencia de hipertensión arterial fue del 16,0% (IC95% 15,3; 16,7) de 37.216 participantes, siendo mayor en aquellos con dieta que incluía carne y bebidas alcohólicas (RP=1,21 - IC95% 1,08;1,35). El patrón con verduras y hortalizas no mostró asociación con niveles presóricos elevados (RP=0,94 - IC95% 0,84; 1,06) Conclusión: El patrón con consumo de carne y bebidas alcohólicas se asoció con niveles de presión arterial alta.

Objective: To analyze association between patterns of food intake markers and high blood pressure levels among Brazilians. Methods: This was a cross-sectional study using National Health Survey data. Its outcome was high blood pressure levels, measured during interviews between August and November 2013. Food intake marker patterns were identified. These were the exposure variables. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated using multivariate Poisson regression. Results: High blood pressure prevalence was 16.0% (95%CI - 15.3;16.7) in the sample of 37,216 participants. It was higher in those with a diet that included meat and alcoholic beverages (PR=1.21 - 95%CI 1.08;1.35). The pattern with greater presence of greens and vegetables did not show statistically significant association with high blood pressure levels (PR=0.94 - 95%CI 0.84;1.06). Conclusion: The pattern marked by meat and alcoholic beverages was associated with high blood pressure levels.

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Fundamento: A ação antioxidante de alguns nutrientes é importante na proteção vascular. O zinco, em particular, tem sido associado a um risco reduzido de aterosclerose, acidente vascular cerebral e trombose.Objetivo: O estudo avaliou o status do zinco e sua relação com biomarcadores de risco cardiovascular em adultos saudáveis. Métodos: Estudo transversal com 186 estudantes universitários de ambos os sexos, com idades entre 20 e 30 anos, selecionados através de amostra por conveniência. As medições dos biomarcadores de risco cardiovascular incluíram o perfil lipídico, o índice de Castelli I e II e circunferência da cintura. O zinco dietético foi avaliado por registro alimentar de três dias utilizando o programa NutWin versão 1.6.0.7. As concentrações plasmáticas e de eritrócitos do mineral foram determinadas por espectrofotometria de absorção atômica com chama. O perfil lipídico foi determinado pelo método enzimático colorimétrico. Resultados: Os valores médios do consumo de zinco estavam superiores à NME (Necessidade Média Estimada) em ambos os sexos. Os participantes apresentaram concentrações médias de zinco no plasma e eritrócitos inferiores aos pontos de corte. Os valores médios do perfil lipídico, índice de Castelli I e II, e circunferência da cintura estavam adequados. Houve correlação negativa entre o zinco dietético e colesterol total e triglicérides. Conclusões: Os participantes têm uma ingestão elevada de zinco e apresentam concentrações plasmáticas e eritrocitárias reduzidas do mineral. Além disso, esse estudo revelou uma associação negativa entre a ingestão de zinco dietético e o colesterol total e triglicérides, biomarcadores do risco cardiovascular, sugerindo a importância do zinco na proteção contra doenças cardiovasculares

Background: The antioxidant action of some nutrients is important in vascular protection. Zinc, particularly, has been associated with reduced risk of atherosclerosis, stroke and thrombosis. Objective: The study evaluated zinc status and its association to cardiovascular risk biomarkers in healthy adults. Methods: Cross-sectional study with 186 university students of both genders, aged between 20 and 30 years, selected using the convenience sampling method. The cardiovascular risk biomarker measurements included the lipid profile, Castelli index I and II, and waist circumference. Zinc analysis was performed by a three-days food record using NutWin program version 1.6.0.7. Plasma and erythrocyte mineral concentrations were determined by flame atomic absorption spectrophotometry. The lipid profile was determined by enzymatic colorimetric methods. Results: The mean values of zinc intake were higher than the EAR in both genders. Participants had mean plasma and erythrocyte zinc concentrations lower than the cutoff points. The mean values of the lipid profile, Castelli index I and II, and waist circumference were adequate. There was a negative correlation between dietary zinc and total cholesterol and triglycerides. Conclusions: The participants have a high dietary zinc intake and reduced plasma and erythrocyte concentrations of this mineral. Additionally, this study showed a negative association between zinc dietary intake and total cholesterol and triglycerides, biomarkers of cardiovascular risk, suggesting the importance of zinc in protecting against cardiovascular disease

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O objetivo deste estudo foi avaliar o estado nutricional relativo ao selênio em indivíduos adultos relacionando-o com polimorfismos no gene da enzima GPx e sua influência sobre a enzima e o balanço redox. Foram selecionados 343 estudantes da Universidade Federal do Piauí entre 20 e 50 anos, de ambos os sexos, selecionados de acordo com critérios de inclusão adotados, como ausência de doenças crônicas não transmissíveis (DCNT) dentre outros. Sangue venoso foi coletado para análise de Se, genotipagem dos SNP da GPx1 (Pro198Leu, -602A/G e Arg5Pro), da atividade das enzimas antioxidantes (GSH-Px e SOD) eritrocitárias, malondialdeído (MDA) e capacidade de absorção de radicais de oxigênio (ORAC) plasmáticas. A análise de Se foi realizada por meio de espectrometria de absorção atômica por geração de hidretos, a genotipagem por PCR em tempo real em Step One Plus, as enzimas em analisador bioquímico automático utilizando kits comerciais, o MDA em cromatografia líquida de alta eficiência e ORAC em um leitor de microplaca. A análise estatística foi realizada por meio do software R 3.0.2. Foram realizados testes de comparação de duas e de mais que três médias entre as variáveis genéticas e os parâmetros de avaliação do Se e do balanço redox. Análises de regressão linear e linear generalizada foram realizadas para identificar a influência das variáveis genéticas, antropométricas, do perfil lipídico e estilo de vida sobre o Se sanguíneo e as variáveis do balanço redox. Os dados foram considerados significativos com p menor que 5%. A idade média dos participantes foi de 24,4±5,0 anos sendo 57,7% do sexo feminino. Entre os participantes, 95,7% eram carreadores do alelo Leu do SNP Pro198Leu e G do -602A/G e não possuíam quantidades mínimas de Se plasmático para otimizar a atividade da GPx. A atividade da GPx foi significativamente mais baixa e de ORAC mais alta nos indivíduos com o genótipo Leu/Leu em relação ao Pro/Pro do SNP Pro198Leu. Os indivíduos com o genótipo Arg/Pro apresentaram atividade da GPx significativamente maior que aqueles com o genótipo Arg/Arg do SNP Arg5Pro. Não houve diferença significativa entre as médias de MDA e SOD e os genótipos dos três SNP. As variáveis genéticas, de avaliação antropométrica, do perfil lipídico e estilo de vida mostraram influência sobre os marcadores do balanço redox, alterando o perfil antioxidante dos participantes. Os indivíduos são deficientes em Se e aqueles com o alelo Leu do SNP Pro198Leu apresentam em seu organismo maior concentração de ORAC, provavelmente para proteção contra radicais livres. O alelo variante do SNP Arg5Pro mostrou-se benéfico para o estado nutricional relativo ao Se

The aim of this study was to evaluate the nutritional status relative to Se of adult individuals relating it to polymorphisms in the GPx enzyme gene and its influence on the enzyme and the redox balance. We selected 343 students of the Federal University of Piauí between 20 and 50 years, of both genders, selected according to inclusion criteria, such as the absence of chronic noncommunicable diseases (NCD) among others. Venous blood was collected for analysis of Se, genotyping of SNP of GPx1 (Pro198Leu, -602A / G and Arg5Pro), the activity of antioxidant enzymes (GSH-Px and SOD) erythrocyte, malondialdehyde (MDA) and absorption capacity of plasma oxygen radicals (ORAC). The analysis of Se was performed by atomic absorption spectrometry through hydride generation, genotyping by real time PCR in Step One Plus, enzymes in automatic biochemical analyzer by the use of commercial kits, MDA analysis was conducted in high-performance liquid chromatography and ORAC in a microplate reader. Statistical analysis was obtained using the software R version 3.0.2. Comparison tests were performed with two and more than three averages between the genetic variables and the evaluation parameters from Se and redox balance. Linear regression analysis and generalized linear were carried out to identify the influence of genetic variables, anthropometric, lipid profile and lifestyle on the sanguine Se and the variables of the redox balance. Data were considered significant for p less than 5%. The average age of participants was 24.4±5.0 years and 57.7% were female. Among the participants, 95.7% were allele carriers Leu of SNP Pro198Leu and G of -602A/G, and they did not have minimal amounts of Se plasma to optimize the activity of GPx. The GPx activity was significantly lower and that of ORAC was higher in subjects with the Leu/Leu genotype compared to Pro/Pro of SNP Pro198Leu. Individuals with the Arg/Pro genotype had GPx activity significantly higher than those with genotype Arg/Arg of SNP Arg5Pro. There was no significant difference between the means of MDA and SOD of the genotypes of the three SNP. The genetic variables, anthropometric measurements, lipid profile and lifestyle showed influence on markers of redox balance by changing the antioxidant profile of the participants. Individuals are deficient in Se, and those with the Leu allele of SNP Pro198Leu present in their bodies highest concentration of ORAC, probably to protect against free radicals. The variant allele of the SNP Arg5Pro proved to be beneficial to the nutritional status of the Se

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Evidence has shown that metabolic disorders are common in tumor cells, leading to increased oxidative stress. The increase in the production of reactive oxygen species (ROS) associated with low antioxidant activity has been related to several types of cancer. Selenium, an antioxidant micronutrient, may function as an antimutagenic agent, preventing the malignant transformation of normal cells. A review of the literature was conducted based on a survey of articles published between 2000 and 2009 in the PubMed database; 39 articles that analyzed the relationship between cancer, oxidative stress and selenium supplementation were selected. The protective effect of this mineral is especially associated with its presence in the glutathione peroxidase and thioredoxin reductase, enzymes that are known to protect DNA and other cellular components against oxidative damage caused by ROS. Several studies have shown reduced expression of these enzymes in various types of cancer, especially when associated with low intake of selenium, which may increase the damage. Selenium supplementation appears to reduce the risk of some types of cancer by reducing oxidative stress and DNA damage. However, further studies are needed to clarify the adequate dose of selenium for each situation (sex, geographic location, and type of cancer).

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Evidências têm demonstrado que distúrbios do metabolismo são comuns em células tumorais, levando ao aumento do estresse oxidativo. A elevação na produção de espécies reativas de oxigênio (EROs) associada à baixa atividade antioxidante tem sido relacionada a vários tipos de câncer. O selênio, micronutriente antioxidante, pode funcionar como um agente antimutagênico, prevenindo transformações malignas de células normais. Realizou-se um levantamento bibliográfico no período 2000 a 2009 mediante consulta à base de dados PubMed (National Library of Medicine´s Medline Biomedical Literature, USA), selecionando-se 39 artigos que avaliaram a relação entre câncer, estresse oxidativo e suplementação com selênio. O efeito protetor desse mineral é especialmente associado à sua presença na glutationa peroxidase e na tioredoxina redutase, enzimas protetoras do DNA e outros componentes celulares contra o dano oxidativo causado pelas EROs. Vários estudos têm demonstrado a expressão reduzida destas enzimas em diversos tipos de câncer, principalmente quando associados a uma baixa ingestão de selênio, que pode acentuar os danos causados. A suplementação de selênio parece ocasionar redução do risco de alguns tipos de câncer diminuindo o estresse oxidativo e o dano ao DNA. No entanto, mais estudos são necessários para esclarecer as doses de selênio adequadas para cada situação (sexo, localização geográfica e tipo de câncer).

There are evidences that metabolic disorders are common in tumoral cells, leading to increased oxidative stress. The rising in the production of reactive oxygen species associated to low antioxidant activity have been associated to different types of cancer. Selenium, an antioxidant micronutrient can work as an anti-cancer agent preventing malignant modification in healthy cells. A literature review was carried out in the period 2000-2009 in the database PubMed selecting 39 articles which assessed the relationship between cancer, oxidative stress, and supplementation with selenium. The protective effect of selenium is specially associated to the presence of glutathione peroxidase and of thioredoxin reductase enzymes and with other cell components which protect the tissues against the oxidative damage caused by reactive oxygen species - ROS. Several studies have shown a decrease of these enzymes in many types of cancer, mainly when associated with low selenium consumption, increasing the damage caused by ROS. Selenium supplementation seems to reduce the risk of some types of cancer by stress oxidative reduction and by limiting the damage to DNA. Nevertheless, more studies are necessary to clarify the adequate selenium doses in each situation (gender, geographic localization and type of cancer).

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