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This study aimed to assess the prevalence and factors associated with lipid profile abnormalities of children aged 6 to 42 months in a Central-West Brazilian capital city. This cross-sectional study used data from the baseline of a cluster-randomized clinical trial conducted in parallel. It evaluated the lipid profile, usual nutrients intake (direct food-weighing method and 24-hour dietary recall), anthropometric parameters, and socioeconomic aspects of 169 children from early childhood education centers. Poisson regression with robust variance analysis was conducted. Of the total sample, 85% had dyslipidemia, 72% had high-density lipoproteins (HDL-c) levels below the desired range, 49% had increased triglycerides (TG), 17% exhibited elevated low-density lipoproteins (LDL-c), and 15% showed high total cholesterol (TC). An increase in the body mass index (BMI) for age z-score was associated with a higher prevalence of increased TG (PR = 1.22; 95%CI: 1.05-1.41; p = 0.009). Higher age in children was associated with an increased prevalence of high LDL-c (PR = 1.037; 95%CI: 1.01-1.07; p = 0.022) and TC (PR = 1.036; 95%CI: 1.00-1.07; p = 0.037), however it was a protective factor against low HDL-c (PR = 0.991; 95%CI: 0.98-1.00; p = 0.042). High energy intake was associated with low HDL-c (PR = 1.001; 95%CI: 1.00-1.00; p = 0.023). A higher prevalence of increased LDL-c (PR = 1.005; 95%CI: 1.00-1.01; p = 0.006) and decreased HDL-c (PR = 1.002; 95%CI: 1.00-1.00; p < 0.001) were associated with dietary cholesterol intake. Most of the children presented at least one alteration in serum lipids. Lipid profile abnormalities were associated with higher BMI, older age, and increased caloric and cholesterol intake.

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Fe-deficiency anaemia is a major public health concern in children under 5 years of age. TMPRSS6 gene, encoding matriptase-2 protein, is implicated in Fe homoeostasis and has been associated with anaemia and Fe status in various populations. The aim of this cross-sectional study was to investigate the associations between the single nucleotide polymorphism (SNP) TMPRSS6 rs855791 and biomarkers of anaemia and Fe deficiency in Brazilian children attending day care centres. A total of 163 children aged 6-42 months were evaluated. Socio-economic, demographic, biochemical, haematological, immunological and genotype data were collected. Multiple logistic and linear regressions with hierarchical selection were used to assess the effects of independent variables on categorised outcomes and blood marker concentrations. Minor allele (T) frequency of rs855791 was 0·399. Each copy of the T allele was associated with a 4·49-fold increased risk of developing anaemia (P = 0·005) and a 4·23-fold increased risk of Fe deficiency assessed by serum soluble transferrin receptor (sTfR) (P < 0·001). The dose of the T allele was associated with an increase of 0·18 mg/l in sTfR concentrations and reductions of 1·41 fl and 0·52 pg in mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH), respectively. In conclusion, the T allele of SNP TMPRSS6 rs855791 was significantly associated with anaemia and Fe deficiency assessed by sTfR in Brazilian children attending day care centres. The effect was dose dependent, with each copy of the T allele being associated with lower MCV and MCH and higher concentrations of sTfR.

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This study aimed to assess the prevalence and factors associated with lipid profile abnormalities of children aged 6 to 42 months in a Central-West Brazilian capital city. This cross-sectional study used data from the baseline of a cluster-randomized clinical trial conducted in parallel. It evaluated the lipid profile, usual nutrients intake (direct food-weighing method and 24-hour dietary recall), anthropometric parameters, and socioeconomic aspects of 169 children from early childhood education centers. Poisson regression with robust variance analysis was conducted. Of the total sample, 85% had dyslipidemia, 72% had high-density lipoproteins (HDL-c) levels below the desired range, 49% had increased triglycerides (TG), 17% exhibited elevated low-density lipoproteins (LDL-c), and 15% showed high total cholesterol (TC). An increase in the body mass index (BMI) for age z-score was associated with a higher prevalence of increased TG (PR = 1.22; 95%CI: 1.05-1.41; p = 0.009). Higher age in children was associated with an increased prevalence of high LDL-c (PR = 1.037; 95%CI: 1.01-1.07; p = 0.022) and TC (PR = 1.036; 95%CI: 1.00-1.07; p = 0.037), however it was a protective factor against low HDL-c (PR = 0.991; 95%CI: 0.98-1.00; p = 0.042). High energy intake was associated with low HDL-c (PR = 1.001; 95%CI: 1.00-1.00; p = 0.023). A higher prevalence of increased LDL-c (PR = 1.005; 95%CI: 1.00-1.01; p = 0.006) and decreased HDL-c (PR = 1.002; 95%CI: 1.00-1.00; p < 0.001) were associated with dietary cholesterol intake. Most of the children presented at least one alteration in serum lipids. Lipid profile abnormalities were associated with higher BMI, older age, and increased caloric and cholesterol intake.

O objetivo deste estudo foi avaliar a prevalência e os fatores associados às anormalidades do perfil lipídico de crianças de 6 a 42 meses de idade em uma capital do Centro-oeste do Brasil. Este estudo transversal utilizou dados da linha de base de um ensaio clínico randomizado por conglomerados realizado em paralelo. Avaliou-se o perfil lipídico, a ingestão habitual de nutrientes (método de pesagem direta de alimentos e recordatório alimentar de 24 horas), parâmetros antropométricos e aspectos socioeconômicos de 169 crianças de centros de educação infantil. Foi realizada uma regressão de Poisson com análise de variância robusta. Da amostra total, 85% apresentavam dislipidemia, 72% tinham níveis de lipoproteínas de alta densidade (HDL-c) abaixo da faixa desejada, 49% tinham triglicerídeos (TG) aumentados, 17% apresentavam lipoproteínas de baixa densidade (LDL-c) elevadas e 15% apresentavam colesterol total (CT) elevado. Um aumento no índice de massa corporal (IMC) para o escore z da idade foi associado a uma maior prevalência de aumento de TG (RP = 1,22; IC95%: 1,05-1,41; p = 0,009). A idade mais avançada das crianças foi associada a uma maior prevalência de LDL-c alto (RP = 1,037; IC95%: 1,01-1,07; p = 0,022) e CT (RP = 1,036; IC95%: 1,00-1,07; p = 0,037), mas foi um fator de proteção contra HDL-c baixo (RP = 0,991; IC95%: 0,98-1,00; p = 0,042). A alta ingestão de energia foi associada ao baixo HDL-c (RP = 1,001; IC95%: 1,00-1,00; p = 0,023). Uma maior prevalência de aumento de LDL-c (RP = 1,005; IC95%: 1,00-1,01; p = 0,006) e diminuição de HDL-c (RP = 1,002; IC95%: 1,00-1,00; p < 0,001) foi associada à ingestão de colesterol na dieta. A maioria das crianças apresentou pelo menos uma alteração nos lipídios séricos. As anormalidades do perfil lipídico foram associadas ao IMC mais alto, à idade mais avançada e ao aumento da ingestão calórica e de colesterol.

El objetivo de este estudio fue evaluar la prevalencia y los factores asociados con las anomalías del perfil lipídico en niños de 6 a 42 meses de edad en una ciudad del Centro-Oeste de Brasil. Este estudio transversal utilizó datos de referencia de un ensayo clínico aleatorizado por grupos realizado en paralelo. Se evaluó el perfil lipídico, la ingesta habitual de nutrientes (pesaje directo de alimentos y recordatorio de alimentación de 24 horas), los parámetros antropométricos y los aspectos socioeconómicos de 169 niños de centros de educación infantil. Se realizó una regresión de Poisson con un análisis robusto de la varianza. Se reveló que el 85% de los participantes tenían dislipidemia; el 72% presentaron niveles de lipoproteínas de alta densidad (HDL-c) por debajo del rango esperado; el 49% tenía aumento de triglicéridos (TG); el 17% de lipoproteínas de baja densidad (LDL-c) elevadas y el 15% tenía colesterol total (CT) elevado. Un aumento en el índice de masa corporal (IMC) para la puntuación z de la edad se asoció con una mayor tendencia a aumento de TG (RP = 1,22; IC95%: 1,05-1,41; p = 0,009). La edad más avanzada de los niños se asoció con una mayor prevalencia de LDL-c alta (RP = 1,037; IC95%: 1,01-1,07; p = 0,022) y CT (RP = 1,036; IC95%: 1,00-1,07; p = 0,037), pero fue un factor de protección contra HDL-c baja (RP = 0,991; IC95%: 0,98-1,00; p = 0,042). La ingesta alta de energía se asoció con HDL-c baja (RP = 1,001; IC95%: 1,00-1,00; p = 0,023). Se encontraron que la mayor tendencia a aumento de LDL-c (RP = 1,005; IC95%: 1,00-1,01; p = 0,006) y disminución de HDL-c (RP = 1,002; IC95%: 1,00-1,00; p < 0,001) estuvieron asociadas con la ingesta de colesterol en la dieta. La mayoría de los niños tuvieron al menos un cambio en los lípidos séricos. Las anomalías del perfil lipídico se asociaron con un mayor IMC, mayor edad y mayor consumo de calorías y colesterol.

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Vitamin E is an important nutrient from the earliest stages of life. It plays key roles as an antioxidant and in the maintenance of the immune system, among others. Vitamin E deficiency (VED), which occurs more frequently in children, is rarely addressed in the literature. This narrative review aims to summarise the chemistry, biology, serum indicators and clinical trials that have evaluated the impact of fortification and other relevant aspects of vitamin E, in addition to the prevalence of its deficiency, in children worldwide. Vitamin E intake in recommended amounts is essential for this nutrient to perform its functions in the body. Serum α-tocopherol is the most widely used biochemical indicator to assess the prevalence of VED. VED has been associated with symptoms secondary to fat malabsorption and may lead to peripheral neuropathy and increased erythrocyte haemolysis. Reduced concentrations of α-tocopherol may be caused by the combination of diets with low amounts of vitamin E and inadequate consumption of fats, proteins and calories. The lowest prevalence of VED was found in Asia and the highest in North America and Brazil. High proportions of VED provide evidence that this nutritional deficiency is a public health problem in children and still little addressed in the international scientific literature. The planning, evaluation and implementation of health policies aimed at combatting VED in the paediatric population are extremely important.

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Vitamin D deficiency and insufficiency as well as low serum calcium levels can trigger negative health outcomes in women of childbearing age. Therefore, we aimed to estimate the prevalence of serum vitamin D and calcium deficiencies and insufficiencies and associated risk factors in Brazilian women of childbearing age and to assess whether there are differences in prevalence according to regions of the country and the presence or absence of pregnancy. The systematic literature review was performed using the following databases: PubMed, LILACS, Embase, Scopus, and Web of Science. Cross-sectional, cohort, and intervention studies were included. Among pregnant women, the prevalence of vitamin D deficiency ranged from 0% to 27% and of vitamin D insufficiency from 33.9% to 70.4%. Among non-pregnant women, the prevalence of vitamin D deficiency ranged from 0% to 41.7% and of vitamin D insufficiency from 38.5% to 69.3%. We found a high prevalence of vitamin D deficiency and insufficiency in women of childbearing age, with insufficiency affecting more than half of these women. The highest prevalence of vitamin D deficiency and insufficiency was observed in the South region. It was not possible to assess the prevalence and factors associated with calcium deficiency.

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Fortification with multiple micronutrient powder has been proposed as a public health intervention able to reduce micronutrient deficiencies in children. Our objective was to compare the effectiveness of fortification with multiple micronutrient powder with drug supplementation in the prevention and treatment of iron deficiency and anaemia. This was a cluster trial with anemic and non-anaemic children between six and 42 months old, in randomization data. Non anaemic children received fortification with multiple micronutrient powder or standard drug supplementation of ferrous sulfate associated with folic acid in a prevention dose. Anaemic children who were randomized to receive multiple micronutrient powder also received the recommended iron complementation for anaemia treatment. A total of 162 children were evaluated. The prevalence of anaemia decreased from 13.58 to 1.85%. Iron deficiency decreased from 21.74% to 7.89% (by serum ferritin) and iron deficiency decreased from 66.81 to 38.27% (by soluble transferrin receptor). No difference was identified between interventions for hemoglobin (p = 0.142), serum ferritin (p = 0.288), and soluble transferrin receptor (p = 0.156). Fortification with multiple micronutrient powder was effective in preventing iron deficiency and anaemia in children aged six to 48 months. In anaemic children; it was necessary to supplement the dose of multiple micronutrient powder with ferrous sulfate.

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Home fortification with multiple micronutrient powder (MNP) is effective in the prevention of anemia in young children. However, the impact on their vitamin A status remains controversial. This study aimed to evaluate the effect of MNP on vitamin A status in young Brazilian children. A multicenter pragmatic, controlled trial was carried out in primary health centers in four Brazilian cities. In the beginning of the study, the control group (CG) consisted of children 11-14 months old (n = 395) attending in routine pediatric health care. In parallel, the intervention group (IG) was composed of children 6-8 months old (n = 399), in the same health centers, who followed the intervention with MNP for 2-3 months. The analysis of the effect of MNP on vitamin A status was performed by comparing the IG with the CG after a 4- to 6-month follow-up when IG children had reached the age of the controls. The prevalence of vitamin A deficiency (VAD; serum retinol <0.70 µmol/L) in the CG was 16.2%, while in the IG was 7.5%-a 55% reduction in the VAD [prevalence ratio (95% confidence interval) = 0.45 (0.28; 0.72)]. This reduction was also significant when stratifying the study centers by coverage of the Brazilian Vitamin A Supplementation Program. The adjusted mean of vitamin A serum concentrations improved in the IG compared with CG children, with a shift to the right in the vitamin A distribution. Home fortification with MNP was effective in reducing VAD among young Brazilian children.

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OBJECTIVE: This study aimed to assess the nutritional status of vitamin A and associated factors in children assisted in Primary Care Health in Goiânia, Goiás, Brazil. METHODS: This is a cross-sectional study with a sample of 228 children 12 to 16 months of age. The nutritional status of vitamin A was assessed by serum retinol concentration, determined by high performance liquid chromatography. Multiple linear regression models with hierarchical selection of independent variables were used to evaluate the correlation with serum retinol as the dependent variable. RESULTS: The vitamin A deficiency (retinol < 0,7 µmol/L) was observed in 14,0% of the children. Maternal schooling and hemoglobin concentration were positively correlated with serum retinol concentration, while C-reactive protein showed a negative correlation (R2 = 0,1648). CONCLUSION: The vitamin A deficiency in one-year-old children attended in Basic Health Units in Goiânia configures itself as a moderate public health problem. Actions to promote maternal education, morbidity control and prevention of other micronutrient deficiencies are important for prevention and control of the vitamin A deficiency in this population.

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This study aimed to assess the nutritional status of vitamin A and associated factors in children assisted in Primary Care Health in Goiânia, Goiás, Brazil.

Este estudo teve por objetivo avaliar o estado nutricional de vitamina A e fatores associados em crianças atendidas em Unidades Básicas de Saúde de Goiânia, Goiás.

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Objetivo: Avaliar o consumo alimentar e o perfil antropométrico, comparar a composição corporal entre os sexos e analisar a adequação da ingestão alimentar às necessidades de bailarinos profissionais e semiprofissionais. Métodos: Foram analisados 16 bailarinos de ambos os sexos, com idade entre 20 e 35 anos de uma companhia de dança contemporânea, de nível internacional, de Goiânia (GO). Foram coletados peso; altura, dobras cutâneas tricipital, peitoral, subescapular, axilar média, suprailíaca, abdominal e da coxa; e dois recordatórios de 24 horas. Para ingestão energética, as recomendações utiizadas foram a do Institute of Medicine e para o s macronutrientes, Institute of Medicine e American College of Sports Medicine. Os dados foram digitados no Epi Info 6.04 e analisados no Statistical Package for Social Sciences 18.0. Foram aplicados os testes Shapito-Wilk, Mann Whitney e Wilcoxon com nível de significância de 0,05. Resultados: A única medida corporal que diferiu entre os grupos foi, no caso das mulheres, a dobra tricipital, com menor valor no grupo profissional (p=0,03). As dobras cutâneas tricipital e da coxa (p,0,001), peitoral (p=0,007) e suprailíaca (p=0.009) diferiram entre os sexos, sendo maiores entre as mulheres. A ingestão energética foi inferior às necessidades tanto para as mulheres (p=0,01), quanto para os homens (p=0,02). Conclusão: Não houve diferença significativa na composição entre indivíduos do mesmo sexo. A porcentagem de gordura e as dobras cutâneas tricipital, peitoral, suprailíaca e da coxa foram maiores entre as mulheres. Os consumos de energia, carboidratos e proteínas foram inferiores às recomendações

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The objective of this study was to assess the prevalence of anemia and the therapeutic and prophylactic response to ferrous sulfate and folic acid. A double-blind, randomized, controlled clinical trial was conducted with 196 children 6 to 24 months of age enrolled in municipal daycare centers in Goiânia, Goiás State, Brazil. The children were assigned to two treatment groups that received a daily dose (5 times a week) of either 4.2mg/kg/day of ferrous sulfate + folic acid (50microg) or 4.2mg/kg/day of ferrous sulfate + folic acid placebo. One of the prevention groups received 1.4mg/kg/day of ferrous sulfate + folic acid (50microg/day) and the other 1.4mg/kg/day of ferrous sulfate + folic acid placebo. Supplementation lasted approximately three months. Baseline anemia prevalence was 56.1% (95%CI: 48.9-63.1). After treatment, anemia prevalence in the folic acid group (14%) was lower than in the placebo group (34.9%) (p = 0.02). After prophylaxis in the non-anemic children, the incidence of anemia did not differ between the groups, but there was an increase in hemoglobin level in the folic acid group (p = 0.003). Iron plus folic acid was effective for the treatment of anemia and improvement of hemoglobin level in non-anemic children.

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The objective of this study was to assess the prevalence of anemia and the therapeutic and prophylactic response to ferrous sulfate and folic acid. A double-blind, randomized, controlled clinical trial was conducted with 196 children 6 to 24 months of age enrolled in municipal daycare centers in Goiânia, Goiás State, Brazil. The children were assigned to two treatment groups that received a daily dose (5 times a week) of either 4.2mg/kg/day of ferrous sulfate + folic acid (50µg) or 4.2mg/kg/day of ferrous sulfate + folic acid placebo. One of the prevention groups received 1.4mg/kg/day of ferrous sulfate + folic acid (50µg/day) and the other 1.4mg/kg/day of ferrous sulfate + folic acid placebo. Supplementation lasted approximately three months. Baseline anemia prevalence was 56.1 percent (95 percentCI: 48.9-63.1). After treatment, anemia prevalence in the folic acid group (14 percent) was lower than in the placebo group (34.9 percent) (p = 0.02). After prophylaxis in the non-anemic children, the incidence of anemia did not differ between the groups, but there was an increase in hemoglobin level in the folic acid group (p = 0.003). Iron plus folic acid was effective for the treatment of anemia and improvement of hemoglobin level in non-anemic children.

Avaliar a prevalência de anemia e a resposta terapêutica e profilática do sulfato ferroso e ácido fólico. Realizou-se um ensaio clínico controlado randomizado, duplo-cego, com 196 crianças de 6 a 24 meses, dos Centros Municipais de Educação Infantil de Goiânia, Goiás, Brasil. As crianças foram alocadas em dois grupos de tratamento que receberam dose diária (5x/semana) com 4,2mg/kg/dia de sulfato ferroso + ácido fólico (50µg) ou 4,2mg/kg/dia de sulfato ferroso + placebo de ácido fólico. Um dos grupos de prevenção recebeu 1,4 mg/kg/dia de sulfato ferroso + ácido fólico (50µg/dia) e o outro 1,4mg/kg/dia de sulfato ferroso + placebo de ácido fólico. A suplementação durou cerca de três meses. A prevalência de anemia inicial foi de 56,1 por cento (IC95 por cento: 48,9-63,1). Após o tratamento, a prevalência de anemia no grupo ácido fólico (14 por cento) foi menor que no grupo placebo (34,9 por cento; p = 0,02). Após profilaxia dos não anêmicos, a incidência de anemia não diferiu entre os grupos, porém, houve incremento da hemoglobina no grupo ácido fólico (p = 0,003). O ferro associado com ácido fólico foi eficaz no tratamento da anemia e na melhoria da hemoglobina nos não anêmicos.

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Objetivos: Verificar a prevalência de anemia e da etiologia ferropriva em lactentes, e identificar os seus fatores de risco; avaliar um novo método indireto para estimativa dos riscos de anemia, e a imunidade humoral destas crianças. Métodos: Estudo transversal foi realizado com 110 lactentes a termo, de 6 a 12 meses de idade, em uma unidade pública de saúde em Goiânia, Brasil. Realizou-se inquéritos socioeconômico, demográfico, reprodutivo, antropométrico e dietético. Colheu-se sangue venoso, em jejum, para análise da hemoglobina, amplitude de distribuição dos eritrócitos (RDW), ferritina, ferro sérico, proteína C-reativa, imunoglobulinas séricas IgA, IgM, e IgG e suas subclasses (IgG1, IgG2, IgG3, IgG4) e os componentes do complemento C3c e C4. Resultados: A prevalência de anemia observada foi de 60,9 por cento. Ao se considerar no diagnóstico da anemia a alteração da hemoglobina mais dois índices entre volume corpuscular médio (VCM), hemoglobina corpuscular média (HCM), ferritina ou ferro sérico, a prevalência de etiologia ferropriva foi de 87 por cento. Porém, ao se incluir entre os índices o RDW, a prevalência foi de 97,8 por cento. As melhores correlações entre as variáveis bioquímicas e hematológicas foram hemoglobina e hematócrito (r = 0,95) e HCM com o VCM (r = 0,95). Os fatores de risco identificados pela regressão logística múltipla foram o sexo masculino (OR=2,38), lactentes cujas mães eram donas de casa (OR = 5,01) e residências com mais de três membros (OR = 3,08). A introdução da carne após os 6 meses foi também um fator de risco (OR = 3,3). Houve um efeito dose resposta entre o consumo de leite e a prevalência de anemia ajustada pelo sexo e idade (Efeito = 0,12; IC 95 por cento: 0,02, 0,22). A densidade de ferro (6 aos 9 meses) e a velocidade de ganho de peso (9 aos 12 meses) afetaram significativamente a probabilidade do lactente ter anemia. A anemia e a deficiência de ferro não alteraram a imunidade humoral dos lactentes, ao se utilizar a ferritina como parâmetro. Os níveis de IgG, IgG1, IgG2, C3c e C4 foram significativamente maiores naqueles com redução do ferro sérico. As principais imunoglobulinas que tiveram os níveis aumentados nos anêmicos e não anêmicos foram a IgG, IgG1, e componentes C3c e C4 do complemento...

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No intuito de melhor conhecer a saúde da populaçäo, os fatores que a determinam, a evoluçäo do processo da doença e a repercussäo das açöes propostas para a cura ou erradicaçäo de seu curso, a ciência desenvolveu várias formas de abordagem e investigaçäo. Sendo assim, na prática pediátrica, a epidemiologia tem papel preponderante na atençäo à saúde, contribuindo no conhecimento das relaçöes entre doenças infantis graves, na etiologia de doenças controladas por vacinaçäo, e ainda no estabelecimento das condiçöes sociais e econômicas como determinantes dos perfis de morbidade e mortalidade infantis. Na investigaçäo de um tema, os estudos epidemiológicos podem ser observacionais ou experimentais. Os estudos observacionais incluem os descritivos (transversais) e analíticos (coorte e caso-controle)...

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