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The use of social media in medicine offers unprecedented opportunities for social interaction. Activity on platforms such as X (formerly Twitter), Instagram, Facebook, and LinkedIn plays crucial roles in various medical services, particularly regarding patients' access to information and healthcare services, medical education, and professional networking. However, the integration of social media into healthcare is not challenge-free and has certain pitfalls. In this article, we address several critical issues that compromise the reliability and effectiveness of social media as a professional healthcare resource, particularly in the field of radiology. We discuss possible solutions and tips and tricks to facilitate the use of this valuable tool to our advantage and in a reliable manner.
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Obesity causes inflammation in the adipose tissue and can affect the central nervous system, leading to oxidative stress and mitochondrial dysfunction. Therefore, it becomes necessary to seek new therapeutic alternatives. Gold nanoparticles (GNPs) could take carnitine to the adipose tissue, thus increasing fatty acid oxidation, reducing inflammation, and, consequently, restoring brain homeostasis. The objective of this study was to investigate the effects of GNPs associated with carnitine on the neurochemical parameters of obesity-induced mice. Eighty male Swiss mice that received a normal lipid diet (control group) or a high-fat diet (obese group) for 10 weeks were used. At the end of the sixth week, the groups were divided for daily treatment with saline, GNPs (70 µg/kg), carnitine (500 mg/kg), or GNPs associated with carnitine, respectively. Body weight was monitored weekly. At the end of the tenth week, the animals were euthanized and the mesenteric fat removed and weighed; the brain structures were separated for biochemical analysis. It was found that obesity caused oxidative damage and mitochondrial dysfunction in brain structures. Treatment with GNPs isolated reduced oxidative stress in the hippocampus. Carnitine isolated decreased the accumulation of mesenteric fat and oxidative stress in the hippocampus. The combination of treatments reduced the accumulation of mesenteric fat and mitochondrial dysfunction in the striatum. Therefore, these treatments in isolation, become a promising option for the treatment of obesity.
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Encéfalo , Carnitina , Modelos Animales de Enfermedad , Oro , Nanopartículas del Metal , Obesidad , Estrés Oxidativo , Animales , Carnitina/farmacología , Carnitina/administración & dosificación , Carnitina/uso terapéutico , Oro/farmacología , Masculino , Obesidad/tratamiento farmacológico , Obesidad/patología , Obesidad/complicaciones , Ratones , Estrés Oxidativo/efectos de los fármacos , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Encéfalo/patología , Dieta Alta en Grasa , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Lesiones Encefálicas/tratamiento farmacológico , Lesiones Encefálicas/patología , Lesiones Encefálicas/metabolismo , Peso Corporal/efectos de los fármacosRESUMEN
(1) Background: Malaria remains a significant global public health issue. Since parasites quickly became resistant to most of the available antimalarial drugs, treatment effectiveness must be constantly monitored. In Brazil, up to 10% of cases of vivax malaria resistant to chloroquine (CQ) have been registered. Unlike P. falciparum, there are no definitive molecular markers for the chemoresistance of P. vivax to CQ. This work aimed to investigate whether polymorphisms in the pvcrt-o and pvmdr1 genes could be used as markers for assessing its resistance to CQ. (2) Methods: A total of 130 samples from P. vivax malaria cases with no clinical and/or parasitological evidence of CQ resistance were studied through polymerase chain reaction for gene amplification followed by target DNA sequencing. (3) Results: In the pvcrt-o exons, the K10 insert was present in 14% of the isolates. Regarding pvmdr1, T958M and F1076L haplotypes showed frequencies of 95% and 3%, respectively, while the SNP Y976F was not detected. (4) Conclusions: Since K10-pvcrt-o and F1076L/T958M-pvmdr1 polymorphisms were detected in samples from patients who responded well to CQ treatment, it can be concluded that mutations in these genes do not seem to have a potential for association with the phenotype of CQ resistance.
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ABSTRACT Objective This study aimed to estimate the daily energy intake and overconsumed nutrients for adolescents and young adults concerning public health based on the food source, eating location, and occasion. Methods This study constituted a cross-sectional analysis of the 2015 Health Survey of São Paulo focusing on Nutrition with 707 adolescents (n=554, 12-19 years) and young adults (n=153, 20-30 years). Dietary intake was measured using 24 h recall, and energy, added sugars, sodium, and saturated food sources were calculated. Foods were classified using the "What We Eat in America?" classification system. Eating locations were divided into two categories-at home and away from home-for each main meal (breakfast, lunch, and dinner). Other sociodemographic and weight status variables were included. Descriptive statistics, the Wald test, and proportion rates were applied for analysis. Results Most meals were consumed at home by 80.5% of adolescents and 66.4% of young adults. Young adults consumed more daily calories and saturated fats than adolescents. Both adolescents and young adults consumed equal daily saturated fatty acids, sodium, and added sugars away from home at dinner. Food consumed at home was consumed both at home and away from home, with the main exception of dinner, which consisted of mainly processed foods rich in saturated fatty acids, sodium, and added sugars consumed away from home. Conclusion Adolescents and young adults had meals higher in fat, sugar and sodium away from home than those who ate at home when eaten at dinner. Public health policies and behavioral change strategies should be considered independently of where their meals are consumed but with particular attention to eating occasions.
RESUMO Objetivo Este estudo teve como objetivo estimar a ingestão diária de energia e nutrientes de maior preocupação em saúde pública entre adolescentes e jovens adultos, com base nos alimentos fonte, local e tipo de refeição. Métodos Este estudo é de delineamento transversal que utilizou dados do Inquérito de Saúde do Município de São Paulo 2015 (ISA-Capital) focado na Nutrição. A amostra compreendeu 707 adolescentes (n=554, 12-19 anos) e adultos jovens (n=153, 20-30 anos). O consumo alimentar foi avaliado por meio do Recordatório Alimentar de 24h (R24H) e a calculou-se as fontes de energia, açúcar de adição, sódio, e gordura saturada. Os alimentos foram classificados pelo sistema de classificação "What We Eat in America?" Os locais de alimentação foram divididos em duas categorias - "em casa" e "fora de casa" - para cada refeição principal (café da manhã, almoço e jantar). Outras variáveis sociodemográficas e antropométricas foram incluídas. Estatísticas descritivas, teste de Wald e proporções foram aplicadas para análise. Resultados A maioria das refeições era consumida em casa por 80,5% dos adolescentes e 66,4% dos adultos jovens. Os adultos jovens consumiam mais calorias diárias e gorduras saturadas do que os adolescentes. Tanto adolescentes, quanto adultos jovens, consumiam majoritariamente ácidos graxos saturados, sódio e, açúcares de adição fora de casa, no jantar. Os alimentos consumidos em casa eram consumidos tanto em casa quanto fora de casa, com a principal exceção do jantar, que consistia, principalmente, em alimentos processados ricos em ácidos graxos saturados, sódio e açúcares de adição consumidos fora de casa. Conclusão Adolescentes e adultos jovens apresentaram refeições mais ricas em gordura, açúcares e sódio fora de casa em comparação com aqueles que consomem em casa quando consumidos no jantar. Políticas de saúde pública e estratégias de mudança de comportamento devem ser consideradas independentemente do local onde suas refeições são consumidas, mas com especial atenção ao tipo de refeição.
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This study aimed to evaluate the behavioral and energy metabolism parameters in female mice subjected to obesity and offspring deprivation (OD) stress. Eighty female Swiss mice, 40 days old, were weighed and divided into two groups: Control group (control diet, n = 40) and Obese group (high-fat diet, n = 40), for induction of the animal model of obesity, the protocol was based on the consumption of a high-fat diet and lasted 8 weeks. Subsequently, the females were subjected to pregnancy, after the birth of the offspring, were divided again into the following groups (n = 20): Control non-deprived (ND), Control + OD, Obese ND, and Obese + OD, for induction of the stress protocol by OD. After the offspring were 21 days old, weaning was performed and the dams were subjected to behavioral tests. The animals were humanely sacrificed, the brain was removed, and brain structures were isolated to assess energy metabolism. Both obesity and OD led to anhedonia in the dams. It was shown that the structures most affected by obesity and OD are the hypothalamus and hippocampus, as evidenced by the mitochondrial dysfunction found in these structures. When analyzing the groups separately, it was observed that OD led to more pronounced mitochondrial damage; however, the association of obesity with OD, as well as obesity alone, also generated damage. Thus, it is concluded that obesity and OD lead to anhedonia in animals and to mitochondrial dysfunction in the hypothalamus and hippocampus, which may lead to losses in feeding control and cognition of the dams.
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Anhedonia , Efectos Tardíos de la Exposición Prenatal , Embarazo , Ratones , Femenino , Animales , Humanos , Obesidad/metabolismo , Dieta Alta en Grasa/efectos adversos , Destete , Metabolismo EnergéticoRESUMEN
(1) Background: Malaria is a public health problem worldwide. Despite global efforts to control it, antimalarial drug resistance remains a great challenge. In 2009, our team identified, for the first time in Brazil, chloroquine (CQ)-susceptible Plasmodium falciparum parasites in isolates from the Brazilian Amazon. The present study extends those observations to include survey samples from 2010 to 2018 from the Amazonas and Acre states for the purpose of tracking pfcrt molecular changes in P. falciparum parasites. (2) Objective: to investigate SNPs in the P. falciparum gene associated with chemoresistance to CQ (pfcrt). (3) Methods: Sixty-six P. falciparum samples from the Amazonas and Acre states were collected from 2010 to 2018 in patients diagnosed at the Reference Research Center for Treatment and Diagnosis of Malaria (CPD-Mal/Fiocruz), FMT-HVD and Acre Health Units. These samples were subjected to PCR and DNA Sanger sequencing to identify mutations in pfcrt (C72S, M74I, N75E, and K76T). (4) Results: Of the 66 P. falciparum samples genotyped for pfcrt, 94% carried CQ-resistant genotypes and only 4 showed a CQ pfcrt sensitive-wild type genotype, i.e., 1 from Barcelos and 3 from Manaus. (5) Conclusion: CQ-resistant P. falciparum populations are fixed, and thus, CQ cannot be reintroduced in malaria falciparum therapy.
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Background: Economic dimension comprises important determinants of food choices, particularly income and prices. Aim: Identification of the influence of food prices and diet costs on the consumption of food groups considered protection and risk factors for cardiometabolic diseases. Methods: Food groups classification follows the proposal of "What we eat in America?" from the National Health and Nutrition Examination Survey (NHANES), adapted to Latin America. Data on food consumption from the Health Survey of Sao Paulo (2003, 2008, and 2015), representative at population level, was used. Log-linear regressions were estimated for food groups, controlling for endogeneity through augmented regression-test Results: Results showed increase in prices per calorie of whole grains and red meat from 2003-2015 and a decrease in prices per calorie of fruits, vegetables, beans, legumes, oilseeds and fish/seafood. Food groups had price elasticities between -0.01 and -1.6, i.e., decrease in consumption associated with increase in prices. Results showed statistically significant effects of substitution and complementarity, particularly substitution between sweetened beverages and fruits (2003, ß = 0.606; 2008: ß = 0.683; 2015, ß = 0.848), complementarity between nuts and seeds and whole grains (2003, ß = -0.646; 2008, ß = -0.647; 2015,ß = -0.901), and vegetables and processed meat (2003, ß = -1.379; 2015, ß = -1.685). Conclusion: Findings of the study represent relevant evidence for design strategies towards the adoption of healthier diets, particularly through subsidies to protection food groups, promoting lower prices and higher diet quality. The evidence may be useful for policymakers and researchers in fields of nutrition and health in diverse countries worldwide, especially due to absence of robust evidence in literature.
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Artemisinin (ART) is recommended as the first-line drug for P. falciparum infections combined with a long-acting partner drug. The emergence of P. falciparum resistance to ART (ARTR) is a concern for malaria. The most feared threat remains the spread of ARTR from Southeast Asia to Africa or the independent emergence of ARTR in Africa, where malaria accounts for 93% of all malaria cases and 94% of deaths. To avoid this worst-case scenario, surveillance of Pfkelch13 mutations is essential. We investigated mutations of Pfkelch13 in 78 P. falciparum samples from Huambo, Angola. Most of the parasites had a wild-type Pfkelch13 allele. We identified one synonymous mutation (R471R) in 10 isolates and one non-synonymous mutation (A578S) in two samples. No Pfkelch13 validated or candidate ARTR mutants were identified. The finding suggests that there is little polymorphism in Pfkelch13 in Huambo. Since cases of late response to ART in Africa and the emergence of ARTR mutations in Rwanda and Uganda have been reported, efforts should be made toward continuous molecular surveillance of ARTR. Our study has some limitations. Since we analyzed P. falciparum parasites from a single health facility, the study may not be representative of all Angolan endemic areas.
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Obesity is currently one of the most serious health problems, affecting 13% of the world's adult population. Obesity is characterized by persistent low-grade chronic inflammation that assumes systemic proportions and triggers several associated metabolic diseases. Furthermore, obesity has been associated with an increased occurrence of central disorders such as impaired cognitive function, reward system dysfunction, and depression. In summary, there is a quantitative reduction in the release of neurotransmitters in depression. Postsynaptic cells capture lower concentrations of neurotransmitters, which leads to a functional reduction in the central nervous system (CNS). Globally, approximately 15-65% of women experience depressive symptoms during pregnancy, depending on their location. Depressive symptoms persist in some women, leading to postpartum depression (PPD). Thus, obesity may be considered a risk factor for PPD development. This study aimed to synthesize studies on the impact of obesity-related neuroinflammation and PPD. We conducted a narrative review of the relevant literature. The search was performed in electronic databases, specifically PubMed, selecting articles in English published from 2014 to 2021 using the narrative review methodology.
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Depresión Posparto , Adulto , Depresión , Depresión Posparto/complicaciones , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Femenino , Humanos , Enfermedades Neuroinflamatorias , Obesidad/complicaciones , Embarazo , Factores de RiesgoRESUMEN
Cost-effectiveness analysis of diets may comprise an important tool to promote food security; however, studies show divergent evidence regarding the relationship between diet quality and cost in diverse populations. Thus, this study assesses differences in cost-effectiveness ratios regarding adherence to nutritional recommendations using data representative of the population level in Sao Paulo municipality, Brazil. Information from adolescents and adult individuals (n = 1742) was used to estimate diet quality and cost in 2015. Differences in cost-effectiveness ratios were investigated through application of two diet quality indexes and exploration of individuals' personal and contextual characteristics. Results indicated that higher diet cost was associated with higher adherence to nutritional recommendations at the national level and inversely associated with adherence to international recommendations. Purchasing foods in street markets was linked to healthier diets at lower costs, and protein consumption was associated with higher diet cost regardless of diet quality; however, diet quality was linked to type of protein consumed by individuals. Differences in cost-effectiveness ratios were attributable to methodological choices in measuring dietary quality (why); individuals' personal and contextual characteristics, in particular, access to retail equipment (where); and certain food choices (what). Therefore, cost-effectiveness analyses should be tailored to policy goals and local environments to ensure proper assessment of nutrition programs and to foster improvements in nutritional diet quality at lower cost.
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Dieta , Alimentos , Adulto , Adolescente , Humanos , Análisis Costo-Beneficio , Brasil , Estado NutricionalRESUMEN
Introdução: Ter uma alimentação adequada e saudável envolve diferentes aspectos, entre os quais o custo é um dos principais determinantes. Objetivo: Investigar os custos da alimentação em amostra representativa da população residente no município de São Paulo em 2003, 2008 e 2015. Métodos: Foram utilizados dados do estudo transversal, base populacional, ISA-Nutrição, com residentes no município de São Paulo. Dados socioeconômicos e estilo de vida foram coletados em visitas domiciliares e inquérito telefônico e, consumo alimentar, por dois recordatórios de 24 horas. Para avaliação da qualidade e classificação da dieta foram utilizados: Índice de Qualidade da Dieta Revisado - IQD-R, grupos de alimentos de proteção ou de risco para doenças cardiometabólicas baseados na classificação What we eat in América? (WEEIA), adaptada para América Latina e análise da aderência às recomendações da Organização Mundial da Saúde (OMS) quanto ao consumo de frutas, verduras e legumes, açúcar, sódio e gordura saturada. A estimativa de custos da alimentação foi baseada em preços dos alimentos das Pesquisas de Orçamento Familiar (POF) do Instituto Brasileiro de Geografia e Estatística (IBGE), sendo adotados critérios definidos de pareamento para linkage (ano de estudo, renda familiar per capita, perfil familiar), incluindo, aplicação de fatores de cocção e conversão, assim como uso de deflatores para comparação entre diferentes períodos. Elasticidades da demanda por alimentos foram analisadas utilizando-se regressão log-linear (endogeneidade/teste Durbin-Wu-Hausman). Associação entre custo e qualidade da dieta foi avaliada por meio de custo-efetividade/incremental. Resultados: De 2003 a 2015, houve aumento nos preços por caloria de cereais integrais e carne vermelha. Por outro lado, queda para frutas, verduras/legumes, feijão, leguminosas, oleaginosas/sementes e peixes/frutos do mar. Elasticidades-preço destes grupos de alimentos apresentaram coeficientes negativos, mostrando tendência de redução do consumo devido ao aumento dos preços. Cereais integrais mostraram complementaridade com oleaginosas e sementes, enquanto verduras/legumes, complementaridade com carnes processadas em 2003 e 2015, e oleaginosas/sementes em 2008 e 2015. Frutas e bebidas açucaradas apresentaram relação de substituição. Em 2015, dietas que apresentaram maior aderência às recomendações dietéticas (IQD-R - maiores pontuações) possuíam maior custo. No entanto, maior aderência às recomendações da Organização Mundial da Saúde (OMS) quanto ao consumo de frutas, verduras/legumes, sódio, açúcares e gordura saturada representou menor custo. Indivíduos que compraram alimentos em feiras livres tiveram menor custo da dieta e aqueles com renda inferior a um salário-mínimo comprometem quase totalidade do orçamento familiar com alimentação (99,49%). Verifica-se maior participação no custo da dieta, do grupo das carnes, independente da qualidade da dieta. Conclusões: O método linkage constituiu-se um recurso importante para avaliação do custo das dietas em estudos em que estas informações estão ausentes. Devido à alta elasticidade-preço no período avaliado (12 anos), consumidores do município de São Paulo responderam ao aumento dos preços com redução do consumo. Grandes mudanças nos preços relativos de bebidas açucaradas deveriam ser necessárias para reduzir seu consumo, com possibilidade de substituição às frutas. Impostos para carnes ou subsídios para legumes e verduras devem considerar potenciais efeitos cruzados. Por outro lado, subsídios, aos cereais integrais, beneficiaria o consumo de oleaginosas e sementes. Maior custo de dietas apresentou maior aderência às recomendações dietéticas e local de compra de alimentos (feiras livres) melhoria na qualidade nutricional da dieta com menor custo.
Introduction: Having an adequate and healthy diet involves different aspects, among which cost is one of the main determinants. Objective: To investigate the costs of food in a representative sample of the population living in São Paulo in samples from the years 2003, 2008 and 2015. Methods: We used data from the cross-sectional, population-based study, ISA-Nutrition, with residents in the municipality of São Paulo in 2003, 2008, and 2015. Socioeconomic and lifestyle data were collected in home visits and telephone survey and, food intake, by two 24-hour recall. To evaluate the quality and classification of diet, we used: the Brazilian Health Eating Index - Revised (BHEI-R); protection or risk groups for cardiometabolic diseases based on the "What we eat in America?" (WEEIA) classification, adapted for Latin America and analysis of adherence to World Health Organization (WHO) recommendations for fruit and vegetable consumption, sugar, sodium, and saturated fat. The estimation of food costs was based on food prices from the Household Budget Surveys (HBS) of the Brazilian Institute of Geography and Statistics (IBGE), adopting well-defined pairing criteria for linkage (year of study, per capita family income, family profile), including the application of cooking and conversion factors, as well as the use of deflators for comparison between different periods. Food demand elasticities were analyzed using log-linear regression (endogeneity/Durbin-Wu-Hausman test). Association between cost and diet quality was assessed using cost-effectiveness/incremental. Results: From 2003 to 2015, there was an increase in prices per calorie for whole grains and red meat. On the other hand, declines for fruits, vegetables/legumes, beans, legumes, oilseeds/seeds, and fish/seafood. The price elasticities of these food groups showed negative coefficients, showing a tendency of consumption to decrease due to price increases. Whole grains showed complementarity with oilseeds and seeds, while vegetables/legumes, complementarity with processed meats in 2003 and 2015, and oilseeds/seeds in 2008 and 2015. Fruits and sugar-sweetened beverages showed a substitution relationship. In 2015, diets that showed higher adherence to dietary recommendations (BHEI-R - higher scores) had higher cost. However, higher adherence to World Health Organization (WHO) recommendations for fruit, vegetable intake, sodium, sugars, and saturated fat represented lower cost. Individuals who bought food at street markets had lower dietary costs and those with incomes below one minimum wage spent almost the entire family budget on food (99.49%). There was a greater participation of the meat group in the cost of the diet, regardless of the quality of the diet. Conclusions: The linkage method can be an important resource for evaluating the cost of diets in studies where this information is absent. Due to the high price elasticity over the evaluated period (12 years), consumers in São Paulo responded to price increases by reducing consumption. Large changes in the relative prices of sugar-sweetened beverages would be necessary to reduce their consumption, with the possibility of substitution to fruit. Taxes for meat or subsidies for vegetables should consider potential cross effects. Subsidies, to whole grains, would benefit the consumption of oilseeds and seeds. Higher cost of diets showed greater adherence to dietary recommendations and location of food purchase (street markets) improved nutritional diet quality at lower cost.
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Dieta/economía , Ingestión de Alimentos , Economía , Alimentos/economíaRESUMEN
ABSTRACT Objective: To evaluate associations between snacking and energy, nutrients and food source, and to identify the contribution of snacking across age, sex, weight status and lifestyle behaviors among adolescents and young adults. Methods: A sub-sample was calculated from the population-based cross-sectional study 2015-Health Survey of São Paulo (ISA-Capital). The survey "ISA-Nutrição" used a sample of non-institutionalized individuals aged >15 years. For this study, only adolescents (12-18 years old; n=418) and young adults (19-29 years old; n=218) were included. Snacks were identified, and their contribution to energy, nutrients, and food sources were calculated. Descriptive statistics and logistic regressions were used. Results: Participants experienced an average of 2.9±0.6 snacking occasions per day. Young adults consumed more energy from morning and night snacks, and adolescents, from afternoon snacks. The top three food sources on snacking contributed to 30.5% of energy: cookies (11.8%), sugar sweetened beverages (9.4%), sweets and other desserts (9.3%). Although results were non-significant, being a female (Odds Ratio [OR] 0.93; 95% confidence interval [95%CI] 0.36-1.49), meeting the physical activity recommendations (OR 0.75; 95%CI 0.25-1.25), and scoring higher for the healthy eating index (OR 0.88; 95%C 0.24-1.52) were all factors related to increased intake of snacks. Alternatively, overweight individuals (OR -0.54; 95%CI -1.00 to -0.08) consumed less snacks. Conclusions: Improving the quality of snacks should be considered in behavior-change strategies.
RESUMO Objetivo: Avaliar associações entre lanches e consumo de energia, nutrientes e fontes alimentares e identificar seus contribuintes por idade, sexo, status de peso e comportamentos de estilo de vida entre adolescentes e jovens adultos. Métodos: Subamostra calculada a partir do estudo de base-populacional transversal Inquéritos de Saúde de São Paulo (ISA-Capital, 2015). O ISA-Nutrição utilizou amostra de indivíduos não-institucionalizados com idade >15 anos. Para este estudo, apenas adolescentes (12-18 anos; n=418) e jovens adultos (19-29 anos; n=218) foram incluídos. Os "lanches" foram definidos, bem como foram calculadas a contribuição de energia e nutrientes, e as fontes alimentares. Estatística descritiva e regressões logísticas foram utilizadas. Resultados: Em média foram realizados 2,9±0,6 lanches por dia pelos participantes. Jovens adultos consumiram mais energia nos lanches da manhã e noite, enquanto adolescentes, à tarde. As três principais fontes de alimentos nos lanches contribuíram em 30,5% para o total de energia: biscoitos (11,8%), bebidas açucaradas (9,4%), e doces e outras sobremesas (9,3%). Apesar de os resultados não serem significantes, ser do sexo feminino (Odds Ratio [OR] 0,93, intervalo de confiança de 95% [IC95%] 0,36-1,49), atingir as recomendações de atividade física (OR 0,75, IC95% 0,25-1,25), e ter alta pontuação no índice do total da qualidade dieta (OR 0,88, IC95% 0,24-1,52) resultou em aumento na ingestão de lanches. Alternativamente, ter sobrepeso (OR -0.54, IC95% -1.00 a -0.08) está relacionado a menores chances de consumir lanches. Conclusões: Estratégias para melhorar a qualidade dos lanches deveriam ser consideradas nas intervenções de mudança de comportamentos.
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Health and nutrition surveys usually comprise detailed information on health characteristics and food consumption of certain population groups; however, the lack of data collection on the food prices may pose challenges for the estimation of the diet costs for the comprehensive analysis of food demand. The Household Budget Survey (HBS) represents an opportunity to obtain the data on the food prices for the nutrition surveys in the diverse countries worldwide. Although the HBS and the health and nutrition surveys may correspond to different periods, the application of the appropriate Consumer Price Index (CPI) allows to address the changes in the relative prices to perform the linkage between the data of food consumption with information on the food prices. Therefore, the aim of this study was to present the methods for the extraction and linkage of the food prices data from the Brazilian HBS (2002-2003 and 2008-2009) by using the pairing features related to the household characteristics to match the Health Survey of São Paulo [Inquérito de Saúde de São Paulo (ISA-Capital)] conducted in 2003, 2008, and 2015. Data referring to the household characteristics and food prices acquired by the household members living in São Paulo municipality were selected from the HBS datasets for integration with the ISA-Capital dataset. Specific deflators referring to the food items surveyed in São Paulo were obtained from the datasets of the Brazilian Broad Consumer Price Index (BCPI). Therefore, the pairing criteria referring to time, location, and household characteristics were adopted to allow linking foods consumed by the individuals in the ISA-Capital with the prices from the foods acquired by household members interviewed in the HBS. Matching data on the key pairing criteria (location/year/household income per capita/number of residents/family profile) resulted in the linkage of 94.4% (2003), 92.6% (2008), and 81.2% of the cases (2015). Following the data linkage, it was possible to estimate diet costs per gram and per calorie including application of cooking and conversion factors. Data were presented in the International Monetary Unit under the purchasing power parity (PPP) to allow the comparison at the international level. The mean diet costs identified in the population of São Paulo municipality were $8.45 (dp = 0.38) per capita per day in 2003, $8.72 (dp = 0.24) per capita per day in 2008, and $9.62 (dp = 0.23) per capita per day in 2015. Thus, it was possible to estimate the diet costs based on the prices of food items through pairing linkage of information from the household surveys, such as the Brazilian HBS, with the health and nutrition surveys lacking information on the expenditures or prices such as the ISA-Capital. Similar procedures may be used in the diverse countries with availability of the datasets of the household expenditures and health and nutrition surveys, allowing the researchers worldwide to associate the diet quality with food demand.
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OBJECTIVE: To evaluate associations between snacking and energy, nutrients and food source, and to identify the contribution of snacking across age, sex, weight status and lifestyle behaviors among adolescents and young adults. METHODS: A sub-sample was calculated from the population-based cross-sectional study 2015-Health Survey of São Paulo (ISA-Capital). The survey "ISA-Nutrição" used a sample of non-institutionalized individuals aged >15 years. For this study, only adolescents (12-18 years old; n=418) and young adults (19-29 years old; n=218) were included. Snacks were identified, and their contribution to energy, nutrients, and food sources were calculated. Descriptive statistics and logistic regressions were used. RESULTS: Participants experienced an average of 2.9±0.6 snacking occasions per day. Young adults consumed more energy from morning and night snacks, and adolescents, from afternoon snacks. The top three food sources on snacking contributed to 30.5% of energy: cookies (11.8%), sugar sweetened beverages (9.4%), sweets and other desserts (9.3%). Although results were non-significant, being a female (Odds Ratio [OR] 0.93; 95% confidence interval [95%CI] 0.36-1.49), meeting the physical activity recommendations (OR 0.75; 95%CI 0.25-1.25), and scoring higher for the healthy eating index (OR 0.88; 95%C 0.24-1.52) were all factors related to increased intake of snacks. Alternatively, overweight individuals (OR -0.54; 95%CI -1.00 to -0.08) consumed less snacks. CONCLUSIONS: Improving the quality of snacks should be considered in behavior-change strategies.
Asunto(s)
Ingestión de Energía , Conducta Alimentaria , Bocadillos , Adolescente , Adulto , Brasil , Estudios Transversales , Encuestas sobre Dietas , Dieta Saludable , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the validity of self-reported body mass and height measurements in adolescents, adults and older adults according to sex, age, leisure-time physical activity level, nutritional status, and cardiometabolic risk factors. METHODS: The study included 856 subjects, aged 12 years or older, who participated in the São Paulo Health Survey (ISA-2015) and who had their body mass and height measured and self-reported. Based on the Body Mass Index (BMI), a classification of nutritional status was made according to standardized criteria for each phase of life. The validation of self-reported data was examined by the Intraclass Correlation Coefficient, Bland-Altman and paired T-Test. Linear regression models were used to estimate the calibration coefficients, and sensitivity and specificity tests were performed. RESULTS: Self-reported body mass and height values tend to be very similar to measured values, with a few exceptions. For the adolescents, an underestimation of height was noted, while for the older adults, an overestimation. There was a consistent underestimation of self-reported body mass among women, and an overestimation of BMI among men who practiced less than 150 minutes of physical activity per week during leisure time. The calibration process of self-reported measures made them more consistent with the values measured, increasing the sensitivity in the classification of nutritional status among women and the specificity among men. CONCLUSIONS: Self-reported measures of height, body mass and BMI provided valid and reliable measures, presenting a substantial improvement after calibration.
OBJETIVO: Avaliar a validade da massa corporal e da estatura autorreferidas em adolescentes, adultos e idosos segundo sexo, idade, nível de atividade física no lazer, estado nutricional e fatores de risco cardiometabólicos. MÉTODOS: Participaram do estudo 856 sujeitos, com 12 anos ou mais, que responderam ao Inquérito de Saúde de São Paulo (ISA-2015) e que possuíam a massa corporal e a estatura autorreferidas e aferidas. Com base no índice de massa corporal, realizou-se uma classificação do estado nutricional de acordo com critérios padronizados para cada fase da vida. A validade das medidas autorreferidas foi examinada usando o coeficiente de correlação intraclasse, Bland-Altman e o teste t pareado. Utilizaram-se regressões lineares para elaborar os coeficientes de calibração, e realizaram-se testes de sensibilidade e especificidade. RESULTADOS: Os principais resultados apontam que os valores de massa corporal e estatura autorreferidas tendem a ser bem similares aos aferidos, apesar de algumas exceções. Para os adolescentes, notou-se uma subestimação da estatura, ao passo que, para os idosos, houve superestimação. Com relação à massa corporal, houve consistente subestimação da medida autorreferida entre as mulheres. Entre os homens que praticavam menos de 150 minutos semanais de atividade física no lazer, notou-se superestimação do índice de massa corporal. O processo de calibração das medidas autorreferidas tornou-as mais concordantes com as medidas aferidas, aumentando a sensibilidade na classificação do estado nutricional entre as mulheres e a especificidade entre os homens. CONCLUSÕES: As medidas autorreferidas de estatura, massa corporal e índice de massa corporal forneceram medidas válidas e confiáveis, apresentando melhoras substanciais após a calibração.
Asunto(s)
Estatura , Factores de Riesgo Cardiometabólico , Adolescente , Anciano , Índice de Masa Corporal , Peso Corporal , Brasil/epidemiología , Ejercicio Físico , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Autoinforme , Factores SexualesRESUMEN
Unforeseen Plasmodium infections in the Atlantic Forest of Brazilian Extra-Amazonian region could jeopardise malaria elimination. A human malaria case was registered in Três Forquilhas, in the Atlantic Forest biome of Rio Grande do Sul, after a 45 years' time-lapsed without any malaria autochthonous notification in this southern Brazilian state. This finding represents the expansion of the malaria distribution areas in Brazil and the southernmost human malaria case record in South America in this decade. The coexistence of the bromeliad-breeding vector Anopheles (Kerteszia) cruzii and non-human primates in the Atlantic Forest regularly visited by the patient claimed for the zoonotic origin of this infection. The reemergence of Atlantic Forest human malaria in Rio Grande do Sul was also discussed.
Asunto(s)
Anopheles , Malaria , Animales , Brasil/epidemiología , Bosques , Humanos , Malaria/epidemiología , Mosquitos VectoresRESUMEN
Increased consumption of energy-dense, nutrient-poor foods can lead to inadequate intakes of shortfall nutrients, including vitamin A, D, C, and E, dietary folate, calcium, iron, magnesium, potassium, and fiber. The objective was to examine the prevalence of inadequate intake of shortfall nutrients and identify food sources of shortfall nutrients in eight Latin American countries. Data from ELANS, a multi-country, population-based study of 9218 adolescents and adults were used. Dietary intake was collected through two 24 h Recalls from participants living in urban areas of Argentina, Brazil, Chile, Colombia, Ecuador, Peru, and Venezuela. Foods and beverages were classified using the adapted version of the NHANES "What We Eat in America" system. Nutrients inadequacy was estimated using the Institute of Medicine recommendations and descriptive statistics were calculated. Prevalence of inadequacy was above 50% for most of the nutrients, which the exception of vitamin C with a prevalence of inadequacy of 39%. Milk, cheese, seafoods, breads, and fruit juices/drinks were among the top 5 sources for each of the 10 shortfall nutrients examined. Many food categories were top contributors to more than one dietary component examined. Understanding the nutrient intake and food sources can help inform dietary guidance and intervention approaches.
Asunto(s)
Dieta , Estado Nutricional , Adolescente , Adulto , Argentina/epidemiología , Brasil , Chile , Colombia , Ecuador/epidemiología , Ingestión de Energía , Humanos , América Latina/epidemiología , Encuestas Nutricionales , Perú , Venezuela , VitaminasRESUMEN
Este artigo tem como objetivo avaliar o estado nutricional em relação à presença de cáries dentárias em crianças de 4 a 6 anos de idade, do município de Cajamar, São Paulo. Trata-se de estudo transversal com crianças entre 4 a 6 anos (n=1642), acompanhadas pelo Programa Saúde na Escola (PSE) do Município de Cajamar, São Paulo. A classificação do estado nutricional foi baseada no Índice de Massa Corporal (IMC) e a avaliação das condições bucais, por meio do índice ceo-d e critério para Risco de Cárie. A análise do estado nutricional, faixa etária e sexo conforme o número de cáries, foi feita por meio dos testes Mann-Whitney U e Kruskal-Wallis (p<0,05). Observou-se maior prevalência de meninos entre 4 a 6 anos. Em todas as faixas etárias a prevalência de excesso de peso foi de aproximadamente 30% e eutrofia em torno de 70%. 65% (n=1068) das crianças não apresentavam risco de cárie (A) e 28,8% (n=475), alto risco (D, E e F). Das 1162 crianças sem cáries, 0,2% eram magras (n=2), 67,2% (n=781) eutróficas e 32,7% (n=380) possuíam excesso de peso. A frequência de 1 a 5 cáries maior entre meninas e de 6 ou mais cáries, entre meninos. Segundo estado nutricional, o número médio do número de cáries foi de 2,17 para magreza, 0,93 para eutrofia e 0,65 para excesso de peso (p<0,010). Conclui-se que houve diferença entre número cáries e estado nutricional, na qual crianças com déficit nutricional apresentavam maior número de cáries dentárias comparadas às eutróficas ou com excesso de peso, sugerindo-se a inclusão do estado nutricional na avaliação odontológica.
This article aims at evaluating the nutritional status in relation to the presence of dental caries in children aged 4 to 6 years in the city of Cajamar, in the state of São Paulo. It is a cross-sectional study with children aged 4 to 6 years (n=1642) accompanied by the School Health Program of the City of Cajamar, São Paulo. The nutritional status classification was based on the Body Mass Index (BMI) and the evaluation of oral conditions, through the ceo-d index, and criteria for risk for caries. The analysis of the nutritional status, age, and sex according to the number of caries was made through the Mann-Whitney U and Kruskal-Wallis tests (p<0.05). A higher prevalence was observed among boys aged 4 to 6 years. In all age groups, there was a prevalence of 30% of overweight children, and eutrophy of approximately 70%. A total of 65% (n=1068) of the children presented no risk of caries (A), whereas 28.8% (n=475) showed high risk (D, E, and F). Among the 1162 children with no caries, 0.2% were thin (n=2); 67.2% (n=781) eutrophic; and 32.7% (n=380) were overweight. Girls presented a higher frequency of 1 to 5 caries while boys presented frequency of having 6 or more caries. According to the nutritional status, the average number of caries was 2.17 for thin individuals; 0.93 for eutrophic individuals; and 0.65 for overweight individuals (p<0.010). It could be concluded that there was a difference between the number of caries and the nutritional status, in which children with nutritional deficit presented a higher number of dental caries when compared to eutrophic or overweight ones, suggesting the inclusion of the nutritional status in the dental evaluation.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Evaluación Nutricional , Caries Dental/diagnóstico , Delgadez , Programas de Nutrición/organización & administración , Índice de Masa Corporal , Salud Pública/educación , Desnutrición Proteico-Calórica/diagnóstico , Odontología , Sobrepeso , Obesidad Infantil , Dieta SaludableRESUMEN
OBJECTIVE: To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans. DESIGN: Data from the Latin American Study of Nutrition and Health (ELANS). SETTING: ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. PARTICIPANTS: Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15-65 years. 'What We Eat in America' food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount. RESULTS: Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %). CONCLUSION: Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.
Asunto(s)
Dieta , Ingestión de Energía , Adolescente , Adulto , Anciano , Estudios Transversales , Hispánicos o Latinos , Humanos , América Latina , Persona de Mediana Edad , Nutrientes , Encuestas Nutricionales , Estados Unidos , Verduras , Adulto JovenRESUMEN
Community Health Agents (CHAs) are important collaborators in combating illnesses related to poor eating habits. The objective of this work was to verify the knowledge of the community health workers of Cajamar city about food and the main diseases related to bad eating habits. This is a cross-sectional study, conducted from August to September 2011, in Cajamar city, São Paulo by trained interviewers. 57 HCWs were interviewed who answered two questionnaires, the first to characterize them and the second to obtain data on basic knowledge about food and the main diseases related to poor eating habits. 96.5% of the CHA were female, had an average of 34 years, 88.1% had two children, predominance of complete high school (56.1%; n=32). They had the function of CHAs as the main source of income, receiving up to three minimum wages and exercising it for at least six months (52.6%). When the subject was food, 94.5% report that they are the first to address the issue. The main difficulties were that people did not follow the guidelines (43%) and lack of knowledge (40%). There was a good performance in the issues regarding chronic diseases (76.6% of hits) and risk groups (97%). In questions about food groups and food security, there was low performance (rate of hits of 55.2% and 55.3%, respectively). The qualification of CSAs is fundamental for the improvement of the work performed, being important the use of educational strategies that provide continuous learning. (AU)
Os Agentes Comunitários de Saúde (ACS) são importantes colaboradores no combate de doenças relacionadas aos maus hábitos alimentares. O objetivo deste trabalho foi verificar o conhecimento dos ACS do município de Cajamar sobre alimentação e as principais doenças relacionadas aos maus hábitos alimentares. Trata-se de um estudo transversal, realizado no período de agosto a setembro de 2011, no município de Cajamar, São Paulo por entrevistadores treinados. Foram entrevistados 57 ACS que responderam a dois questionários, o primeiro com intuito de caracterizá-los e o segundo para obter dados quanto aos conhecimentos básicos sobre alimentação e as principais doenças relacionadas aos maus hábitos alimentares. 96,5% dos ACS eram do sexo feminino, possuíam em média 34 anos, 88,1% possuíam dois filhos, predominância de ensino médio completo (56,1%; n=32). Possuíam a função de ACS como principal fonte de renda, recebendo até três salários mínimos e exercendo-a há pelo menos seis meses (52,6%). Quando o assunto foi alimentação, 94,5% relatam que são os primeiros a abordar o assunto. As principais dificuldades encontradas foram que as pessoas não seguem as orientações (43%) e a falta de conhecimentos (40%). Verificou-se bom desempenho nas questões que se referiam às doenças crônicas (76,6% de acertos) e grupos de risco (97%). Já nas questões sobre grupos alimentares e segurança alimentar, houve baixo desempenho (índice de acertos de 55,2% e 55,3%, respectivamente). A capacitação dos ACS mostra-se fundamental para o aprimoramento do trabalho desempenhado, sendo importante o uso de estratégias educativas que proporcionem aprendizado contínuo. (AU)