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BACKGROUND: Besides body mass index (BMI), new parameters have been developed to classify individual body shape. AIM: To investigate the relationship between BMI, waist circumference (WC), a body shape index (ABSI) and ABSI-adolescents among adolescents and verify which would better predict lower adiponectin/leptin (A/L) ratio and disturbances on glucose metabolism. SUBJECTS AND METHODS: A cross-sectional study with 197 Brazilian adolescents of 14-18 years. Serum leptin, adiponectin, glucose and insulin were measured. A/L ratio, ABSI, ABSI-adolescents, BMI, homeostasis model assessment estimates of insulin resistance (HOMA-IR) and ß-cell function (HOMA-ß) and the quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS: ABSI-adolescents positively correlated with WC (r = 0.83, p < 0.0001) and BMI (r = 0.66, p < 0.0001), but stronger correlations were observed between WC and BMI (r = 0.95, p < 0.0001). ABSI-adolescents, BMI and WC negatively correlated with A/L ratio (all p < 0.0001). The correlation between BMI and A/L ratio was the strongest (r = -0.63, p < 0.001). A/L ratio, BMI, WC and ABSI-adolescents correlated with markers of glucose metabolism (all p < 0.0001) and the strongest correlation was observed with BMI (QUICKI: r = -0.75; HOMA-IR: r = 0.76; HOMA-ß: r = 0.77; insulin: r = 0.79). Associations were confirmed by linear regression analysis, adjusted for sex and age. CONCLUSIONS: ABSI-adolescents, but not ABSI, was related to A/L ratio and to markers of glucose metabolism, but not more strongly than BMI and WC.

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OBJECTIVES: This study aimed to investigate the relationship between 25-hydroxyvitamin D (25(OH)D), osteocalcin, markers of glucose metabolism, and obesity-related parameters among adolescents. METHODS: This was a cross-sectional study with 198 adolescents age 14-18 years. Weight, height, and waist and hip circumferences were measured, as well as the following biochemical parameters: serum 25(OH)D, parathyroid hormone (PTH), total (tOC) and undercarboxylated (ucOC) osteocalcin, adiponectin, leptin, glucose, and insulin. The homeostasis model of assessment estimate of insulin resistance (HOMA-IR) and ß-cell function (HOMA-ß) and quantitative insulin sensitivity check index (QUICKI) were calculated. Student's t test, analysis of variance (ANOVA), Pearson's correlation, and linear regression models were performed. RESULTS: Overweight was observed in 42.6% of the sample. This group presented significantly higher PTH, leptin, insulin, HOMA-IR, and HOMA-ß and lower 25(OH)D, adiponectin, tOC, ucOC, and QUICKI than normal-weight subjects. 25(OH)D was positively correlated with ucOC and adiponectin and negatively associated with body mass index (BMI), weight, and waist circumference (p < 0.05 for all). The association between 25(OH)D and ucOC was also observed in the multiple regression analysis, adjusted for age, BMI, and season of the year (partial r2 = 0.071, p < 0.0001). 25(OH)D and ucOC were not associated with markers of glucose metabolism. However, leptin was strongly correlated with insulin, HOMA-IR, HOMA-ß, and QUICKI (p < 0.0001 for all). CONCLUSION: The present study demonstrated that undercarboxylated osteocalcin is related to 25(OH)D and adiponectin concentrations. Both ucOC and 25(OH)D were lower in overweight and obese adolescents, reinforcing the importance of fighting obesity. Although a relationship of ucOC and 25(OH)D with markers of glucose metabolism was not observed, leptin has shown to be the hormone most related to energy homeostasis.

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OBJECTIVE: To identify body mass index (BMI) trajectories from birth to age 10 years and to assess their association with child and parental characteristics and with adult nutritional status and metabolic risk factors. STUDY DESIGN: Retrospective cohort study with 1188 subjects aged 20-60 years. Childhood growth was assessed using measured weight and height data collected retrospectively from health booklets, which also provided information on gestational age, birth weight, and early nutrition. Height, weight, waist circumference, fasting blood glucose, lipids profile, and blood pressure were measured at adulthood. Participants self-reported parental silhouette based on a 9-figural scale. Group-based modeling was applied to identify BMI trajectories. Associations were assessed using ANOVA and multiple logistic regression. RESULTS: Five growth trajectories following or crossing BMI percentiles emerged: stable-25th (15.3% of the sample), stable-50th (35.9%), stable-75th (28.0%), ascending-75th (19.2%), and ascending-obesity (1.6%). Overall, associated factors from early life were mother's corpulence (higher in the ascending-obesity group), gestational age (higher in the stable-50th, stable-75th, and in the ascending-obesity groups), and birth weight (higher in the ascending-obesity group) (all P < .05). Childhood trajectories were associated with adult BMI and waist circumference (higher in the stable-75th and in the ascending groups) (all P < .0001). CONCLUSIONS: This study shows heterogeneity in patterns of growth trajectories. Specific trajectories were associated with greater BMI and waist circumference during adulthood. Monitoring growth trajectories may improve chronic disease prevention.

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This study aimed to review and synthesize the available scientific evidence on the relationship between serum 25(OH)D concentrations and glucose metabolism among adolescents. A total of 19 studies were included. Many studies did not find a relation between 25(OH)D concentrations and insulin sensitivity, but most studies have shown that vitamin D status influences glucose dysregulation in youth due to particularities of this life stage. Considering the prevalence of vitamin D deficiency and insufficiency were high among adolescents, the importance for vitamin D status correction in this young group, in which chronic diseases are not expected but getting every day more common, is mandatory.

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O tecido adiposo e o osso dialogam entre si e influenciam a homeostase da glicose por meio da ação de seus produtos (leptina, adiponectina e osteocalcina). A insuficiência de vitamina D (VD) pode levar a alterações metabólicas em ambos tecidos. Objetivos: Investigar as relações entre concentrações séricas de 25 hidroxivitamina D [25(OH)D], osteocalcina, adipocinas, marcadores do metabolismo da glicose e estado nutricional em crianças e adolescentes. Métodos: Estudo transversal com 198 indivíduos brasileiros (14 a 18 anos) e 318 norte-americanos (8 a 13 anos). Coleta de sangue (após jejum de 12h) foi realizada para mensurar 25(OH)D, paratormônio (PTH), osteocalcina carboxilada (cOC), adiponectina (A), colesterol total, triglicérides, HDL-c, LDL-c e VLDL-c (amostra brasileira); osteocalcina total (tOC) (amostra norte-americana); glicose, insulina, osteocalcina não-carboxilada (ucOC) e leptina (L) (em ambas as amostras). Marcadores do metabolismo da glicose (HOMA-IR, HOMA- e QUICKI) foram calculados. Nos indivíduos brasileiros, o nível de atividade física foi determinado, e a ingestão alimentar foi mensurada por um Recordatório de 24 horas, repetido em 62,6 por cento da amostra. Resultados: População brasileira Indivíduos com excesso de peso (42,6 por cento ) apresentaram menores concentrações de 25(OH)D, adiponectina, cOC, ucOC, HDL-c e QUICKI, e maiores PTH, leptina, LDL-c, VLDL-c, colesterol total, triglicérides, insulina, HOMA-IR e HOMA-, comparados aos eutróficos (p<0,05)...

Bone and adipose tissue interact and influence glucose homeostasis through the action of their products (leptin, adiponectin and osteocalcin). Vitamin D insufficiency can lead to metabolic alterations in both tissues. Objectives: To investigate the relationships between serum 25 hidroxivitamin D [25(OH)D], osteocalcin, adipokines, markers of glucose metabolism and nutritional status among children and adolescents. Methods: Cross-sectional study with 198 Brazilian (14 to 18 years old) and 318 American (8 to 13 years old) individuals. Blood was collected after 12-hour fasting to measure 25(OH)D, parathyroid hormone (PTH), carboxylated osteocalcin (cOC), adiponectin (A), total cholesterol, triglycerides, HDL-c, LDL-c and VLDL-c (Brazilian sample); total osteocalcin (tOC) (American sample); glucose, insulin, undercarboxylated osteocalcin (ucOC) and leptin (L) (both samples). Markers of glucose metabolism were calculated (HOMA-IR, HOMA- and QUICKI). Among Brazilian individuals, physical activity level was determined and food intake was assessed by a 24-hour food record, repeated in 62.6 per cent of the sample. Results: Brazilian population Individuals with weight excess (42.6 per cent from the total) presented lower serum 25(OH)D, adiponectin, cOC, ucOC, HDL-c and QUICKI, and higher PTH, leptin, LDL-c, VLDL-c, total cholesterol, triglycerides, insulin, HOMA-IR and HOMA-, compared to normal weight individuals (p<0.05)...

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CONTEXT AND OBJECTIVE The number of people living with HIV (PLHIV) in Brazil is between 600,000 and 890,000. Assessing the diet is important in planning healthcare actions and improving PLHIV's quality of life. This study aimed to estimate the prevalence of inappropriate protein, total fat, saturated fat, carbohydrate, fiber, sodium, calcium and cholesterol intake among PVHIV on highly-active antiretroviral therapy (HAART). DESIGN AND SETTING Cross-sectional study in nine Specialized STD/AIDS Healthcare Centers in São Paulo. METHODS Men and women aged 20 to 59 years, on HAART for at least three months, were included. Nutrient intake was assessed using 24-hour food recall applied in person and repeated among 30% of the population by telephone. The between and within-person variances were corrected. RESULTS 507 individuals were evaluated: 58% male, mean age 41.7 years (standard deviation, SD = 7.8). The mean time since HIV diagnosis was 6.6 years (SD = 4.1), and since HAART onset, 5.1 years (SD = 3.3). More than 20% of the population presented intake above the recommendations for saturated fat, cholesterol and/or sodium, and below the recommendations for fiber. The recommended maximum tolerable sodium level was exceeded by 99% of the sample, and 86% of men and 94% of women did not reach the daily recommendations for calcium. Protein, carbohydrate and total fat intakes were adequate for the majority of the population. CONCLUSIONS A significant portion of the population presented inappropriate intake of saturated fat, sodium, fiber and calcium. Interventions aimed at improving PLHIV's dietary quality are needed.

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CONTEXT AND OBJECTIVE The number of people living with HIV (PLHIV) in Brazil is between 600,000 and 890,000. Assessing the diet is important in planning healthcare actions and improving PLHIV's quality of life. This study aimed to estimate the prevalence of inappropriate protein, total fat, saturated fat, carbohydrate, fiber, sodium, calcium and cholesterol intake among PVHIV on highly-active antiretroviral therapy (HAART). DESIGN AND SETTING Cross-sectional study in nine Specialized STD/AIDS Healthcare Centers in São Paulo. METHODS Men and women aged 20 to 59 years, on HAART for at least three months, were included. Nutrient intake was assessed using 24-hour food recall applied in person and repeated among 30% of the population by telephone. The between and within-person variances were corrected. RESULTS 507 individuals were evaluated: 58% male, mean age 41.7 years (standard deviation, SD = 7.8). The mean time since HIV diagnosis was 6.6 years (SD = 4.1), and since HAART onset, 5.1 years (SD = 3.3). More than 20% of the population presented intake above the recommendations for saturated fat, cholesterol and/or sodium, and below the recommendations for fiber. The recommended maximum tolerable sodium level was exceeded by 99% of the sample, and 86% of men and 94% of women did not reach the daily recommendations for calcium. Protein, carbohydrate and total fat intakes were adequate for the majority of the population. CONCLUSIONS A significant portion of the population presented inappropriate intake of saturated fat, sodium, fiber and calcium. Interventions aimed at improving PLHIV's dietary quality are needed. .

CONTEXTO E OBJETIVO O número de pessoas vivendo com HIV (PVH) no Brasil oscila entre 600.000 e 890.000. A avaliação de dietas é relevante para o planejamento de ações de saúde e melhoria da qualidade de vida desses indivíduos. Este estudo visa estimar a prevalência de inadequação do consumo de proteínas, lipídios totais, lipídios saturados, carboidratos, fibras, sódio, cálcio e colesterol em PVH em terapia antirretroviral de alta atividade (TARV). TIPO DE ESTUDO E LOCAL Estudo transversal em nove Centros de Assistência Especializados em DST/Aids localizados em São Paulo. MÉTODOS Homens e mulheres com idade entre 20 e 59 anos, em TARV por no mínimo 3 meses, foram incluídos. O consumo de nutrientes foi avaliado com um recordatório alimentar de 24 horas aplicado pes-soalmente e repetido em 30% da população por telefone. A variabilidade intra e interpessoal foi corrigida. RESULTADOS Foram avaliados 507 indivíduos, 58% homens e idade média de 41,7 anos (desvio padrão, DP = 7,8). O tempo médio de infecção por HIV foi de 6,6 anos (DP = 4,1), e de TARV, de 5,1 anos (DP = 3,3). Mais que 20% da população apresentou consumo acima das recomendações para lipídios saturados, colesterol e/ou sódio, e abaixo para fibras. Excederam a recomendação máxima tolerada para sódio 99% da amostra, enquanto 86% dos homens e 94% das mulheres não atingiram as recomendações diárias para o cálcio. O consumo de proteínas, carboidratos e lipídios totais mostrou-se adequado para a maioria da população. CONCLUSÕES Uma importante parcela da população apresentou consumo inadequado para lipídios saturados, sódio, fibras ...

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The study aimed at verifying the associated factors of self-perceived body changes in adults living with HIV in highly-active antiretroviral therapy (HAART) in the city of São Paulo, Brazil. This cross-sectional study was conducted among people living with HIV on HAART for at least three months. A standardized questionnaire was used for assessing self-perceived body changes. Associated factors relating to self-reported body changes in people living with HIV (PLHIV) were assessed with Student's t-test and chi-square test. In total, 507 patients were evaluated. The mean time since diagnosis was 6.6 years [standard deviation (SD) +/- 4.1], and the mean duration of HAART was 5.1 years (SD +/- 3.3). Self-perceived body changes were reported by 79.5% of the participants and were associated with viral load and duration of HAART. Fibre intake was lower among males who gained in abdominal fat (p=0.035). HAART-related body changes were reported by the large majority of the population and were associated with demographic and clinical variables.

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To review and synthesize the available scientific evidence on the relationship between dietary intake and dyslipidemias in HIV-infected patients in combination antiretroviral therapy (ART). A systematic review of literature was carried out. Original and published studies were investigated and two categories of dietary exposure were considered: energy and nutrient intake, and consumption of a test diet. A narrative review of included studies was conducted. The findings were summarized according to category of metabolic outcomes (effect on total cholesterol and LDL-c, effect on HDL-c and effect on triglycerides). Twenty original studies were included in this review, being 13 clinical trials and 7 observational studies. Omega-3 fatty acid supplementation led to a significant decrease in triglycerides. There was very little evidence on the effectiveness of dietary interventions for the prevention and control of dyslipidemias in HIV-infected patients receiving ART.

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Revisar e sintetizar as evidências científicas disponíveis sobre a relação entre o consumo alimentar e dislipidemia em pacientes infectados pelo HIV em terapia antirretroviral combinada de alta atividade (TARV). Desenvolveu-se uma revisão sistemática de literatura. Foram pesquisados estudos originais e duas categorias de exposição dietética foram revisadas: consumo de energia e nutriente ou consumo de uma dieta teste. Foi feita síntese narrativa dos estudos selecionados. Os achados foram sintetizados segundo a categoria de desfecho metabólico (efeito sobre colesterol total e LDL-c, efeito sobre HDL-c e efeito sobre triglicérides). Vinte estudos originais foram incluídos na revisão, sendo 13 ensaios clínicos e 7 estudos epidemiológicos observacionais. A suplementação com ácido graxo ω-3 resultou em significativa redução nos níveis séricos de triglicérides. Observou-se evidência insuficiente acerca da efetividade de intervenções dietéticas na prevenção e controle das dislipidemias em pacientes infectados pelo HIV em uso de TARV.

To review and synthesize the available scientific evidence on the relationship between dietary intake and dyslipidemias in HIV-infected patients in combination antiretroviral therapy (ART). A systematic review of literature was carried out. Original and published studies were investigated and two categories of dietary exposure were considered: energy and nutrient intake, and consumption of a test diet. A narrative review of included studies was conducted. The findings were summarized according to category of metabolic outcomes (effect on total cholesterol and LDL-c, effect on HDL-c and effect on triglycerides). Twenty original studies were included in this review, being 13 clinical trials and 7 observational studies. ω-3 fatty acid supplementation led to a significant decrease in triglycerides. There was very little evidence on the effectiveness of dietary interventions for the prevention and control of dyslipidemias in HIV-infected patients receiving ART.

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