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BACKGROUND: Executive function is often altered in overweight/obese children and adolescents, which has a negative impact on their learning and daily life. Furthermore, research has shown the benefits of physical exercise in improving cognitive performance. This protocol aims to define in a detailed and structured manner the procedures that will be conducted for the development of a systematic review of the literature aimed at evaluating the effects of physical exercise on the executive functions of children and adolescents (≤18 years) with overweight/obesity in comparison with peers in control groups. METHODS: The Web of Science, PubMed, Scopus, and EBSCO databases will be searched for longitudinal studies that have at least one experimental and one control group using pre- and post-intervention measures of executive function, including working memory, inhibition, and cognitive flexibility in the pediatric population who are overweight or obese. The risk of bias and certainty of evidence will be assessed using Cochrane RoB2 and GRADE, respectively. Furthermore, Der Simonian-Laird's random effects model will be employed for meta-analyses. The effect sizes will be calculated with 95% confidence intervals, and p values < 0.05 indicate statistical significance for each dimension of executive function in the different groups before and after the intervention. DISCUSSION: The results of this review may be useful for education and health professionals to design treatment plans for overweight/obese children and adolescents, offering potential benefits related to the learning and cognitive abilities of this population. PROSPERO registration number: CRD42023391420.

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Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

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Introducción. El Programa Alimentario Nutricional Integral (PANI) viene ejecutando acciones desde el año 2015 en servicios de salud de Asunción y años antes en otras regiones del país, con el fin de reducir los efectos negativos de la desnutrición; sin embargo, el éxito del PANI depende de la adherencia de los beneficiarios. Objetivo. Determinar la adherencia a un programa alimentario para el tratamiento de la desnutrición en niños menores de 5 años, ingresados en un Hospital Materno Infantil de Asunción, entre los años 2018 y 2021. Materiales y Método. Estudio observacional, descriptivo, de corte transversal. Se incluyeron todos los niños ingresados al PANI del Hospital Materno Infantil de elección entre los años 2018 y 2021, digitalizados en planilla Excel y analizados con el software Epi Info versión 7. Resultados. De 211 niños registrados se obtuvo datos de 166 pacientes con una edad media ± 1 de 1,3 años ± 1, 53% niñas, el 50% presentaba un ingreso familiar menor al salario mínimo. El 87,35% de los niños ingresó con riesgo de desnutrición, 10,84% con desnutrición moderada y 1,81% grave. La tasa de deserción fue de 67,5%. Conclusión. La adherencia al tratamiento de la desnutrición fue baja. La implementación del PANI como política de salud debe ser fortalecida y monitoreada permanentemente de forma a garantizar sus objetivos, abordando otras variables que puedan estar relacionadas a la deserción. Palabras clave: desnutrición infantil; programas y políticas de nutrición y alimentación; cumplimiento y adherencia al tratamiento.

Introduction. The Comprehensive Nutritional Food Program (PANI) has been carrying out actions since 2015 in health services in Asunción and years before in other regions of the country, in order to reduce the negative effects of malnutrition, however; the success of PANI depends of the beneficiaries' adherence. Objective. To determine adherence to a food program for the treatment of malnutrition in children under 5 years of age, admitted to a Maternal and Child Hospital in Asunción, between 2018 and 2021. Materials and Method. Observational, descriptive, cross-sectional study, with non-probabilistic sampling. Secondary data from children admitted to the PANI of the Maternal and Child Hospital of choice between 2018 and 2021 were included, digitized in an Excel spreadsheet and analyzed with the Epi Info version 7 software. Results. 166 samples participated in the study; The average age of the users was 1.3 years ± 1 SD. 53% were girls; 100% were of Latin ethnicity. 87.35% of children were admitted at risk of malnutrition, while moderate and severe malnutrition was 10.84% and 1.81% respectively. 50% had an income less than the minimum wage. Dropouts were 67.5% and admissions were 32.5%. Conclusion. Adherence to malnutrition treatment was low. The implementation of the PANI as a health policy must be strengthened and permanently monitored in order to guarantee its objectives, addressing other variables that may be related to dropout.

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Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.

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Resumen El propósito de este trabajo fue evaluar la efectividad de la entrevista motivacional en la consulta de nutrición sobre indicadores de riesgo cardiometabólico en pacientes con trastorno bipolar. Se realizó un estudio experimental en que el grupo control recibió orientación nutricional basada en planes de alimentación y el grupo de intervención recibió consulta nutricional incorporando los principios y habilidades de la entrevista motivacional. Los participantes fueron seguidos por tres meses y se realizaron evaluaciones de hábitos alimenticios, actividad física, riesgo cardiometabólico, composición corporal y calidad de vida. El grupo de entrevista motivacional redujo el consumo de carnes (B=-0.45, p=0.032) y embutidos (B=-0.60, p=0.002). Asimismo, la presión arterial diastólica (B=-6.97, p=0.029) y glucemia (B=-9.27, p=0.097) de estos pacientes tendieron a disminuir. La entrevista motivacional promueve cambios que pueden hacer una diferencia clínica; aun en reducidos periodos de tiempo. Los nutriólogos capacitados para su implementación disponen de una herramienta adicional para el manejo de comorbilidad cardiometabólica en población vulnerable.

Abstract The purpose of this work was to assess the effectiveness of the motivational interviewing in the nutrition consultation on indicators of cardiometabolic risk in patients with bipolar disorder. An experimental study was conducted in which the control group receives nutritional guidance based on feeding plans and the intervention group received nutritional consultation incorporating the principles and skills of the motivational interviewing. Participants were followed by three months and evaluations of eating habits, physical activity, cardiometabolic risk, body composition and quality of life were carried out. The motivational interviewing group reduced the consumption of meats (B=-0.45, p=0.032) and sausages (B=-0.60, p=0.002). Likewise, the diastolic blood pressure (B=-6.97, p=0.029) and glycemia (B=-9.27, p=0.097) of these patients tended to decrease. Motivational interviewing promotes changes that can make a clinical difference, even in short periods of time. Nutritionists trained for its implementation have an additional tool for the management of cardiometabolic comorbidity in a vulnerable population.

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BACKGROUND AND AIMS: Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional reports, identified several risk factors associated with the prevalence and incidence of this condition. However, alterations in body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults. METHODS: This is a secondary analysis of older adults (≥60 years) derived from the study "Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)", a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression. RESULTS: The cohort included 241 subjects. The average age was 75.6 ± 7.8 years, and 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in those with an excess fat mass, even after adjusting for several covariates. Regarding total lean tissue, the unadjusted model showed that RM was more likely to occur in men and women with a low TLT by the TLTI classification, compared to the normal group. However, after adjusting for several covariates (models 1 and 2), the association lost significance. Results on the association between gait speed and RM showed that this condition was also more likely to occur in subjects with low gait speed, according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance. CONCLUSIONS: RM diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, and a significant association emerged between low gait speed and RM after 4.1 years of follow-up in these community-dwelling older adults. These results confirm the association between some alterations of body composition and impaired physical performance with the risk of malnutrition and highlight that excess fat mass and low gait speed precede the risk of malnutrition, not vice versa.

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To determine the association between women's autonomy and the presence of childhood anemia in children under five years of age in Peru, a cross-sectional study utilizing data from the 2019 Demographic and Family Health Survey was carried out. The study employed generalized linear models with a Poisson distribution and log link function. Crude and adjusted prevalence ratios (aPR) were calculated, along with their corresponding 95% confidence intervals (CI), to assess the association of interest. A total of 15,815 women and their children under five years of age were analyzed. The prevalence of childhood anemia was 30.4% (95%CI: 29.5-31.3%), while the proportions of low, moderate and high autonomy of the mothers were 44.5%, 38.4% and 17.1%, respectively. Children under five years of age of women with a low level of autonomy were more likely to have anemia (aPR: 1.10; 95%CI: 1.00-1.21). Three out of ten children under five years of age suffer from anemia, and four out of ten mothers have a low level of autonomy. A low level of women's autonomy was associated with a higher probability of anemia in children under 5 years of age.

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SUMMARY OBJECTIVE: The aim of this study was to evaluate the clinical efficacy of crisaborole ointment in the treatment of vulvar leukoplakia. METHODS: A prospective, randomized controlled clinical trial was conducted, and a total of 100 patients with vulvar leukoplakia were divided into the observation group (n=50) treated with crisaborole ointment and the control group (n=50) treated with vitamin E. The symptom improvement and vulvar leukoplakia score after 2 weeks of treatment were analyzed, and the clinical efficacy of vulvar leukoplakia was evaluated by referring to the Guidelines for Clinical Research of New Drugs of Traditional Chinese Medicine (2018 Edition). RESULTS: After 2 weeks of treatment, the overall score of lesions in the observation group decreased, and the total treatment efficiency of patients in the observation group was 92% (46/50), which was significantly higher than that of 52% (26/50) in the control group P<0.05). CONCLUSION: Crisaborole ointment can effectively treat vulvar leukoplakia, improving the symptoms and pathological changes of the vulvar skin.

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SUMMARY OBJECTIVE: The objective of this study was to compare the nutritional status and dietary intake of pregnant women with sickle cell disease (SS hemoglobinopathy and SC hemoglobinopathy) to healthy controls and report the maternal and perinatal outcomes. METHODS: This is a prospective, longitudinal cohort study. Pregnant women with a diagnosis of sickle cell disease and control group were recruited in an outpatient clinic of a tertiary care hospital in São Paulo, Brazil. Maternal anthropometric data and dietary intake data were collected at the second and third trimesters. RESULTS: A total of 49 pregnancies complicated by sickle cell disease were included. Prepregnancy body mass index was significantly lower in the SS hemoglobinopathy group (n=26, median 20.3 kg/m2) than the SC hemoglobinopathy group (n=23, 22.7 kg/m2) or control group (n=33, 23.2 kg/m2, p<0.05). The prepregnancy nutritional status revealed significantly more women classified as underweight in the SS hemoglobinopathy group (15.4%) than in the SC hemoglobinopathy group (4.4%) and control group (1.6%, p=0.009). In the second trimester, maternal protein intake was significantly lower in SS hemoglobinopathy (73.2 g/day) and SC hemoglobinopathy (68.8 g/day) than in the control group (95.7 g/day, p=0.004). In the third trimester, only SS hemoglobinopathy mothers showed dietary intake of protein significantly lower than that of the controls (67.5 g/day vs. 92.8 g/day, p=0.02). Vitamin A and E consumption was also reduced in the third trimester in the SS hemoglobinopathy group (p<0.05). CONCLUSION: The nutritional status of pregnant women with SS hemoglobinopathy is characterized by a state of undernutrition. The lower protein intake in the second and third trimesters of pregnant women with SS hemoglobinopathy may contribute to this condition. Undernourishment is a serious complication of sickle cell disease, primarily during pregnancy, and it should be addressed during the prenatal period.

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Introducción: La malnutrición fetal incide de forma negativa en el crecimiento y la maduración, afectando las estructuras craneofaciales en el feto. Objetivo: Determinar los efectos de la malnutrición fetal por defecto en el crecimiento y desarrollo craneofacial en niños. Métodos: Se realizó un estudio analítico de casos y controles, en el área de salud José Martí del municipio Camagüey, desde enero de 2018 hasta diciembre de 2020. El universo estuvo constituido por niños de 6-11 años de edad, pertenecientes al área salud y la muestra quedó conformada por 40 niños, 20 en el grupo de estudio y 20 controles. El grupo de estudio se conformó por niños que presentaron bajo peso al nacer por defecto y tuvieron alteraciones en el crecimiento del complejo craneofacial y el grupo control por niños que no presentaron alteraciones en el crecimiento del complejo craneofacial y que al nacimiento se encontraban normopeso. A todos los niños se les efectuaron mediciones antropométricas craneofaciales. Resultados: La medida de la circunferencia cefálica al nacer en los controles masculinos superó en 0,78 cm al sexo femenino y entre los malnutridos por defecto, los masculinos lograron 1,57 cm más que los femeninos. En el diámetro bicigomático hubo una fuerte asociación estadística y el riesgo relativo indicó que la incidencia del bajo peso al nacer fue mayor que en los controles (p <0,05). Conclusiones: Los niños con bajo peso al nacer presentan menor crecimiento y desarrollo craneofacial según las variables antropométricas.

Introduction: Fetal malnutrition impacts in a negative way the growth and development, thus affecting the craniofacial structures of the fetus. Objective: To determine the effects of fetal malnutrition by defect on craniofacial growth and development in children. Methods: An analytical case and control study was carried out in Jose Martí health area of Camagüey, from January 2018 to December 2020. A sample of 40 was selected from the totality of the children between 6 and 11 years old who belong to the referred health area, to be divided into 20 cases and the same number in the control group. The study group was composed of those low birth weight who present craniofacial abnormalities while control group included the children without craniofacial abnormalities and normal weight at birth. Anthropometric craniofacial measurements were performed on all the sample. Results: The head circumference at birth in male children of control group was 0.78 cm higher than that on female sex. Among those low birth weight, male children exhibited 1.57 cm higher than females. Regarding the bizygomatic diameter there was a strong statistic association and the relative risk indicated a higher incidence on the study group compared to the control group (p <0.05). Conclusions: Low birth weight children show lower craniofacial growth and development, with higher impact on females according to anthropometric variables.

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Abstract: Malnutrition affects billions of individuals worldwide and represents a global health challenge. This study aimed to determine the prevalence of malnutrition (undernutrition or overweight) among mother-child dyads in children under 5 years old in Brazil in 2019 and to estimate changes in this prevalence from 2006 to 2019. Individual-level data from the Brazilian National Survey on Child Nutrition (ENANI-2019) and the Brazilian National Survey of Demography and Health of Women and Children carried out in 2006 (PNDS 2006) were analyzed. Malnutrition outcomes in mother-child dyads included overweight mother and child, undernourished mother and child, and the double burden of malnutrition, i.e., overweight mother and child having any form of undernourishment (stunting, wasting, or underweight). Prevalence and 95% confidence intervals (95%CI) were estimated. Most women (58.2%) and 9.7% of the children were overweight, 6.9% were stunted, and 3.1% of mothers and 2.9% of the children were underweight. The prevalence of overweight in the mother-child dyad was 7.8% and was statistically higher in Southern Brazil (9.7%; 95%CI: 7.5; 11.9) than in the Central-West (5.4%; 95%CI: 4.3; 6.6). The prevalence of overweight mother and stunted child was 3.5%, with statistically significant difference between the extremes of the mother's education [0-7 vs. ≥ 12 years, 4.8% (95%CI: 3.2; 6.5) and 2.1%, (95%CI: 1.2; 3.0), respectively]. Overweight in the dyad increased from 5.2% to 7.8%, and the double burden of malnutrition increased from 2.7% to 5.2% since 2006. Malnutrition in Brazilian mother-child dyads seems to be a growing problem, and dyads with lower formal education, higher maternal age, and from the South Region of Brazil were more vulnerable.

Resumo: A má nutrição afeta bilhões de indivíduos em todo o mundo e representa um desafio de saúde global. Este estudo teve como objetivo determinar a prevalência de má nutrição (desnutrição ou excesso de peso) entre díades mãe-filho em crianças menores de cinco anos no Brasil em 2019 e estimar as mudanças nessa prevalência de 2006 a 2019. Foram analisados dados individuais do Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019) e da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher realizada em 2006 (PNDS 2006). Os desfechos de má nutrição incluíram mãe e filho com excesso de peso, mãe e filho desnutridos e a dupla carga de má nutrição, ou seja, mãe com excesso de peso e filho com qualquer forma de desnutrição (défict de crescimento, magreza ou baixo peso). Foram estimadas a prevalência e os intervalos de 95% de confiança (IC95%). A maioria das mulheres (58,2%) e 9,7% das crianças estavam acima do peso, 6,9% apresentaram déficit de crescimento e 3,1% das mães e 2,9% das crianças estavam abaixo do peso. A prevalência de excesso de peso na díade mãe-filho foi de 7,8% e foi estatisticamente maior no Sul do Brasil (9,7%; IC95%: 7,5; 11,9) do que no Centro-oeste (5,4%; IC95%: 4,3; 6,6). A prevalência de mãe com sobrepeso e filho com déficit de crescimento foi de 3,5%, com uma diferença estatisticamente significante entre os extremos de escolaridade materna [(0-7 vs. ≥ 12 anos de estudo), 4,8% (IC95%: 3,2; 6,5) and 2,1% (IC95%: 1,2; 3,0), respectivamente]. O excesso de peso na díade aumentou de 5,2% para 7,8% e a dupla carga de má nutrição aumentou de 2,7% para 5,2% desde 2006. A má nutrição nas díades mãe-filho brasileiras parece ser um problema crescente, sendo as mais vulneráveis aquelas com menor escolaridade e maior idade materna e residentes na Região Sul do Brasil.

Resumen: La malnutrición afecta a muchas personas en todo el mundo y representa un desafío para la salud mundial. Este estudio tuvo como objetivo determinar la prevalencia de malnutrición (desnutrición o sobrepeso) entre díadas madre-hijo en niños menores de cinco años en Brasil en 2019 y estimar cambios en esta prevalencia de 2006 a 2019. Se analizaron datos individuales del Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019) y de la Encuesta Nacional de Demografía y Salud del Niño y de la Mujer de 2006 (PNDS 2006). Los resultados de la malnutrición incluyeron a madre e hijo con sobrepeso, madre e hijo desnutridos y la doble carga de mala nutrición, es decir, madre con sobrepeso e hijo con cualquier forma de desnutrición (retardo en el crecimiento, emaciación o bajo peso). Se calcularon prevalencias y los intervalos de 95% de confianza (IC95%). La mayoría de las mujeres (58,2%) y el 9,7% de los niños tenían sobrepeso, el 6,9% de los niños presentaban retraso en el crecimiento, y el 3,1% de las madres y el 2,9% de los niños, bajo peso. La prevalencia de sobrepeso en la díada madre-hijo fue del 7,8%, estadísticamente mayor en el Sur de Brasil (9,7%; IC95%: 7,5; 11,9) que en el Centro-Oeste (5,4%; IC95%: 4,3; 6,6). La prevalencia de madres con sobrepeso y de niños con retraso del crecimiento fue del 3,5%, con una diferencia estadísticamente significativa entre los extremos de nivel educativo de la madre [(0-7 vs. ≥ 12 años de nivel educativo), 4,8% (IC95%: 3,2; 6,5) y 2,1% (IC95%: 1,2; 3,0), respectivamente]. El sobrepeso en la díada tuvo un aumento del 5,2% al 7,8%, y la doble carga de mala nutrición aumentó del 2,7% al 5,2% desde 2006. La malnutrición en la díada madre-hijo brasileña resulta ser un problema creciente, siendo las más vulnerables aquellas con menor escolaridad y mayor edad materna y residentes en la Región Sur de Brasil.

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Resumen Los pacientes con discapacidad tienen limitaciones para ejecutar las actividades básicas cotidianas de la vida diaria y la participación social. Además, son diagnosticadas con patologías asociadas de forma tardía como la malnutrición. El objetivo de la presente revisión es proporcionar herramientas diagnósticas nutricionales en pacientes con discapacidad; dando a conocer las técnicas disponibles de evaluación subjetivas, como instrumentos y encuestas, y objetivas como la antropometría. La búsqueda en la literatura se realizó en bases de datos Pubmed y Scopus, en el buscador Google Scholar y Uptodate, adicionalmente se incluyeron guías internacionales, resoluciones, tesis y capítulos de nutrición descritos. Las medidas antropométricas, en especial las circunferencias (braquial, cintura y pantorrilla), son de fácil implementación en los diferentes tipos de discapacidad, de acuerdo con el entorno donde se encuentra el paciente (ambulatorio, hospitalizado o institucionalizado), además, proporcionan información que permite el manejo integral de acuerdo con el diagnóstico nutricional.

Abstract Patients with disabilities have limitations to carry out the basic daily activities of daily life and social participation. In addition, they are diagnosed late with associated pathologies such as malnutrition. The objective of this review is to provide nutritional diagnostic tools in patients with disabilities; making known the techniques available for subjective evaluation, such as instruments and surveys, and objectives such as anthropometry. The search in the literature was carried out in Pubmed and Scopus databases, in the Google Scholar and Uptodate, additionally international guides, resolutions, theses and described nutrition chapters are included. The Anthropometric measurements, especially circumferences (brachial, waist and calf), are easy to implement in the different types of disability, according to the environment where the patient is (outpatient, hospitalized or institutionalized), in addition, it provides information that allows comprehensive management according to the nutritional diagnosis.

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Resumo Objetivo Avaliar parâmetros hematológicos de crianças desnutridas após intervenção nutricional com farinha da castanha de caju. Métodos Ensaio clínico randomizado, controlado, cego. O estudo foi realizado no período de abril a dezembro de 2017, em duas Unidades Básicas de Saúde. A amostra foi composta de crianças menores de 5 anos que preencheram os critérios de inclusão, sendo 15 no Grupo Intervenção (farinha da castanha de caju) e 15 crianças no Grupo Controle (farinha de carboximetilcelulose), alocadas nos grupos de forma randômica aleatória simples. Foram analisados os parâmetros de eritrócitos, hemoglobina e hematócrito (série vermelha) e de leucócitos, neutrófilos, segmentados, eosinófilos, monócitos e linfócitos (série branca). A coleta de sangue foi realizada em dois momentos: o primeiro antes da implementação da intervenção e o segundo após 32 semanas de utilização da farinha da castanha de caju. Para avaliação da normalidade e homogeneidade da amostra, utilizaram-se os testes de Shapiro-Wilk e de variância de Bartlett, respectivamente. Utilizou-se o teste T pareado dentro de cada grupo e, para avaliar possíveis associações entre os Grupos Intervenção e Controle e o nível de leucócitos (abaixo, normal e acima), utilizaram-se o teste exato de Fisher e/ou o teste Fisher-Freeman-Halton. Resultados Houve incremento na média das células individuais da série vermelha do hemograma, sobretudo nos padrões de hemoglobina de crianças desnutridas do Grupo Intervenção (p<0,05). A investigação também apontou diferença intragrupo no parâmetro da hemoglobina, tanto no Grupo Controle (p=0,007) como no Intervenção (p<0,001), bem como no parâmetro hematócrito para ambos os grupos (p=0,001). Especificamente na série branca, após a intervenção, evidenciou-se diminuição significativa nos leucócitos (p=0,04) e linfócitos (p<0,01) Conclusão Após intervenção, a utilização da farinha da castanha de caju melhorou os parâmetros hematológicos das crianças desnutridas. Registro Brasileiro de Ensaios Clínicos (REBEC): U1111.1213.9219

Resumen Objetivo Evaluar parámetros hematológicos de niños desnutridos después de la intervención nutricional con harina da castaña de cajú. Métodos Ensayo clínico aleatorizado, controlado, ciego. El estudio se realizó en el período de abril a diciembre de 2017, en dos Unidades Básicas de Salud. La muestra se compuso por niños menores de 5 años que cumplieron con los criterios de inclusión, 15 en el Grupo Intervención (harina de castaña de cajú) y 15 niños en el Grupo Control (harina de carboximetilcelulosa), repartidas en los grupos de forma muestreo aleatorio simple. Se analizaron los parámetros de eritrocitos, hemoglobina e hematocrito (serie roja) y de leucocitos, neutrófilos, segmentados, eosinófilos, monocitos e linfocitos (serie blanca). La muestra de sangre se realizó en dos momentos: el primero antes de la implementación de la intervención y el segundo después de 32 semanas de utilización de la harina da castaña de cajú. Para la evaluación de la normalidad y la homogeneidad de la amuestra, se utilizaron los tests de Shapiro-Wilk y de varianza de Bartlett, respectivamente. Se utilizó la prueba T pareada dentro de cada grupo y, para evaluar posibles asociaciones entre los Grupos Intervención y Control y el nivel de leucocitos (debajo, normal y superior), se utilizó la prueba exacta de Fisher o prueba de Fisher-Freeman-Halton. Resultados Hubo un aumento en el promedio de las células individuales de la serie roja del hemograma, sobre todo en los estándares de hemoglobina de niños desnutridos del Grupo Intervención (p<0,05). La investigación también apuntó una diferencia intragrupo en el parámetro de la hemoglobina, tanto en el Grupo Control (p=0,007) como en la Intervención (p<0,001), así como en el parámetro hematocrito para ambos grupos (p=0,001). Específicamente en la serie blanca, después de la intervención, se evidenció una disminución significativa en los leucocitos (p=0,04) y linfocitos (p<0,01) Conclusión Después de la intervención, la utilización de la harina de la castaña de cajú mejoró los parámetros hematológicos de los niños desnutridos.

Abstract Objective To assess hematological parameters of malnourished children after nutritional intervention with cashew nut flour. Methods This is a randomized, controlled, blind trial. The study was conducted from April to December 2017, in two Basic Health Units. The sample consisted of children under 5 years of age who met the inclusion criteria, 15 in the Intervention Group (cashew nut flour) and 15 children in the Control Group (carboxymethylcellulose flour), randomly allocated to the groups. The parameters of erythrocytes, hemoglobin and hematocrit (red blood cells) and leukocytes, neutrophils, segmented, eosinophils, monocytes and lymphocytes (white blood cells) parameters were analyzed. Blood collection was performed in two moments: the first before intervention implementation and the second after 32 weeks of use of cashew nut flour. To assess the sample normality and homogeneity, Shapiro-Wilk and Bartlett variance tests were used, respectively. The paired t-test was used within each group and, to assess possible associations between the Intervention and Control Groups and the level of leukocytes (below, normal and above), Fisher's Exact test and/or Fisher-Freeman-Halton test were used. Results There was an increase in the mean of the individual red blood cell count, especially in the hemoglobin patterns of malnourished children in the Intervention Group (p<0.05). The investigation also showed an intragroup difference in the hemoglobin parameter, both in the Control Group (p=0.007) and in the Intervention (p<0.001) as well as in the hematocrit parameter for both groups (p=0.001). Specifically in the white blood cells, after intervention, there was a significant decrease in leukocytes (p=0.04) and lymphocytes (p<0.01) Conclusion After intervention, the use of cashew nut flour improved the hematological parameters of malnourished children. Brazilian Clinical Trial Registry (REBEC): U1111.1213.9219

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Introducción: la desnutrición crónica en menores de 5 años se define como el retraso en el crecimiento, resultado de recurrentes carencias nutricionales, asociadas con pobreza, de salud y nutrición materna. El objetivo fue identificar la prevalencia de desnutrición crónica y factores asociados en menores de 5 años de la comunidad indígena awá, atendidos en la ips Unidad del Pueblo Indígena Awá (unipa) de Barbacoas (Nariño, Colombia) durante 2019. Materiales y métodos: estudio de corte transversal con enfoque analítico. Se incluyeron 527 niños menores de 5 años de la comunidad awá acudientes al programa de crecimiento y desarrollo de la ipsunipa. Se evaluó como desenlace la desnutrición crónica y, como factores asociados, características sociodemográficas, nutricionales y otras del estado de salud. Se consideró un valor de p menor al 5 % cuando se utilizó chi cuadrado, test exacto de Fisher y U de Mann-Whitney para determinar asociación estadística; además, se ajustó la relación a través de un modelo de regresión logística múltiple. Resultados: el 17.6 % de los niños pre-sentó desnutrición crónica. Se encontró asociación estadística con ser hijo de madre adolescente (p = 0.006), esquema de vacunación incompleto (p = 0.012), la edad (p = 0.017) y el peso al nacer (p = 0.017). Conclusión: en menores de 5 años de la comunidad awála frecuencia de desnutrición crónica está por encima de la media para esta población en general en Colombia. Es importante priorizar la búsqueda activa de desnutrición crónica en niños cuyas madres son adolescentes, niños con bajo peso al nacer y vacunación incompleta

Introduction: Chronic malnutrition in children under 5 years old is defined as stunting due to recurrent nutritional deficiencies associated with poverty, maternal health, and nutrition. This study aimed to iden-tify the prevalence of chronic malnutrition and associated factors in children under 5 years old from the indigenous Awá community, at Barbacoas, Nariño in 2019. Materials and methods: A cross-sectional study was conducted, which included 527 children under 5 years old from the Awá community who attended a health institution for growth and development program. Chronic malnutrition was evaluated as an outcome, whereas sociodemographic, nutritional and other health characteristics as associated factors. Chi-square, Fisher's exact, and Mann­Whitney's U test were used to determine statistical association. Additionally, the relationship was adjusted through a multiple logistic regression model. Results: Chronic malnutrition was found in 17.6% of children. The statistical association was found in children of the ado-lescent mother, incomplete vaccination schedule, and age and birth weight. Conclusion: In children under 5 years old in the Awá community, the frequency of chronic malnutrition is above the average for the general population in Colombia. Prioritizing the active search for chronic malnutrition in children whose mothers are adolescents and those with low birth weight and incomplete vaccination is important

Introdução: a desnutrição crônica em crianças menores de cinco anos é definida como retardo de crescimento como resultado de deficiências nutricionais recorrentes associadas à pobreza, saúde materna e nutrição. O objetivo é identificar a prevalência de desnutrição crônica e fatores associados em crianças menores de 5 anos da comunidade indígena Awá, atendidas na Unidade ips do Povo Indígena Awá (unipa) de Barbacoas, Nariño durante 2019. Materiais e métodos: estudo transversal de abordagem analítica. Foram incluídas 527 crianças menores de 5 anos da comunidade Awá que participaram do programa de crescimento e desen-volvimento da ipsunipa. A desnutrição crônica foi avaliada como desfecho e as características sociodemo-gráficas, nutricionais e outras características de saúde como fatores associados. Um valor de p inferior a 5% foi considerado quando o qui-quadrado, o teste exato de Fisher e o U de Mann Whitney foram usados para determinar a associação estatística, além disso, a relação foi ajustada por meio de um modelo de regressão logística múltipla. Resultados: 17,6% das crianças apresentavam desnutrição crônica. Associação estatística foi encontrada com os fatores ser filho de mãe adolescente (valor p: 0,006), esquema vacinal incompleto (valor p: 0,012), idade (valor p: 0,017) e peso ao nascer (valor p: 0,017). Conclusão: em crianças menores de 5 anos da comunidade Awá, a frequência de desnutrição crônica está acima da média geral para esta popu-lação na Colômbia. É importante priorizar a busca ativa da desnutrição crônica em crianças cujas mães são adolescentes, em crianças com baixo peso ao nascer e com esquema de vacinação incompleto

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BACKGROUND: The excess adiposity, even in the absence of diseases, is responsible for a decline in pulmonary function, which is considered a predictor of mortality and a risk factor for diseases in several epidemiological studies. However, studies on the association between obesity and pulmonary function have found only few associations or inconclusive results. The aim of the study is to evaluate the association between body composition and spirometric parameters, comparing simple obesity measures such as body mass index (BMI) and waist circumference with more precise body composition measurements such as dual-energy X-ray absorptiometry (DXA) and air-displacement plethysmography (BOD POD). METHODS: This is an observational, cross-sectional study that used data from the 1978/79 Ribeirão Preto birth cohort (São Paulo, Brazil). The study included 1746 participants from the 5th follow-up of the cohort. Linear regressions were calculated to evaluate the association between BMI, waist circumference, waist-height ratio (WHtR), BOD POD- and DXA-measured fat mass percentage, and spirometric parameters FEV1, and FVC. RESULTS: For every 1-kg/m2 BMI increase, FVC decreased by 13 ml in males and by 6 ml in females and FEV1 decreased by 11 ml and 5 ml, respectively. Regarding body composition measurements, for a 1% increase in fat mass assessed by BOD POD, FVC decreased by 16 ml in males and by 8 ml in females and FEV1 decreased by 13 ml and 7 ml, respectively. Hence, negative associations between body measurements and FEV1 and FVC were observed in both genders, especially when using the fat mass measurement and were more expressive in men. CONCLUSION: The anthropometric and body composition parameters were negatively associated with the spirometric variables FVC and FEV1. We have also observed that simple measures such as waist-height ratio were sufficient to detect the association of body composition with pulmonary function reduction.

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Abstract The verification of factors associated with growth, body composition and nutritional and nutritional aspects after HIV infection in children or adolescents in Brazil is fundamental for progress in this area. We selected articles published until 2018, available on the platforms PubMed and Lilacs, using the keywords The following descriptors and their associations were used, extracted from MeSH: "Children", "Adolescent", "Anthropometry", "Nutritional Assessment", "HIV", "Brazil" adding the filter "and" for advanced searches. A total of 1,450 articles were found, and after selection and full reading, 19 were selected. The studies agreed that children and adolescents living with HIV present or may present alterations in bone metabolism, lipid metabolism and body composition due to infection or associated with therapy. Significant differences were observed in weight and height in infected infants compared to uninfected infants. The evaluation and monitoring of diet quality, as well as serum micronutrient monitoring, are fundamental to guarantee the clinical and treatment conditions of these patients, as well as to prevent disorders due to low nutrient intakes.

Resumo A verificação de fatores associados ao crescimento, composição corporal e aspectos alimentares e nutricionais, após a infecção pelo HIV em crianças ou adolescentes no Brasil é fundamental para avanços nesta área. Foram selecionados artigos publicados até 2018, disponibilizados nas plataformas PubMed e Lilacs, extraídas do MeSH: "Children", "Adolescent", "Anthropometry", "Nutritional Assessment", "HIV", "Brazil" adicionadas do filtro "and" para as pesquisas. Foram encontrados 1.450 artigos e após seleção e leitura integral foram selecionados 19. Os estudos concordaram que crianças e adolescentes vivendo com HIV apresentam ou podem apresentar alterações no metabolismo ósseo, de lipídeos e na composição corporal devido à infecção ou associadas à terapia. Observou-se diferença significativa do peso e estatura em crianças infectadas em relação às não infectadas. Percebe-se que a avaliação e o monitoramento da qualidade da dieta, bem como o acompanhamento sérico de micronutrientes, são fundamentais para garantir as condições clínicas e de tratamento destes pacientes, bem como para prevenir desordens por baixo consumo de nutrientes.

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Literature describes breast milk as the best food for the newborn, recommending exclusive breastfeeding for up to 6 months of age. However, it is not available for more than 40% of children worldwide. Pharmacological and non-pharmacological models of 3-day early weaning were developed in rodents to investigate later outcomes related solely to this nutritional insult. Thus, the present work aimed to describe biometric, nutritional, biochemical, and cardiovascular outcomes in adult male rats submitted to 3-day early weaning achieved by maternal deprivation. This experimental model comprises not only nutritional insult but also emotional stress, simulating mother abandoning. Male offspring were physically separated from their mothers at 21st (control) or 18th (early weaning) postnatal day, receiving water/food ad libitum. Analysis performed at postnatal days 30, 90, 150, and 365 encompassed body mass and food intake monitoring and serum biochemistry determination. Further assessments included hemodynamic, echocardiographic, and cardiorespiratory evaluation. Early-weaned males presented higher body weight when compared to control as well as dyslipidemia, higher blood pressure, diastolic dysfunction, and cardiac hypertrophy in adult life. Animals early deprived of their mothers have also presented a worse performance on the maximal effort ergometer test. This work shows that 3-day early maternal deprivation favors the development of cardiovascular disease in male rats.

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RESUMEN Fundamento: el tratamiento de los trastornos nutricionales por exceso genera distintos niveles de estrés que en muchas ocasiones son los responsables del abandono de la dieta o de la no adherencia terapéutica. Objetivo: implementar rutina de ejercicios de Yoga como terapia alternativa para el control del estrés. Métodos: se realizó una investigación aplicada, cuasi experimental, consistente en la implementación de un programa de yoga en pacientes con sobrepeso y obesidad sometidos a tratamiento. El universo estuvo constituido por 78 pacientes, de los cuales 69 formaron parte de la muestra. Se aplicó un cuestionario de estrés al inicio de la investigación y después de terminar el programa de ejercicio. Se utilizó prueba no paramétrica de McNemar para identificar significación de los cambios en el nivel de estrés de los pacientes investigados. Resultados: el promedio de edad de 46,28 años con predominio de pacientes femeninas, con sobrepeso y comorbilidades asociadas, donde la hipertensión arterial fue la más frecuente. Predominaron niveles de estrés elevado al inicio del estudio y bajos al finalizar la intervención. Conclusiones: la implementación del programa de ejercicios de Yoga provocó cambios estadísticamente significativos en la disminución de los niveles de estrés de los pacientes con sobrepeso y obesidad.

ABSTRACT Background: the treatment of excess nutritional disorders generates different levels of stress that often are responsible for abandoning the diet or for the non-therapeutic adherence. Objective: to implement Yoga exercise routine as an alternative therapy for stress management. Methods: it was carried out an applied, quasi-experimental research, consisting of the implementation of a yoga program in patients with overweight and obesity undergoing treatment. The universe was constituted of 78 patients, and 69 were part of the sample. A stress questionnaire was applied at the beginning and the end of the application to the exercise program. McNemar's non-parametric test was used to identify significance of changes in the stress level of the investigated patients. Results: With a predominance of female patients over 46.28 years on average, with the presence of overweight and the associated comorbidities, where arterial hypertension was the most frequent. High stress levels predominated at the beginning of the study and low levels at the end of the intervention. Conclusions: the implementation of the Yoga exercise program provided statistically significant changes in the decrease of stress levels in overweight and obese patients.

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Analisar a distribuição espacial da desnutrição em crianças brasileiras de baixa renda e sua correlação com indicadores socioeconômicos e de serviços de saúde. Estudo ecológico, com dados secundários de representação nacional, tendo como variáveis a desnutrição infantil, os indicadores socioeconômicos e de serviços de saúde no Brasil. Utilizaram-se técnicas de estatística univariada e bivariada para a análise espacial. Foi observada uma dependência espacial para a desnutrição infantil (I=0,52; p=0,010), com as menores prevalências nas regiões mais desenvolvidas do país, Sul e Sudeste. Associação negativa foi obtida entre desnutrição infantil e a renda per capita (p<0,001) e o IDH (p<0,001). E associação positiva entre a desnutrição e os investimentos na atenção primária (p<0,001). Foram encontradas assimetrias espaciais, com maior prevalência de desnutrição nas regiões Norte-Nordeste e associações com os indicadores socioeconômicos e de serviços de saúde, o que reflete um processo histórico de desigualdades no país.

The spatial distribution of stunting in low-income Brazilian children and its correlation with socioeconomic and health service indicators are analyzed. Current ecological study, based on national secondary data, employed the variables child malnutrition, socioeconomic indicators and health services in Brazil. Univariate and bivariate statistical techniques were used for spatial analysis. A spatial dependence was reported for child malnutrition (I=0.52; p=0.010), with the lowest prevalence in the most developed regions of the country (South and Southeast regions). A negative association was detected between child malnutrition and per capita income (p <0.001) and Human Development Index (p <0.001), whilst there was a positive association between malnutrition and investments in primary care (p <0.001). Spatial asymmetries were found with a higher prevalence of malnutrition in the north-northeast regions and associations with socioeconomic and health service indicators, reflecting a historical process of inequalities in Brazil.

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RESUMEN Una política pública creada para abordar el problema de la obesidad en Chile, es la Ley de Alimentos del año 2016 y su Reglamento que incluye etiquetado frontal de advertencia. El objetivo del estudio es evaluar el reconocimiento, juicio de valor y utilización del etiquetado frontal de advertencia descrito en la reglamentación, en personas responsables de escolares de las comunas de La Serena y Coquimbo. En estudio transversal, se aplicaron 543 encuestas personales en 22 establecimientos educacionales seleccionados por muestreo probabilístico estratificado. Se utilizó prueba de Chi-cuadrado para bondad de ajuste y tablas de contingencia, se consideró significativo un valor p<0,05. El 98,7% reconoció los sellos de advertencia, principalmente en los envases. El 86,2% valoró como no saludable su presencia y 68,1%, como saludable su ausencia. La comparación de sellos fue realizada por el 67,5% de los encuestados, de los cuales un 97,4% eligió los alimentos con menor cantidad de sellos. El 91,3% señaló que disminuyó la cantidad de alimentos comprados con presencia de sellos en relación al período anterior a la vigencia de la Ley. Los sellos de advertencia son conocidos, entendidos y considerados en la selección de los alimentos.

ABSTRACT The Chilean Food Law of 2016 was a public policy created to address the problem of obesity in Chile and includes front-of-package warning labeling. The objective of the study is to evaluate the recognition, value judgment and use of the front-of-package warning labels described in the regulation, among caretakers of schoolchildren, in the districts of La Serena and Coquimbo, Chile. A cross-sectional study was conducted. A total of 543 personal surveys were applied in 22 educational establishments selected by stratified probability sampling. Chi-square goodness of fit test and contingency tables were used, a p value<0.05 was considered significant. Almost all caretakers surveyed (98.7%) recognized warning labels, mainly in packaging, 82% of the participants rated the presence of the labels as unhealthy and 68.1% reported the absence of the label indicated a healthy food. The label comparison was made by 67.5% of the respondents, of which 97.4% chose foods with fewer labels. 91.3% indicated that the quantity of food purchased with warning labels decreased in relation to the period before the law was launched. Warning labels are known, understood, and considered in food selection.

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