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Olive oil, as well as by-products and waste that are left after production, particularly olive pomace and olive leaf, have been extensively researched as sources of phenolic compounds. These compounds are known for their biological properties and have been associated with the prevention of chronic non-communicable diseases. Metabolomics has been used as a methodological tool to elucidate the molecular mechanisms underlying these properties. The present review explores the health outcomes and changes in endogenous metabolite profiles induced by olive derivatives. A literature search was conducted using the scientific databases Scopus, Web of Science and PubMed, and the selected articles were published between the years 2012 and 2023. The reviewed studies have reported several health benefits of olive derivatives and their phenolic components, including appetite regulation, fewer cardiovascular disorders, and antiproliferative properties. This review also addressed the bioavailability of these compounds, their impact on the microbiota, and described biomarkers of their intake. Therefore, there should be further research using this methodology for a better understanding of the performance and therapeutic potential of olive derivatives.

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This study aimed to evaluate the sociodemographic, behavioral, and biological profile and its relationship with the emergence of chronic non-communicable diseases in riverside populations in the Xingu region, Pará, Brazil. Characteristics related to health indicators and which risk factors are considered most important were analyzed. This is a cross-sectional, exploratory, and descriptive study. The sample consisted of riverside people of over 18 years of both sexes. The sample size (n = 86) was calculated with a confidence level of 95% and a sample error of 5%. The K-means clustering algorithm was adopted through an unsupervised method to divide the groups, and the values were expressed as a median. For continuous and categorical data, the Mann-Whitney and chi-square tests were used, respectively, and the significance level was set at p < 5%. The multi-layer perceptron algorithm was applied to classify the degree of importance of each variable. Based on this information, the sample was divided into two groups: the group with low or no education, with bad habits and worse health conditions, and the group with opposite characteristics. The risk factors considered for cardiovascular diseases and diabetes in the groups were low education (p < 0.001), sedentary lifestyle (p < 0.01), smoking, alcoholism, body mass index (p < 0.05), and waist-hip ratio, with values above the expected being observed in both groups. The factors considered important so as to be considered to have good health condition or not were the educational and social conditions of these communities, and one part of the riverside population was considered healthier than the other.

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Consideradas o maior problema global de saúde, as doenças crônicas não transmissíveis (DCNT) são a causa de grande parte das morbimortalidades no Brasil atualmente e possuem fatores de risco comuns, o que possibilita uma abordagem preventiva semelhante. Sabendo que a escola é um local fundamental para promoção em saúde, este artigo tem como objetivo relatar a experiência de um projeto de extensão universitária que foi realizado com alunos do ensino fundamental, em duas escolas públicas do município de Juiz de Fora ­MG, nos anos de 2018 e 2019. Foram realizadas palestras expositivas e dinâmicas sobre os sistemas do corpo humano e a sua relação com as DCNT, tendo sido aplicado um questionário, no início e fim da intervenção, a fim de avaliar o desempenho e compreensão dos alunos. Foram feitas estatísticas descritivas com valores absolutos, mínimos e máximos, médias e porcentagens. Após isso, foi possível constatar que os alunos obtiveram uma melhora significativa do desempenho não apenas no questionário, mas também no âmbito social, pois foi perceptível a troca de saberes entre alunos e acadêmicos, o que proporcionou um ambiente dinâmico e favorável para o aprendizado.

Considered the biggest global health problem, non-communicable chronic diseases (NCDs) are the cause of most morbidity and mortality in Brazil today and have common risk factors, which allows for a similar preventive approach. Knowing that school is a fundamental place for health promotion, this article aims to report the experience of a university extension project, carried out with elementary school students,in two public schools in the city of Juiz de Fora -MG, in the years from 2018 and 2019. Expository and dynamic lectures were held on human body systems and their relationship with CNCDs, with a questionnaire being applied at the beginning and end of the intervention, in order to assess the performance and understanding of students. Descriptive statistics were performed with absolute, minimum and maximum values, means and percentages. After that, it was possible to verify that the students obtained a significant performance improvement not only in the questionnaire, but also in the social sphere, as the exchange of knowledge between students and academics was noticeable, which provided a dynamic and favorable environment for learning.

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Caracterizados como Doenças Crônicas não Transmissíveis, o Diabetes Mellitus (DM) e a Hipertensão Arterial (HA), classificam-se como um problema de saúde pública mundial. No cenário nacional, a Atenção Primária à Saúde ainda encontra desafios para enfrentar esta realidade. Trata-se de um estudo de método misto, que analisou e comparou a presença e extensão dos atributos da Atenção Primária à Saúde (APS) na perspectiva dos usuários com DM e HA e, ainda, analisou, na concepção destes sujeitos, o cuidado desenvolvido pelo enfermeiro na APS. Foram entrevistados 118 pessoas usuárias do Sistema Único de Saúde (SUS) com diagnóstico autorreferido de DM e HA concomitantes e cadastrados nas unidades de saúde com equipes de saúde da família (eSF) e equipes de atenção básica (eAB) de dezoito serviços da APS do Distrito Oeste do município de Ribeirão Preto-SP. A abordagem quantitativa caracteriza-se por um estudo analítico e delineamento transversal, utilizando o instrumento Primary Care Assessment Tool (PCATool) para adultos versão reduzida e um questionário de caracterização sociodemográfica. Para os cálculos, utilizou-se o teste t de Student e o teste Mann-Whitney, indicando presença e extensão dos atributos com escores ≥6,6, e, para a análise estatística, adotou-se o nível de significância α=0,05. Para a abordagem qualitativa, realizou-se uma entrevista semiestrutrurada, com questões disparadoras sobre o cuidado de enfermagem. As entrevistas foram audiogravadas e depois transcritas em formato digital. Os dados foram analisados por meio da modalidade da interpretação dos sentidos e interpretados a partir dos conceitos dos atributos da APS. Houve predominância de participantes do sexo feminino (60,1%), média de idade estratificada entre 50 e 69 anos (72,0%), autodeclarados brancos (52,5%), casados (60,2%), com residência própria (79,2%) e renda familiar de um salário mínimo (35,6%). 28,0% das pessoas convivem com o diagnóstico de HA entre 11 e 20 anos, e 40,7% entre 1 e 10 anos com DM e 26,3% utilizam duas medicações para HA e 38,1% utilizam apenas uma medicação para DM. Os atributos Grau de Afiliação (7,3), o Acesso de Primeiro Contato (Utilização) (7,9) e a Longitudinalidade (7,6) apresentaram presença e extensão dos atributos da APS, tendo os demais obtido escores <6,6. Na interpretação dos sentidos, identificou-se como núcleo do sentido central "Os cuidados às pessoas com Diabetes Mellitus e Hipertensão Arterial", sendo dividido em três subnúcleos dos sentidos: "Concepções sobre a utilização dos serviços de saúde"; "As concepções sobre o trabalho da enfermagem"; "Concepções sobre o cuidado no contexto da pandemia". Os resultados constatam que a maior parte dos atributos caracterizam baixa presença e extensão da APS e em relação às concepções dos usuários, a busca pelo serviço deve-se a uma necessidade expressa e destaca-se a dificuldade de um acompanhamento que julguem adequado, observou-se o desconhecimento e distinção do profissional enfermeiro e suas atribuições. A avaliação dos atributos da APS é importante, pois permite a reflexão acerca das práticas em saúde e serve como ferramenta de orientação às políticas de saúde, assim como ao enfermeiro desenvolver seu trabalho de forma efetiva

Characterized as non-communicable chronic disease, the Diabetes Mellitus (DM) and the Arterial Hypertension (AH), are classified as a worldwide health condition. In the national overview, the Primary Health Care still faces challenges to deal with this reality. The study is based on hybrid methods and analyzed and compared the presence and extension of the Primary Health Care (PHC) assignments from the DM and AH users' perspectives and also analyzed it from this community's conception the care developed by nurses at the PHC. 118 people were interviewed; all of them are National Health Service (SUS) users and were diagnosed under DM and AH simultaneously and also registered in the health unities with family health teams (eSF) and primary care teams (eAB) in eighteen APS services of the West District in Ribeirão Preto/SP city. The quantitative approach is characterized by an analytical study cross-sectional study, using the Primary Care Assessment Tool (PCATool) reduced version to adults and a questionnaire of a social-demographic characterization. To have the calculations done, it was used the t de Student and Mann-Whitney tests, showing the presence and extension of the assignments with ≥6,6 scores and to the statistics analysis it was used the significance level as α=0,05. For the qualitative approach, it was made a semi-structured interview with trigger questions about the nurse care. The interviews were audio recorded and after that transcribed in a digital format. The data were analyzed by the interpretation of meanings and interpreted by the APS assignments concepts. There was the prevalence of female participants (60,1%), average age estimated in 50-69 years (72%), self-declared white (52,5%), married (60,2%), own residence (79,2%) and with family income up to the minimum wage (35,6%). Out of them, 28,0% of the people were diagnosed with AH between 11 to 20 years and 40,7% between 1 to 10 years with DM and 26,3% use two kinds of medication to AH and 38,1% use only one kind of medication to DM. The features affiliation degree (7,3), first contact accessibility (utilization) (7,9) and the longitudinally (7,6) showed presence and extension of the APS assignments, and the other ones received the score <6,6. In the interpretation of meanings, it was identified as the core of the central meaning the "The care to people under Diabetes Mellitus and Hypertension Arterial condition", being divided into 3 sub-cores of meanings: "Concepts about the utilization of health care"; "The concepts about the nurse team work"; "Concepts about care in the meaning of pandemic". The results show that the most part of the assignments characterizing the low presence and extension of the APS related to the users' concepts the seek for the service is due to a clear need and highlights the difficulty of an assistance that they consider adequate, it was observed the unawareness and distinction of the professional nurse and his/her assignments. The APS assignments evaluation is important as it allows the thinking related to the health practices and can be a tool to guide not only the health policies but also the nurse to develop his/her job in a effective way

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Obesity is associated with a higher risk of Vitamin D (VD) inadequacy and metabolic diseases. The Edmonton Obesity Staging System (EOSS) is an innovative tool for the evaluation of obesity that goes beyond body weight and considers clinic, functional and menta- health issues. This study aimed to evaluate the nutritional status of VD according to the stages of EOSS and its relationship with the metabolic profile. In the cross-sectional study, we evaluated anthropometric parameters, physical activity, blood pressure, biochemical and metabolic variables, and VD nutritional status. A total of 226 individuals were categorized using EOSS: 1.3%, 22.1%, 62.9%, and 13.7% were in stages 0, 1, 2 and 3, respectively. Regarding the metabolic changes and comorbidities, insulin resistance and hyperuricemia were diagnosed in some individuals in EOSS 1, 2, and 3. EOSS 2 and 3 presented a significant relative-risk for the development of arterial hypertension, metabolic syndrome, and liver disease, compared with EOSS 0. In all stages, there were observed means of 25(OH)D serum concentrations below 30 ng/mL (EOSS 0 24.9 ± 3.3 ng/mL; EOSS 3 15.9 ± 5.4 ng/mL; p = 0.031), and 25(OH)D deficiency was present in all stages. Individuals with obesity classified in more advanced stages of EOSS had lower serum concentrations of 25(OH)D and a worse metabolic profile.

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This study showed the effectiveness of biomedical interventions in obesity, diabetes and hypertension (NCDs), but innovative and intersectoral elements in the fight against obesity, type 2 diabetes and hypertension were rare. BACKGROUND: Is it possible to find effective and innovative actions to promote health and prevent NCDs in Brazilian municipalities? Can they be replicated? OBJECTIVE: Our objectives were to identify innovative and effective intersectoral actions for promoting and preventing NCDs in Brazilian municipalities. METHODS: This is a systematic review in an exploratory theoretical essay with a qualitative and quantitative approach. It is descriptive and analytical in terms of reporting findings and results. Inclusion and exclusion criteria favored health promotion work. Bias risk assessments was performed using the Cochrane GRADE and bias risk, with meta-analyses using RevMan and Iramuteq. RESULTS: Meta-analysis of biometric markers resulted in -4.46 [95% IC; -5.42, -3.49], p = 0.00001, indicating a reduction in NCD risk rates. The textual meta-analysis revealed P(r) ≈ 83% (Reinert), meaning low connectivity between the 'halos'. CONCLUSIONS: There is evidence of the effectiveness in interventions, but innovative and intersectoral elements to combat and prevent NCDs were barely seen. While evidence of intervention effectiveness was observed, innovative and intersectoral elements to combat and prevent NCDs were barely noticed.

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Objective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives. Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed. Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients' education. Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers' role bringing medicines closer; and patients' health education and disease management.

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Objetivo: O presente estudo analisou os casos notificados por COVID-19, com diagnóstico de Diabetes Mellitus ­ DM, acompanhados ou não nas unidades de Atenção Primária à Saúde ­ APS e os fatores associados ao óbito por COVID-19, na Área Planejamento 3.1- AP 3.1 do Município do Rio de Janeiro ­ MRJ, em 2020-2021. Métodos: Foi realizado relacionamento probabilístico de bases de dados a partir das bases de dados dos casos notificados por COVID19 e dos dados de prontuário eletrônico (SSMRJ) de pessoas vivendo com DM. A partir disto, realizou-se uma análise descritiva dos casos e de sobrevivência, utilizando-se o modelo de regressão de Cox. Resultado: Os achados desta dissertação estão estruturados e formato de 2 artigos. O primeiro artigo descreveu o perfil sociodemográfico e clínico dos casos notificados por COVID-19 que vivem com DM na AP 3.1 do MRJ em 2020 ­ 2021 e estimou a incidência de casos novos de COVID-19 entre esta população. Os resultados mostraram que a metade dos casos de COVID-19 ocorreu no sexo feminino, raça/cor negra com duas ou mais comorbidades, incluindo o DM. No segundo artigo observou-se que indivíduos cadastrados na APS da AP3.1 possuíam risco duas vezes maior de óbito por COVID-19 (HR= 2,0; HRaj = 1,3 - IC95%) quando comparados com os não cadastrados na APS da AP3.1. Indivíduos do sexo masculino, com 70 anos ou mais, negros e vivendo com comorbidades apresentaram maior risco de óbito por COVID-19. Conclusão: Estratégias de vigilância para identificação e acompanhamento adequado de grupos de maior risco, dentre indivíduos que vivem com DM, no âmbito da Atenção Primária podem contribuir para a redução da mortalidade devido à CoVID-19. (AU)

Objective: This dissertation analyzed the cases reported by COVID-19 with diagnostics of Diabetes Mellitus ­ DM in Primary Health Care units (or not) and the factors associated with death from COVID-19 in Area Planning 3.1 ­ AP3.1 of Rio de Janeiro ­ RJ city, in 2020 ­ 2021. Method: Was make a probabilistic Record Linkage of cases reported by COVID-19 of database and electronic medical records of people living with DM data. Furthermore, we made the descriptive analysis and Cox regression model. Results: The outcomes were structured in two articles. The first article described the sociodemographic profile, clinical and evolution of cases reported by COVID-19 and estimated an incidence of news cases of COVID-19 in people living with DM in AP 3.1 of RJ city in 2020 ­ 2021. The outcomes showed that black women with two or more chronic diseases were the majority of COVID-19. The second article analyzed the factors associated with death from COVID-19 through the Cox regression model living with DM in AP 3.1 of RJ city in 2020 ­ 2021. The results were that black men registered in APS (HR= 2,0; HRaj = 1,3 - IC95%), with 70-year-old or more and living whit chronic diseases, have been more likely to die of COVID-19. Conclusion: We think that strategic vigilance, identification, and suitable accompaniment in Primary Health Care of people living with DM could reduce the mortality in these people. (AU)

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Synchronization to periodic cues such as food/water availability and light/dark cycles is crucial for living organisms' homeostasis. Both factors have been heavily influenced by human activity, with artificial light at night (ALAN) being an evolutionary challenge imposed over roughly the last century. Evidence from studies in humans and animal models shows that overt circadian misalignment, such as that imposed to about 20% of the workforce by night shift work (NSW), negatively impinges on the internal temporal order of endocrinology, physiology, metabolism, and behavior. Moreover, NSW is often associated to mistimed feeding, with both unnatural behaviors being known to increase the risk of chronic diseases, such as eating disorders, overweight, obesity, cardiovascular, metabolic (particularly type 2 diabetes mellitus) and gastrointestinal disorders, some types of cancer, as well as mental disease including sleep disturbances, cognitive disorders, and depression. Regarding deleterious effects of ALAN on reproduction, increased risk of miscarriage, preterm delivery and low birth weight have been reported in shift-worker women. These mounting lines of evidence prompt further efforts to advance our understanding of the effects of long-term NSW on health. Emerging data suggest that NSW with or without mistimed feeding modify gene expression and functional readouts in different tissues/organs, which seem to translate into persistent cardiometabolic and endocrine dysfunction. However, this research avenue still faces multiple challenges, such as functional characterization of new experimental models more closely resembling human long-term NSW and mistimed feeding in males versus females; studying further target organs; identifying molecular changes by means of deep multi-omics analyses; and exploring biomarkers of NSW with translational medicine potential. Using high-throughput and systems biology is a relatively new approach to study NSW, aimed to generate experiments addressing new biological factors, pathways, and mechanisms, going beyond the boundaries of the circadian clock molecular machinery.

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Resumo O objetivo desse estudo foi analisar a prevalência e os fatores associados à prática de atividade física no lazer (PAFL) suficiente em brasileiros com diagnósticos de hipertensão arterial, diabetes e/ou hipercolesterolemia. Trata-se de um estudo transversal de base populacional com representatividade para todo o território brasileiro. Foram entrevistados adultos com 20 ou mais anos de idade. Foram estimadas prevalências e, por meio de regressão logística, calculadas as razões de chance (OR) bruta e ajustada do desfecho segundo cada uma das variáveis exploratórias. A prevalência de PAFL suficiente foi de 15,9%, 15,3% e 21,4% entre as pessoas com hipertensão arterial (n=12.228), diabetes (n=3.577) e hipercolesterolemia (n=7.124), respectivamente. Tais valores foram inferiores ao observado entre os adultos que não referiram uma das três doenças. Análise ajustada mostrou que indivíduos com autopercepção positiva da saúde, com maior escolaridade, que referiram espaço público próximo ao domicílio para a realização de atividade física, presença no município de programas públicos que estimulem a prática de atividade física e recomendação de profissional de saúde para a PAFL estiveram associados a maior chance de serem suficientemente ativos.

Abstract The scope of this study was to analyze the prevalence and the factors associated with sufficient leisure-time physical activity (LTPA) among Brazilians diagnosed with hypertension, diabetes and/or hypercholesterolemia. It involved a representative, cross-sectional population-based study for the entire Brazilian territory. Adults aged 20 years and over were interviewed. Prevalences were estimated and, by means of logistic regression, the crude and adjusted odds ratios (OR) of the outcome were calculated in accordance with each of the exploratory variables. The prevalence of sufficient LTPA was 15.9%, 15.3% and 21.4% among people with hypertension (n=12,228), diabetes (n=3,577) and hypercholesterolemia (n=7,124), respectively. These values were lower than those observed among adults who did not report one of the three diseases. Adjusted analysis showed that individuals with positive self-perception of health and with more schooling, who reported a public space near their homes for physical activity, the existence in the city of public programs that encourage physical activity and the recommendation of health professionals to practice LTPA, were associated with a greater chance of being sufficiently active.

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The objective of this meta-analysis was to evaluate the factors associated with the mortality of elderly Italians diagnosed with coronavirus who resided in institutions or who were hospitalized because of the disease. METHODS: A systematic review following the recommendations of The Joanna Briggs Institute (JBI) was carried out, utilizing the PEO strategy, i.e., Population, Exposure and Outcome. In this case, the population was the elderly aged over 65 years old, the exposure referred to the SARS-CoV-2 pandemic and the outcome was mortality. The National Center for Biotechnology Information (NCBI/PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), Excerpta Medica Database (EMBASE) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used until 31 July 2020. RESULTS: Five Italian studies were included in this meta-analysis, with the number of elderly people included varying between 18 and 1591 patients. The main morbidities presented by the elderly in the studies were dementia, diabetes, chronic kidney disease and hypertension. CONCLUSIONS: The factors associated with the mortality of elderly Italian people diagnosed with SARS-CoV-2 who lived in institutions or who were hospitalized because of the disease were evaluated. It was found that dementia, diabetes, chronic kidney disease and hypertension were the main diagnosed diseases for mortality in elderly people with COVID-19.

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Global public policies have advocated strategies for reducing sodium consumption due to the high incidence of non-communicable chronic diseases (NCDs) worldwide. The objectives of this study were to identify the bread loaves sodium content considered as ideal by the consumers and determine hedonic thresholds. In this descriptive cross-sectional study, 114 consumers evaluated the ideal sodium content in bread loaves by the Just About Right (JAR) test, (first sensorial stage) studying four decreased levels of sodium (10%, 20%, 30%, 40%) from the mean values observed from bread in 11 food composition tables from various regions of the world, and Brazil. This ideal sodium content was used as the control in pairwise acceptance tests with five other reduced-sodium samples of bread loaves (10%, 30%, 50%, 70%, 100% of reduction from the control), and hedonic threshold tests were performed with 156 consumers (a second stage sensorial test of five sessions). The data from the JAR were analyzed by a regression analysis graph and correlated with the consumption of salt and family income range by a Principal Component Analysis with a 5% significance level. In the Hedonic Threshold tests, each paired session was analyzed by Student's t-test (test t), and an adjusted regression graph was built. The Compromised Acceptance Threshold (CAT) was performed, where the calculated t corresponded to the tabulated t. In the Hedonic Rejection Threshold (HRT), the hedonic scale five ("indifferent" term) was considered. The average sodium content of bread marketed in different regions of the world was 457 mg Na/100 g of bread, and the ideal sodium content observed was 395 mg Na/100 g of bread. The gender, age and income family rates as well as attitudes and knowledge regarding the salt consumption of the trial consumers were not directly related to the evaluations of the bread loaves in the JAR test, according to the Principal Components Analysis at p ≤ 0.05. From this ideal content, a 42% reduction was possible according to the CAT test (267 mg Na/100 g of bread), and more reductions were acceptable until an 85% (to 58 mg Na/100 g of bread) reduction, as the samples began to be rejected according to HRT test. These findings demonstrated that this methodology can be applied to sodium reduction product formulations and bread as a food matrix. With this kind of methodology, it is possible to provide to the bakery industry a methodology to know a safe region to work on food reformulations and subsidize the formulation of new products without compromising consumer acceptability, in addition to meeting the demand for safer food.

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OBJECTIVES: To assess the consumption of ultra-processed foods and its association with the overall dietary content of nutrients related to non-communicable diseases (NCD) in the Chilean diet and to estimate the population attributable fraction of ultra-processed food consumption on the unhealthy nutrient content. DESIGN: Cross-sectional analysis of dietary data collected through a national survey (2010). SETTING: Chile. PARTICIPANTS: Chilean population aged ≥2 years (n 4920). RESULTS: In Chile, ultra-processed foods represented 28·6 % of the total energy intake. A significant positive association was found between the dietary share of ultra-processed foods and NCD-promoting nutrients such as dietary energy density (standardised regression coefficient (ß) = 0·22), content of free sugars (ß = 0·45), total fats (ß = 0·26), saturated fats (ß = 0·19), trans fats (ß = 0·09) and Na:K ratio (ß = 0·04), while a significant negative association was found with the content of NCD-protective nutrients such as K (ß = -0·19) and fibre (ß = -0·31). The content of Na (ß = 0·02) presented no significant association. Except for Na, the prevalence of inadequate intake of all nutrients (WHO recommendations) increased across quintiles of the dietary share of ultra-processed foods. With the reduction of ultra-processed foods consumption to the level seen among the 20 % lowest consumers (3·8 % (0-9·3 %) of the total energy from ultra-processed foods), the prevalence of nutrient inadequacy would be reduced in almost three-fourths for trans fats; in half for energy density (foods); in around one-third for saturated fats, energy density (beverages), free sugars and total fats; in near 20 % for fibre and Na:K ratio and in 13 % for K. CONCLUSIONS: In Chile, decreasing the consumption of ultra-processed foods is a potentially effective way to achieve the WHO nutrient goals for the prevention of diet-related NCD.

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Mexico recently voted to implement front-of-pack warning labels on food and beverage products deemed high in calories, sugar, saturated fat, trans fat, and sodium, and those containing non-caloric sweeteners. Research shows that warning labels allow consumers to quickly identify healthy and unhealthy products. Supporters claim these labels can help people make healthier decisions and combat growing rates of obesity and diet-related diseases. Warning labels will replace the Guideline Daily Amount (GDA) nutrition labels, which were implemented in 2014 against the guidance of public health leaders who argued the GDA was hard to understand and ineffective at conveying health risks. Conflicting interests between public health, government, and food industry slowed efforts to adopt a new nutrition label. Actions by academia and civil society to change the GDA were met with common strategies used to interfere in public health policies. However, in 2019, several factors came together to create favorable conditions for the approval of warning labels. The new leftist government's public promises to fight corruption fit well with labeling advocates' calls for transparency. Civil society and academia developed a highly coordinated response thanks to international funding, which propelled extensive marketing campaigns around the country and supported research efforts. These actions helped make the topic visible and place it strategically in the political and public agendas. Despite this legislative victory, the opposition has been strong and there are struggles ahead. Only time will reveal how effectively the law is implemented and to what extent it is upheld and defended.

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Background: Implementation is a key step in ensuring that high-quality clinical practice guideline (CPG) recommendations are followed and have a positive impact. This step must be planned during CPG development. This study aims to inform professionals tasked with developing and implementing CPGs regarding implementation strategies and tools reported in high-quality CPGs for chronic non-communicable diseases (NCDs). Methods: NCD guidelines were selected based on Appraisal of Guideline Research and Evaluation (AGREE) II assessment. CPGs with a score of ≥60% in AGREE II domains 3 (rigor of development), 5 (applicability), and 6 (editorial independence), were considered high quality. The content related to implementation was extracted from CPG full texts and complementary materials. Implementation strategies and tools were assessed and classified using Mazza taxonomy. Results: Twenty high-quality CPGs were selected, most of which were developed by government institutions (16; 80%) with public funding (16; 80%); almost half (9; 45%) addressed the treatment of cardiovascular diseases. The countries with the most high-quality CPGs were the UK (6; 30%) and Colombia (5; 25%). These countries also had the highest average number of strategies, Colombia with 28 (SD = 1) distributed in all levels, and the UK with 15 (SD = 7), concentrating on professional and organizational levels. Although the content of the Colombian CPGs was similar regardless the disease, the CPGs from the UK were specific and contained data-based feedback reports and information on CPG compliance. Implementation strategies most frequently identified were at the professional level, such as distributing reference material (18; 80%) and educating groups of healthcare professionals (18; 80%). At the organizational level, the most frequent strategies involve changes in structure (15; 75%) and service delivery method (13; 65%). Conclusion: Countries with established CPG programs, such as the UK and Colombia, where identified as having the highest number of high-quality CPGs, although CPG implementation content had significant differences. Among high-quality CPGs, the most common implementation strategies were at the professional and organizational levels. There is still room for improvement regarding the implementation strategies report, even among high-quality CPGs, especially concerning monitoring of implementation outcomes and selection of strategies based on relevant implementation barriers.

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El hecho de que el desarrollo fetal pueda ser un factor influyente en el desarrollo humano durante todo el ciclo de la vida ha sido explorado desde la primera mitad del siglo XX, cuando Kermack y otros analizan las tasas históricas de mortalidad en Gran Bretaña y Suiza, y observan que la expectativa de vida estaba determinada por las condiciones existentes durante las etapas tempranas de la vida. Los estudios de Forsdhal, en 1977, determinaron como factor de riesgo cardiovascular los estados de pobreza, seguidos de prosperidad durante la infancia y la adolescencia. Estas observaciones conllevaron a Barker a conformar su hipótesis acerca de la relación entre el bajo peso al nacer y el riesgo cardiovascular, la resistencia insulínica y la diabetes tipo II en la adultez. Aunque no se ha podido demostrar una relación causal única entre el bajo peso al nacer y el desarrollo de las enfermedades crónicas no transmisibles (siendo esta una relación multicausal, tanto los estudios in vitro como in vivo), han demostrado que un medio intrauterino deficiente, independiente de su causa, puede incrementar el riesgo de padecer esas enfermedades, al igual de que si persiste el medio adverso durante la infancia y la adolescencia (estados nutrimentales carenciales), se perpetúa el riesgo. El presente reporte tiene el objetivo de analizar algunos aspectos teóricos relacionados con la programación temprana de la vida y su relación con el desarrollo de las enfermedades crónicas no transmisibles, así como su importancia para el médico de familia y el pediatra general en la práctica médica diaria, encaminado a su prevención en etapas ulteriores del desarrollo humano(AU)

The fact that the fetal development may be an influential factor on the human development during the whole life cycle has been explored since the first half of the 20th century when Kermack and others analyzed the historical mortality rates in Great Britain and Switzerland, and observe that the life expectancies are determined by the existing conditions during the early phases of life. The studies by Forsdhal in 1977 determined that the poverty conditions, followed by prosperity in childhood and adolescence, were cardiovascular risk factors. These considerations led Barker to create his hypothesis on the relationship between the low birth weight and the cardiovascular risk, the insulin resistance and the type II diabetes in adulthood. Although a unique causative relationship has not been yet proved between the low birth weight and the development of non-communicable chronic diseases (a multi-causal relationship in both in vitro and in vivo studies), it has been demonstrated that a deficient intrauterine medium, regardless of the cause, may increase the risk of suffering these diseases as it may happen if the adverse medium persists during childhood and adolescents (deficient nutritional states) since the risk perpetuates. The present report is aimed at analyzing some theoretical aspects related to early programming of life and its relation with the development of non-communicable chronic diseases as well as its importance for the family physician and the general pediatrician in daily medical practice to prevent them in further stages of the human development(AU)

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Introducción: el proyecto Determinantes individuales y sociales de salud en la medicina familiar, concebido con una duración de dos años, se propone desarrollar la opción de evitar la aparición de enfermedades crónicas no trasmisibles interviniendo en los determinantes sociales e individuales de la salud. Objetivo: describir los resultados preliminares después de un año de trabajo en el citado proyecto. Métodos: estudio descriptivo prospectivo en 1 496 individuos dispensarizados en el policlínico universitario Tomás Romay. La muestra se dividió en dos grupos homogéneos: el grupo intervenido, cuyos miembros fueron invitados cuatro veces en el año a una consulta salutogénica y un grupo control, al que se le realizó dos consultas, una al inicio y otra al final del mismo año. Se utilizó una entrevista que actualiza el estado de los determinantes individuales y sociales y permite ofrecer orientaciones salutogénicas. Resultados: en el grupo intervenido disminuyó la frecuencia del tabaquismo (p< 0,0001), el bebedor de riesgo (p< 0,05), el peso (p< 0,05) y el valor del índice de masa corporal (p< 0,05), así como el número de personas con sobrepeso (p< 0,001), la presión arterial diastólica (p< 0,05), y la presión arterial sistólica (p< 0,001). Por otro lado, durante el período de intervención, aumentó la incidencia de diabetes mellitus en el grupo control en comparación con el grupo intervenido (p< 0,05). Conclusiones: los resultados son aun modestos, pero avalan una posibilidad racional para disminuir el riesgo de la aparición de enfermedades crónicas no trasmisibles...

Introduction: the project Individual and social determinants of health in family medicine conceived for two years, is aimed at developing the option of preventing the occurence of non-communicable chronic diseases by intervening in the individual and social determinants of health. Objective: to describe the preliminary results after one-year work in the mentioned project. Methods: prospective and descriptive study of 1 496 subjects classified in Tomas Romay university polyclinics. The sample was divided into two homogeneous groups: the intervened group whose members were invited to salutogenic consultation four times a year, and a control group which went to two consultations, one at the beginning and other at the end of the year. An interview was made to update the state of the individual and social determinants and allowed providing salutogenic guiding. Results: the intervened group reduced the frequency of smoking (p< 0.001), risky drinking (p< 0.05), weight (p< 0.05) and the body mass index (p< 0.05) as well as the number of overweighed persons (p< 0.001), diastolic blood pressure ((p< 0.005), and systolic blood pressure (p< 0.001). On the other hand, the incidence of diabetes mellitus rose during the intervention period in the control group compared with that of the intervened group (p< 0.05). Conclusions: the results are still modest, but they support a rational possibility to diminish the risk of emergence of non-communicable chronic diseases...

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This study aimed to delineate the nutritional profile and to investigate the presence and distribution of factors of risk and protection for Non-Communicable Diseases (NCD) in diabetic participants. For this, 54 individuals of both sexes participated in this study, aged 28 to 87 years who have been attended by a health center of the municipality of Maringá, Paraná State. It was measured the weight, height and waist circumference and applied two questionnaires related to risk factors and food frequency (FFQ) respectively. The study design is cross-sectional and the descriptive analysis was performed using the statistical software Epi info version 3.32 (2005). The results showed that the most relevant risk factors in the diabetic population in relation to NCD have been related to the overweight, lack of physical activity and self-reported hypertension. The protection factors were healthy diet and quitting of smoking. Based on nutritional assessment, the BMI (Body Mass Index) and waist circumference have been positively correlated with high significance. Health education is necessary for the prevention and health promotion of these individuals through the change of lifestyle.

Este estudo teve como objetivo traçar o perfil nutricional e investigar a presença e a distribuição dos fatores de risco e de proteção para Doenças Crônicas Não-Transmissíveis (DCNT) em portadores de Diabetes Mellitus (DM). Participaram do estudo 54 indivíduos de ambos os sexos, com idade entre 28 a 87 anos, que frequentam um posto de saúde da cidade de Maringá, Estado do Paraná. Foram aferidos o peso, a estatura e a circunferência da cintura e aplicados dois questionários relacionados com fatores de risco e frequência alimentar (QFA), respectivamente. O delineamento da pesquisa é transversal e foi feita análise descritiva pelo programa estatístico Epi info, versão 3.32 (2005). Os resultados demonstraram que os fatores de risco mais relevantes encontrados na população diabética em relação às DCNT´s foram relacionados ao excesso de peso, falta de atividade física e hipertensão autorreferida Os fatores de proteção encontrados foram alimentação saudável e suspensão de tabagismo. Pela avaliação nutricional, o IMC (Índice de Massa Corpórea) e a Circunferência da Cintura tiveram correlação positiva e alta significância. A educação em saúde é necessária para que haja prevenção e promoção da saúde desses indivíduos por meio da mudança dos hábitos de vida.

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As doenças crônicas não transmissíveis (DCNT), em particular as cardiovasculares (DCV) e o diabetes melito (DM), têm um importante papel no atual perfil de saúde da população mundial, com projeções de crescimento. O objetivo deste artigo é identificar fatores de risco para doenças crônicas não transmissíveis (DCNT) associados à alimentação em trabalhadores atendidos em um ambulatório de nutrição. Trata-se de estudo de corte transversal. Os dados foram obtidos por meio de entrevista, avaliação antropométrica e bioquímica. A amostra foi selecionada entre trabalhadores de ambos os sexos, que frequentavam oambulatório de nutrição do Centro Estadual de Referência em Saúde do Trabalhador em Salvador, Bahia, em 2010. Os resultados indicam que o IMC ? 25,0 kg/m2 foi o fator de risco de maior frequência (91,8%), seguido da hipercolesterolemia (61,8%) e da hipertrigliceridemia (50,0%). Simultaneidade de dois ou mais fatores de risco foi encontrada em 70,6% dos trabalhadores. Baixo consumo diário de frutas (14,3%), hortaliças (44,4%) e tubérculos (8,0%) e elevado consumo de alimentos ricos em gordura saturada (embutidos ? 48,9%) e açúcar simples (76,0%). O tabagismo era hábito de 3,6% dos trabalhadores. A análise das frequências das dislipidemias segundo a idade mostrou níveis elevados de colesterol total (p=0,02) e triglicérides (p=0,03) em trabalhadores com idade ?41anos. Concluiu-se que as elevadas frequências de fatores de risco modificáveis são preocupantes e reforçam a necessidade de implementação de ações que visem a promoção da saúde e a prevenção de DCNT.

Non-communicable Chronic diseases (NCCD), predominantly cardiovascular (CVD) and diabetes mellitus (DM), play a major role in the current health profile of the world population and are expected to increase its numbers. The purpose of this article is to identify the risk factors for non-communicable chronic diseases (NCCD) in workers that received assistance at a neurology clinic. This is a cross sectional study whose data were collected through interviews, anthropometric and biochemical assessments. The sample was selected between workers of both sexes, who received assistance in the nutrition clinic at the State Centre of Reference on Health of Workers in Salvador, Bahia, in 2010. The results indicate that the body mass index (BMI) ?25.0 kg/m2 was the most frequent risk factor (91.8%), followed by hypercholesterolemia (61.8%) and hypertriglyceridemia (50.0%). Simultaneity of two or more risk factors was found in 70.6% of the workers. Low daily ingestion of fruits (14.3%), vegetables (44.4%), and tubers (8.0%) and a high consumption of foods rich in saturated fat (embedded: 48.9%) and simple sugars (76.0%) were verified. Smoking was a habit in 3.6% of workers. Analysis of frequencies of dyslipidemias according to age showed high levels of total cholesterol (p=0.02) and triglycerides (p=0.03) in workers of age ?41 years. It was concluded that the elevated frequency of modifiable risk factors is worrisome, reinforcing the need for implementation of actions aimed at health promotion and prevention of NCCD.

Las enfermedades crónicas no transmisibles (ECNT), en particular las cardiovasculares (DCV) y la Diabetes Mellitus (DM), desempeñan un importante rol en el actual perfil de la salud de la población mundial, con proyecciones de crecimiento. El propósito de este artículo es identificar los factores de riesgo para las enfermedades crónicas no transmisibles (ECNT), asociadas a la alimentación de trabajadores atendidos en un ambulatorio de nutrición. Estudio de enfoque transversal. Los datos fueron recolectados a través de entrevistas, evaluación antropométrica y bioquímica. La muestra fue seleccionada entre trabajadores de ambos sexos, que frecuentaban, en 2010, el ambulatorio de nutrición del Centro Estatal de Referencia en Salud del Trabajador, en Salvador, Bahía. Los resultados indican que el IMC ? 25,0kg/m2 fue el factor de riesgo de mayor frecuencia (91,8%), seguido de la hipercolesterolemia (61,8%), y de la hipertrigliceridemia (50,0%). Simultaneidad de dos o más factores de riesgo fue encontrada en 70,6% de los trabajadores. Bajo consumo diariode frutas (14,3%), hortalizas (44,4%) y tubérculos (8,0%) y un elevado consumo de alimentos con grasa saturada (embutidos: 48,9%) y azúcar simple (76,0%). El tabaquismo era hábito en el 3,6% de los trabajadores. El análisis de las frecuencias de las dislipidemias según la edad, constató niveles elevados de colesterol total (p=0,02) y triglicéridos (p=0,03) en trabajadores con edad ?41años. Se concluye que las elevadas frecuencias de factores de riesgo cambiables son inquietantes, reforzando la necesidad de implementación de acciones que visen a lapromoción de la salud y a la prevención de ECNT.

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