Camilo Adalton Mariano da Silva

Association between nutritional status, environmental and socio-economic factors and Giardia lamblia infections among children aged 6–71 months in Brazil

A cross-sectional study was conducted on a randomised sample of 405 children aged 6-71 months in Brazil to investigate the association between nutritional status, environmental and socio-economic factors and Giardialamblia infection. Data collection entailed an interview, anthropometric measurements and the collection of faeces and venous blood samples. The analysis was performed using multivariate logistic regression. The prevalence rate for G. lamblia was 26.3%. Nutritional status evaluation showed that 7.9% of the children had chronic malnutrition and 11.1% had acute malnutrition. The risk factors associated with infection by G. lamblia were an age of 2 years or older [odds ratio (OR)=2.4], living in a two-bedroom house or smaller (OR=2.3), living among a family of five or more people (OR=2.4) and living in a house without access to a sewerage system (OR=2.1). Non-participation in the social service programme was associated with a lower risk of infection (OR=0.2). The model adjusted for age, including only biochemical and nutritional variables, showed weak associations with G. lamblia infection for two variables: inadequate animal protein intake according to the Dietary Reference Intake recommendation and low haemoglobin concentration. The sociodemographic and environmental risk factors classically described were associated with G. lamblia infection, but nutritional variables were only weakly associated with it.

Práticas de amamentação no município de Ouro Preto, MG, Brasil

OBJETIVO: Conhecer a frequencia e a duracao mediana das praticas de aleitamento materno em criancas de 0-24 meses no municipio de Ouro Preto, MG. METODOS: Estudo epidemiologico tipo transversal em amostra estratificada de 229 criancas provenientes de 1.800 domicilios, visitados em 1996 e sorteados por conglomerado em tres estagios. A frequencia e a duracao mediana das praticas foram calculadas mediante tabua de vida. RESULTADOS: A duracao mediana da amamentacao foi de 198 dias, sendo de 71 dias para a amamentacao exclusiva somada a predominante e 17 dias para a amamentacao exclusiva. CONCLUSAO: Embora a maioria das maes amamente seus filhos ao nascer, a introducao de outros alimentos ainda e bastante prematura, fato que justifica a necessidade de intervencoes para prevenir o desmame parcial e/ou total precoce.

O Programa Nacional de Alimentação Escolar sob a ótica dos alunos da rede estadual de ensino de Minas Gerais, Brasil

O objetivo deste artigo e analisar o Programa de Alimentacao Escolar sob a otica dos alunos atendidos na rede estadual de ensino de Minas Gerais. Trata-se de estudo transversal, quali-quantitativo, com amostra de 1500 alunos, representativa do universo da rede estadual de ensino de Minas Gerais, utilizando questionario semiestruturado analisado por meio de frequencia simples, media, desvio padrao, teste exato de Fisher, teste qui-quadrado e regressao logistica (p < 0,05; IC 95%). Houve efetiva aceitacao de 28,8% e efetiva adesao de 45,1% ao Programa. A aceitacao foi significativamente maior entre alunos do sexo masculino e entre aqueles que apresentaram menor consumo de alimentos extrainstitucionais. A aceitacao e a adesao foram significativamente maiores entre alunos do grupo etario mais velho e entre aqueles que referiram participar de atividades de Educacao Alimentar e Nutricional. No total, 73,5% dos alunos sugeriram melhorias para a Alimentacao Escolar. Muitos principios e diretrizes do programa nao estao sendo cumpridos. A aceitacao da Alimentacao Escolar mostrou-se negativamente influenciada pelo consumo de alimentos extrainstitucionais e positivamente influenciada pelas acoes de Educacao Alimentar e Nutricional.In this paper the authors describe and contextualize the participation of users and family members in mental health research in Brazil, addressing the recent tradition of the experiences of recovery and empowerment to define the analysis of some Brazilian experiences of evaluative research and intervention projects, which count on these social actors to act as researchers. The experiences of Self-Help Groups and the Guide to Autonomous Medication Management are described briefly, in order to analyze the limits and possibilities of participation of users and their family members in research, which is still incipient and sporadic in the Brazilian reality. The authors also recommend the creation of an agenda in public health policy that encourages this participation.In this paper the authors describe and contextualize the participation of users and family members in mental health research in Brazil, addressing the recent tradition of the experiences of recovery and empowerment to define the analysis of some Brazilian experiences of evaluative research and intervention projects, which count on these social actors to act as researchers. The experiences of Self-Help Groups and the Guide to Autonomous Medication Management are described briefly, in order to analyze the limits and possibilities of participation of users and their family members in research, which is still incipient and sporadic in the Brazilian reality. The authors also recommend the creation of an agenda in public health policy that encourages this participation.

The Brazilian School Nutrition Program from the standpoint of students attending state schools in Minas Gerais, Brazil

The scope of this article is to analyze the Brazilian School Nutrition Program from the standpoint of students attending state schools in Minas Gerais. It is a qualitative and quantitative cross-sectional study with a sample of 1500 students, representing the population of the state schools of Minas Gerais, involving the administration of a semi-structured questionnaire. The data were analyzed using simple frequency, mean, standard deviation, Fishers exact test, the chi-square test and logistic regression (p < 0.05, CI 95%). The effective acceptance of the program was 28.8% and the effective adhesion to the program was 45.1%. Program acceptance was significantly higher among males and students who consumed less extra-institutional food. Acceptance and adhesion to the program was significantly higher among the older students and those who reported participating in activities related to nutritional education. In total, 73.5% of the students suggested improvements in school food. Many of the programs norms and guidelines are not being implemented. The acceptance of school food was negatively influenced by the consumption of extra-institutional foods and positively influenced by food and nutritional education activities.

Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil

Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6–71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2–40.8) and 9.8% (95%CI 7.2–12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7–22.6) and 21.8% (95%CI 17.8–26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2–2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4–3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1–2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.

Increased Obesity-Associated Circulating Levels of the Extracellular Matrix Proteins Osteopontin, Chitinase-3 Like-1 and Tenascin C Are Associated with Colon Cancer.

Background Excess adipose tissue represents a major risk factor for the development of colon cancer with inflammation and extracellular matrix (ECM) remodeling being proposed as plausible mechanisms. The aim of this study was to investigate whether obesity can influence circulating levels of inflammation-related extracellular matrix proteins in patients with colon cancer (CC), promoting a microenvironment favorable for tumor growth. Methods Serum samples obtained from 79 subjects [26 lean (LN) and 53 obese (OB)] were used in the study. Enrolled subjects were further subclassified according to the established diagnostic protocol for CC (44 without CC and 35 with CC). Anthropometric measurements as well as circulating metabolites and hormones were determined. Circulating concentrations of the ECM proteins osteopontin (OPN), chitinase-3-like protein 1 (YKL-40), tenascin C (TNC) and lipocalin-2 (LCN-2) were determined by ELISA. Results Significant differences in circulating OPN, YKL-40 and TNC concentrations between the experimental groups were observed, being significantly increased due to obesity (P<0.01) and colon cancer (P<0.05). LCN-2 levels were affected by obesity (P<0.05), but no differences were detected regarding the presence or not of CC. A positive association (P<0.05) with different inflammatory markers was also detected. Conclusions To our knowledge, we herein show for the first time that obese patients with CC exhibit increased circulating levels of OPN, YKL-40 and TNC providing further evidence for the influence of obesity on CC development via ECM proteins, representing promising diagnostic biomarkers or target molecules for therapeutics.

Promoção da aquisição de produtos da agricultura familiar para a alimentação escolar em Territórios da Cidadania de Minas Gerais e Espírito Santo.

OBJECTIVE: This study hopes to promote the acquisition of family farm products for school meals in Brazils Territories of Citizenship. METHODS: This intervention study coordinated intersectoral networks face-to-face. The networks consisted of teams composed of a dietician, popular educator, and agronomist or agronomy technician. These teams visited all municipalities within the Citizenship Territories at least twice to coordinate the said networks, capable of promoting local mobilization processes, organization, and empowerment of different actors to acquire family farm products for school meals in the said municipalities. RESULTS: The most expressive results were: 14% of the municipalities improved the family farm organization; 14% of the managers began to support the food acquisition process according to Law no 11.947/2009; and 27% of the municipalities without a dietician hired one. The results were not considered satisfactory by the School Food Council. CONCLUSION: The actions were capable of promoting the implementation of the Federal Law Lei Federal no 11.947/2009 in the study Territories of Citizenship.

Prevalence of iron-deficiency anemia in children aged less than 60 months: A population-based study from the state of Minas Gerais, Brazil

OBJECTIVE: To identify the prevalence of iron-deficiency anemia in children aged less than 60 months and the conditioning factors in Minas Gerais, Brazil. METHODS: This cross-sectional study conducted from February 2007 to July 2008 in Minas Gerais included a random sample of 725 male and female children aged less than 60 months. A household survey was administered to the childrens parents or guardians to collect socioeconomic, demographic, food security, and the childs anthropometric data. The hemoglobin level was determined by a portable hemoglobinometer. Anemia was considered present when hemoglobin levels were below 11.0 g/dL. Statistical analyses estimated the prevalence of anemia and its association with socioeconomic, demographic, and food security-related variables. The model was adjusted by multivariate logistic regression. The significance level was set at 5% (p<0.05). RESULTS: The prevalence of anemia was 37.4%. The greatest prevalence occurred in the age group 6 to 24 months (43.0%). The associated variables were being female (PR=1.43; p<0.026); age (PR=1.53; p<0.024); and not frequenting a daycare center (PR=2.41; p<0.001). In the multivariate regression model, the variables being female and not frequenting a daycare center remained in the model. CONCLUSION: The present population-based study found that in Minas Gerais, one-third (37.5%) of the children aged less than 60 months have iron-deficiency anemia. The results show that not frequenting a daycare center and being female are risk factors for anemia.

Metabolic syndrome components can predict C reactive protein concentration in adolescents

BACKGROUND Metabolic syndrome (MS) is suggested to be associated with a low grade inflammation state, but the relationship between inflammation biomarkers and the components of metabolic syndrome in adolescents are still lacking. OBJECTIVE To investigate the association between C-reactive protein (CRP) serum concentrations and metabolic syndrome components in adolescents. METHODS A cross-sectional population based study was conducted. Anthropometric, biochemical and clinical data were collected from 524 adolescents (11-15 years old) randomly sampled from school population of Alegre city, Espírito Santo, Brazil. Data were analyzed by STATA version 9.0. RESULTS Adolescents with higher values for BMI (p = 0.001) and higher body fat percentage (p = 0.003) had higher CRP concentrations than those with lower BMI and body fat percentage. CRP concentrations was directly correlated with BMI (r = 0.17, p = 0.0001), waist circumference (r = 0.15, p = 0.0005), HDL-c (r = 0.13, p = 0.003), fasting insulin (r = 0.12, p = 0.003) and systolic blood pressure (r = 0.11, p with = 0.01). In the multiple linear regression analysis BMI (r = 0.05, p = 0.002), fasting glucose (r = -0.01, p = 0.003) and HDL-c (r = 0.017, p < 0.001) were associated to CRP concentrations after adjusting for the other components of MS. CONCLUSION The association found between individual components of MS and CRP concentrations suggests that inflammation might be an early event in the development of metabolic disorders in adolescents.

Deficiência de iodo e fatores associados em lactentes e pré-escolares de um município do semiárido de Minas Gerais, Brasil, 2008

The aim of this study was to evaluate the prevalence of iodine deficiency in children aged 6 to 71 months in Novo Cruzeiro, Minas Gerais State, Brazil. A total of 475 children, allocated by stratified probability sampling, were analyzed with respect to the iodine concentrations in the salt consumed by the family and urinary iodine. Iodine deficiency was verified in 34.4% of the children, of which 23.5% showed slight deficiency, 5.9% moderate and 5% serious deficiency. A difference in the distribution of iodine deficiency was observed between the urban and the rural environments (p < 0.001) where average urinary iodine concentrations of 150.8 and 114.3µg/L respectively were found. A greater proportion of iodine deficiency was observed among children where the proportion of iodine in the salt consumed was below the recommended level. Although expressive, iodine deficiency in Novo Cruzeiro is not a public health problem according to World Health Organization (WHO), The limitrophe distribution of the urinary iodine associated with low iodine levels in salt suggests that efforts to control this deficiency are not yet complete.