Carolina Abreu de Carvalho

Associação entre fatores de risco cardiovascular e indicadores antropométricos de obesidade em universitários de São Luís, Maranhão, Brasil

The article aims to evaluate the relation between cardiovascular risk factors (CVRF) and anthropometric indicators in a sample of university students from Sao Luis-MA, Brazil. It is a cross-sectional study conducted with 968 university students, with median age of 22. Glycemia, triglycerides, HDL-c, smoking, alcohol consumption, physical inactivity, metabolic syndrome (Joint Interim Statement criteria) and insulin resistance (IR), were associated and correlated with anthropometric indicators such as BMI, WC, WHR and WHtR. Associations were found between TGL, SH, SM and higher values of all anthropometric variables. The RI was associated with higher BMI values and WHtR in men and women. The low HDL-c was associated with higher values of all anthropometric variables in women. Consumption of alcohol was associated with higher values of BMI and WC in women and WHR in men and WHtR. Smoking was associated with higher values of WHtR in both sexes. Physical inactivity was associated with higher values of WHR in men only. The highest correlations were established for women between TGL and BMI CC, WHR and WHtR. The indicators most associated with CVRF were BMI, WC and WHtR in females and WHR and WHtR in men.The article aims to evaluate the relation between cardiovascular risk factors (CVRF) and anthropometric indicators in a sample of university students from São Luís-MA, Brazil. It is a cross-sectional study conducted with 968 university students, with median age of 22. Glycemia, triglycerides, HDL-c, smoking, alcohol consumption, physical inactivity, metabolic syndrome (Joint Interim Statement criteria) and insulin resistance (IR), were associated and correlated with anthropometric indicators such as BMI, WC, WHR and WHtR. Associations were found between TGL, SH, SM and higher values of all anthropometric variables. The RI was associated with higher BMI values and WHtR in men and women. The low HDL-c was associated with higher values of all anthropometric variables in women. Consumption of alcohol was associated with higher values of BMI and WC in women and WHR in men and WHtR. Smoking was associated with higher values of WHtR in both sexes. Physical inactivity was associated with higher values of WHR in men only. The highest correlations were established for women between TGL and BMI CC, WHR and WHtR. The indicators most associated with CVRF were BMI, WC and WHtR in females and WHR and WHtR in men.

Food consumption and nutritional adequacy in Brazilian children: a systematic review

OBJECTIVE: To perform a review of studies of food consumption and nutritional adaptation in Brazilian infants pointing the main findings and limitations of these studies. DATA SOURCE: The articles were selected from Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) (Latin-American and Caribbean Literature in Health Sciences), Scientific Electronic Library Online (SciELO) and Science Direct in Portuguese and in English. The descriptors were: food consumption, nutritional requirements, infant nutrition and child. The articles selected were read by two evaluators that decided upon their inclusion. The following were excluded: studies about children with pathologies; studies that approached only food practices or those adaptation of the food groups or the food offert; and studies that did not utilize the Dietary Reference Intakes (DRI). DATA SYNTHESIS: Were selected 16 studies published between 2003 and 2013. In the evaluation of the energy consumption, four studies presented energetic consumption above the individual necessities. The prevalence of micronutrients inadequacy ranged from 0.4% to 65% for iron, from 20% to 59.5% for vitamin A, from 20% to 99.4% for zinc, from 12.6% to 48.9% for calcium and from 9.6% 96.6% for vitamin C. CONCLUSIONS: The food consumption of Brazilian infants is characterized by high frequencies of inadequacy of micronutrients consumption, mainly iron, vitamin A and zinc. These inadequacies do not exist only as deficiencies, but also as excesses, as noted for energetic consumption.

Prevalence and Risk Factors for Microcephaly at Birth in Brazil in 2010

Before the Zika virus epidemic, microcephaly was endemic in Brazil and was associated with IUGR and sociodemographic, reproductive, and lifestyle variables. OBJECTIVES: To estimate the baseline prevalence and risk factors for microcephaly at birth before the Zika virus epidemic in 2 Brazilian cities. METHODS: We used population-based data from the Brazilian Ribeirão Preto (RP) and São Luís (SL) birth cohort studies of 2010 that included hospital deliveries by resident mothers. The final sample was 7376 live births in RP and 4220 in SL. Gestational age was based on the date of the mother’s last normal menstrual period or obstetric ultrasonography, if available. Microcephaly at birth was classified according to the criteria of the International Fetal and Newborn Growth Consortium for the 21st Century and the Brazilian Ministry of Health. Risk factors for microcephaly, proportionate and disproportionate microcephaly, and severe microcephaly were estimated in a hierarchized logistic regression model. RESULTS: According to the International Fetal and Newborn Growth Consortium for the 21st Century definition, the prevalence of microcephaly (>2 SDs below the mean for gestational age and sex) was higher in SL (3.5%) than in RP (2.5%). The prevalence of severe microcephaly (>3 SDs below the mean) was higher in SL (0.7%) than in RP (0.5%). Low maternal schooling, living in consensual union or without a companion, maternal smoking during pregnancy, primiparity, vaginal delivery, and intrauterine growth restriction were consistently associated with microcephaly. The number of cases of microcephaly is grossly underestimated, with an underreporting rate of ∼90%. CONCLUSIONS: The prevalence of severe microcephaly was much higher than expected in both cities. Our findings suggest that microcephaly was endemic in both municipalities before the circulation of the Zika virus.

Consumo de energia e macronutrientes no lanche escolar de adolescentes de São Luís, Maranhão, Brasil

Objective:This report evaluated nutritional composition of school lunch consumed by teenagers at two schools in Sao Luis (MA).Methods:Cross-sectional study setting a sample of 200 teenagers aged 15-17 years from two schools, one public and one private. There were undertaken dietary recalls of school lunch of the last three days the teenagers were at school. These dietary data were analyzed according to the Brazilian Table of Food Composition. Carbohydrates, lipids and proteins consumption were compared to the Dietary Reference Intakes (DRI) recommendations. Statistical analysis was performed using Stata 10.0. For comparisons, there were used Students t-test and χ2. The significance level was set at 5%.Results:The school lunch consumption was reported by 69.5% of adolescents. Most acquired this snack canteens of schools: private (76.0%) and public (51.0%). Adolescents from public schools had higher energy consumption (338.7 versus 286.3 kcal, p = 0.043) and carbohydrates (52.5 vs. 39.3 g, p = 0.006). The adequacy of macronutrients appeared in half of the sample: carbohydrates (43.9%), protein (43.2%) and lipids (49.6%). Almost the half (43.9%) of teenagers had appropriate carbohydrate intake. This adequacy of carbohydrate was higher between public school students (p<0.001) as well as the adequacy of lipid (p<0.001). Boys had higher adequacy of protein (55.6 versus 32.9%; p=0.007), whereas girls had higher adequacy of carbohydrate (52.6% versus 33.3%; p=0.005) and lipid (61.8 versus 34.9%; p=0.006).Conclusions:The inadequacy of macronutrients was high in the sample, suggesting the low quality of school lunch consumed by these teenagers.

Maternal smoking during pregnancy and early development of overweight and growth deficit in children: an analysis of survival

Objectives: to evaluate the association between smoking during pregnancy and nutritional status. Methods: cohort study with a sample of 460 children in the baseline. The children were assessed four times, being measured for weight and length to be converted in indexes length forage (L/A) and body mass index forage (BMI/A) in Z-score. The time until occurrence of growth deficit and overweight was calculated in days and compared to maternal smoking during pregnancy. To assess the association between smoking during pregnancy and the outcomes, a Hazard Ratio by Cox regression was obtained, adjusting by confounding variables selected from Directed Acyclic Graphs (DAG). Results: the time until occurrence of growth deficit and overweight was lower in children whose mothers smoked during pregnancy. Smoking during pregnancy was a risk factor for length deficit (HR = 2.84; CI95% = 1.42 to 5.70) and for overweight (HR = 1.96; CI95% = 1, 09 to 3.53), even after the adjustment. Conclusions: maternal smoking was a changeable factor associated with anthropometric outcomes, which demonstrates the need for actions to combat smoking during pregnancy in order to prevent early nutritional deviations.

Association of exclusive breastfeeding duration with consumption of ultra-processed foods, fruit and vegetables in Brazilian children

BackgroundThere has been little evidence of the influence of breastfeeding on childhood eating habits.AimTo evaluate the association between duration of exclusive breastfeeding (EB) and consumption of ultra-processed foods, fruits and vegetables by Brazilian children.MethodsThis is a cross-sectional study nested in a cohort of 403 children age 4–7xa0years. Food consumption was evaluated by three food records and the foods were grouped by the amount of processing involved (minimal, including fruit and vegetables to ultra-processed foods). Adjusted linear and multinomial regression models were proposed to evaluate the association of EB with children’s food intake. Median duration of EB was 4.0xa0(2.0–6.0)xa0months and the prevalence of EB of 4xa0months or more was 60.9%.ResultsMean energy consumption was 1536xa0kcal/day, 38% of energy was from ultra-processed foods. Mean intake of fruit and vegetables was 130xa0g/day. For each 1-month increase in duration of EB there was a 0.7% decrease in energy from ultra-processed foods (β: −u20090.7; 95% CI: −u20091.3 to 0.1; pu2009=u20090.038). EB of less than 4xa0months was associated with the child being in the lowest tercile for consumption of fruit and vegetables (Adjusted OR: 1.8; 95% CI: 1.1–3.0; pu2009=u20090.030) and the highest for consumption of ultra-processed foods (adjusted OR: 1.7; 95% CI: 1.1–2.9; pu2009=u20090.040).ConclusionsIn addition to other benefits of EB, we emphasize its importance for the formation of healthy eating habits, contributing to a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods in childhood.

Fatores sociodemográficos, perinatais e comportamentais associados aos tipos de leite consumidos por crianças menores de seis meses: coorte de nascimento

This study evaluated factors associated with the consumption of breast milk (BM), infant formula (IF) and cow milk (CM) in children. This was a cohort study with 256 children followed-up at the 1st, 4th and 6th month of age in Viçosa (MG), Brazil. With respect to CM and IF, consumption was recorded regardless of BM intake. Regarding BM, only exclusive or predominant consumption was considered. From the 1st to the 6th month, an increase was recorded in the number of children who did not consume BM exclusively or predominantly (31.6%), as well as the consumption of CM (27.2%) and IF (9.3%). BM was associated with pacifier use at 1st month, and mothers employment status and pacifier use in the 4th and 6th month. Pacifier use was a risk factor for IF consumption in every month, while belonging to the lower income group was inversely associated in the 6th month. As for CM, the number of prenatal visits was a risk factor in every month, the mothers employment status and use of pacifier in the 4th month, family income, mothers employment status, low birth weight, number of prenatal visits and pacifier use in the 6th month. Since the 1st month, the introduction of other milk types is high, revealing that there is still much to go to ensure exclusive breastfeeding up to 6 months.Resumo Avaliar os fatores associados ao consumo de leite materno (LM), formulas lacteas (FL) e leite de vaca (LV). Estudo de coorte com 247 criancas acompanhadas no 1°, 4° e 6° mes de vida, em Vicosa-MG. Para o LV e FL contabilizouse o consumo independentemente da ingestao de LM. Para o LM, considerou-se apenas o consumo exclusivo ou predominante. Do 1° ao 6° mes observou-se o aumento do nao consumo de LM de forma exclusiva ou predominante (31,6%), bem como do consumo de LV (27,2%) e FL (9,3%). O LM associou-se ao uso de chupeta no 1° mes, e ao trabalho materno e uso de chupeta no 4° e 6° mes. O uso de chupeta foi fator de risco para o consumo de FL em todos os meses, enquanto pertencer ao grupo de menor renda foi inversamente associado no 6° mes. Para o LV, o numero de consultas pre-natal foi fator de risco em todos os meses, o trabalho materno e o uso de chupeta no 4° mes, a renda familiar, trabalho materno, baixo peso ao nascer, numero de consultas pre-natal e uso de chupeta no 6° mes. Desde o 1° mes a introducao de outros tipos de leite e elevada, revelando que ainda ha muito a se percorrer para a garantia do aleitamento materno exclusivo ate os 6 meses.

Determinantes da velocidade média de crescimento de crianças até seis meses de vida: um estudo de coorte

This study aimed to investigate some factors that contributed to higher or lower growth rate of children up to the sixth month of life. This is a cohort study with 240 children evaluated in four stages. Variables of birth, eating habits of the child, mothers breast-feeding difficulty and pacifier use were investigated. Childrens weight gain rate (grams/day) and size gain (cm/month) were measured in all assessments and compared according to the variables of interest. In the first month, weight gain rate of children born by cesarean section was smaller. By the second month, the growth rate (weight and size gain) was higher among children who were exclusively or predominantly breastfed and lower among those who consumed infant formula. Children of mothers who reported difficulty to breastfeed showed a lower growth rate until the second month. Children age four months who consumed porridge had lower weight and size gain rate. Pacifier use was associated with lower weight gain rates up the first, second and fourth month.