Juliana Farias de Novaes

Association of vitamin D insufficiency with adiposity and metabolic disorders in Brazilian adolescents.

OBJECTIVE The present study aimed to evaluate the frequency of deficiency/insufficiency of vitamin D in adolescents and its relationship to overweight and metabolic disorders. DESIGN Cross-sectional study. Nutritional status was assessed by BMI according to WHO recommendations. Dietary intake was evaluated using a 3 d dietary record. The biochemical evaluation comprised measurements of serum lipids, lipoproteins, glucose, insulin, calcidiol (25(OH)D) and parathyroid hormone. Insulin resistance was calculated using the homeostasis model assessment. Body composition and blood pressure were assessed. SETTING Fifteen schools (eight public and seven private) in the central city of Juiz de Fora, Brazil. SUBJECTS The analysis included a study population of 160 adolescents (seventy-seven eutrophic and eighty-three overweight) aged 15 to 17 years. RESULTS Vitamin D deficiency and insufficiency was observed in 1.25 and 70.6 % of adolescents, respectively. Serum 25(OH)D levels were statistically lower in adolescents with weight excess, abdominal obesity, hypercholesterolaemia, higher levels of parathyroid hormone, insulin resistance, hyperinsulinaemia and hypertension (P < 0.05). Lower BMI and waist circumference were observed in the third (highest) tertile of vitamin D intake for all adolescents. The high prevalence of vitamin D insufficiency is primarily nutritional and reflects a low vitamin D intake. CONCLUSIONS Our results support the negative association among serum 25(OH)D levels and vitamin D intake with non-skeletal outcomes in Brazilian adolescents. Vitamin D fortification of foods and/or the use of vitamin D supplements need to be considered to raise vitamin D intake in the adolescent population, even in a sunny country like Brazil.

Hábitos alimentares de crianças eutróficas e com sobrepeso em Viçosa, Minas Gerais, Brasil

OBJECTIVE: To compare the food habits between well nourished and overweight children. METHODS: Case-control study with 50 well nourished children and 50 overweight children, paired by gender, age and socioeconomic conditions. They were selected from the nutritional assessment of 2074 children aging from 6 to 8 years, enrolled in public and private schools of the urban area of Vicosa, Minas Gerais State. Nutritional status was classified according to the Body Mass Index criteria of the Center for Disease Control and Prevention. A food frequency questionnaire with the foods that contribute to overweight as well as the usual food recalls regarding week and weekend days were applied. The food recalls were also used to determine intake of energy, carbohydrates, lipids, proteins, vitamin C, vitamin A, iron, calcium and fibers. A fourth questionnaire was applied in order to determine if the children had the habit of going on diets. RESULTS: Food intake among overweight children was excessive. They had a higher intake of energy, lipids, carbohydrates, proteins, vitamin C and vitamin A (p<0.05). However, the food habits were similar in both groups. A high percentage of overweight children had the habit or have the habit of dieting (p<0.05). CONCLUSION: This study confirms the importance of educating both well nourished and overweight children with respect to diet. They need a healthier and more varied diet, especially at this age, and the overweight children need to make smaller meals.

Resistência à insulina e componentes da síndrome metabólica, análise por sexo e por fase da adolescência

OBJECTIVE To analyze the influence of metabolic syndrome components in insulin resistance, by gender and adolescence phase. SUBJECTS AND METHODS We evaluated biochemical, clinical, lifestyle and body composition data of 800 adolescents from 10 to 19 years old, from both genders, from Viçosa, MG/Brasil, and there was the division by stage: early (10 to 13 years), intermediate (14 to 16 years) and late (17 to 19 years). RESULTS 10.3 and 3.4% had, respectively, insulin resistance and metabolic syndrome. In the initial phase there was a higher prevalence of dyslipidemia and intermediate hyperuricemia and excess body fat. Females had a higher prevalence of dyslipidemia, excess body fat and insulin resistance and higher male prevalence of low HDL, hyperuricemia and blood pressure changes. Those from the initial phase had higher levels of total cholesterol, LDL, HDL, triglycerides, fasting glucose and waist/hip ratio, stayed less time sitting and had more meals (p < 0.05) in relation to other phases. The final model, adjusted for gender, was different for each phase of adolescence. CONCLUSIONS Insulin resistance is associated with inadequate body composition, in biochemical levels and lifestyle, being the factors associated different in each phase of adolescence.Objective: To analyze the influence of metabolic syndrome components in insulin resistance, by gender and adolescence phase. Subjects and methods: We evaluated biochemical, clinical, lifestyle and body composition data of 800 adolescents from 10 to 19 years old, from both genders, from Vicosa, MG/Brasil, and there was the division by stage: early (10 to 13 years), intermediate (14 to 16 years) and late (17 to 19 years). Results: 10.3 and 3.4% had, respectively, insulin resistance and metabolic syndrome. In the initial phase there was a higher prevalence of dyslipidemia and intermediate hyperuricemia and excess body fat. Females had a higher prevalence of dyslipidemia, excess body fat and insulin resistance and higher male prevalence of low HDL, hyperuricemia and blood pressure changes. Those from the initial phase had higher levels of total cholesterol, LDL, HDL, triglycerides, fasting glucose and waist/hip ratio, stayed less time sitting and had more meals (p < 0.05) in relation to other phases. The final model, adjusted for gender, was different for each phase of adolescence. Conclusions: Insulin resistance is associated with inadequate body composition, in biochemical levels and lifestyle, being the factors associated different in each phase of adolescence. Arq Bras Endocrinol Metab. 2014;58(6):610-8

Breastfeeding and obesity in Brazilian children

BACKGROUND The association between breastfeeding and obesity is inconsistent by the literature. This study aims to assess whether obesity is associated to occurrence of breastfeeding and to duration of total and exclusive breastfeeding in Brazilian children. METHODS A cross-sectional study was conducted with 764 children enrolled in public and private schools from Viçosa, Minas Gerais, Brazil. Obesity (outcome variable) was defined as body mass index above the +2 standard deviations score using sex and age specific standards of World Health Organization. Exposure was the occurrence and duration of breastfeeding. Potential confounders were controlled by multiple logistic regression analysis and were divided in two groups: children (gender, age, birth weight, gestational age, order of birth, number of siblings, number of persons in the residence, type of school, physical activity patterns and time watching television) and mothers (age, nutritional status, level of education, weight gain during pregnancy, smokes currently and during the pregnancy). RESULTS Prevalence of obesity was 10.7%; 6.8% of the children were not breastfed and 59.0% did not receive exclusive breastfeeding. After adjustment for confounding variables by logistic regression analysis, no statistically significant association was observed between obesity and the occurrence and/or duration of total and exclusive breastfeeding. There was no dose-response effect of duration of breastfeeding on prevalence of obesity. CONCLUSION Our results do not support the hypothesis that breastfeeding promotion would reduce obesity in this population. Controversial findings regarding this association by literature indicate a need for further investigations.

Does the Body Mass Index Reflect Cardiovascular Risk Factors in Brazilian Children

This cross-sectional study aimed to: (i) investigate whether obesity and overweight defined according to body mass index (BMI) are good predictors of body fat excess, abdominal adiposity and hypertension in 769 Brazilian children aged 6-11 years, (ii) assess the relationship between overweight/obesity and cardiovascular risk factors. Overweight and obesity were estimated using cut-off points corresponding to World Health Organization 1 and 2 SD (standard deviation) scores. Based on the results of a multiple logistic regression analysis, overweight and obesity were significantly associated with body fat excess, abdominal adiposity and hypertension. The prevalence of obesity (10.7%), overweight (18.7%), abdominal adiposity (17.6%) and systolic (10.1%) and diastolic hypertension (9.3%) was high in this population of Brazilian children. The cardiovascular risk factors increased significantly according to the BMI SD scores, indicating that in epidemiologic studies, BMI may be a good indicator of risk for cardiovascular diseases.

Análise crítica da qualidade da dieta da população brasileira segundo o Índice de Alimentação Saudável: uma revisão sistemática

In light of the importance of studying instruments that assess the food quality of the population, this study sought to conduct a systematic review of the quality of the diet of the Brazilian population using the Healthy Eating Index (HEI) and duly analyzing its methodology and results. The major electronic databases were used for the selection of studies. After the searches with the key words, 32 articles were included in this review. The growing interest of the scientific community in addressing this issue was observed, with recent studies using this instrument in Brazil. Methodological issues of articles were evaluated and discussed taking into consideration the revised versions and adaptations of the HEI. Some common results were highlighted among the studies such as low consumption of fruit, vegetables and/or dairy products, and the wider consumption of meat and eggs, cholesterol, total fat and saturated fat. Among the articles that address the HEI and socioeconomic aspects it was seen that quality of diet improves both in accordance with the increasing level of education of parents and with the family income in the population studied. The HEI can be used to monitor changes in dietary patterns and also as a nutrition education and health promotion tool.In light of the importance of studying instruments that assess the food quality of the population, this study sought to conduct a systematic review of the quality of the diet of the Brazilian population using the Healthy Eating Index (HEI) and duly analyzing its methodology and results. The major electronic databases were used for the selection of studies. After the searches with the key words, 32 articles were included in this review. The growing interest of the scientific community in addressing this issue was observed, with recent studies using this instrument in Brazil. Methodological issues of articles were evaluated and discussed taking into consideration the revised versions and adaptations of the HEI. Some common results were highlighted among the studies such as low consumption of fruit, vegetables and/or dairy products, and the wider consumption of meat and eggs, cholesterol, total fat and saturated fat. Among the articles that address the HEI and socioeconomic aspects it was seen that quality of diet improves both in accordance with the increasing level of education of parents and with the family income in the population studied. The HEI can be used to monitor changes in dietary patterns and also as a nutrition education and health promotion tool.

Vitamin D insufficiency/deficiency is associated with insulin resistance in Brazilian children, regardless of body fat distribution

OBJECTIVE To assess the prevalence of vitamin D insufficiency and deficiency and its association with cardiometabolic risk factors, controlled by adiposity, in a representative sample of prepubescent children. DESIGN Cross-sectional population-based study. Body composition was evaluated by dual-energy X-ray absorptiometry. Anthropometric measures and blood pressure were performed. Laboratory analyses were performed to determine the levels of vitamin D (25-hydroxyitamin D; 25(OH)D), glucose, insulin, serum lipids and intact parathyroid hormone. Dietary intake was assessed by three 24 h recalls. SETTING Viçosa, Minas Gerais, Brazil, 2015. SUBJECTS Representative sample of 378 children aged 8 and 9 years from urban schools. RESULTS Inadequate serum concentrations of 25(OH)D were diagnosed in more than half of the children and none of them met the recommended vitamin D intake. After adjusting for confounding factors in the multiple regression analysis, lower prevalence of insulin resistance and hypertriacylglycerolaemia was found in children with serum 25(OH)D levels ≥75 nmol/l (prevalence ratio=0·25; 95 % CI 0·08, 0·85) and ≥50 nmol/l (prevalence ratio=0·61; 95 % CI 0·37, 0·99), respectively. However, after adjusting for different indicators of adiposity, insulin resistance remained independently associated and the association with hypertriacylglycerolaemia was lost after adjusting for central adiposity. The prevalence of vitamin D insufficiency/deficiency was associated with the number of cardiometabolic alterations in children. CONCLUSIONS The study results showed that prevalence of vitamin D insufficiency/deficiency was high among the children and insulin resistance was the main cardiometabolic alteration associated with this condition, even in a tropical climate country such as Brazil.

Dietary calcium intake is inversely associated with blood pressure in Brazilian children.

Abstract This study aimed to evaluate the dietary calcium intake and its association with blood pressure in childhood. It is a cross-sectional study with a sample of 347 Brazilian children aged 8 and 9 years. We evaluated calcium intake through three dietary records. Blood pressure was measured following the recommendations of the Brazilian Society of Cardiology. The intake of calcium was below recommendations for almost all children (96.3%). There was statistically significant difference in the means of systolic (p = .041) and diastolic (p = .047) blood pressure in the tertiles of calcium intake. After adjustment of regression model, each tertile of calcium intake showed that the systolic and diastolic blood pressure was reduced in 1.53 (95% confidence interval: −2.84 to −0.21) and 1.83 mmHg (95% confidence interval: −3.49 to −0.19), respectively. Our results showed an inverse association between dietary calcium intake and blood pressure in childhood.

Short CommunicationSedentary behavior is associated with lower serum concentrations of vitamin D in Brazilian children

L.C. Milagres , N.P. Rocha , F.M. Albuquerque , A.P.P. Castro , M.S. Filgueiras , M.C. Pessoa , M.C. Gouveia Peluzio , J.F. Novaes a a Department of Nutrition and Health, Federal University of Viçosa, Av. Peter Henry Rolfs, 36570-900, Viçosa, Minas Gerais, Brazil b Department of Nutrition, Federal University of Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, 30130-100, Belo Horizonte, Minas Gerais, Brazil

Association between food and nutrition insecurity with cardiometabolic risk factors in childhood and adolescence: a systematic review

Abstract Objective: To address the association between food and nutrition insecurity and cardiometabolic risk factors in childhood and adolescence. Data source: Articles were selected from the Medline, Lilacs and SciELO databases with no publication date limit, involving children and adolescents, using the descriptors: food and nutrition security, diabetes mellitus, hypertension, metabolic syndrome, stress and dyslipidemia. The terms were used in Portuguese, English and Spanish. The search was carried out systematically and independently by two reviewers. Data synthesis: Exposure to food insecurity during childhood and adolescence ranged from 3.3% to 82% in the selected publications. Exposure to food insecurity was associated with stress, anxiety, greater chance of hospitalization, nutritional deficiencies, excess weight and inadequate diets with reduced intake of fruits and vegetables and increased consumption of refined carbohydrates and fats. Conclusions: Food and nutrition insecurity was associated with the presence of cardiometabolic risk factors in the assessed publications. Childhood and adolescence constitute a period of life that is vulnerable to food insecurity consequences, making it extremely important to ensure the regular and permanent access to food. Because this is a complex association, some difficulties are found, such as the synergy between risk factors, the assessment of heterogeneous groups and extrapolation of data to other populations, in addition to the influence of environmental factors.