Luana Caroline dos Santos

Prevalence of Vitamin D Insufficiency in Brazilian Adolescents

Background/Aims: Cutaneous sun exposure and dietary vitamin D intake are important determinants of vitamin D status. The objective of the present study was to evaluate the vitamin D status of a group of healthy adolescent students living in Brazil. Methods: One hundred and thirty-six adolescents, 64 boys and 72 girls, aged 16–20 years old, living in a rural town in the state of São Paulo, Brazil, participated in this study. Results: The mean dietary vitamin D intake was 140 (120–156) IU/day [3.5 (3.0–3.9) μg/day]. Only 14.9% of the students met the daily adequate intake recommendation of vitamin D. Only 27.9% practice physical activity outdoors and 17.6% of the adolescents apply sunscreen daily. The mean 25(OH)D concentration was 73.0 (22.0) nmol/l [29.2 (8.8) ng/ml]. Vitamin D insufficiency was observed in 60% of adolescents. Conclusions: The present study suggests that even in a sunny climate like Brazil the prevalence of vitamin D insufficiency in adolescents is high. Most likely this is due to low intakes of vitamin D in this group. Due to the limited extent of natural dietary sources of vitamin D, a policy of vitamin D food fortification should be considered in the future, and in the meantime greater use of vitamin D supplements in this population group should be encouraged to provide the increased amounts of this essential nutrient for optimal health.

Prevalência de diagnóstico auto-referido de osteoporose, Brasil, 2006

OBJETIVO: Estimar a prevalencia de osteoporose auto-referida (com diagnostico medico previo) e de fatores de risco e protecao associados. METODOS: Estudo transversal baseado em dados do sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico (VIGITEL). Foram entrevistados 54.369 individuos com idade >18 anos residentes em domicilios servidos por pelo menos uma linha telefonica fixa nas capitais brasileiras e Distrito Federal em 2006. Estimativas de osteoporose segundo fatores socioeconomicos, comportamentais e indice de massa corporal foram estratificadas por sexo. Foram calculados riscos de ocorrencia de osteoporose para cada variavel individualmente, e em modelo multivariado, considerando-se odds ratio como proxy da razao de prevalencia. RESULTADOS: A prevalencia de osteoporose referida foi de 4,4%, predominantemente entre mulheres (7,0%), com idade >45 anos, estado civil nao solteiro e ex-fumante. Entre homens, ter mais de 65 anos, ser casado ou viuvo e sedentario associaram-se positivamente ao desfecho. CONCLUSOES: Dentre os fatores associados a osteoporose, destacam-se aspectos modificaveis relacionados com a prevencao da doenca, como a atividade fisica e tabagismo.

Academia da Cidade: um serviço de promoção da saúde na rede assistencial do Sistema Único de Saúde

This is an analysis of the health and nutritional profile of users of the Unified Health System admitted to a City Academy in Belo Horizonte, Minas Gerais during a triennium. It is a cross-sectional study with users> 20 years and socio-demographic characteristics, health habits, food intake and anthropometrics were gathered. Kolmogorov-Smirnov tests, ANOVA, Kruskal-Wallis test, chi-square and Fisher exact test were applied. There was a high prevalence of hypertensive subjects (41.6%), overweight (70.6%) and metabolic risks associated with obesity (67.6%). About 40% of entrants had 1-3 chronic diseases and over 65% used medication daily. There was an imbalance in daily consumption of fruits and vegetables (75.3%), fatty meat (72.4%) and sweetened drinks (54.2%). They had low education and income, and inadequate eating habits and high prevalence of hypertension, overweight and metabolic risks associated with obesity, which suggests users seeking health care services for treatment of diseases. This illustrates the perceived quest for cure, further demonstrating the lack of healthcare initiatives in the population. This reveals the need to review the actions at different levels of health care, to promote greater comprehensiveness of care provided.

Ingestão de cálcio e indicadores antropométricos entre adolescentes

OBJETIVO: Este estudo teve como objetivo investigar a relacao da ingestao de calcio com indicadores antropometricos de adolescentes. METODOS: Foram avaliados 507 alunos de duas escolas publicas e uma particular de Ouro Preto, Minas Gerais, por meio de questionario sobre condicoes socioeconomicas, avaliacao da maturacao sexual, antropometria, composicao corporal e consumo alimentar. RESULTADOS: A ingestao media de calcio foi 703,7 (396,0) mg/dia, sendo a maior ingestao verificada na escola de maior nivel socioeconomico. Apenas 8% dos adolescentes apresentavam ingestao superior a ingestao adequada. Houve associacao negativa do calcio, ajustado para o indice de massa corporal (r=-0,203, p=0,001), na escola de medio nivel socioeconomico e nos adolescentes com ingestao desse mineral entre 400 e 800mg/dia (r=-0,134, p=0,044). CONCLUSAO: Verificou-se ingestao insuficiente de calcio entre os adolescentes de Ouro Preto, evidenciando a necessidade de estimular o consumo de alimentos fontes desse mineral nesta populacao.

Body trunk fat and insulin resistance in post-pubertal obese adolescents

CONTEXT AND OBJECTIVEnInsulin resistance is a metabolic disorder commonly associated with excess body fat accumulation that may increase chronic disease risk. The present study was undertaken to evaluate the relationship between body composition and insulin resistance among obese adolescents.nnnDESIGN AND SETTINGnCross-sectional study, at the Adolescence Center, Pediatric Department, Universidade Federal de São Paulo.nnnMETHODSnBody composition was assessed using dual-energy X-ray absorptiometry. Dietary intake was evaluated using a three-day dietary record. The biochemical evaluation comprised glucose, insulin, serum lipid, leptin and ghrelin measurements. Insulin resistance was calculated by means of the homeostasis model assessment of insulin resistance (HOMA-IR).nnnRESULTSnForty-nine post-pubertal obese adolescents participated in the study: 12 boys and 37 girls of mean age 16.6 (1.4) years and mean body mass index (BMI) of 35.0 (3.9) kg/m(2). The mean glucose, insulin and HOMA values were 90.3 (6.4) mg/dl, 16.6 (8.1) microIU/ml and 3.7 (1.9), respectively. Hyperinsulinemia and insulin resistance were observed in 40.2% and 57.1% of the subjects, respectively. Adolescents with insulin resistance had higher BMI and body trunk fat. There was a trend towards higher leptin concentration in obese individuals with insulin resistance. Insulin resistance was positively correlated with body trunk fat, BMI, body fat mass (kg), leptin and body fat percentage. Furthermore, there was a negative correlation between HOMA-IR and lean body mass. The body composition predicted 30% of the HOMA-IR levels, according to linear regression models.nnnCONCLUSIONnBody trunk fat was significantly associated with insulin resistance, demonstrating the clinical importance of abdominal obesity during adolescence.

Iron deficiency and anemia are associated with low retinol levels in children aged 1 to 5 years

OBJECTIVEnTo analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency.nnnMETHODSnThis was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n=692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected.nnnRESULTSnThe prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95%xa0CI: 3.36, 6.34, p<0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p<0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r=0.597; p<0.001) and hemoglobin vs. retinol serum (r=0.770; p<0.001).nnnCONCLUSIONSnAnemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency.

Consumo de micronutrientes e excesso de peso: existe relação?

INTRODUCAO: O incremento da obesidade nas ultimas decadas se associa as mudancas nos modos de vida da populacao, incluindo amplas alteracoes dieteticas, sobretudo na ingestao de micronutrientes. OBJETIVO: Descrever o consumo de micronutrientes e revisar sua implicacao no estado nutricional. METODOS: Realizou-se levantamento bibliografico contemplando artigos nacionais e internacionais, publicados nos ultimos 11 anos, nas bases de dados SciELO, LILACS, Medline e sites de organizacoes governamentais, usando como descritores: micronutrientes, consumo alimentar, excesso de peso , saude e estado nutricional e suas traducoes em ingles. RESULTADOS: A deficiencia no consumo de micronutrientes e um problema de saude global, atingindo cerca de 2 bilhoes de pessoas, e parece se associar com maior risco de doencas e agravos nao transmissiveis, incluindo a obesidade. A insuficiente ingestao de vitamina A favorece o excesso de peso por alteracao no metabolismo da tireoide, enquanto a vitamina C se relaciona a sintese de carnitina e oxidacao da gordura; e a vitamina D favorece o controle da saciedade e do gasto energetico. Quanto aos minerais, o calcio auxilia a regulacao da termogenese e lipogenese/lipolise; e o zinco esta envolvido na regulacao de insulina e leptina. CONCLUSAO: A promocao de habitos alimentares saudaveis por meio de praticas educativas se faz necessaria para maior conscientizacao da populacao acerca das implicacoes do consumo de micronutrientes no estado nutricional, devendo compor as estrategias de Saude Publica de controle da obesidade e suas complicacoes.

Notificação imprecisa da ingestão energética na dieta de adolescentes

Objectives: To examine the prevalence of under and overreporting of energy intake in adolescents and their associated factors. Methods: Cross-sectional study with 96 postpubertal adolescents (47 normal-weight and 49 obese), mean age of 16.6±1.3 years. Weight and height were measured, and body mass index was calculated. Body composition was assessed by dual energy X-ray absorptiometry. Dietary intake was evaluated by a 3-day dietary record. Biochemical assessment was performed (serum total cholesterol, LDL-cholesterol, HDL-cholesterol, plasma glucose, and insulin). Underreporters reported energy intake 2.4 x BMR. Results: Energy intake misreporting (under or overreporting) was identified in 65.6% of adolescents (64.6 and 1% of under and overreporting, respectively). Obese adolescents were 5.0 times more likely to underreport energy intake (95%CI 2.0-12.7) than normalweight participants. Underreporters showed higher rates of insufficient intake of carbohydrate (19.3 vs. 12.1%, p = 0.046) and lipids (11.3 vs. 0%, p < 0.001) than plausible reporters. Cholesterol intake was also lower in underreporters (p = 0.017). There were no significant differences in body composition and biochemical parameters in relation to misreporting. Conclusions: The results obtained demonstrated a high percentage of misreporting of energy intake among adolescents, especially among obese subjects, which suggests that energy-adjusted nutrient intake values should be employed in diet-disease risk analysis in order to contribute to a reduction in errors associated with misreporting.

Bone mineral density, body composition, and food intake of adolescent runway models

OBJETIVO: Avaliar a densidade mineral ossea (DMO) e relaciona-la com a ingestao alimentar e composicao corporal de adolescentes modelos de passarela. METODOS: Estudo transversal avaliando 33 modelos e 33 nao modelos de 15 a 18 anos pareadas por idade e indice de massa corporal (IMC). A densidade mineral ossea da coluna (L1-L4) foi avaliada por meio da tecnica da absorciometria de feixe duplo de energia (Lunar® DPX Alpha), e a composicao corporal, pela tecnica de pletismografia. A ingestao alimentar foi avaliada por meio do registro alimentar de 3 dias. RESULTADOS: A media de idade das adolescentes foi de 16,75±1,04 anos, sendo que 24% apresentaram IMC abaixo dos valores ideais para a idade. Nao houve diferenca de DMO entre modelos (1,108±0,080 g/cm2) e nao modelos (1,096±0,102 g/cm2) (p > 0,05), sendo identificada uma porcentagem de 6% de baixa DMO para a idade. Observou-se que a media de ingestao de energia foi menor entre as modelos em comparacao as adolescentes nao modelos (1.480,93±582,95 versus 1.973,00±557,63 kcal) (p > 0,05) e que a maioria das adolescentes de ambos os grupos apresentou consumo inadequado de micronutrientes, ressaltando-se a baixa ingestao de calcio. Verificou-se correlacao significativa da DMO apenas com a massa magra (kg) (modelos r = 0,362 e nao modelos r = 0,618; p < 0,05). CONCLUSAO: Apesar de nao ter sido encontrada associacao entre a DMO, o IMC e a ingestao de nutrientes importantes no processo de mineralizacao ossea, as inadequacoes na ingestao alimentar podem influenciar negativamente a aquisicao de massa ossea, que se encontra potencializada neste estagio de vida.

Different equations for determining height among the elderly: the Bambuí cohort study of aging

The aim of this study was to compare measured height with estimates of height derived from equations using half arm-span measurements and assess how this affects the calculation of the body mass index (BMI) among elderly individuals. Direct height measurements of a subsample of elderly individuals from the baseline sample of the Bambuí Project were compared with estimates of height derived from equations proposed by Bassey and the WHO. The data was analyzed using the McNemar test, Lin concordance correlation coefficient (CCC) and Bland-Altman method (p < 0.05). Estimates of height using the WHO method showed a low CCC in relation to measured height. For BMI, the concordance was greater. However, with this method height was found to be underestimated so leading to the overestimation of BMI. The Bassey equation showed high concordance with measured height in elderly people over 80 years of age. With respect to BMI, the WHO method resulted in a much greater prevalence of overweight, whereas the estimates derived from the Bassey method did not differ from the results obtained from direct height measurement. Height estimates using the Bassey equation were similar to the results obtained from direct measurements, suggesting that this method is applicable.