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Selenium intake is not associated with the metabolic syndrome in Brazilian adolescents: an analysis of the Study of Cardiovascular Risk Factors in Adolescents. Br J Nutr 2022; 127:1404-1414. [PMID: 34176526 DOI: 10.1017/s0007114521002385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Se reduces cellular inflammation and lipid peroxides; therefore, its association with CVD and the metabolic syndrome (MetS) has been studied. We aimed to investigate the association between Se intake and the MetS and its parameters (high waist circumference, hyperglycaemia, high blood pressure, high TAG and low HDL-cholesterol) in Brazilian adolescents between 12 and 17 years old. This research is part of the Study of Cardiovascular Risks in Adolescents (ERICA), a Brazilian nationwide school-based study with regional and national relevance. We assessed: (1) socio-demographic data (sex, age, type of school and maternal education) using a self-administered questionnaire; (2) dietary intake using a 24-h recall applied for the whole sample and a second one applied to a subsample to allow within-person variability adjustment; (3) anthropometric data (weight, height, waist circumference) and blood pressure using standardised procedures; and (4) biochemical analyses (fasting glucose, TAG and HDL-cholesterol). Logistic regression was applied, basing the analysis on a theoretical model. Median Se intake was 98·3 µg/d. Hypertension and hyperglycaemia were more prevalent among boys, while a high waist circumference was more frequent in girls, and low HDL-cholesterol levels were higher among private school students. The prevalence of the MetS was 2·6 %. No association between the MetS and its parameters and Se intake was found. This lack of association could be due to an adequate Se intake in the studied population.
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Higher carbohydrate quality index is associated with better adequate micronutrient consumption in Brazilian women. NUTR HOSP 2022; 39:594-602. [DOI: 10.20960/nh.03662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Verly E, Marchioni DM, Araujo MC, Carli ED, de Oliveira DCRS, Yokoo EM, Sichieri R, Pereira RA. Evolution of energy and nutrient intake in Brazil between 2008-2009 and 2017-2018. Rev Saude Publica 2021; 55:5s. [PMID: 34910054 PMCID: PMC9586436 DOI: 10.11606/s1518-8787.2021055003343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess the evolution of energy and nutrient intake and the prevalence of inadequate micronutrients intakes according to sociodemographic characteristics and Brazilian regions. METHODS The food consumption of 32,749 individuals from the National Dietary Survey of the Household Budget Survey 2008-2009 was analyzed by two food registries, as well as 44,744 subjects from two 24-hour recalls in 2017-2018. Usual intake and percentage of individuals with consumption below the average recommendation for calcium, magnesium, phosphorus, copper and zinc, vitamins A, C, D, E, thiamine, riboflavin, pyridoxine and cobalamin were estimated. Sodium intake was compared to the reference value to reduce the risk of chronic diseases. Analyses were stratified by sex, age group, region and income. RESULTS Mean daily energy intake was 1,753 kcal in 2008-2009 and 1,748 kcal in 2017-2018. The highest prevalence of inadequacy (> 50%) in the two periods were calcium; magnesium; vitamins A, D and E; pyridoxine and, only among adolescents, phosphorus. There was an increase in the prevalence of inadequate vitamin A, riboflavin, cobalamin, magnesium, and zinc among women, and riboflavin among men. The prevalence of inadequacy decreased for thiamine. Sodium intake was excessive in approximately 50% of the population in both periods. The highest variations (about 50%) in the prevalence of inadequacy between the lowest and highest income (< 0.5 minimum wage and > 2 minimum wages per capita) were observed for vitamin B12 and C in both periods. The North and Northeast regions had the highest prevalence of inadequacy. CONCLUSION Both surveys found high prevalence of inadequate nutrient intake and excessive sodium intake. The inadequacy varies according to income strata, increasing in the poorest regions of the country.
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Affiliation(s)
- Eliseu Verly
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dirce Maria Marchioni
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Marina Campos Araujo
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartamento de Epidemiologia e Métodos Quantitativos em SaúdeRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
| | - Eduardo De Carli
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, SP, Brasil
| | - Dayan Carvalho Ramos Salles de Oliveira
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Edna Massae Yokoo
- Universidade Federal FluminenseInstituto de Saúde ColetivaDepartamento de Epidemiologia e BioestatísticaNiteróiRJBrasilUniversidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Rosangela Alves Pereira
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroDepartamento de Nutrição Social e AplicadaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Departamento de Nutrição Social e Aplicada. Rio de Janeiro, RJ, Brasil
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Jordão KSDLU, Assumpção DD, Barros MBDA, Barros Filho ADA. VITAMIN E INTAKE AND FOOD SOURCES IN ADOLESCENT DIET: A CROSS-SECTIONAL POPULATION-BASED STUDY. REVISTA PAULISTA DE PEDIATRIA 2020; 39:e2019295. [PMID: 33331545 PMCID: PMC7737246 DOI: 10.1590/1984-0462/2021/39/2019295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 02/16/2020] [Indexed: 11/21/2022]
Abstract
Objective: To assess vitamin E intake and its relationship with sociodemographic
variables, and to identify the main dietary sources of the nutrient in the
diet of adolescents. Methods: This is a population-based cross-sectional study that used data from 891
adolescents living in Campinas, SP, participating in ISACamp 2014/15 (Health
Survey) and ISACamp-Nutri 2015/16 (Food Consumption and Nutritional Status
Survey). The nutrient intake averages were estimated using the Generalized
Linear Model, adjusted for the total energy of the diet. Dietary sources of
vitamin E were identified from the calculation of the relative
contribution. Results: The average vitamin E intake was 3.2 mg for adolescents aged 10 to 13 years
and 3.5 mg for those aged 14 to 19 years, results far below the recommended
values of 9 and 12 mg, respectively. The prevalence of inadequacy was 92.5%.
Ten foods/food groups represented 85.7% of vitamin E present in the
adolescents’ diet; the vegetable oils group accounted for more than a
quarter of the contribution (25.5%), followed by cookies (9.1%) and beans
(8.9%). Conclusions: There were a low intake and a high prevalence of inadequate vitamin E intake
among adolescents in Campinas, with vegetable oil as the main source. For
the total number of adolescents, almost 33% of the nutrient content was
derived from foods of poor nutritional quality such as cookies, packaged
snacks, and margarine. The results of this study can guide public health
actions that aim to improve the quality of adolescents’ diets.
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Dhir S, Tarasenko M, Napoli E, Giulivi C. Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults. Front Psychiatry 2019; 10:207. [PMID: 31019473 PMCID: PMC6459027 DOI: 10.3389/fpsyt.2019.00207] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/22/2019] [Indexed: 01/19/2023] Open
Abstract
Thiamine (vitamin B1) is an essential nutrient that serves as a cofactor for a number of enzymes, mostly with mitochondrial localization. Some thiamine-dependent enzymes are involved in energy metabolism and biosynthesis of nucleic acids whereas others are part of the antioxidant machinery. The brain is highly vulnerable to thiamine deficiency due to its heavy reliance on mitochondrial ATP production. This is more evident during rapid growth (i.e., perinatal periods and children) in which thiamine deficiency is commonly associated with either malnutrition or genetic defects. Thiamine deficiency contributes to a number of conditions spanning from mild neurological and psychiatric symptoms (confusion, reduced memory, and sleep disturbances) to severe encephalopathy, ataxia, congestive heart failure, muscle atrophy, and even death. This review discusses the current knowledge on thiamine deficiency and associated morbidity of neurological and psychiatric disorders, with special emphasis on the pediatric population, as well as the putative beneficial effect of thiamine supplementation in autism spectrum disorder (ASD) and other neurological conditions.
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Affiliation(s)
- Shibani Dhir
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Maya Tarasenko
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Eleonora Napoli
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Cecilia Giulivi
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- Medical Investigations of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Davis, CA, United States
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Nguyen CL, Hoang DV, Nguyen PTH, Ha AVV, Chu TK, Pham NM, Lee AH, Duong DV, Binns CW. Low Dietary Intakes of Essential Nutrients during Pregnancy in Vietnam. Nutrients 2018; 10:nu10081025. [PMID: 30082626 PMCID: PMC6116189 DOI: 10.3390/nu10081025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 01/05/2023] Open
Abstract
Inadequate intake of nutrients during pregnancy has been associated with poor pregnancy and infant outcomes; however, evidence remains limited in low-resource settings in Asia. This paper assessed food, macronutrient, and micronutrient intakes among 1944 Vietnamese pregnant women. Dietary information was collected via an interviewer-administered food frequency questionnaire, and nutrient intakes were estimated using the Vietnamese food composition tables. The levels of nutrient intakes were evaluated against the Vietnamese recommended nutrient intakes (RNI) for pregnancy. The diet profiles were reported as means and percentages. The average daily food intakes across socio-demographic factors were compared using ANOVA, with adjustment for multiple comparisons by the Tukey–Kramer test. Rice, fruits, and vegetables were the main food sources consumed. The mean energy intake was 2004 kcal/day with 15.9%, 31.8%, and 52.2% of energy deriving from proteins, fats, and carbohydrates, respectively. Just over half of the women did not meet the RNI for total energy intake. The intakes of essential micronutrients including folate, calcium, iron, and zinc were below the RNI, and almost all pregnant women failed to meet the recommendations for these micronutrients. The associations of maternal age, education, and pre-pregnancy body mass index with nutrient intakes varied across the nutrient subgroups. Targeted programs are needed to improve nutrient intakes in Vietnamese pregnant women.
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Affiliation(s)
- Cong Luat Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
| | - Dong Van Hoang
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
| | - Phung Thi Hoang Nguyen
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Nutrition and Food, Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam.
| | - Anh Vo Van Ha
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Environmental and Occupational Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.
| | - Tan Khac Chu
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Epidemiology, Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam.
| | - Ngoc Minh Pham
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam.
| | - Andy H Lee
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
| | - Dat Van Duong
- Department of Sexual & Reproductive Health, United Nations Population Fund, Hanoi 100000, Vietnam.
| | - Colin W Binns
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
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Jia X, Wang Z, Zhang B, Su C, Du W, Zhang J, Zhang J, Jiang H, Huang F, Ouyang Y, Wang Y, Li L, Wang H. Food Sources and Potential Determinants of Dietary Vitamin C Intake in Chinese Adults: A Cross-Sectional Study. Nutrients 2018. [PMID: 29518947 PMCID: PMC5872738 DOI: 10.3390/nu10030320] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Vitamin C is essential for human health. It is important to estimate the dietary vitamin C intake in the Chinese population to examine the effects of the nutritional transition occurred in recent decades. The present study aimed to estimate the dietary vitamin C intake in Chinese adults by using cross-sectional data from the 2015 China Nutritional Transition Cohort Study and selecting those aged 18–65 years with complete records of sociodemographic characteristics and dietary measurements (n = 11,357). Wilcoxon rank-sum test, Kruskal-Wallis analysis, Chi-squared test, and multiple logistic regression were employed to analyze the daily dietary vitamin C intake on the basis of three-day 24 h dietary recalls and food sources in relation to demographic factors, to evaluate vitamin C intake status using the estimated average requirement cut-off point, and to explore underlying influencing factors. The mean (SD (standard deviation)) and median (interquartile range) levels of the dietary vitamin C intake in adults were 78.1 (54.6) and 65.4 (61.4) mg/day, respectively. Light vegetables, dark vegetables, fruits, and tubers were the top four food sources, contributing a combined 97.3% of total daily dietary vitamin C intake in the study population. The prevalence of risk of insufficient dietary vitamin C intake was 65.1%. Both the distribution of vitamin C intake and the prevalence of risk of insufficient dietary vitamin C intake differed by several demographic factors. Educational level, residence area, geographic location, vegetable consumption, and total energy intake were independent determinants of the risk of insufficient dietary vitamin C intake. In conclusion, dietary vitamin C intake is inadequate in Chinese adult population, and an increase in vitamin C intake should be recommended especially to the population at risk for vitamin C insufficiency.
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Affiliation(s)
- Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Wenwen Du
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Ji Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Feifei Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Yun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Li Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Inadequate dietary intake of minerals: prevalence and association with socio-demographic and lifestyle factors. Br J Nutr 2017; 117:267-277. [DOI: 10.1017/s0007114516004633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AbstractThis cross-sectional, population-based study aimed to estimate the prevalence of dietary mineral inadequacies among residents in urban areas of Sao Paulo, to identify foods contributing to mineral intake and to verify possible associations between socio-demographic and lifestyle factors and mineral intake. Data were obtained from the 2008 Health Survey of Sao Paulo (n 1511; mean age 43·6 (sd 23·2), range 14–97 years). Dietary intake of minerals was measured using two 24-h dietary recalls. Socio-demographic and lifestyle data were collected. The prevalence of inadequate intake was estimated according to Dietary Reference Intakes methods. Associations between mineral intake and baseline factors were determined using multiple linear regression. Na, Ca and Mg showed the highest dietary inadequacies. Some age/sex groups had lower intakes of P, Zn, Cu and Se. Rice, beans and bread were the main foods contributing towards mineral intake. Female sex was negatively associated with K, Na, P, Mg, Zn and Mn intakes. All age groups were positively associated with the intakes of K, P, Mg and Mn. Family income above one minimum wage was positively associated with Se intake. Living in a household whose head completed ≥10 years of education was positively associated with Ca and negatively associated with Na intake. Former smoker status was negatively associated with Ca intake. Current smoker status was inversely associated with K, Ca, P and Cu intakes. Sufficient physical activity was positively associated with K, Ca and Mg intakes. Overall, the intakes of all major minerals were inadequate and were influenced by socio-demographic and lifestyle factors.
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SPERANDIO N, RODRIGUES CT, FRANCESCHINI SDCC, PRIORE SE. Impact of the Bolsa Família Program on energy, macronutrient, and micronutrient intakes: Study of the Northeast and Southeast. REV NUTR 2016. [DOI: 10.1590/1678-98652016000600008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: To assess the impact of the Bolsa Família Program on the energy and nutrient intakes of beneficiaries from the Brazilian Northeast and Southeast regions. Methods: The study used data from the 2008-2009 Pesquisa de Orçamento Famíliar, which assessed individual food intake on two nonconsecutive days of individuals aged more than 10 years. Based the personal information booklet, food intake values were transformed into nutritional values (energy and nutrients). Analysis of the impact measure was preceded by propensity score matching, a technique that matches some socioeconomic characteristics of beneficiaries and nonbeneficiaries. Once the score was calculated, the impact of the Bolsa Família Program was estimated by nearest neighbor matching. Results: The program increased energy and macronutrient intakes and decreased calcium and vitamin A, D, E, and C intakes of adolescent beneficiaries in both regions. Adult beneficiaries from the Southeast region increased their fiber, iron, and selenium intakes, and those from the Northeast region decreased their energy, lipid, added sugar, sodium, zinc, vitamin E, and pyridoxine intakes. Conclusion: The results show a positive impact of the program on the energy and macronutrient intakes, and a negative impact on the intakes of most study micronutrients, especially in adolescents, which reinforce the importance of implementing intersectoral actions to improve the nutritional quality of the Bolsa Família Program beneficiaries' diet.
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Abstract
OBJECTIVE To describe nutrient intakes, characterize dietary patterns and analyse their associations with sociodemographic characteristics among pregnant women in Shaanxi, China. DESIGN Population-based cross-sectional survey. SETTING Twenty counties and ten districts in Shaanxi Province of Northwest China, 2013. SUBJECTS Women (n 7462) were recruited using a stratified multistage random sampling method to report diets during pregnancy, at 0-12 months (median 3 months; 10th-90th percentile, 0-7 months) after delivery. RESULTS Pregnant women had higher intakes of fat, niacin and vitamin E than the nutrient reference values, while most micronutrients such as vitamin A, folate, Ca and Zn were reportedly low. Women in the highest education, occupation and household income groups had higher nutrient intakes than those in the lowest groups. Nutrient intake differences also existed by geographic area, residence and maternal age at delivery. Three dietary patterns were identified: balanced pattern, vegetarian pattern and snacks pattern. Participants with high balanced pattern scores tended to be better educated, wealthier, 25-29 years old at delivery, working outside and living in urban areas and central Shaanxi. Women with high scores on the vegetarian pattern and snacks pattern tended to be in low balanced pattern score groups, and had lower nutrient intakes than those in the high balanced pattern score groups. CONCLUSIONS The study suggested that pregnant women in Shaanxi, China had low intakes of most nutrients such as vitamin A, folate and Ca. Dietary patterns and most nutrient intakes varied by sociodemographic characteristics. Targeted programmes are needed to improve dietary intakes and dietary patterns among sociodemographically disadvantaged groups.
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Hilger J, Goerig T, Weber P, Hoeft B, Eggersdorfer M, Carvalho NC, Goldberger U, Hoffmann K. Micronutrient Intake in Healthy Toddlers: A Multinational Perspective. Nutrients 2015; 7:6938-55. [PMID: 26295254 PMCID: PMC4555155 DOI: 10.3390/nu7085316] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/07/2015] [Accepted: 08/12/2015] [Indexed: 12/31/2022] Open
Abstract
Adequate nutrient intake during early childhood is of particular importance for optimal growth and future health. However, cross-national comparative research on nutrient intake of toddlers is still limited. We conducted a literature review to examine the nutrient intake in healthy toddlers from some of the world's most populous nations currently on different stages of socioeconomic development: Brazil, Germany, Russia and the United States. We aimed to identify national surveys reporting mean intakes of the following nutrients: vitamins A, D, E, folate, calcium, iron and zinc. To calculate the prevalence of inadequate nutrient intake, we used a modified version of the Estimated Average Requirement cut-point method. Overall, five studies with 6756 toddlers were eligible for inclusion in this review. In countries where data were available, a prevalence of inadequate intake higher than 20% was found for vitamins A, D, E and calcium. In Germany, folate intake also appeared to be inadequate. The results of our review indicate that inadequate micronutrient intake in toddlers might be a global challenge affecting also affluent countries. However, to explore the full scope of this important public health issue joint efforts of researchers worldwide are needed to combine existing data and fill in data gaps.
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Affiliation(s)
- Jennifer Hilger
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 7-11, Mannheim 68167, Germany.
| | - Tatiana Goerig
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 7-11, Mannheim 68167, Germany.
| | - Peter Weber
- DSM Nutritional Products Limited, Wurmisweg 576, Kaiseraugst 4303, Switzerland.
| | - Birgit Hoeft
- DSM Nutritional Products Limited, Wurmisweg 576, Kaiseraugst 4303, Switzerland.
| | | | - Nina Costa Carvalho
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 7-11, Mannheim 68167, Germany.
| | - Ursula Goldberger
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 7-11, Mannheim 68167, Germany.
| | - Kristina Hoffmann
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Strasse 7-11, Mannheim 68167, Germany.
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Yu SH, Song Y, Park M, Kim SH, Shin S, Joung H. Relationship between adhering to dietary guidelines and the risk of obesity in Korean children. Nutr Res Pract 2014; 8:705-12. [PMID: 25489411 PMCID: PMC4252531 DOI: 10.4162/nrp.2014.8.6.705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 08/05/2014] [Accepted: 08/06/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dietary guidelines for Korean children were released in 2009. The goal of the present study was to examine diet quality in terms of adherence to these dietary guidelines as well as explore the association between guideline adherence and risk of obesity in Korean children. SUBJECTS/METHODS Children aged 5-11 years (mean age = 8.9 years old, n = 191, 80.6% girls) were recruited from a university hospital in Seoul, Korea. Adherence to dietary guidelines for Korean children was calculated using the Likert scale (1-5), and children were then categorized into low, moderate, and high groups based on adherence scores. Obesity or being overweight was determined based on an age- and gender- specific percentile for body mass index (BMI) of the 2007 Korean National Growth Charts. Diet quality was evaluated from 3 days of dietary intake data. RESULTS Children in the high adherence group were characterized by significantly lower BMI percentiles and paternal BMIs as well as higher percentages of fathers with a high level of education and higher household incomes compared to those in the low or moderate group. Children in the high adherence group consumed significantly higher amounts of milk and dairy products, were less likely to consume lower than the EAR of phosphorus and iron, and had higher NARs for calcium, phosphorus, iron, zinc, and MAR than those in low groups. The ORs for obesity (BMI ≥ 95th percentile) or being overweight including obesity (BMI ≥ 85th percentile) were significantly lower in the high adherence group compared to the low adherence group (OR: 0.33, 95% CI = 0.13-0.82, P for trend = 0.019; OR: 0.26, 95% CI: 0.11-0.61 P for trend = 0.002). CONCLUSIONS Korean children who adhered to dietary guidelines displayed better diet quality and a reduced risk of obesity.
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Affiliation(s)
- Soo Hyun Yu
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - YoonJu Song
- Major of Food and Nutrition, School of Human Ecology, the Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi 420-743, Korea
| | - Mijung Park
- Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-702, Korea
| | - Shin Hye Kim
- Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-702, Korea
| | - Sangah Shin
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea
| | - Hyojee Joung
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea. ; Department of Public Health Nutrition, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea
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Oldewage-Theron WH, Kruger R, Egal AA. Socio-Economic Variables and Nutrient Adequacy of Women in the Vaal Region of South Africa. Ecol Food Nutr 2014; 53:514-527. [DOI: 10.1080/03670244.2013.873423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Castro MA, Carlos JV, Lopes RCV, Januário BL, Marchioni DML, Fisberg RM. Dietary Glycemic Index, Glycemic Load, and Nutritional Correlates in Free-Living Elderly Brazilians: A Population-Based Survey. J Am Coll Nutr 2014; 33:111-9. [DOI: 10.1080/07315724.2013.874887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bagni UV, Yokoo EM, da Veiga GV. Association between nutrient intake and anemia in Brazilian adolescents. ANNALS OF NUTRITION AND METABOLISM 2014; 63:323-30. [PMID: 24576823 DOI: 10.1159/000357955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/11/2013] [Indexed: 11/19/2022]
Abstract
AIMS The association between the intake of iron, vitamins A and C and calcium and the prevalence of anemia and hemoglobin (Hb) levels was investigated in adolescents. METHODS A cross-sectional study was developed with 529 Brazilian students. Anemia was defined in terms of Hb concentration. Nutrient intake was assessed by a 3-day food record. The association between the prevalence of inadequate nutrient intake and anemia was estimated by the χ(2) test, and that between nutrient intake and Hb by linear regression. RESULTS The prevalence of inadequate nutrient intake did not differ between nonanemic and anemic subjects. Anemic adolescents had a lower mean intake of iron than nonanemic adolescents. Among boys aged 11-13 years, the anemic subjects had lower vitamin C intake than those who were nonanemic (41.1 vs. 62.6 mg, p < 0.01), and among those aged 14-19 years, there was a tendency for a positive association between Hb and heme iron intake (β = 0.64, p = 0.06) and a negative association with calcium intake (β = -0.003, p = 0.02). In females, daily nutrient intake did not differ between anemic and nonanemic individuals. CONCLUSIONS Heme iron and vitamin C are possible protective factors against anemia in boys. However, the lack of association between inadequate iron intake and anemia, especially in girls, suggests that other factors beyond diet could explain anemia in this age range.
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Affiliation(s)
- Ursula Viana Bagni
- Health Sciences College of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
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Iglesia I, Mouratidou T, González-Gross M, Novakovic R, Breidenassel C, Jiménez-Pavón D, Huybrechts I, De Henauw S, Geelen A, Gottrand F, Kafatos A, Mistura L, de Heredia FP, Widhalm K, Manios Y, Molnar D, Stehle P, Gurinovic M, Cavelaars AEJM, Van't Veer P, Moreno LA. Socioeconomic factors are associated with folate and vitamin B12 intakes and related biomarkers concentrations in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Nutr Res 2014; 34:199-209. [PMID: 24655486 DOI: 10.1016/j.nutres.2014.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 01/11/2014] [Accepted: 01/21/2014] [Indexed: 10/25/2022]
Abstract
Because socioeconomic factors (SEFs) may influence dietary quality and vitamin intakes, this study aimed to examine associations between socioeconomic factors and folate and vitamin B12 intakes as well as their related biomarkers in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Vitamin intakes were obtained from two 24-hour recalls in 2253 participants (47% males). Vitamin B biomarkers were assessed in a subsample of 977 participants (46% males). Socioeconomic factors were assessed by questionnaire, and 1-way analysis of covariance and linear regression analysis were applied. For males and females, mean intakes of folate were 211.19 and 177.18 μg/d, and for vitamin B12, 5.98 and 4.54 μg/d, respectively. Levels of plasma folate, red blood cell folate, serum B12, and holotranscobalamin were 18.74, 807.19, 330.64, and 63.04 nmol/L in males, respectively, and 19.13, 770.16, 377.9, and 65.63 nmol/L in females, respectively. Lower folate intakes were associated with several SEFs, including maternal and paternal education in both sexes. Regarding folate biomarkers, lower plasma folate intakes were associated with single/shared care in males and with lower paternal occupation in females. Lower vitamin B12 intakes were associated with almost all the studied SEFs, except paternal occupation in both sexes. In females, when considering vitamin B12 biomarkers, lower plasma vitamin B12 was associated with lower maternal education and occupation, and lower holotranscobalamin was associated with lower maternal education and lower paternal occupation. In conclusion, from the set of socioeconomic determinants studied in a sample of European adolescents, maternal education and paternal occupation were more consistently associated with folate and vitamin B12 intakes and biomarkers concentrations.
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Affiliation(s)
- Iris Iglesia
- GENUD: "Growth, Exercise, Nutrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Theodora Mouratidou
- GENUD: "Growth, Exercise, Nutrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Marcela González-Gross
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Romana Novakovic
- Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
| | - Christina Breidenassel
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain; Department of Nutrition and Food Science, University of Bonn, D-53115 Bonn, Germany
| | - David Jiménez-Pavón
- GENUD: "Growth, Exercise, Nutrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium; International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | | | - Anouk Geelen
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | - Anthony Kafatos
- University of Crete School of Medicine, GR-71033 Crete, Greece
| | | | - Fátima Pérez de Heredia
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Yanis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Denes Molnar
- Department of Paediatrics, University of Pécs, Pécs, Hungary
| | - Peter Stehle
- Department of Nutrition and Food Science, University of Bonn, D-53115 Bonn, Germany
| | - Mirjana Gurinovic
- Institute for Medical Research, Centre of Research Excellence in Nutrition and Metabolism, University of Belgrade, Belgrade, Serbia
| | | | - Pieter Van't Veer
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Luis A Moreno
- GENUD: "Growth, Exercise, Nutrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
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Tornaritis MJ, Philippou E, Hadjigeorgiou C, Kourides YA, Panayi A, Savva SC. A study of the dietary intake of Cypriot children and adolescents aged 6-18 years and the association of mother's educational status and children's weight status on adherence to nutritional recommendations. BMC Public Health 2014; 14:13. [PMID: 24400785 PMCID: PMC3909376 DOI: 10.1186/1471-2458-14-13] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A balanced diet is fundamental for healthy growth and development of children. The aim of this study was to document and evaluate the dietary intake of Cypriot children aged 6-18 years (y) against recommendations, and to determine whether maternal education and children's weight status are associated with adherence to recommendations. METHODS The dietary intake of a random sample of 1414 Cypriot children was assessed using a 3-day food diary. Adherence to recommendations was estimated and the association of their mother's education and their own weight status on adherence were explored. RESULTS A large percentage of children consumed less than the minimum of 45% energy (en) of carbohydrate (18.4%-66.5% in different age groups) and exceeded the recommended intakes of total fat (42.4%-83.8%), saturated fatty acids (90.4%-97.1%) and protein (65.2%-82.7%), while almost all (94.7%-100%) failed to meet the recommended fibre intake. Additionally, a large proportion of children (27.0%-59.0%) consumed >300 mg/day cholesterol and exceeded the upper limit of sodium (47.5%-78.5%). In children aged 9.0-13.9y, there was a high prevalence of inadequacy for magnesium (85.0%-89.9%), in girls aged 14.0-18.9y, of Vitamin A (25.3%), Vitamin B6 (21.0%) and iron (25.3%) and in boys of the same group, of Vitamin A (35.8%). Children whose mother was more educated were more likely to consume >15%en from protein, Odds Ratio (OR) 1.85 (95% CI:1.13-3.03) for mothers with tertiary education and exceed the consumption of 300 mg/day cholesterol (OR 2.13 (95% CI:1.29-3.50) and OR 1.84 (95% CI:1.09-3.09) for mothers with secondary and tertiary education respectively). Children whose mothers were more educated, were less likely to have Vitamin B1 (p<0.05) and Vitamin B6 intakes below the EAR (p < 0.05 for secondary school and p < 0.001 for College/University) and iron intake below the AI (p < 0.001). Overweight/obese children were more likely to consume >15%en protein (OR 1.85 (95% CI:1.26-2.71) and have a < Adequate Intake of calcium (OR 1.85 (95% CI:1.11-3.06)). CONCLUSION Cypriot children consume a low quality diet. Maternal education and children's own weight status are associated with children's adherence to recommendations. Public health policies need to be evaluated to improve dietary quality and reduce disease burden.
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Affiliation(s)
- Michael J Tornaritis
- Research and Education Institute of Child Health, 138 Limassol Ave, 2015 Strovolos, Cyprus
- Pedagogical Institute of Cyprus, 40, Macedonia Ave, 2238 Latsia, Cyprus
| | - Elena Philippou
- Research and Education Institute of Child Health, 138 Limassol Ave, 2015 Strovolos, Cyprus
| | | | - Yiannis A Kourides
- Research and Education Institute of Child Health, 138 Limassol Ave, 2015 Strovolos, Cyprus
| | - Adamos Panayi
- Research and Education Institute of Child Health, 138 Limassol Ave, 2015 Strovolos, Cyprus
| | - Savvas C Savva
- Research and Education Institute of Child Health, 138 Limassol Ave, 2015 Strovolos, Cyprus
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Araujo MC, Bezerra IN, Barbosa FDS, Junger WL, Yokoo EM, Pereira RA, Sichieri R. Macronutrient consumption and inadequate micronutrient intake in adults. Rev Saude Publica 2013; 47 Suppl 1:177S-89S. [PMID: 23703262 DOI: 10.1590/s0034-89102013000700004] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 04/16/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To estimate energy and nutrient intake and prevalence of inadequate micronutrient intake among Brazilian adults. METHODS Data from the National Dietary Survey, from the 2008-2009 Household Budget Survey, were used. Food consumption was evaluated through food record on two non-consecutive days. A total of 21,003 individuals (52.5% women), between 20-59 years old, participated in the survey. Usual nutrient intake was estimated according to the National Cancer Institute method. The Estimated Average Requirement (EAR) cut-off points were used to determine the prevalence of inadequate micronutrient intake. For manganese and potassium, the Adequate Intake (AI) was used as cut-off. Sodium intake was compared with the Tolerable Upper Intake Level (UL). The probability approach was used to determine the prevalence of inadequate iron intake. The data were analyzed according to the location of the household (urban or rural) and macro regions of Brazil. RESULTS The mean energy intake was 2,083 kcal among men and 1,698 kcal among women. Prevalence of inadequacy equal to or greater than 70% were observed for calcium among men and magnesium, vitamin A, and sodium among both men and women. Prevalence equal to or greater than 90% were found for calcium in women and vitamins D and E in both genders. Prevalence lower than 5% were found for iron in men and for niacin in men and women. In general, prevalence of inadequate intake was higher in the rural area and in the Northeast region. CONCLUSIONS Energy intake was higher among individuals who live in urban areas and in the North region. The greatest risk groups of inadequate micronutrient intake were women and those living in rural areas and in the Northeast region.
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Affiliation(s)
- Marina Campos Araujo
- Programa de Pós-Graduação em Saúde Coletiva, Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
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Verly Junior E, Cesar CLG, Fisberg RM, Marchioni DML. Variância intrapessoal da ingestão de energia e nutrientes em adolescentes: correção de dados em estudos epidemiológicos. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2013. [DOI: 10.1590/s1415-790x2013000100016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Este artigo objetiva fornecer valores de componentes de variância intrapessoal da ingestão de energia e nutrientes que possibilita estimar a ingestão habitual em adolescentes, em inquéritos dietéticos quando há disponível somente um recordatório de 24 horas para cada indivíduo. Também será fornecido um exemplo de sua aplicação na correção da distribuição da ingestão de nutrientes proveniente de adolescentes de outro estudo. MÉTODOS: Foram utilizados recordatórios de 24 horas de 215 adolescentes do município de São Paulo. Os componentes de variância foram estimados utilizando o Software for Intake Distribution Estimation (PC-SIDE). Para cada nutriente foi construído um modelo, estratificado por sexo, que inclui o dia e o mês da coleta, e variáveis de ponderação. RESULTADOS: Os componentes de variância intrapessoal variaram de 0,55 para gordura mono-saturada (sexo feminino) a 0,96 para o folato (sexo masculino). Entre os macronutrientes e energia foram observados valores mais elevados para o sexo masculino. No exemplo da aplicação do componente de variância, foi estimada a distribuição da ingestão de vitamina B6 com menos viés comparada à distribuição sem a correção. CONCLUSÃO: Estes dados podem ser utilizados na estimativa da ingestão habitual de energia e nutrientes e cálculo da prevalência de inadequação em adolescentes de populações semelhantes, quando há disponível somente um recordatório de 24 horas para cada indivíduo do estudo.
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Veiga GVD, Costa RSD, Araújo MC, Souza ADM, Bezerra IN, Barbosa FDS, Sichieri R, Pereira RA. Inadequação do consumo de nutrientes entre adolescentes brasileiros. Rev Saude Publica 2013. [DOI: 10.1590/s0034-89102013000700007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Estimar o consumo de energia e nutrientes e a prevalência de inadequação da ingestão de micronutrientes entre adolescentes brasileiros. MÉTODOS: Amostra probabilística composta por 6.797 adolescentes (49,7% do sexo feminino) entre dez e 18 anos de idade foi avaliada no Inquérito Nacional de Alimentação, 2008-2009. Os fatores de expansão, a complexidade do desenho da amostra e a correção da variabilidade intrapessoal do consumo foram considerados. A prevalência de inadequação de consumo de micronutrientes foi estimada pela proporção de adolescentes com ingestão abaixo da necessidade média estimada. Para o sódio, estimou-se a prevalência de consumo acima do valor de ingestão máxima tolerável. RESULTADOS: A média de consumo de energia variou de 1.869 kcal, observada nas adolescentes de 10 a 13 anos, a 2.198 kcal, estimada para os adolescentes de 14 a 18 anos. Os carboidratos forneceram 57% da energia total, os lipídios, 27% e as proteínas, 16%. As maiores prevalências de inadequação foram observadas para cálcio (> 95%), fósforo (entre 54% e 69%) e vitaminas A (entre 66% e 85%), E (100%) e C (entre 27% e 49%). Mais de 70% dos adolescentes apresentaram consumo de sódio superior à ingestão máxima tolerável. CONCLUSÕES: As médias de consumo energético e a distribuição de macronutrientes eram adequadas, mas foram observadas elevadas prevalências de inadequação no consumo de vitaminas e minerais, destacando-se consumo de sódio muito acima do recomendado, consumo de cálcio reduzido e nas adolescentes de 14 a 18 anos foi observada importante inadequação na ingestão de ferro.
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