Association between Consumption of Ultra-Processed Food and Body Composition of Adults in a Capital City of a Brazilian Region

The present study investigates the relationship between the consumption of ultra-processed foods (UPF) and anthropometric indices of body composition in adults and seniors living in Teresina, the state capital of an area in northeastern Brazil. The article seeks to address two questions: Is UPF consumption linked to worsening body composition in different age groups? Do anthropometric indicators of body composition change with the increasing consumption of UPF? The study is a cross-sectional, household, population study, carried out with 490 adults and seniors. The food consumption was obtained with a 24 h food recall, and the foods were classified using NOVA. Anthropometric indicators evaluated were waist-to-height ratio, triceps skinfold thickness, arm circumference, corrected arm muscle area, subscapular skinfold thickness, and calf circumference. The association between energy contribution of UPF with anthropometric indicators was verified with a simple and multiple linear regression analysis. Individuals aged 20 to 35 years showed a significant association between UPF consumption and skinfold thickness (ß: 0.04; CI: 0.03/0.09), demonstrating an increase in this subcutaneous body fat marker with higher UPF consumption. Moreover, in participants aged 36 to 59 years, an inverse correlation between UPF intake and muscle mass markers, arm circumference (ß: -0.02; confidence interval: -0.03/-0.01), and corrected arm muscle area (ß: -0.07; confidence interval: -0.12/-0.02) were observed. Such results suggest there is decreased muscle mass with increasing UPF consumption. This is the first study that verified an association between UPF consumption and low-cost body composition indicators in different age groups.

Syphilis detection rate trend in aged people: Brazil, 2011-2019

OBJECTIVE

To analyze the trend in the detection rate of syphilis in elderly people in Brazil from 2011 to 2019.

METHODS

An ecological, time-series study with data from the Notifiable Diseases Information System. The temporal trend of syphilis detection rates was analyzed according to the Prais-Winsten linear regression method.

RESULTS

62,765 cases of syphilis in aged people were reported. There was a growing trend in the rate of syphilis detection in aged people in Brazil. The increase was of approximately six times, with a mean increase of 25% each year (annual percent change [APC]: 25.0; 95%CI 22.1-28.1). The increase in the detection rate was identified in both genders and for all age groups, with emphasis on the increase in females (APC: 49.1; 95%CI 21.9-26.8) and in the group aged 70 to 79 years old (APC: 25.8; 95%CI 23.3-28.3). All macro-regions of the country showed an increasing trend, with emphasis on the Northeast (APC: 51.2; 95%CI 43.0-59.8) and South (APC: 49.2; 95%CI 32.3-68.3).

CONCLUSION

The growing trend in the detection rate of syphilis in aged people throughout Brazil highlights the need for planning and developing effective and multidisciplinary prevention actions and assistance adapted to this public.

Association between Polyphenol Intake and Lipid Profile of Adults and Elders in a Northeastern Brazilian Capital

This research was aimed at evaluating the relationship between the estimated polyphenol intake and the atherogenic lipid profile in adult and elder residents in the city of Teresina, located in the Northeastern Region of Brazil. This study was a cross-sectional population-based survey with 501 adults and elders, conducted in Teresina, Brazil. Food intake was obtained by 24-h food recall. The estimated polyphenol intake was calculated by multiplying the food consumption data from the recall by the polyphenol content in the foods described in the Phenol-Explorer database. The mean intake of total polyphenols was 1006.53 mg/day. The phenolic acids was the class with the highest intake, followed by the flavonols. Coffee, beans and apples were the main foods contributing to the total polyphenol intake. In the individuals with elevated serum concentrations of total cholesterol and triglycerides, the intake of total polyphenols was significantly higher. The intake of total polyphenols, phenolic acids and lignans was higher in the subjects with dyslipidemia. This article provides, for the first time, data on the intake of the total polyphenol classes and subclasses in the evaluated population and the relationship with the lipid profile. The individuals with a higher intake of total polyphenols had a worse lipid profile, which may be a consequence of an improved diet in those individuals who present with dyslipidemia.

Nutritional, Physicochemical and Structural Parameters of Mauritia flexuosa Fruits and By-Products for Biotechnological Exploration of Sustainable Goods

Research background

Commercialization of Mauritia flexuosa (buriti) fruits in Brazil is at an early stage. Herein, we evaluate the nutritional value of pulp, peel and endocarp samples from buriti fruits, perform macroscopic and microscopic evaluations and analyze their physicochemical properties.

Experimental approach

Size and mass, pH, sugar and protein contents, soluble/insoluble fiber, total titratable acidity and energy value of the samples were analyzed. Mineral profiling was performed by energy dispersive X-ray fluorescence spectrometry, and fatty acids and phytosterols were determined by gas chromatography-mass spectrometry. Samples were also submitted to differential scanning calorimetry coupled to a thermal analyzer, and microstructure, morphology, surface and viscosity were evaluated by scanning electron microscopy (SEM) and X-ray diffraction (XRD) with copper radiation. Rheological behavior was also studied.

Results and conclusions

Lyophilized pulp had higher nutritional content of minerals, proteins, carbohydrates and energy than in natura pulp. Lyophilized pulp and its by-products showed suitable yields (>17.31%) and low a_w, and potassium, manganese and monounsaturated fatty acid contents. Peels showed elevated amounts of saturated and polyunsaturated fatty acids and phytosterols (β-sitosterol and stigmasterol), and endothermic behavior. The reductions of calcium, magnesium and manganese ranging from 18.5 to 22.7% were observed following the lyophilization. Drying processes generated semi-crystalline powders. Both peels and endocarp contained higher amounts of insoluble fiber and lower contents of sugars. Similar results were obtained by microscopic morphological analysis, differential scanning calorimetry and XRD analysis. Pulp and endocarp exhibited pseudoplastic non-Newtonian behavior, and flow behavior index values were lower than 1, while peels presented dilatant behaviour. Thus, physicochemical and nutritional characterization of pulp and by-products, such as peels and endocarp, are essential to support scientific research and exploration of new sustainable products.

Novelty and scientific contribution

Processing and conservation techniques, like lyophilization, maintain the good quality of nutritional contents and bioactive compounds of buriti whole fruits, and can be used to extend their shelf life, preserve alimentary characteristics and provide wider purposes and availability. Such parameters may generate income and food security for local and regional communities.

Effects of Vitamin D Levels on Cardiovascular Diseases: A Systematic Review

Background:

Cardiovascular diseases (CVDs) are a group of pathologies that involve heart and blood vessel disorders and are considered the main cause of death in the world. Epidemiological studies have shown the association between low vitamin D (VD) levels and CVD. This vitamin, in addition to acting on bone metabolism, plays a role in modulating the cardiovascular system.

Objective:

The present study assesses the effects of VD levels on CVD through a systematic literature review.

Method:

For this purpose, the PICO strategy was used to prepare the guiding question, and articles were searched in the PubMed, Scopus, Science Direct, and Web of Science databases by two authors independently. To guarantee the quality of the evidence of the articles included in the review, the Newcastle-Ottawa scale was used. The literature review followed the PRISMA recommendations.

Results:

In this review, 22,757 articles were identified, but only 10 were considered eligible, of which 70% are prospective cohorts and 30% are retrospective cohorts. The study showed that low 25(OH)D levels correlate with an increased risk of cardiovascular events and death from CVD, including in patients who had preexisting CVD. However, one article did not demonstrate this association.

Conclusion:

As a result, VD correlates with cardiovascular events and the risk of death.

Sampling plan and methodological aspects: a household healthcare survey in Piauí

OBJECTIVE

To describe the methodological aspects of the Piauí home healthcare survey (ISAD-PI) and assess the relation between sampling plan, precision, and design effects, assuming that population health surveys are relevant instruments for health monitoring.

METHODS

ISAD-PI was a population-based cross-sectional study that analyzed the living conditions and health status of the population residing in urban areas in the municipalities of Teresina and Picos, in Piauí. Sampling was carried out by conglomerates in two stages: Primary Sampling Units and households. To calculate the sample size, we considered the stratification of the population in both cities, according to the age of the individuals. We evaluated the “non-response” rate (NRR) and estimated the proportions according to sex and age, as well as the prevalence of social determinants of health in order to assess the compliance of the sampling plan. Analyses related to the precision according to the coefficient of proportion variation of the standard error (Cv-pˆ) and the design effect (deff). Cv-pˆ less than 20% and deff less than 1.5 were considered adequate. The total NRR of households was 38.2% in Teresina and 38.3% in Picos. We carried out twenty-four proportion estimates in relation to age and sex and 48 prevalence of social and health determinants estimates, totaling 72 estimates. Among them, 71 had Cv-pˆ less than 20% and 61 had deff less than or equal to 1.5.

CONCLUSION

Data generated from the ISAD-PI may contribute to the assessment of health and morbidity conditions in the population. Furthermore, methodological aspects employed in this research may serve as a basis for studies carried out in other cities in Brazil.

Metabolic syndrome in adolescents and antioxidant nutrient intake: a cross-sectional study

OBJECTIVE

To verify the association between metabolic syndrome and its components, and intake of antioxidant nutrients in adolescents.

METHODS

This is a cross-sectional study of the data of 327 adolescents in a high school in Teresina, Piauí, Brazil, pertaining to their socioeconomic background, anthropometric measurements, dietary intake (selenium; copper; zinc; vitamins A, C, and E), hemodynamics, and biochemical tests. The criteria for diagnosing metabolic syndrome in adolescents were applied. Binary logistic regression was used to verify the association between metabolic syndrome and its components, and intake of antioxidants. The level of significance was established at p<0.05.

RESULTS

Prevalence of metabolic syndrome was 7.0%, with a significant association between body mass index and blood pressure. Lower tertiles of copper and vitamins A and E intake were associated with high triglyceride and glycemic levels. The association with vitamins A and E remained after adjustment.

CONCLUSIONS

A significant association between lower vitamins A and E intake and metabolic syndrome components (altered triglycerides and glycemic levels) was found. Besides further studies on this issue, the need for health interventions was found, which ensures the appropriate intake of antioxidant nutrients during adolescence.

Impact of intermittent fasting on body weight in overweight and obese individuals

OBJECTIVE

To verify the relationship of intermittent fasting in the bodyweight of overweight and obese individuals through a systematic literature review.

METHODS

This is a systematic review based on randomized controlled trials. The articles were consulted in the databases: Science Direct, PubMed e BVS. This review was evaluated through the PRISMA recommendation.

RESULTS

After the selection process, four articles were included in this review, comparing intermittent fasting (IF) with calorie restriction diet (CRD) as a control group. In 2 studies using similar protocols, there was no significant reduction in body weight of overweight or obese subjects. In the other two studies using different protocols, weight loss was significant in the IF group compared to the CRD group.

CONCLUSIONS

Results did not provide evidence of the effect of intermittent fasting on weight loss in overweight or obese individuals.

Prevalence of arterial hypertension and associated factors: a population-based study

SUMMARY OBJECTIVE To estimate the prevalence of hypertension in adults and analyze its association with socioeconomic, demographic, and lifestyle risk factors. METHODS Home-based cross-sectional epidemiological study conducted with adults of both sexes living in the cities of Teresina and Picos (PI). The prevalence of hypertension was estimated by self-reported diagnosis. The associations between hypertension and the following variables were tested: age, gender, skin color, education, family income, marital status, alcohol and cigarette consumption, physical activity, and nutritional status. RESULTS A total of 1,057 adult individuals with a mean age of 38.6 ± 11.5 years participated in the study, of which 62.3% were female. The prevalence of hypertension in the population was 16.4%. In the crude analysis, a significant association was observed between the prevalence of hypertension and factors such as older age, lower education, single marital status, brown skin color, smoking, and overweight (p < 0.05). However, after adjustments, only the associations with older age, brown skin color, sedentary lifestyle and overweight remained significant. CONCLUSION Older age, brown skin color, sedentary lifestyle, and the presence of overweight or obesity were significantly associated with hypertension. Among the modifiable risk factors, a sedentary lifestyle and overweight stand out as important for the genesis of hypertension, subject to intervention measures.

Prevalence and factors associated with violence against high school teachers in Teresina, Piauí, 2016: a cross-sectional study

OBJECTIVE

to analyze prevalence of violence against high school teachers and associated factors in Teresina, Piauí, Brazil.

METHODS

this was a cross-sectional study using convenience sampling. Data was collected in 2016 in public and private high schools, using a self-administered questionnaire. Prevalence ratios (PR) using Poisson regression and 95% confidence intervals (95%CI) were calculated.

RESULTS

279 teachers participated, of whom 54.8% (95%CI 48.8;60.7) reported having suffered at least one type of violence. Verbal insults were most prevalent (39.4%; 95%CI 33.7;45.4), positively associated with public schools (PR=1.45; 95%CI 1.00;2.11) and with schools in the city's Eastern region (PR=1.85; 95%CI 1.17;2.93) and Southern region (PR=1.59; 95%CI 1.05;2.41). Sexual harassment was associated with males (PR=2.38; 95%CI 2.02;2.71).

CONCLUSION

violence against teachers was higher in public schools in poorer outskirt regions and regions with high indicators of urban violence.

Suicidal ideation and associated factors among high school adolescents

OBJECTIVE

To analyze the prevalence of suicidal ideation and its associated factors in school adolescents.

METHODS

Cross-sectional school-based study with 674 students from public and private schools in Teresina, Piauí, in 2016. Bivariate analysis was performed with the chi-square test and multiple analysis by the Poisson regression model to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI).

RESULTS

The study participants were mostly female (56.7%), black (77.4%), who lived with their parents (85%), whose mothers had schooling greater than or equal to 8 years of schooling (68.8%), with family income greater than a minimum wage (58.3%), practitioners of some religion (86.8%) and coming from public school (64.7%). The prevalence of suicidal ideation was 7.9%. Higher frequency of suicidal ideation was reported among female students (10.2%). Suicidal ideation was statistically associated with students who reported not living with their parents (adjusted PR = 2.27; 95%CI 1.26–4.10; p < 0.05) and those who reported having suffered sexual violence by other students, teachers or school staff (adjusted PR = 3.40; 95%CI 1.80–6.44; p < 0.05), among which the prevalence of suicidal ideation was more than three times that observed among those who did not mention this type of violence.

CONCLUSION

The prevalence of suicidal ideation in school adolescents was associated with female students, who did not live with parents and have been victim of sexual violence at school. We recommend advising the school community and health professionals to identify signs of suicidal behavior, especially in those with suspicion or proof of the occurrence of sexual violence at school.

[Do children and adolescents who consume ultra-processed foods have a worse lipid profile? A systematic review]

The increase in the input of ultra-processed ingredients in the food of children and adolescents is related to the development of noncommunicable diseases such as dyslipidemia. The scope of this study was to conduct a systematic review of the literature on the relationship of consumption of ultra-processed foods in the lipid profile of children and adolescents. A search in the PubMed, Scopus, Cochrane and LILACS databases was carried out to locate cross-sectional and longitudinal studies, with or without intervention, in apparently healthy children and/or adolescents, who had the intake of ultra-processed food as an exposure variable and the lipid profile as an outcome. After screening, 14 studies were included, of which nine demonstrated that ultra-processed food consumption was related to increased LDL-c, total cholesterol, triglycerides and a reduction in HDL-c. Three studies found no relationship and two demonstrated that the increased intake of ready-to-eat cereals was related to the decrease in total cholesterol and LDL-c. There was a high consumption of ultra-processed foods and positive relation with blood lipids among children and adolescents, which calls attention to interventions, such as nutritional education, with a view to reducing the intake of these foods.

Cruciferous Vegetables as Antioxidative, Chemopreventive and Antineoplasic Functional Foods: Preclinical and Clinical Evidences of Sulforaphane Against Prostate Cancers

Background:

Sulforaphane (SF, 1-isothiocyanato-4-(methyl-sulfinyl)-butane) is found in broccoli, cabbage and cauliflower.

Methods:

we performed a critical review on the antioxidative, chemopreventive and antitumor effects of SF from cruciferous vegetables against prostate cancers and molecular pathways. For a complete and reliable review, primary and secondary resources were used, including original and review articles, books and government documents published until March 2018. Articles that are in duplicity and disconnected are not considered for review. SF is derived from glucoraphanin (4-methyl-sulfinyl-butyl-glucosinate), being one of the most commonly found isothiocyanates in vegetables from Brassica spp., especially in broccoli samples. In vitro studies indicate that SF induces apoptosis in a dependent or non-dependent method of androgens by transcription of tumor suppressor genes, oxidation response and higher expression of phase II enzymes in prostate cancer cells. Sulforaphane also decreases transcription of the nuclear factor kB and antiapoptotic proteins, expression of cyclin D2 and survivin and DNA synthesis, increases Nrf2 gene activity, interferes with genome compacting by inhibition of histone deacetylases and disrupts Hsp90 complexes, which cause cell cycle arrest, mitosis interruption, activation of caspases and mitochondria depolarization.

Conclusion:

SF and cruciferous vegetables play antioxidative and chemopreventive role, delaying or blocking in vivo carcinogenesis, causing biochemical and epigenetic changes, preventing, delaying, or reversing preneoplastic or advanced prostate lesions, and frequently activating tumor cell death by intrinsic methods of apoptosis. These outcomes encourage the consumption of Brassica specimens, which could be easily achieved by the incorporation of food and vegetables rich in cruciferous isothiocyanates in the diet.

[Association between ultra-processed food consumption and lipid parameters among adolescents]

The scope of this study was to analyze the association between ultra-processed food (UPF) consumption and lipid parameters. It was a cross-sectional study performed with high school adolescents. Food consumption was analyzed by means of a 24-hour food recall form, where UPF were identified in line with the NOVA system of food classification. The total cholesterol levels, HDL-c and triglycerides were determined by enzymatic colorimetry and the LDL-c fraction estimated by formula. The Student's t-test or Mann-Whitney was used to compare averages, and linear regression to make associations among the variables. The results show that UPF consumption was more frequent in female adolescents between 17 and 19 years of age, with a family income above two minimum wages and from private schools. It was observed that individuals in the upper third of UPF consumption had a higher energetic, carbohydrate and sodium intake, with a lower intake of proteins and fibers. Moreover, it was found that a higher UPF intake was negatively associated with HDL-c levels and positively associated with triglyceride levels and dyslipidemia. Therefore, UPF is associated with a worsening of the nutritional profile of the diet and contributes to negative changes in the lipid parameters of young individuals.

Overweight and obesity in preschoolers: Prevalence and relation to food consumption

Summary Objective: To determine overweight and obesity prevalence in preschool children from public education, and to determine their relation to food consumption. Method: Cross-sectional study with children aged between 2 and 5 years, of both sexes, enrolled at municipal day care centers. Socioeconomic, demographic and anthropometric data were collected, in order to calculate the body mass index (BMI) for age. Data on food consumption were assessed using a Food Frequency Questionnaire. χ2 test, Kruskal-Wallis test, Student's t-test and Pearson's correlation were used at a significance level of 5%. Results: Of 548 children, 52% were male, with mean age of 4.2 years old. Most families had incomes between 1 and 2 minimum wages (59.7%), in addition to 10 years (mothers) of education. Anthropometric parameters did not differ significantly between sexes. According to the BMI-for-age, it was found that most of children were well-nourished (85.2%), 8.2% had the risk of becoming overweight, and 4.2% were overweight. The most consumed foods were: rice (100%), beans (99.4%), bread (98.5%), fruit (98.5%), red meat (97.1%), butter and margarine (95.4%), biscuits, cakes and sweet pies (94.1%), dairy products (94.1%), chocolate milk (91.7%), and soft drinks (90.2%). Consumed foods that were strongly correlated (r > 0.7) to the risk of/excess weight were, as follows: bread; biscuits, cakes, sweet pies; dairy products; chocolate milk; sausages. Conclusion: There was low prevalence of overweight and absence of obesity among the population assessed. The risk of overweight was greater among girls. Data from the study showed deviations in food consumption.

Risk factors for cardiovascular diseases in adolescents

OBJECTIVE

Identify risk factors for cardiovascular disease in adolescents.

METHODOLOGY

Descriptive cross-sectional study, conducted from May to September 2012, in the public schools of the city of Picos (Piaui State, Brazil). The sample consisted of 320 adolescents 10-19 years.

RESULTS

As to gender, 60% were female. With regard to blood pressure values, 15.3% of participants had altered blood pressure values (6.9% with hypertension) and, in relation to nutritional status, 15.6% were overweight and 5.3% obese. None of the variables showed statistically significant differences according to sex. Correlation were found between the variables: family history of hypertension with arm circumference and triceps skinfold; maternal education with triceps skinfold thickness and diastolic blood pressure; uptime with body mass index, arm circumference, waist-hip ratio and heart rate; birth weight with body mass index and arm circumference.

CONCLUSION

A significant proportion of adolescent respondents had risk factors for cardiovascular disease. Nursing should lead the adoption of interventions that promote the improvement of healthy lifestyle in adolescence, thus avoiding not only cardiovascular disease, but also other chronic diseases that can develop.

Effect of storage and processing of Brazilian flaxseed on lipid and lignan contents

Flaxseed has been widely studied around the world; its incorporation into products habitually consumed by human populations has been stimulated due to its unique nutritional value. The objective of this study was to evaluate the chemical composition of Brazilian flaxseed, to analyze the stability of lipids present in whole flaxseed flour (WFF) or partially defatted flaxseed flour (DFF) stored under several temperatures, and to investigate the effect of bread making on a product containing flaxseed. Whole flaxseed flour presented (g.100 g-1) 25.7 of insoluble fiber, 10.7 of soluble fiber, 38.9 of lipids, and 2.65 of lignan. Defatted flaxseed flour presented 65% less lipids, 36% more fiber and 56% more lignan than whole flaxseed flour. The fatty acid profile was maintained in the defatted flaxseed flour, and it presented a stable composition during storage under ambient temperature, refrigeration, and freezing. The fatty acid profile was similar in the bread containing defatted flaxseed flour after dough development, baking, and storage at room temperature or refrigerated. After baking, 89% of the lignan content was kept in bread. Results show that Brazilian flaxseed has an interesting chemical composition, and that defatted flaxseed, by-product of lipid extraction, presents a good stability to grind and storage under several temperatures. Thus, defatted flaxseed flour can be incorporated in bread, increasing its nutritional and functional value.

Utilização da farinha de feijão-caupi (Vigna unguiculata L. Walp) na elaboração de produtos de panificação

Este trabalho teve como objetivo enriquecer produtos de panificação do tipo biscoito e rocambole com farinha de feijão-caupi (FFC), avaliar sua aceitabilidade e composição química, incluindo o conteúdo dos minerais (ferro, zinco, magnésio, potássio e fósforo) e das vitaminas (tiamina e piridoxina). Foram desenvolvidas três formulações de biscoito contendo 10, 20 e 30% FFC e duas formulações de rocambole contendo 10 e 20% FFC. Observou-se um aumento no teor protéico do biscoito 30% FFC e do rocambole 20% FFC e na quantidade de cinzas dos biscoitos 20 e 30% FFC e rocambole 20% FFC, quando comparados às formulações padrão. O teor dos minerais analisados e de piridoxina aumentou à medida que FFC foi adicionada, enquanto a concentração de tiamina aumentou somente no rocambole 20% FFC. O biscoito com 10% FFC apresentou maior aceitação (84,4%), dentre os biscoitos formulados com FFC, além disso, os rocamboles com 10 e 20% FFC tiveram boa aceitação (86,7 e 77,8%, respectivamente). Todas as formulações contendo FFC tiveram notas superiores a 6, mostrando que os produtos foram aceitos sensorialmente. Desta forma, a adição de FFC visando melhorar o valor nutritivo de formulações à base de cereais é viável.