Avaliou-se a validade relativa dos indicadores de práticas alimentares do questionário utilizado na Pesquisa Nacional de Saúde do Escolar (PeNSE) entre adolescentes da cidade do Rio de Janeiro, Brasil. Foram estudados 174 alunos. Foram avaliados os indicadores: a ingestão regular (≥ 5 vezes/semana) dos alimentos marcadores de alimentação saudável, marcadores de alimentação não saudável e as rotinas alimentares: realizar refeição com responsável (REFEIÇÃO), realizar o desjejum (DESJEJUM) e comer enquanto estuda ou assiste à TV. Foram comparados os resultados do questionário e dos três recordatórios de 24 horas. Para todos os marcadores de alimentação saudável, não houve diferença na proporção de ingestão regular de acordo com os dois métodos. As frequências geradas pelo questionário foram superiores para os indicadores salgadinhos de pacote e biscoitos salgados e mais baixas para embutidos e REFEIÇÃO. Os indicadores de consumo regular de marcadores de alimentação saudável e aquele referente a DESJEJUM foram os que apresentaram maior acurácia. Os indicadores de práticas alimentares utilizados pela PeNSE apresentaram validade satisfatória.
RESUMOObjetivo: Identificar a prevalência e os fatores associados à hipertensão arterial sistêmica (HAS) em adolescentes de uma coorte. Sujeitos e métodos: Estudo transversal com 1.716 adolescentes, de 10 a 16 anos, participantes de um estudo de coorte. Os dados sociodemográficos, econômicos e de estilo de vida foram obtidos por meio de entrevista e os dados referentes ao nascimento e à infância foram obtidos na linha de base. Foram considerados hipertensos os adolescentes que apresentaram pressão arterial sistólica e/ou diastólica acima do percentil 95, segundo a classificação preconizada pelo Second Task Force High Blood Pressure in Children and Adolescents. O estado nutricional foi diagnosticado pelo índice de massa corporal (IMC), segundo o escore z. O perímetro da cintura foi medido ao nível da cintura natural. A associação da HAS com as variáveis explicativas foi estimada por regressão logística. Resultados: Os entrevistados correspondem a 71,4% dos avaliados na linha de base, sendo 50,7% do sexo masculino. A prevalência global de HAS foi de 11,7%. Na análise ajustada para idade, sexo e cor de pele, a hipertensão arterial associou-se à obesidade [OR = 2,27; IC (95%) = 1,64-3,14], mas não ao perímetro da cintura, que, após ajuste para o IMC, perdeu a associação. Os eventos precoces na vida não foram associados à HAS na adolescência. Conclusão: Os resultados enfatizam a obesidade como principal fator associado à HAS em adolescentes. Arq Bras Endocrinol Metab. 2013;57(7):520-6 Descritores Adolescentes; hipertensão; fatores de risco; obesidade ABSTRACT Objective: To identify the prevalence and factors associated with hypertension in adolescents. Subjects and methods: Cross-sectional study of 1,716 adolescents of a cohort study, aged from 10 to 16 years old sociodemographic, economic, and lifestyle characteristics were obtained from an interview, and birth weight from hospital records. Hypertension was defined as systolic or diastolic blood pressure above the 95 th percentile according to the classification recommended by the Second Task Force High Blood Pressure in Children and Adolescents. Nutritional status was diagnosed by body mass index (BMI), according to the z score from curves published by the World Health Organization. Waist circumference was measured at the natural waist. The association between hypertension and the explanatory variables was measured using logistic regression. Results: The adolescents interviewed represent 71.4% of the baseline, and 50.7% of them were males. The prevalence of hypertension was 11.7%. In the multivariate analysis, after adjustment for age sex and skin color, hypertension was associated with obesity [OR = 2.27, (95%) CI = 1.64 to 3.14] but not associated with waist circumference after adjusting for BMI. Early life factors were not associated with hypertension in adolescence. Conclusion: The results show an association between obesity and hypertension among adolescents. Arq Bras Endocrinol Metab. 2013;57(7):520-6
Dietary iron requirements in patients with sickle cell disease (SCD) remain unclear. SCD is a neglected hemoglobinopathy characterized by intense erythropoietic activity and anemia. Hepcidin is the hormone mainly responsible for iron homeostasis and intestinal absorption. Intense erythropoietic activity and anemia may reduce hepcidin transcription. By contrast, iron overload and inflammation may induce it. Studies on SCD have not evaluated the role of hepcidin in the presence and absence of iron overload. We aimed to compare serum hepcidin concentrations among individuals with sickle cell anemia, with or without iron overload, and those without the disease. Markers of iron metabolism and erythropoietic activity such as hepcidin, ferritin, and growth differentiation factor 15 were evaluated. Three groups participated in the study: the control group, comprised of individuals without SCD (C); those with the disease but without iron overload (SCDw); and those with the disease and iron overload (SCDio). Results showed that hepcidin concentration was higher in the SCDio > C > SCDw group. These data suggest that the dietary iron intake of the SCDio group should not be reduced as higher hepcidin concentrations may reduce the intestinal absorption of iron.
Resumo As tecnologias de informação e comunicação (TIC) apresentam o potencial de melhorar a gestão da informação, o acesso a serviços de saúde, a qualidade do cuidado prestado, a continuidade dos serviços, e a contenção de custos. Além disso, fornecem uma oportunidade singular para a promoção de estilos de vida saudáveis e valorização de iniciativas de políticas de saúde pública, atingindo simultaneamente um grande público. O objetivo do presente estudo foi revisar as experiências do uso das TIC na área da Nutrição, além de refletir sobre seus os impactos e desafios. Verificaram-se um contínuo avanço e difusão do uso das TIC na área de nutrição, as quais são utilizadas como ferramentas de educação em saúde, de registro e de informação em saúde, além de apoiarem a tomada de decisões clínicas por profissionais e de serviços de saúde. Contudo, as limitações no emprego das tecnologias de informação e comunicação em nutrição devem ser levadas em consideração, uma vez que dependem do acesso dos potenciais beneficiários a ferramentas de comunicação, da motivação e aptidão para seu manuseio e dos custos de sua execução. Palavras-chave:
Children with sickle cell anemia (SCA) often exhibit nutritional deficiencies and are at high risk of dying before the age of 5 years. Ensuring adequate nutrition is a critical part of health care for such children. This study aimed to investigate the association between nutritional status, nutrient intake, and food diversity in children with SCA. A descriptive cross-sectional study was conducted on 74 children with SCA, between 24 and 71 months of age. Anthropometric measurements, food and nutrients consumption were determined. The prevalence of low weight, stunting, and overweight/obesity were 16.2%, 35.1%, and 16.2%, respectively. Mean folic acid intake was low (49.05%±51.22%), whereas the intakes of protein (426.71%±171.93%), retinol (292.97%±403.88%), phosphorus (204.55%±151.35%), magnesium (233.02%±151.14%), iron (250.76%±165.81%), and zinc (243.21%±148.40%) were high. The dietary phosphorus/protein ratio was high for 31.1% of the children, and 44.6% of the children had low dietary diversity score. No correlation was found between food diversity, nutrient adequacy, and nutritional status. Despite the adequacy of the intake of most micronutrients, diet quality was inadequate, constituting mainly ultraprocessed foods. Knowing the food consumption pattern of these children enables a more resolute nutritional intervention.
Background: Historically, malnutrition is described in individuals with SCD. However, more recent studies have shown a change in the profile of the nutritional status and distribution of body composition of SCD patients, mainly adult individuals. Aims: To assess the body composition (BC), resting energy expenditure (REE), and the biomarkers of hemolysis in adults with sickle cell disease (SCD). Subjects and Methods: A cross-sectional observational study was performed with 64 individuals over 39 years old in the treatment from two reference centers for SCD located in the city of Rio de Janeiro, Brazil. The dual-energy X-ray absorptiometry (DXA) and indirect calorimetry were used to assess BC and REE, respectively. Blood levels of hemoglobin, reticulocytes, lactate dehydrogenase (LDH), leukocytes, platelets, total and direct bilirubin, total protein, and albumin were measured to assess the hemolysis and protein status. The descriptive and inferential analysis was composed of the different methods (one-way ANOVA with the multiple comparison test of Tukey, Student t-test, and Pearson's correlation coefficient). Were considered statistically significant when the p-values were ≤ 0.05. Results: Most participants with SCD were female sex, colored (brown/black), and mean age of 51.2 years old. The obesity prevalence was 70.7% according to the body fat (BF%), with a major mean among women (p < 0.0001). Men had a higher mean of lean mass (LM) (p=0.0005) and fat-free mass (FFM) (p=0.0007). There was no difference for REE in comparing the genotypes (p= 0.53), and genders (p=0.075). The hemolysis markers (LDH, reticulocytes, and TB) correlated inversely with BMI (p=0.013), FM (p=0.022), and FFM (p=0.034). Conclusions: The important change observed in body composition in people with sickle cell disease was characterized by a high percentage of fat body and a decrease in lean mass. The hemolysis markers LDH, reticulocytes, and BT correlated inversely with BMI, FM, and FFM indicating that high levels of hemolysis may affect nutritional status, without influencing the REE. Keywords: sickle cell disease, body composition, fat mass, fat-free mass, energy expenditure, hemolysis.
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