Patients using HD presented a high prevalence of MF loss as assessed by HGS, and it was not influenced by dialysis variables. HGS may be used as a reliable nutritional marker in HD, measured before or after HD sessions.

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A obesidade infantil continua aumentando em todas as regiões do mundo, sendo considerada um dos grandes desafios de saúde pública. A prevalência aumentou de menos de 1% em 1975 para 5,6% em meninas e 7,8% em meninos em 2016. 1 No Brasil, os dados também são preocupantes, uma vez que no último levantamento oficial realizado pelo Instituto Brasileiro de Geografia e Estatística (IBGE), constatouse que entre 2008 e 2009, 51,4% dos meninos e 43,8% das meninas com idade entre 5 a 9 anos apresentavam sobrepeso ou obesidade. 2 Crianças e adolescentes com obesidade têm cinco vezes mais chances de serem obesos quando adultos. 3 Além do mais, a obesidade na infância está associada com a elevação da pressão arterial, resistência à insulina, diabetes mellitus, dislipidemia e com o aumento da morbimortalidade cardiovascular na idade adulta. 4 Por isso, é importante identificar o excesso de gordura corporal nesta população e criar estratégias para prevenir o desenvolvimento de doenças crônicas no futuro.Com o objetivo de detectar crianças e adolescentes com risco cardiometabólico, sugeriu-se o uso de indicadores antropométricos como ferramentas de triagem epidemiológica, uma vez que são métodos não invasivos, de baixo custo e de fácil aplicação. 5,6 A circunferência da cintura (CC) por exemplo, é um indicador de adiposidade central relacionada a complicações metabólicas da obesidade na população pediátrica. 7,8 Porém, ainda não existem pontos de corte de CC padronizados para classificação de adiposidade abdominal em crianças e adolescentes, o que torna o seu uso limitado.Estudos descrevendo valores de percentis para CC têm apresentado resultados diferentes, uma vez que os valores de CC podem ser influenciados por idade, sexo e grupos étnicos, 9-11 dificultando o estabelecimento de valores de referência globais para essa medida antropométrica. Na edição atual dos Arquivos Brasileiros de Cardiologia, Santos et al., 12 publicaram estudo longitudinal, realizado com 22.000 crianças (11.199 meninos) com idades entre 6 e 10 anos de idades, matriculadas em escolas públicas e particulares de 13 cidades do estado de São Paulo. Os autores apresentaram curvas de referência da CC específicas para idade e sexo e pontos de corte para identificar crianças com risco de obesidade. Os autores descreveram que aproximadamente 30% das crianças apresentaram excesso de gordura, sendo classificados com sobrepeso ou obesidade, conforme o índice de massa corporal. As análises da curva ROC mostraram o percentil 75 como ponto de corte ideal para risco de sobrepeso e obesidade e que a obesidade é claramente diagnosticada nas crianças com a CC classificada a partir do percentil 85. 12

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Anorexia is a common complication in patients with chronic kidney disease (CKD) and is associated with the development of malnutrition and an increased risk of mortality. Several compounds are linked to anorexia in these patients; however, the mechanisms are unknown. Zinc (Zn) deficiency is associated with decreased food intake and has been observed in CKD patients. In addition, leptin is an anorexigenic peptide, and patients with CKD present generally high levels of this hormone. Studies have suggested an association between Zn and leptin status in human and rats; however, the results are inconsistent. Some claimed that Zn supplementation does not change leptin release or that there is no significant relationship between Zn and leptin. Others have reported that Zn might be a mediator of leptin production. CKD patients have hyperleptinemia and hypozincemia, but the relationship between Zn deficiency and leptin levels in CKD patients has been poorly understood until now. The aim of this review is to integrate knowledge on leptin and Zn actions to provide a cohesive clinical perspective regarding their interactions in CKD patients.

Background: Social vulnerability can influence in the development of cardiovascular risk factors in adolescents (CRF). For this reason, the objective of our study was to evaluate the presence of CRF in adolescents, according to social vulnerability. Methods: This is a cross-sectional study with 517 adolescents of both sexes, from 10 to 19 years of age, classified into 2 groups by social vulnerability, according to socioeconomic characteristics collected by means of questionnaires, where adolescents who did not have access to drinking water, sewage network, and adequate per capita income were classified as vulnerable. Anthropometric, biochemical, and blood pressure data were evaluated. Level of physical activity was assessed by an adapted questionnaire, and food intake was assessed by a 3-day food record. Paired t, Mann-Whitney, and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS, version 25, at a significance level of 5%. Results: Adolescents had median age of 14 (11 to 15) years; 58.4% were female; 32.4% were overweight, and 52.4% were inactive in leisure. Mean consumption of ultra-processed food was observed to account for 45.0% of calorie intake. Adolescents classified as vulnerable had lower weight, body mass index, waist circumference, hip circumference, and neck circumference when compared to non-vulnerable adolescents. Both groups had cholesterol concentrations above the normal level. Non-vulnerable adolescents had higher triglyceride concentrations, higher alcohol consumption, and lower fiber intake compared to vulnerable adolescents. Conclusions: Adolescents with social vulnerability are less likely to have cardiovascular risk factors.

Introduction: Vegetarian diets have favorable effects on cardiovascular risk, provided that they do not contain ultra-processed foods (UPF).Objective: To compare the metabolic profile, cardiovascular risk, body composition, and food consumption in vegan (VEG), lacto-ovo vegetarian (LOV), and omnivorous (OMNI) women. To verify the association between UPF consumption and cardiovascular risk.Methods: Cross-sectional study with 119 VEG (n = 43), LOV (n = 38), and OMNI (n = 38) women. Anthropometric and biochemical parameters and the Framingham risk score were assessed. Food consumption was assessed by means of a 3-day food register, and intake of macronutrients, micronutrients, and UPF was estimated. The correlation between UPF consumption and cardiovascular risk was assessed using Spearman's coefficient, with a significance level of 5%. Results:The groups showed low cardiovascular risk, without significant difference between them. The VEG and LOV groups had lower body mass index, neck circumference, body shape index, and systolic blood pressure (p < 0.05) than the OMNI group; greater consumption of carbohydrates, sugars, dietary fibers, micronutrients, betacarotene, and carotenoids; and lower consumption of total fat, saturated fatty acids, and cholesterol (p < 0.05). Consumption of UPF was lower in the LOV group (5.7 [0.0-19.8]) than in the OMNI group (14.9 [5.1 -22.3]; p < 0.05). UPF consumption was associated with SBP (ρ = 0.439; p = 0.007) and blood sugar (ρ = 0.422; p = 0.010) in the VEG group, and in the LOV group it was inversely associated with LDL-c (ρ = −0.456; p = 0.010). Conclusion:Vegetarian women showed better body composition and dietary quality than OMNI women. It is important to take consumption of UPF in vegetarians into consideration, in order to improve cardiovascular risk in women.