[Show abstract][Hide abstract] ABSTRACT: Introduction: Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in elderly because they are often unable to maintain the standing position. A alternative is the use of estimated height from measurements of knee height measure. Aims: This study aimed to evaluate the accuracy of the formula proposed by Chumlea et al. (1985) based on the knee of a Caucasian population to estimate the height and its application in calculation of body mass index in community- dwelling older people residents in Viçosa, Minas Gerais, Brazil. Methods: The sample included 621 elderly aged 60 years old and older, living in the community. Measures of weight, height and knee height (KH) were taken and Body Mass Index (BMI) was calculated with the measured weight and estimated. The Student`s t-test was used for comparison of measurements of height between the genders. For the comparison of estimated and measured values it was used paired t-test and also the methodology proposed by Bland and Altman to compare the difference between measurements. To evaluate the agreement between the classifications for BMI was used Cohen's Kappa. Results: The average values obtained from KH were higher than those measured in the whole sample and women. There underestimation of BMI in females and also in the whole. Conclusions: The present results suggest that the equation Chumlea was not adequate to estimate the height of the sample in question, especially for women.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
[Show abstract][Hide abstract] ABSTRACT: To determine the prevalence of metabolic syndrome (MS) and the hypertriglyceridemic waist phenotype (HW) in a representative adolescent sample; as well as to establish which anthropometric indicator better identifies MS and HW, according to gender and adolescent age.
Revista Paulista de Pediatria 03/2015; 29(2). DOI:10.1016/j.rpped.2014.10.001
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE
To assess the determinants of exclusive breastfeeding abandonment.
Longitudinal study based on a birth cohort in Viçosa, MG, Southeastern Brazil. In 2011/2012, 168 new mothers accessing the public health network were followed. Three interviews, at 30, 60, and 120 days postpartum, with the new mothers were conducted. Exclusive breastfeeding abandonment was analyzed in the first, second, and fourth months after childbirth. The Edinburgh Postnatal Depression Scale was applied to identify depressive symptoms in the first and second meetings, with a score of ≥ 12 considered as the cutoff point. Socioeconomic, demographic, and obstetric variables were investigated, along with emotional conditions and the new mothers’ social network during pregnancy and the postpartum period.
The prevalence of exclusive breastfeeding abandonment at 30, 60, and 120 days postpartum was 53.6% (n = 90), 47.6% (n = 80), and 69.6% (n = 117), respectively, and its incidence in the fourth month compared with the first was 48.7%. Depressive symptoms and traumatic delivery were associated with exclusive breastfeeding abandonment in the second month after childbirth. In the fourth month, the following variables were significant: lower maternal education levels, lack of homeownership, returning to work, not receiving guidance on breastfeeding in the postpartum period, mother’s negative reaction to the news of pregnancy, and not receiving assistance from their partners for infant care.
Psychosocial and sociodemographic factors were strong predictors of early exclusive breastfeeding abandonment. Therefore, it is necessary to identify and provide early treatment to nursing mothers with depressive symptoms, decreasing the associated morbidity and promoting greater duration of exclusive breastfeeding. Support from health professionals, as well as that received at home and at work, can assist in this process.
Revista de Saúde Pública 12/2014; 48(6):985-994. DOI:10.1590/S0034-8910.2014048005340 · 1.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An accurate estimate of body composition is important in assessing and monitoring the nutritional status of adolescents.
To compare the accuracy of 2 electrical bioimpedance devices with that of dual-energy X-ray absorptiometry (DXA) to predict body fat in Brazilian adolescents.
We evaluated 500 adolescents aged between 10 and 19 years, stratified by sex and divided into overweight and non-overweight groups. The percentage of body fat (%BF) was estimated using 2 types of electrical bioimpedance devices: BIA1 (horizontal tetrapolar bioimpedance equipment) and BIA2 (vertical 8-electrode bioimpedance equipment), as well as by DXA. A Bland- Altman plot was used to calculate the total errors and standard errors of estimate.
Considering BMI for age, 19.4% were overweight and 47.4% as assessed by %BF of DXA were overweight. The %BF estimated by BIA2 correlated well (p < 0.05) with the %BF predicted by DXA, and only the total errors for BIA2 in the overweight group were acceptable (≤2.5%). The standard errors of estimate was.
Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 12/2014; 30(n06):1270-1278. DOI:10.3305/nh.2014.30.6.7793 · 1.25 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective. To evaluate the influence of the weight gain rate at 4-6 months on nutritional status and body composition in children between 4 and 7 years of age. Methods. Retrospective cohort study, sample of 257 children. Data collection was performed in two stages, with the first relating to retrospective data of weight gain from birth to the first 4-6 months of life in the patient records. Measurements of weight, height, waist circumference, and body composition in children between ages 4 and 7 years were obtained. Nutritional status was assessed by the BMI/age. Control variables, such as pregnancy, breastfeeding, lifestyle, and sociodemographics, were studied. Descriptive analysis and multiple linear regression were performed. Results. In the nutritional status assessment, the prevalence of overweight observed was 24.9%. After adjusting for control variables, it was found that the increase of the WGR at 4-6 months of age explained the occurrence of higher BMI/age, percentage of total body fat, body fat percentage in the android region, and waist circumference in children between 4 and 7 years of age. Conclusion. The increase of the WGR in the first months of life can lead to the occurrence of higher values of parameters of nutritional status and body composition in later life.
[Show abstract][Hide abstract] ABSTRACT: This paper describes NICeSim, an open-source simulator that uses machine learning (ML) techniques to aid health professionals to better understand the treatment and prognosis of premature newborns.
Artificial Intelligence in Medicine 10/2014; 62(3). DOI:10.1016/j.artmed.2014.10.001 · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: O objetivo deste texto é fomentar a reflexão e a crítica no processo de elaboração de
projetos de pesquisa em nutrição clínica. São apresentados aspectos relativos a
evidências, validade e confiabilidade dos resultados dos estudos nesse campo. É
imprescindível que ocorra adequado planejamento da pesquisa, desde a definição do
delineamento e do tipo do experimento, passando pelos aspectos éticos, escolha da
população e cálculo do tamanho amostral até a avaliação da factibilidade dos riscos
envolvidos na sua condução. Após a coleta das informações, as etapas seguintes
correspondem à descrição dos resultados, análise estatística, verificação da
consistência desses resultados e, ao final, sua adequada interpretação.
Revista de Nutrição 10/2014; 27(5):597-604. DOI:10.1590/1415-52732014000500008 · 0.35 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Although exercise promotes beneficial effects in diabetic patients, some studies have questioned the degree of their importance in terms of the increase in total energy expenditure. In these studies, the decrease of physical activity levels (PAL) was referred as "compensatory effect of exercise". However, our aim was to investigate whether aerobic exercise has compensatory effects on PAL in type 2 diabetes patients. Eight volunteers (51.1 ± 8.2 years) were enrolled in a supervised exercise programme for 8 weeks (3 d · wk(-1), 50-60% of VO2 peak for 30-60 min). PAL was measured using tri-axial accelerometers in the 1st, 8th and 12th weeks. Biochemical tests, cardiorespiratory fitness, anthropometric assessment and body composition were measured in the 2nd and 11th weeks. Statistical analysis was performed using non-parametric tests (Friedman and Wilcoxon, P < 0.05). We found no significant differences in PAL between intervention periods, and participants spent the majority of their awake time in sedentary activities. However, the exercise programme generated a significant 14.8% increase in VO2 peak and a 15% reduction in fructosamine. The exercise programme had no compensatory effects on PAL in type 2 diabetes patients, but improved their cardiorespiratory fitness and glycaemic control.
[Show abstract][Hide abstract] ABSTRACT: Introduction: Visceral fat accumulation is associated with several changes, such as, increased production of inflammatory biomarkers, especially, C-reactive protein (CRP) and fibrinogen. Anthropometric measurements for central adiposity evaluation, such as, waist circumference (WC) and sagittal abdominal diameter (SAD) have been highlighted. However, there is no consensus on the best anatomical site for measurement. Objective: To evaluate the reliability of different measurements of WC and SAD and verify their capacity to discriminate changes in inflammatory biomarkers. Method: 130 men (20-59 years) were assessed, having measurements of weight, height, WC and SAD. It was considered as the cutoff point for high-sensitivity CRP (hs-CRP) values >= 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. Results: All measurements presented an intraclass correlation coefficient between 0.998 and 0.999. WC measured at the umbilical level (AUC=0.693 +/- 0.049) and the smallest circumference between the thorax and the hips (AUC=0.607 +/- 0.050) had greater ability to discriminate changes in concentrations of hs-CRP and fibrinogen, respectively. SAD (umbilical level) showed the better ability to detect changes in concentrations of hs-CRP (AUC=0.698 +/- 0.049) and fibrinogen (AUC=0.625 +/- 0.049), according to the ROC analysis (p<0.05). Conclusion: WC (smallest circumference between the thorax and the hips) and SAD (umbilical level) are the anatomic sites of measurement for use in predicting the inflammatory risk in apparently health men.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 09/2014; 30(n03):663-670. DOI:10.3305/nh.2014.30.3.7534 · 1.25 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: To analyze the influence of metabolic syndrome components in insulin resistance, by gender and adolescence phase. Subjects and methods: We evaluated biochemical, clinical, lifestyle and body composition data of 800 adolescents from 10 to 19 years old, from both genders, from Viçosa, MG/Brasil, and there was the division by stage: early (10 to 13 years), intermediate (14 to 16 years) and late (17 to 19 years). Results: 10.3 and 3.4% had, respectively, insulin resistance and metabolic syndrome. In the initial phase there was a higher prevalence of dyslipidemia and intermediate hyperuricemia and excess body fat. Females had a higher prevalence of dyslipidemia, excess body fat and insulin resistance and higher male prevalence of low HDL, hyperuricemia and blood pressure changes. Those from the initial phase had higher levels of total cholesterol, LDL, HDL, triglycerides, fasting glucose and waist/hip ratio, stayed less time sitting and had more meals (p < 0.05) in relation to other phases. The final model, adjusted for gender, was different for each phase of adolescence. Conclusions: Insulin resistance is associated with inadequate body composition, in biochemical levels and lifestyle, being the factors associated different in each phase of adolescence. Arq Bras Endocrinol Metab. 2014;58(6):610-8.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE:
To study anthropometrical and body composition variables as predictors of risk
for metabolic alterations and metabolic syndrome in female adolescents.
Biochemical, clinical and corporal composition data of 100 adolescents from 14 to
17 years old, who attended public schools in Viçosa, Southeastern Brazil, were
Regarding nutritional status, 83, 11 and 6% showed eutrophia, overweight/obesity
and low weight, respectively, and 61% presented high body fat percent. Total
cholesterol presented the highest percentage of inadequacy (57%), followed by
high-density lipoprotein (HDL - 50%), low-density lipoprotein (LDL - 47%) and
triacylglycerol (22%). Inadequacy was observed in 11, 9, 3 and 4% in relation to
insulin resistance, fasting insulin, blood pressure and glycemia, respectively.
The highest values of the fasting insulin and the Homeostasis Model
Assessment-Insulin Resistance (HOMA-IR) were verified at the highest
quartiles of body mass index (BMI), waist perimeter, waist-to-height ratio and
body fat percent. Body mass index, waist perimeter, and waist-to-height ratio were
the better predictors for high levels of HOMA-IR, blood glucose and fasting
insulin. Waist-to-hip ratio was associated to arterial hypertension diagnosis. All
body composition variables were effective in metabolic syndrome diagnosis.
Waist perimeter, BMI and waist-to-height ratio showed to be good predictors for
metabolic alterations in female adolescents and then should be used together for
the nutritional assessment in this age range.
Revista Paulista de Pediatria 06/2014; 32(2):207-15. DOI:10.1590/0103-0582201432215313
[Show abstract][Hide abstract] ABSTRACT: The scope of this systematic review was to relate food insecurity, detected using the Brazilian Food Insecurity Scale (EBIA), with anthropometric, dietary and social indicators. The search was conducted in electronic databases (ScieLO, LILACS, MEDLINE), with a selection of studies by titles and abstracts, and later full reading. Studies identified in bibliographic references were included. Of the 215 reviewed, 15 fulfilled inclusion criteria (association between insecurity and anthropometric, dietary or social indicators, detected by the EBIA), whereby three had more than one variable of interest. A relationship was observed between food insecurity and height/age and weight/age of child indices, as well as obesity in women. Lower consumption of regulating, tissue-building food products and iron, and higher carbohydrate intake are associated with food insecurity. There was a relationship between social indicators, such as lower income and education, lack of employment and basic sanitation. The EBIA was associated in some studies with nutritional and social indicators, but should be used in conjunction with other tools in order to cover the multiple dimensions of food and nutrition security.
[Show abstract][Hide abstract] ABSTRACT: Introduction: Epidemiological studies have shown an association between coronary heart disease and emerging cardiovascular risk factors, such as, levels of fibrinogen and high-sensitivity C-reactive protein (hs-CRP). Objectives: To verify the ability of biochemical indicators in discriminating changes in the levels of hs-CRP and fibrinogen, in apparently healthy adult men. Methods: Were evaluated 130 apparently healthy men (20-59 years), having measurement of weight and height. Biochemical measurements (lipid profile, fasting glucose, uric acid, hs-CRP and fibrinogen) were performed. Body mass index, total cholesterol/HDL-c and LDL-c/HDL-c ratios were calculated. It was considered as the cutoff point for hs-CRP values ≥0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. Results: The uric acid showed the best correlation (r = 0.325) and the higher area under the ROC curve (0.704 ± 0.054), showing greater ability to discriminate higher levels of hs-CRP (p < 0.01). The total cholesterol/HDL-c ratio (r = 0.222) and the LDL-c/HDL-c ratio (r = 0.235) showed the best correlations and the higher areas under the ROC curves (0.624 ± 0.049 and 0.624 ± 0.049) in identify higher levels of fibrinogen (p < 0.05). Conclusion: The uric acid and the total choles - terol/HDL-c and the LDL-c/HDL-c ratios showed greater ability to identify changes in the levels of hs-CRP and fibrinogen, respectively. It was suggested the use of biochemical markers in the clinical practice, in order to establish preventive action for cardiovascular disease in apparently healthy adult men.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 04/2014; 29(n04):935-940. DOI:10.3305/nh.2014.29.4.7094 · 1.25 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To analyze the impact of timing of clamping and obstetric, biological and socioeconomic factors on the iron stores of full-term newborns.
Cross-sectional study between October 2011 and July 2012 in which hematological parameters were evaluated for newborns in Viçosa, MG, Southeastern Brazil. It involved collecting 7 mL of umbilical cord blood from 144 full-term not underweight newborns. The parameters investigated were complete blood count, serum iron, ferritin and C-reactive protein. The time of umbilical cord clamping was measured using a digital timer without interfering in the procedures of childbirth. The birth data were collected from Live Birth Certificates and other information was obtained from the mother through a questionnaire applied in the first month postpartum. Analysis of multiple linear regression was then used to estimate the influence of biological, obstetrics and socioeconomic factors on the ferritin levels at birth.
The median ferritin was 130.3 µg/L (n = 129, minimum = 16.4; maximum = 420.5 µg/L), the mean serum iron was 137.9 μg/dL (n = 144, SD = 39.29) and mean hemoglobin was 14.7 g/dL (n = 144, SD = 1.47). The median time of cord clamping was 36 seconds, ranging between 7 and 100. The bivariate analysis detected an association between ferritin levels and color of the child, timing clamping of 60 seconds, type of delivery, the presence of gestational diabetes and per capita family income. In multivariate analysis, the variables per capita income, number of antenatal visits and length at birth accounted for 22.0% of variation in ferritin levels.
Iron stores at birth were influenced by biological, obstetric and social characteristics. Tackling anemia should involve creating policies aimed at reducing social inequalities, improving the quality of antenatal care, as well as implementing a criterion of delayed clamping of the umbilical cord within the guidelines of labor.
Revista de saude publica 02/2014; 48(1):10-18. DOI:10.1590/S0034-8910.2014048004928 · 1.22 Impact Factor