Helen Hermana Miranda Hermsdorff’s research while affiliated with Federal University of Viçosa and other places

Consuming functional foods alongside the energy-restricted diet can be a great ally in weight loss and improving cardiometabolic risk factors. Whether Brazil nut (BN) consumption in the context of energy restriction affects them remains to be answered. We aimed to evaluate the effect of BN within an energy-restricted diet on cardiometabolic risk markers among women. This is an eight-week, quasi-experimental, controlled nutritional intervention study. The women were allocated into two energy-restricted (-500 kcal/d) groups: a control free of BN (n=29) and a BN-group (BNG) (n=27) with 2 units/day of BN (~ 347 µg of selenium). Both groups had similar weight loss, but in the BNG, the serum selenium increased by 276.7% and apolipoprotein A1 increased by 27.4%. In addition, BNG had a more pronounced reduction in liver enzymes, and presented the most preserved percentages of lean and fat-free mass in relation to the control group. Consuming 2 units/day of BN in an 8-week weight loss intervention improved cardiometabolic risk markers in women. Our results suggest that regular consumption of BN during energy-restricted diets may be a strategy to minimize adiposity, preserve lean mass, improve serum selenium status, lipid, and liver metabolism markers, and, consequently, help obesity management and its comorbidities.

Purpose Insulin resistance (IR) is an important mediator of the relationship between food intake and the development of type 2 diabetes mellitus (T2DM). Most of the few studies that have evaluated this relationship relied on the triglyceride-glucose index (TyG index) tool. Here, we evaluated the association between leucine intake, glycemic index, and T2DM with related mediators in individuals throughout secondary cardiovascular prevention. Methods Sociodemographic, anthropometric, clinical, and food intake data were recorded from the baseline of the trial Brazilian Cardioprotective Nutritional (BALANCE) Program. Path analysis was used to explore the relationships between variables. Results This study enrolled 2,247 participants (median age of 63.0 (45–91) years; 58.8% males). The TyG index showed positive association with T2DM (SC = 0.356; p < 0.001) and negative association with leucine intake (SC= -0.046; p = 0.028). The glycemic index (GI) was positively associated with BMI (SC = 0.072; p = 0.001), and BMI had an indirect positive effect on T2DM mediated by the TyG index (SC = 0.078; p < 0.001). Leucine intake had indirect negative effect on T2DM, mediated by the TyG index (SC= -0.016; p = 0.029), while GI had indirect positive effect on T2DM mediated by BMI and TyG index (SC = 0.006; p = 0.002). Conclusion Leucine intake and GI showed indirect association with T2DM, mediated by TyG and BMI, in individuals on secondary cardiology prevention, reinforcing the importance of assessing food consumption and promotin food quality improvements for cardiometabolic control by different pathways. Trial registration clinicaltrials.gov identifier : NCT01620398. Registered 15 June 2012.

Background Post-Acute COVID-19 Syndrome (PACS) is an important sequalae of COVID-19. Then, our objective was to analyze the risk and protective factors for PACS in Brazilian adults participating in the Cohort of Universities of Minas Gerais (CUME Study), with emphasis on COVID-19 vaccination and food consumption. Methods In this sub-study, we included 2,065 participants of CUME Study who answered the baseline questionnaire in 2016 or 2018 or 2020 or 2022, and the follow-up COVID-19/PACS-specific questionnaire in 2023. PACS diagnosis was based on self-reporting of continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. To estimate the risk and protective factors for PACS, hierarchical multivariate statistical analysis was conducted using the Cox regression technique, producing two models: (1) focusing on consumption of macro and micronutrients; (2) focusing on consumption of food groups. Results After a median of 5.5 years of follow-up, 54.4% of the participants reported PACS. When we analyzed the consumption of macro and micronutrients, higher intake of proteins (HR: 1.36; 95% CI: 1.06–1.74-4th quartile) and lipids (HR: 1.23; 95% CI: 1.02–1.48-4th quartile) were risk factors for PACS. On the other hand, higher intake of vitamin C (HR: 0.78; 95% CI: 0.64–0.94-4th quartile), vitamin D (HR: 0.81; 95% CI: 0.67–0.99-4th quartile), and zinc (HR: 0.66; 95% CI: 0.52–0.83-4th quartile) were protective factors for the outcome (model 1). When we analyzed the consumption of food groups, higher intake of eggs (HR: 1.59; 95% CI: 1.34–1.89-4th quartile) increased the risk of PACS, whereas, respectively, higher and intermediate consumption of white meat (HR: 0.84; 95% CI: 0.71–1.00-4th quartile) and vegetables (HR: 0.81; 95% CI: 0.67–0.99-2nd quartile; HR: 0.81; 95% CI: 0.67–0.99-3rd quartile) decreased the risk of the outcome (model 2). In both models, pre-infection COVID-19 vaccination was a protective factor for PACS. Conclusion A healthy diet, with higher consumption of white meat, vegetables and specific micronutrients (vitamin C, vitamin D, zinc), in parallel with pre-infection COVID-19 vaccination, is essential to reduce the risk of PACS.

Purpose of Review The obesity is a multifactorial disease, result of high adiposity and excessive body fat, with closed relation to the development of other chronic disease. The growing obesity-related costs has relevant public health impact. In turn, the polyphenol is a dietary bioactive compound with recognized antioxidant propriety and healthy benefits. The polyphenol supplementation can be a promising strategy for obesity treatment, due to its potential antiadipogenic and metabolic control effects, improving quality of life of this population. This systematic review evaluated the effect of polyphenol supplementation on adiposity in overweight adults and elderly people (Systematic Review Registration: CRD42024586193). Recent Findings Current research demonstrates that polyphenol supplementation resulted in a significant decrease in markers of central adiposity (percentage of body fat, fat mass, waist circumference) and visceral adiposity (visceral adipose tissue). The mechanisms may be involved in the activation of lipid turnover pathways, AMPK activation and suppression of transcription factors (SREBPs, PPAR-γ and C/EBP-α) and key enzymes in lipid synthesis in adipose tissue. Furthermore, polyphenol supplementation has also beneficial effects on controlling of blood pressure, blood glucose and lipid profile, contribute to the prevention of other chronic metabolic disorders. Summary Adiposity refers to the distribution of body fat, closely related to cardiometabolic risk, while polyphenols are phytochemicals with potential health-promoting effects. However, the role of these bioactive compounds in controlling adiposity is not well established. This systematic review presents antiadipogenic and metabolic control effects of the dietary polyphenol supplementation. However, there is no consensus on a specific dosage or form of presentation that generates the best results. Further studies are needed to elucidate better the potential effect of these compounds and related-pathway, to perform clinical validation of their use, and to establish the benefits of their long-term use.

Resumo O artigo descreve a construção e a validação de um instrutivo destinado ao cuidado nutricional de pessoas com obesidade grave no Sistema Único de Saúde (SUS). Na construção do instrutivo, uma ampla revisão de literatura foi realizada para identificação e discussão dos tópicos a serem abordados. As validações de conteúdo e aparente se deram mediante técnica Delphi e grupos focais, respectivamente, com juízes nutricionistas especialistas e práticos de todas as regiões do Brasil. De acordo com a técnica Delphi, os atributos do instrutivo e seu conteúdo como um todo foram avaliados como adequadamente e suficientemente abordados, mediante valores obtidos para o índice de validade de conteúdo (IVC > 0,8). Nos grupos focais, atingiu-se a saturação de conteúdo. Além disso, discussões alinhadas com a realidade do SUS foram conduzidas e, posteriormente, incorporadas ao instrutivo, para adequar a versão final às necessidades dos profissionais do SUS. Em conclusão, o instrutivo construído para preencher uma lacuna sobre o cuidado nutricional da pessoa com obesidade grave apresenta conteúdo adequado em qualidade e tópicos de interesse (validação de conteúdo), aplicável dentro da realidade do(s) nutricionistas do SUS (validade aparente).

This article describes the construction and validation of an instruction manual geared toward nutritional care (NC) for people with severe obesity in the Brazilian Unified Health System (SUS). In the production of this instruction manual, a broad literature review was conducted for the identification and discussion of topics to be treated. The content and appearance validity were conducted according to the Delphi technique and to focus groups, respectively, with evaluators who were nutritionists and practitioners, from different regions of Brazil. According to the Delphi technique, the instruction attributes and their content as a whole were properly and sufficiently evaluated according to values obtained for the Content Validity Index (CVI > 0.8). In the focus groups, the saturation of content was reached. Furthermore, discussions considering the reality of SUS were conducted and subsequently incorporated into the instructions in order to adequate the final version of the instructions to SUS professionals’ needs. In conclusion, the instruction manual produced to fill the gap regarding nutritional care for people with severe obesity presents an adequate content in terms of both quality and topics of interest (content validation), and is applicable within the reality of SUS nutritionists (appearance validity).

Background: Few studies have evaluated the impact of branched-chain amino acid (BCAA) intake on the risk of obesity in adults. The results are contradictory, and the causality has not been explored. This study assessed the association between BCAA intake and obesity incidence among Brazilian adults and investigated the potential moderating role of the plant-based index (PDI) in this relationship. Methods: A longitudinal study was conducted between 2016 and 2022, with 3090 participants (2043 women, 1047 men; mean age 34 years) from the Cohort of Universities of Minas Gerais (CUME) Study. Data were collected through an online questionnaire. The relationship between BCAA intake and obesity incidence was assessed using crude and adjusted Cox regression models. Restricted cubic spline analysis (RCS) was used to estimate the nonlinearity. The multiplicative interaction with PDI was tested. Results: The overall incidence of obesity was 192 cases (6.21%). The incidence was 16.4/1000 person-years in females; 21.8/1000 person-years in males; and 18.3/1000 person-years total, with a mean follow-up period of 3.4 years. Compared to the first tertile, the highest intake tertiles for BCAA (HR = 1.50, 95% CI = 1.03–2.18), isoleucine (HR = 1.52, 95% CI = 1.04–2.22), and leucine (HR = 1.51, 95% CI = 1.03–2.20) were independently associated with obesity risk. BCAA intake above 16 g/day increases the risk of obesity. Conclusions: There was a positive association between the intake of BCAA, isoleucine, and leucine with the risk of obesity. The PDI accentuated the association between BCAA intake and obesity in both the lowest and highest quintiles.