To determine the association among bone mineral content, sociodemographic, anthropometric and behavioral factors, and health status of Brazilian adults.
This was a cross-sectional, population-based ...study including 701 individuals from both sexes aged between 20 and 59 years. DEXA was used to evaluate dependent variable. The associations were evaluated using linear regression models stratified by sex.
When mean bone mineral content values were compared, we found significant differences related to sex and all the independent variables evaluated. In the adjusted models, we identified an inverse association between bone mineral content and age in both sexes. Among men, to be overweight and/or obese, be highly educated, and have almost sufficiency of 25(OH)D were associated with higher bone mineral content values. On the other hand, among women, to be non-white skin color, overweight and/or obese were associated with better bone health. The main factors associated with low total bone mineral density were advanced age, white skin color, low level of formal education, eutrophy, and 25(OH)D deficiency.
Our results may help to identify adults who are at higher risk, and these findings should be used as guidelines for prevention and early diagnosis.
To establish percentile curves for measures and indices of body composition by age and sex and compare them with data from other ethnic groups.
Cross-sectional, population-based study with adults ...aged 20-59 years (n = 689). Percentile curves adjusted by a third degree polynomial function were constructed for skeletal mass index (SMI), fat mass index, body fat, and load-capacity metabolic indices (LCMI) based on dual-energy X-ray absorptiometry (DXA).
SMIweight and SMIBMI showed decline from the third decade of life in both sexes, whereas SMIheight was not able to identify lean mass loss over the ages studied. There was a slight drop at the end of the fifth decade (50-59 years) in men. Among Americans and Chinese, the 50th percentile curve of SMIheight showed an earlier decline. The estimates of adiposity and LCMI curves peaked between 40-49 years and Americans and Chinese maintained an upward curve throughout adulthood.
The data and curves showed that the SMI adjusted for BMI and body weight were more adequate in detecting the decline of lean mass in adults due to aging. In contrast, SMIheight had a positive correlation with age and its curve increased throughout the evaluated age groups. The results contribute to the evaluation to the nutritional status of adults and to the prevention and treatment of outcomes related to adiposity and deficit lean mass.
This paper explores the association between job strain and adiposity, using two statistical analysis approaches and considering the role of gender. The research evaluated 11,960 active baseline ...participants (2008-2010) in the ELSA-Brasil study. Job strain was evaluated through a demand-control questionnaire, while body mass index (BMI) and waist circumference (WC) were evaluated in continuous form. The associations were estimated using gamma regression models with an identity link function. Quantile regression models were also estimated from the final set of co-variables established by gamma regression. The relationship that was found varied by analytical approach and gender. Among the women, no association was observed between job strain and adiposity in the fitted gamma models. In the quantile models, a pattern of increasing effects of high strain was observed at higher BMI and WC distribution quantiles. Among the men, high strain was associated with adiposity in the gamma regression models. However, when quantile regression was used, that association was found not to be homogeneous across outcome distributions. In addition, in the quantile models an association was observed between active jobs and BMI. Our results point to an association between job strain and adiposity, which follows a heterogeneous pattern. Modelling strategies can produce different results and should, accordingly, be used to complement one another.
To evaluate the association between the consumption of ultra-processed food and the incidence of depression in Brazilian adults.
This longitudinal study included 2572 participants (M = 936 and ...F = 1636, mean age of 36.1 years) from the Cohort of Universities of Minas Gerais – CUME Project, Brazil. Ultra-processed food (UPF) consumption (in % of daily energy intake, DEI), as defined by the NOVA food classification system, was assessed at baseline using a validated semi-quantitative 144-item food frequency questionnaire. Participants were classified as incident cases of depression if they reported a medical diagnosis of depression in at least one of the follow-up questionnaires. Crude and adjusted cox regression models were used to assess the relationship between UPF consumption and the incidence of depression.
After a mean of follow-up of 2,96 years, a total of 246 incident cases of depression were identified. The mean consumption of UPF was 44 g/d or 24 % of DEI. Participants in the highest quartile of UPF consumption (31 to 72 % of DEI) had a higher risk of developing depression (HR = 1.82 95 % CI = 1.15–2.88) than those in the lowest quartile (0 to 16 % of DEI) after adjusting for potential confounders.
Higher UPF consumption is a risk factor of depression incidence in Brazilian adults with high education level.
•In Brazil, the prevalence of this disease among its adult population is 5.8%.•The high incidence of depression observed in CUME participants is almost double that estimated for the Brazilian population.•The high incidence of depression among CUME participants may be due to their contemporary lifestyles.•The consumption of ultra-processed foods is positively associated with the manifestation of depression.
Normal weight obesity (NWO), which is defined by the excess of body fat in normal weight individuals, has been neglected among adolescents, due to their normal weight and young age. Few studies were ...carried out on the topic with adolescents.
To analyze whether the NWO is associated with cardiometabolic risk factors in adolescents.
Cross-sectional study, with 506 normal weight adolescents aged 10-19 years, selected in schools in Brazil. Weight, height, waist circumference (WC) and neck circumference were obtained and the body mass index (BMI) and waist/height ratio (WHR) were calculated. Body composition analysis was performed using dual-energy X-ray absorptiometry. The clinical evaluation included lipid and glycid profile, platelets, leukocytes, lymphocytes, monocytes, uric acid and blood pressure, as well as the presence of metabolic syndrome (MS) and its components. NWO was defined by the presence of normal weight, according to BMI for age, and excess body fat (≥25% and ≥30% in males and females, respectively). Logistic regression models were used to analyze associations between normal weight adolescents with and without the NWO phenotype.
NWO associated positively with abdominal obesity, analyzed through WC (OR = 1.36;95%CI = 1.27-1.47), WHR (OR = 25.89;95%CI = 10.43-64.26) and android fat (OR = 1.49;95%CI = 1.36-1.63); insulin resistance (OR = 4.09;95%CI = 1.72-9.70), hyperinsulinemia (OR = 3.83;95%CI = 1.50-9.76) and the highest values of the triglycerides-glycemia index (OR = 4.28;95%CI = 1.21-15.08); uric acid (OR = 1.81;95%CI = 1.29-2.55), as well as the changes in LDL (OR = 3.39;95%CI = 1.47-7.81), total cholesterol (OR = 2.77;95%CI = 1.22-6.29), and in at least one (OR = 1.87;95%CI = 1.04-3.37) or two (OR = 6.61;95%CI = 1.45-30.19) components of MS.
NWO is associated with the presence of cardiometabolic risk factors in adolescents.
Ambulatory blood pressure monitoring (ABPM) allows the assessment of cardiovascular risk markers that cannot be obtained by casual measurements; however, the evidence on the association between food ...consumption and blood pressure (BP) assessed by ABPM is scarce. We aimed to evaluate the association between food consumption by degree of processing and ambulatory BP.
Cross-sectional analysis (2012–2014) of data from a subsample (n = 815) of ELSA-Brasil cohort participants who performed 24-h ABPM was conducted. Systolic (SBP) and diastolic (DBP) BP means and variability during the 24 h and subperiods (sleep and wake), nocturnal dipping, and morning surge were evaluated. Food consumption was classified according to NOVA. Associations were tested by generalized linear models. The consumption of unprocessed, minimally processed foods, and culinary ingredients (U/MPF&CI) was 63.1% of daily caloric intake, 10.8% of processed (PF), and 24.8% of ultraprocessed (UPF). A negative association was found between U/MPF&CI consumption and extreme dipping (T2: odds ratio OR = 0.56, 95% confidence interval CI = 0.55–0.58; T3: OR = 0.55; 95% CI = 0.54–0.57); and between UPF consumption and nondipping (T2: OR = 0.68, 95% CI = 0.55–0.85) and extreme dipping (T2: OR = 0.63, 95% CI = 0.61–0.65; T3: OR = 0.95, 95% CI = 0.91–0.99). There was a positive association between PF consumption and extreme dipping (T2: OR = 1.22, 95% CI = 1.18–1.27; T3: OR = 1.34, 95% CI = 1.29–1.39) and sleep SBP variability (T3: Coef = 0.56, 95% CI = 0.03–1.10).
The high consumption of PF was associated with greater BP variability and extreme dipping, while the U/MPF&CI and UPF consumption were negatively associated with alterations in nocturnal dipping.
•Studies investigating possible determinants of the Children's Dietary Inflammatory Index (C-DII) are scarce•Breakfast skipping was associated with higher C-DII scores•Sedentary behavior accentuates ...adverse effects of breakfast skipping on C-DII•Interventions encouraging healthy eating and lifestyle behaviors are required
Missed nutrients from skipped meals affect diet quality. However, the extent to which breakfast skipping affects the inflammatory potential of a diet, as indicated by Children's Dietary Inflammatory Index (C-DII) score, remains unknown. We aimed to evaluate the association between breakfast skipping and C-DII score, and investigate the presence of interaction with sociodemographic factors and sedentary behavior.
This representative cross-sectional study enrolled 378 children ages 8 and 9 y from Viçosa, Minas Gerais, Brazil in 2015. We collected sociodemographic data (sex, age, race, and household per-capita income) and screen time using a semistructured questionnaire. Dietary intake and breakfast skipping were evaluated by three 24-h dietary recalls from which energy-adjusted C-DII scores were calculated. We performed linear regression models to test the associations and possible interactions.
The prevalence of breakfast skipping and sedentary behavior were 20.1% and 47.6%, respectively. The mean ± standard deviation of the C-DII scores was 0.60 ± 0.94, and ranged from –2.16 (most anti-inflammatory diet) to 2.75 (most proinflammatory diet). Breakfast skipping was associated with a higher intake of lipids, monounsaturated fat, and polyunsaturated fat, as well as lower carbohydrate, calcium, and magnesium intake (P < 0.05). After adjustment, breakfast skippers had higher C-DII scores (β = 0.33; 95% confidence interval, 0.12–0.54). This association was more pronounced in children with sedentary behavior (β = 0.53; 95% confidence interval, 0.24–0.82).
Breakfast skipping was associated with a more proinflammatory diet in school-age children, and there was significant interaction with sedentary behavior. Early childhood interventions encouraging the habit of eating a breakfast and engaging in physical activity may help reduce the dietary inflammatory potential and prevent related cardiometabolic disorders.
•Mothers’ diet inflammatory index was associated with the inflammatory potential of their children's diets in the complementary feeding period.•Consumption of proinflammatory diets by children was ...associated with the absence of breastfeeding practice.•Maternal education had a direct negative effect on the child's dietary inflammatory index.•Maternal education had a direct negative effect on infant overweight.
The aim of this study was to assess the dietary inflammatory index (DII) and its association with maternal factors and excess body weight in Brazilian children aged <2 y during complementary feeding.
This was a cross-sectional study (2016–2019), conducted with 231 mothers and children ages 6 to 24 mo. The food consumption of the mother-child dyad was obtained through the mean of three 24-h recalls, as well as information on the consumption of breast milk. The DII was used to verify the quality of the diet. Children's weight and length were measured, and the weight/height index was calculated. Path analysis was used to assess the interrelationships between variables. Multiple linear regression was conducted to identify the components of the child's DII (C-DII) that contributed the most to explaining its variation.
The children had an anti-inflammatory diet (C-DII –0.37 ± 0.91) whereas the mothers had a proinflammatory diet (M-DII +0.24 ± 0.86). Fiber was the nutrient that contributed most to the variations in the C-DII. Approximately 28% of children were overweight. In the pathway analysis, we verified a direct negative effect of education on excess body weight (standardized coefficients SC, –0.180; P = 0.034) and C-DII (SC, –0.167; P = 0.002); negative direct effect of breastfeeding on the C-DII (SC, –0.294; P < 0.001); and positive direct effect of M-DII on C-DII (SC, 0.119; P = 0.021).
Children's proinflammatory diet during the period of complementary feeding was associated with maternal proinflammatory diets, lower education, and absence of breastfeeding practice.
•The quality of the BALANCE Program intervention has improved during all follow-up.•The BALANCE Program was positively evaluated according to different indexes.•Brazilian diet may achieve a ...cardioprotective nutritional pattern.
Dietary modifications are essential strategies for cardiovascular disease prevention. However, studies are needed to investigate the diet quality of individuals undergoing secondary prevention in cardiology and who received dietary intervention based on cardiovascular disease management. We prospectively evaluated the diet quality in the Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial). We hypothesized that the BALANCE Program could improve patients’ dietary pattern according to different indices of diet quality such as the Dietary Inflammatory Index (DII); the dietary total antioxidant capacity; overall, healthful, and unhealthful Plant-Based Diet Index (PDI, hPDI, and uPDI, respectively); and modified Alternative Healthy Eating Index (mAHEI). This multicenter randomized, controlled trial included patients aged ≥45 years randomly assigned to either the experimental or control group. Data from 2185 participants at baseline and after 12, 24, 36, and 48 months showed that the intervention group (n = 1077) had lower mean values of DII and higher dietary total antioxidant capacity, PDI, hPDI, and mAHEI than the control group. The results also showed differences between the follow-up times for DII, hPDI, and uPDI (48 months vs baseline) and for PDI and mAHEI (24 months vs baseline), regardless of group. The interaction analysis demonstrated that the intervention group showed better results than the control group at 12, 24, 36, and 48 months for the DII and at months 12, 36, and 48 for the mAHEI. Our results provide prospective evidence that the BALANCE Program improved the diet quality in those in secondary cardiovascular prevention according to different indices, with the intervention group showing better results than the control group.
The BALANCE Program Trial was positively evaluated according to indices of diet quality. The intervention group had lower mean values of DII and higher dTAC, PDI, hPDI, and mAHEI than the control group. The results also showed differences between the follow-up times for all indices, except for dTAC, regardless of group. Finally, the interaction analysis (group × time effect) demonstrated that the intervention group showed better results than the control group for DII and mAHEI. *48 months vs baseline; **24 months vs baseline. CAD, coronary artery disease; CVD, cardiovascular disease; DII, Dietary Inflammatory Index; dTAC, dietary total antioxidant capacity; hPDI, healthy Plant-Based Diet Index; mAHEI, modified Alternative Healthy Eating Index; PAD, peripheral arterial disease; PDI, overall Plant-Based Diet Index; uPDI, unhealthy Plant-Based Diet Index. Display omitted
The aim of this study is to identify maternal consumption of processed and ultra-processed foods and to verify the factors associated with the supply of these foods to Brazilian children. This is a ...cross-sectional study with 231 mothers and children aged from 6 to 24 months. The mother's and children's food consumption was measured using three 24-hour recalls. The foods consumed were categorised according to the NOVA classification. The data were analysed by multinomial logistic regression. The supply of processed and ultra-processed foods to children was associated with the child's age (T2: OR = 1.17, p<.001; T3: OR = 1.23, p<.001), the absence of breast milk consumption (T3: OR = 3.82, p=.006) and the greater consumption of these foods by mothers (T2: OR = 3.15, p=.018; T3: OR = 4.59, p=.004). We conclude that mothers who consume processed and ultra-processed foods also include them in complementary feeding, and the consumption of these foods by the child increases with age, absence of breastfeeding, and with increased maternal consumption.
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