Intake of sugary beverages has been associated with obesity and chronic non-communicable diseases, thereby increasing the direct health costs related to these diseases. Front-of-package nutrition ...labeling (FoPNL) aims to help consumers understand food composition, thereby improving food choices and preventing the development of such diseases.
To estimate, over five years, the impact of implementing FoPNL in Brazil on the prevalence of excess body weight and obesity in adults who consume sugary beverages and the direct costs related to such problems.
A simulation study to performed to estimate the effect of FoPNL implementation on the prevalence of excess body weight and obesity. The VIGITEL research database (2019), published in the 2020 report, was used in this study (the final sample consisted of 12,471 data points representing 14,380,032 Brazilians). The scenarios were considered: base (trend in sugary beverage intake); 1 (base scenario associated with the changes in energy content of the purchased beverages observed after the first phase of the Chilean labeling law (-9.9%); and 2 (scenario 1 associated with reformulation of beverages, total energy reduction of -1.6%). Changes in body weight were estimated using the simulation model of Hall et al. (2011) over five years. A linear trend in the prevalence of obesity and excess body weight in the Brazilian population was considered. The impact of the prevalence of obesity and excess body weight on body mass index was estimated. In addition, the direct health costs related to obesity were estimated.
Energy consumption from sugary beverages after FoPNL implementation is expected to be reduced by approximately 28 kcal/day (95% CI, -30 to -27) considering scenario 1. In scenarios 1 and 2, without FoPNL, the prevalence of obesity and excess body weight over five years was estimated to be 25.3% and 25.2%, and 64.4% and 64.2%, respectively. By extrapolating the results to the entire Brazilian population, it was observed that the implementation of FoPNL may reduce the prevalence of obesity by -0.32 percentage points and -0.35 percentage points (scenario 1 and 2, respectively) and excess body weight by -0.42 percentage points and -0.48 percentage points (scenarios 1 and 2, respectively) in five years. It is estimated that after five years of implementation, it will be possible to save approximately US$ 5,5 millions (95% CI 4,7 to 8,8) in scenario 1, reaching approximately US$ 6,1 millions (95% CI 5,3 to 9,8) in scenario 2.
The results of this modeling study indicate that FoPNL may reduce prevalence of excess body weight and obesity, representing strategic public policies for obesity prevention.
Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021. Knowledge of risk factors of coronavirus disease among Brazilians remains scarce, ...especially in the adult population. This study verified the risk factors for intensive care unit admission and mortality for coronavirus disease among 20-59-year-old Brazilians.
A Brazilian database on respiratory illness was analyzed on October 9, 2020, to gather data on age, sex, ethnicity, education, housing area, and comorbidities (cardiovascular disease, diabetes, and obesity). Multivariate logistic regression analysis was performed to identify the risk factors for coronavirus disease.
Overall, 1,048,575 persons were tested for coronavirus disease; among them, 43,662 were admitted to the intensive care unit, and 34,704 patients died. Male sex (odds ratio=1.235 and 1.193), obesity (odds ratio=1.941 and 1.889), living in rural areas (odds ratio=0.855 and 1.337), and peri-urban areas (odds ratio=1.253 and 1.577) were predictors of intensive care unit admission and mortality, respectively. Cardiovascular disease (odds ratio=1.552) was a risk factor for intensive care unit admission. Indigenous people had reduced chances (odds ratio=0.724) for intensive care unit admission, and black, mixed, East Asian, and indigenous ethnicity (odds ratio=1.756, 1.564, 1.679, and 1.613, respectively) were risk factors for mortality.
Risk factors for intensive care unit admission and mortality among adult Brazilians were higher in men, obese individuals, and non-urban areas. Obesity was the strongest risk factor for intensive care unit admission and mortality.
The aim of this study was to investigate the effect of Hibiscus sabdariffa tea on energy expenditure, satiety response and food intake. This is an open-label, crossover, randomized clinical trial ...that comprised 21 subjects (11 women, 10 men). The individuals were evaluated at acute moments (fasting and after eating standardized breakfast accompanied by water or H. sabdariffa tea). Resting energy expenditure was measured by indirect calorimetry, subjective satiety responses were evaluated with a visual analogue scale and food intake was assessed by using food records. The volunteers who drank the H. sabdariffa tea had lower perception of hunger (p = 0.002) and greater feeling of satiety (p = 0.01) and fullness (p = 0.009) compared to control. Men who ingested the H. sabdariffa tea had an increase in nitrogen energy expenditure (water: 1501 ± 290.7 kcal, H. sabdariffa tea: 1619 ± 288.9 kcal; p = 0.029). In comparison to control, men presented less perception of hunger (p = 0.003) and desire to eat (p = 0.016), increased satiety (p = 0.021) and fullness (p = 0.01), and women oxidized more fat (p = 0.034) when they drank H. sabdariffa tea. There was no difference between treatments regarding the energy and macronutrient intake from the first meal and throughout the day (p > 0.05) for all participants. The H. sabdariffa tea only affected energy expenditure and satiety responses in men. Clinical trial registry: ReBEC Platform of the Brazilian Clinical Trials Registry (
https://ensaiosclinicos.gov.br/
) – RBR-5HZ86T.
Novelty:
H. sabdariffa tea promoted an increase in energy expenditure and caused less perception of hunger/desire to eat in men.
H. sabdariffa tea intake increased postprandial fat oxidation in women.
Resumo O Programa Mais Médicos (PMM) foi implantado no Brasil com o objetivo de reduzir as desigualdades no acesso à Atenção Primária à Saúde (APS). Baseado em diversas evidências que apontavam para ...um cenário de profunda escassez de médicos no país, um dos seus eixos de ação foi a provisão emergencial desses profissionais em áreas vulneráveis, denominado de Projeto Mais Médicos para o Brasil. O artigo analisa o impacto do PMM na redução da escassez de médicos nos municípios brasileiros. Para tanto, lança mão do Índice de Escassez de Médicos em APS, o qual a identifica e a mensura nos períodos março de 2013 e setembro de 2015, antes e depois da implantação do programa. Os resultados mostram que ocorreu um substantivo aumento na oferta de médicos em APS no período, o que contribuiu para reduzir o número de municípios com escassez desses profissionais de 1.200 para 777. Este impacto também contribuiu para reduzir as desigualdades entre os municípios, mas as iniquidades distributivas permaneceram. Foi verificado ainda que ocorreu uma redução na oferta regular de médicos pelos municípios, sugerindo uma substituição da mesma pela do programa. Assim, permaneceu um quadro de insegurança assistencial em função da dependência dos municípios em relação ao provimento federal.
Nutrient profiling is the science of classifying or ranking foods according to their nutritional composition, for reasons related to disease prevention and health promotion. To be effective, policies ...such as front-of-pack nutrition labeling (FoPNL) must have an adequate nutritional profile model, since it will determine which products will be eligible to receive a FoPNL. This study aimed to determine the percentage of packaged food and drink products available in Brazil that would be subject to FoPNL under two different legislations: Brazilian and Mexican. This is a cross-sectional study in which we collected information on food products (photos of the ingredients list, the front label, the barcode, and the nutrition facts table) from one of the largest stores of a supermarket chain in the city of Belo Horizonte-MG, Brazil, from March to May 2021 (~6 months after the publication of the Brazilian legislation about FoPNL and a year and a half before the legislation came into force). The products were classified in relation to the BNPM (added sugars, saturated fats, and sodium) and the MNPM (energy, free sugars, saturated fats, trans fats, sodium, non-sugar sweeteners, and caffeine). A total of 3384 products were collected and, after applying the exclusion criteria, 3,335 products were evaluated. Of these, 2,901 would be eligible to receive FoPNL in Brazil and 2,914 would be eligible to receive FoPNL in Mexico. According to the BNPM, 56.7% (95% CI 54.9; 58.5%) of the products were “high in” critical nutrients, 27.1% (95% CI 25.5; 28.7%) of the products in added sugars, 26.7% (95% CI 25.2; 28.4%) of the products in saturated fats, and 21.4% (95% CI 19.9; 22.9%) of the products in sodium. As for the MNPM, 96.8% (95% CI 96.1; 97.4%) of them were “high in” up to five critical nutrients and up to two warning rectangles (caffeine and non-sugar sweeteners), 45.8% (95% CI 44.0; 47.6%) of them in free sugars, 43.7% (95% CI 41.9; 45.5%) of them in saturated fats, and 47.9% (95% CI 46.1; 49.7%) of them in sodium. We concluded that the eligibility to receive FoPNL by BNPM and MNPM was relatively similar between products; however, almost all products would have at least one FoPNL and/or warning rectangles according to Mexican legislation, and nearly half of them would have at least one FoPNL, considering BNPM. The MNPM is much more restrictive than the BNPM. The Nutrient Profile Model (NPM) that regulates FoPNL, and other health policies, must be carefully defined to ensure that foods are properly classified according to their healthiness.
Metastatic prostate cancer (mPCa) is resistant to several chemotherapeutic agents. Brachydin A (BrA), a glycosylated flavonoid extracted from
, displays a remarkable antitumoral effect against in ...vitro mPCa cells cultured as bidimensional (2D) monolayers. Considering that three-dimensional (3D) cell cultures provide a more accurate response to chemotherapeutic agents, this study investigated the antiproliferative/antimetastatic effects of BrA and the molecular mechanisms underlying its action in mPCa spheroids (DU145) in vitro. BrA at 60-100 μM was cytotoxic, altered spheroid morphology/volume, and suppressed cell migration and tumor invasiveness. High-content analysis revealed that BrA (60-100 µM) reduced mitochondrial membrane potential and increased apoptosis and necrosis markers, indicating that it triggered cell death mechanisms. Molecular analysis showed that (i) 24-h treatment with BrA (80-100 µM) increased the protein levels of DNA disruption markers (cleaved-PARP and p-γ-H2AX) as well as decreased the protein levels of anti/pro-apoptotic (BCL-2, BAD, and RIP3K) and cell survival markers (p-AKT1 and p-44/42 MAPK); (ii) 72-h treatment with BrA increased the protein levels of effector caspases (CASP3, CASP7, and CASP8) and inflammation markers (NF-kB and TNF-α). Altogether, our results suggest that PARP-mediated cell death (parthanatos) is a potential mechanism of action. In conclusion, BrA confirms its potential as a candidate drug for preclinical studies against mPCa.
Eukaryotes from the Excavata superphylum have been used as models to study the evolution of cellular molecular processes. Strikingly, human parasites of the Trypanosomatidae family (T. brucei, T. ...cruzi and L. major) conserve the complex machinery responsible for selenocysteine biosynthesis and incorporation in selenoproteins (SELENOK/SelK, SELENOT/SelT and SELENOTryp/SelTryp), although these proteins do not seem to be essential for parasite viability under laboratory controlled conditions. Selenophosphate synthetase (SEPHS/SPS) plays an indispensable role in selenium metabolism, being responsible for catalyzing the formation of selenophosphate, the biological selenium donor for selenocysteine synthesis. We solved the crystal structure of the L. major selenophosphate synthetase and confirmed that its dimeric organization is functionally important throughout the domains of life. We also demonstrated its interaction with selenocysteine lyase (SCLY) and showed that it is not present in other stable assemblies involved in the selenocysteine pathway, namely the phosphoseryl-tRNASec kinase (PSTK)-Sec-tRNASec synthase (SEPSECS) complex and the tRNASec-specific elongation factor (eEFSec) complex. Endoplasmic reticulum stress with dithiothreitol (DTT) or tunicamycin upon selenophosphate synthetase ablation in procyclic T. brucei cells led to a growth defect. On the other hand, only DTT presented a negative effect in bloodstream T. brucei expressing selenophosphate synthetase-RNAi. Furthermore, selenoprotein T (SELENOT) was dispensable for both forms of the parasite. Together, our data suggest a role for the T. brucei selenophosphate synthetase in the regulation of the parasite's ER stress response.
Introdução: O quadro de transição nutricional mostra um aumento alarmante do número de crianças acima do peso no mundo. Essa mudança tem sido associada a um aumento da ingestão de alimentos ...ultraprocessados e diminuição da ingestão de alimentos naturais. Objetivo: Avaliar o consumo alimentar habitual de crianças em fase escolar e pré-escolar e seu estado nutricional. Materiais e Métodos: Estudo transversal com análise descritiva com abordagem quantitativa desenvolvida com 46 alunos (2 a 10 anos de idade) de uma escola privada de cidade do interior de Minas Gerais. Foi aplicado um questionário de consumo alimentar e realizada a coleta de peso e altura para IMC, além da coleta de informações sobre o cuidador. Para a análise estatística foi utilizado o t test, seguido pelo fator de múltiplas comparações Newman Keyls. Resultado e discussão: Na amostra estudada, a prevalência de sobrepeso foi de 30,4% das crianças. Na avaliação do consumo alimentar, 95,0% das crianças apresentaram consumo inadequado de doces e guloseimas, com média de consumo 4,5 vezes maior do que o recomendado. Maior peso foi relacionado a menor consumo de frutas e vegetais e maior ingestão de doces e guloseimas. Menor grau de instrução do cuidador também se relacionou com maior consumo de doces e guloseimas. Conclusão: O presente trabalho evidencia estado nutricional inadequado em 34,8% das crianças e atitudes alimentares incorretas. Enfatiza-se a importância da realização de atividades de educação nutricional nas escolas, uma vez que má alimentação pode trazer sérios prejuízos à saúde e ao desenvolvimento infantil.
The Mais Médicos (More Doctors) Program (PMM) was put in place in Brazil aiming to reduce inequalities in access to Primary Healthcare. Based on diverse evidence that pointed to a scenario of ...profound shortage of doctors in the country, one of its central thrusts was emergency provision of these professionals in vulnerable areas, referred to as the Mais Médicos para o Brasil (More Doctors for Brazil) Project. The article analyses the impact of the PMM in reducing shortage of physicians in Brazilian municipalities. To do this, it uses the Primary Healthcare Physicians Shortage Index, which identifies and measures the shortage in the periods of March 2003 and September 2015, before and after implementation of the program. The results show that there was a substantial increase in the supply of physicians in primary healthcare in the period, which helped reduce the number of municipalities with shortage from 1,200 to 777. This impact also helped reduce inequalities between municipalities, but the inequities in distribution persisted. It was also found that there was a reduction in the regular supply of doctors made by municipalities, suggesting that these were being simply substituted by the supply coming from the program. Thus, an overall situation of insecurity in care persists, reflecting the dependence of municipalities on the physician supply from the federal government.
•Prevention of mother-to-child transmission of syphilis.•Strengthen syphilis control by automating case management with a control strategy.•Rethink the policy of investigation committees for ...mother-to-child transmission of syphilis.
This study aimed to analyze the relevance of investigation committees in eliminating mother-to-child transmission of syphilis in Brazil.
Questionnaires and interviews were conducted with health managers of 25 Brazilian Federative Units and Brazil's Federal District. Data were analyzed using Bardin's content analysis technique and subsequently compared with the global prescriptions for syphilis response of the Pan American Health Organization, World Health Organization, and recent research publications examining the course of syphilis in Brazil, in Brazilian regions, and globally.
While the investigation committees drew on the successful experience of those in reducing maternal mortality, which helped the country achieve the Millennium Development Goals, they are not demonstrated to be sufficient for preventing mother-to-child transmission of syphilis. The committees’ systematic and bureaucratic agenda has not been efficient in managing avoidable factors for syphilis, nor do they operate in the scope of the integration of surveillance and care actions, as recommended by the health policy.
The committees’ model needs to be reviewed in the context of Brazil's National Health System. The research process should be rescaled in order to remain a cornerstone for the induction of health policy that integrates surveillance and healthcare across Brazilian Federative Units. The advancement toward an automated case management model becomes relevant for the country to meet global commitments to eliminate congenital syphilis transmission and achieve the goals outlined in the 2030 Agenda.
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