Fluid intake patterns: an epidemiological study among children and adolescents in Brazil

Background: Energy from liquids is one of the most important factors that could impact on the high prevalence of children and adolescents obesity around the world. There are few data on the liquid consumption in Brazil. The aim of this study is to evaluate the volume and quality of liquids consumed by Brazilian children and adolescents and to determine the proportion of their daily energy intake composed of liquids. Methods: A multicenter study was conducted in five Brazilian cities; the study included 831 participants between 3 and 17 years of age. A four-day dietary record specific to fluids was completed for each individual, and the volume of and Kcal from liquid intake were evaluated. The average number of Kcal in each beverage was determined based on label information, and the daily energy intake data from liquids were compared with the recommendations of the National Health Surveillance Agency (Agencia Nacional de Vigilancia Sanitaria-ANVISA), the Brazilian food regulation authority, according to each subject's age. Results: As the children aged, the volume of carbonated beverages that they consumed increased significantly, and their milk intake decreased significantly. For children between the ages of 3 and 10, milk and dairy products contributed the greatest daily number of Kcal from liquids. Sugar sweetened beverages which included carbonated beverages, nectars and artificial beverages, accounted for 37% and 45% of the total Kcal from liquid intake in the 3-to 6-year-old and 7- to 10-year-old groups, respectively. Among adolescents (participants 11- to 17-years old), most of the energy intake from liquids came from carbonated beverages, which accounted for an average of 207 kcal/day in this group (42% of their total energy intake from liquids). Health professionals should be attentive to the excessive consumption of sugar sweetened beverages in children and adolescents. The movement toward healthier dietary patterns at the individual and population levels may help to improve programs for preventing overweight and obesity in children and adolescents. Conclusion: From childhood to adolescence the daily volume of liquid ingested increased reaching a total of 2.0 liters on average. Of this volume, the daily volume of milk ingested decreased while the carbonated drinks, sweetened, nectars and artificial beverages increased significantly. The proportion of water remained constant in about 1/3 of the total volume. From 3 to 17 years of age the energy intake from carbonated beverages increased by about 20%. The carbonated drinks on average corresponded to a tenth of the daily requirements of energy of adolescents.

Clinical and nutritional status in the late postoperative of pancreaticoduodenectomy. Influence of pylorus preservation procedure

PURPOSE: To evaluate the nutritional status of patients in the late postoperative period of pancreaticoduodenectomy (PD) and compare the long-term outcome according to pylorus-preserving (PPPD) or the standard technique (SPD) in which the pylorus is resected. METHODS: This prospective study was conducted twelve months prior or more in patients who had underwent PD (PD Group, n=15) and health volunteers (Control Group, n=15). At a post hoc analysis, the PD Group was divided in PPPD Subgroup (n=9) and SPD Subgroup (n=6), according to the PD techniques. Gastrointestinal complaints and nutritional status were evaluated, apart from a biochemical assessment; Student t-test or Mann-Whitney test were used. RESULTS: The patients recovered their body weight and the gastrointestinal complaints were uncommon. The PD Group showed higher energy and protein intake even though BMI was lower than in Control Group. There were no differences in laboratorial data, except for higher glycemia, serum alkaline phosfatase and C-reactive protein in PD Group. There was no difference in the various parameters evaluated when the Subgroups (PPPD and SPD) were compared. CONCLUSION: For long-term pancreaticoduodenectomy, the gastrointestinal symptoms are minimal and the patients had the clinical and nutritional status preserved, regardless of pylorus preservation.

Nutrient Intake of Women 3 Years After Roux-en-Y Gastric Bypass Surgery

Nutritional deficiencies, especially micronutrient deficiencies, can occur in obese individuals. Surgical treatment may aggravate or cause these deficiencies, depending on the type of procedure, food intake and the use of multivitamins, minerals or other supplements. The objective of the study was to evaluate the nutrient intake of women who had undergone Roux-en-Y gastric bypass (RYGB) surgery. A cross-sectional, controlled study was conducted among 44 women after RYGB (operated-group, OG; mean years post-operation = 3.4) and a control group of 38 healthy women (non-operated group, NOG) matched by age and economic condition. The women reported their dietary intake using a 4-day record. The Dietary Reference Intakes was used as a reference. The macronutrient contributions to dietary energy intake presented an acceptable distribution for proteins and carbohydrates. Lipid intake was high among women in the OG and the NOG (43.2 and 55.3 %, respectively). In the evaluation of micronutrients, a statistically significant difference was observed between the groups for iron, zinc and vitamins B1 and B12. Both groups were at high risk for inadequate calcium intake, and the OG was at risk for inadequate zinc, iron and vitamin B1 intake. The nutrient intake of women who had undergone RYGB is very similar to that of non-operated women, with the exception of a reduced intake of iron, zinc and vitamins B1 and B12, which may be due to the difficulty of consuming meat and a balanced diet. The findings of this study emphasize the importance of appropriate nutritional intervention and the regular use of multivitamin and mineral supplements for these patients.

International collaborative project to compare and monitor the nutritional composition of processed foods

Background: Chronic diseases are the leading cause of premature death and disability in the world with overnutrition a primary cause of diet-related ill health. Excess energy intake, saturated fat, sugar, and salt derived from processed foods are a major cause of disease burden. Our objective is to compare the nutritional composition of processed foods between countries, between food companies, and over time. Design: Surveys of processed foods will be done in each participating country using a standardized methodology. Information on the nutrient composition for each product will be sought either through direct chemical analysis, from the product label, or from the manufacturer. Foods will be categorized into 14 groups and 45 categories for the primary analyses which will compare mean levels of nutrients at baseline and over time. Initial commitments to collaboration have been obtained from 21 countries. Conclusions: This collaborative approach to the collation and sharing of data will enable objective and transparent tracking of processed food composition around the world. The information collected will support government and food industry efforts to improve the nutrient composition of processed foods around the world.

Anthropometric, physiological, performance, and nutritional profile of the Brazil National Canoe Polo Team

The purpose of this study was to determine the physiological, anthropometric, performance, and nutritional characteristics of the Brazil Canoe Polo National Team. Ten male canoe polo athletes (age 26.7 +/- 4.1 years) performed a battery of tests including assessments of anthropometric parameters, upper-body anaerobic power (Wingate), muscular strength, aerobic power, and nutritional profile. In addition, we characterized heart rate and plasma lactate responses and the temporal pattern of the effort/recovery during a simulated canoe polo match. The main results are as follows: body fat, 12.3 +/- 4.0%; upper-body peak and mean power, 6.8 +/- 0.5 and 4.7 +/- 0.4 W . kg(-1), respectively; 1-RM bench press, 99.1 +/- 11.7 kg; peak oxygen uptake, 44.3 +/- 5.8 mL . kg(-1) . min(-1); total energy intake, 42.8 +/- 8.6 kcal . kg(-1); protein, carbohydrate, and fat intakes, 1.9 +/- 0.1, 5.0 +/- 1.5, and 1.7 +/- 0.4 g . kg(-1), respectively; mean heart rate, 146 +/- 11 beats . min(-1); plasma lactate, 5.7 +/- 3.8 mmol . L-1 at half-time and 4.6 +/- 2.2 mmol . L-1 at the end of the match; effort time (relative to total match time), 93.1 +/- 3.0%; number of sprints, 9.6 +/- 4.4. The results of this study will assist coaches, trainers, and nutritionists in developing more adequate training programmes and dietary interventions for canoe polo athletes.

Evaluation of the prevalence and nutritional and social determinants of overweight in a population of schoolchildren: a cross-sectional analysis of 5,037 children

Objective: To evaluate the prevalence and nutritional and social determinants of overweight in a population of schoolchildren in Southern Brazil. Methods: Cross-sectional descriptive study of 5,037 children of both genders, between 6 and 10.9 years of age, from public and private schools of Maringa, Parana, Brazil. Evaluation of factors associated with excess weight (overweight and obesity) included gender, age, school type, socioeconomic level, education of the head of the family, eating habits, and means of commuting to school. After univariate analysis (Fisher's exact test), we adjusted a logistic regression model and used Wald's test for decision-making (p < 0.05). Results: The mean age was 8.7 +/- 1.3 years, with 52.8% females; 79.1% of the students attended public school and 54.6% had families of socioeconomic class A or B. Regarding nutritional status, 24% of children were overweight (7% obesity, 17% overweight). Being male, attending a private school, and having a head of the family with over four years of education were significantly associated with excess weight. In relation to food, inadequate intake of,carbohydrates was associated with a 48% greater chance of overweight/obesity (p < 0.001; OR: 1.48; 95% CI: 1.25-1.76), Conclusion: The prevalence of overweight found in this study is approximate to that reported in national studies. Its association with gender and inadequate food intake indicates that these factors should be considered in initiatives aimed at preventive measures in childhood.

Excessive iodine intake in schoolchildren

Inadequate iodine intake may result in iodine deficiency disorders (IDD). Thus, for more than 50 years, policies for the regulation of salt fortification with iodine have existed in Brazil. In 2003, a study on 6-14-year-old schoolchildren from regions of the state of So Paulo showed a median urinary iodine concentration of 360 mu g/L. The objective of the present study was to assess the iodine nutrition status among schoolchildren. The study was conducted on 828 schoolchildren aged 4-13 years from eight schools in the interior of the state of So Paulo. A casual urine sample was collected from each volunteer for iodine determination by the adapted method of Sandell-Kalthoff. Only 1.9% (n = 16) of the children evaluated had low values of urinary iodine (< 100 mu g/L), while 24.6% had urinary iodine excretion values between 200 and 300 mu g/L, and 67.1% had values above > 300 mu g/L. The results show that the iodine nutritional status of the schoolchildren studied is characterized by a high urinary iodine excretion, which might reveal an increase in iodine consumption by this population.

Precision of Usual Food Intake Estimates According to the Percentage of Individuals with a Second Dietary Measurement

Background Statistical methods for estimating usual intake require at least two short-term dietary measurements in a subsample of the target population. However, the percentage of individuals with a second dietary measurement (replication rate) may influence the precision of estimates, such as percentiles and proportions of individuals below cut-offs of intake. Objective To investigate the precision of the usual food intake estimates using different replication rates and different sample sizes. Participants/setting Adolescents participating in the continuous National Health and Nutrition Examination Survey 2007-2008 (n=1,304) who completed two 24-hour recalls. Statistical analyses performed The National Cancer Institute method was used to estimate the usual intake of dark green vegetables in the original sample comprising 1,304 adolescents with a replication rate of 100%. A bootstrap with 100 replications was performed to estimate CIs for percentiles and proportions of individuals below cut-offs of intake. Using the same bootstrap replications, four sets of data sets were sampled with different replication rates (80%, 60%, 40%, and 20%). For each data set created, the National Cancer Institute method was performed and percentiles, Cl, and proportions of individuals below cut-offs were calculated. Precision estimates were checked by comparing each Cl obtained from data sets with different replication rates with the Cl obtained from original data set. Further, we sampled 1,000, 750, 500, and 250 individuals from the original data set, and performed the same analytical procedures. Results Percentiles of intake and percentage of individuals below the cut-off points were similar throughout the replication rates and sample sizes, but the Cl increased as the replication rate decreased. Wider CIs were observed at 40% and 20% of replication rate. Conclusions The precision of the usual intake estimates decreased when low replication rates were used. However, even with different sample sizes, replication rates >40% may not lead to an important loss of precision. J Acad Nutr Diet. 2012;112:1015-1020.

Sugar intake is correlated with adiposity and obesity indicators and sedentary lifestyle in Brazilian individuals with morbid obesity

Obesity is a chronic disease characterized by increased accumulation of body fat. We evaluated the socioeconomic aspects, body composition, risk of metabolic complications associated with obesity, eating habits and lifestyle in both women and men adults and elderly with body mass index (BMI) 40 kg/m(2). Among the subjects studied, 79% (n = 32) are female, 5% (n = 2) smokers, 39% (n = 16) use alcohol and only 24% (n = 10) are practitioners of physical exercise. The higher food intake was breads, followed by rice. The daily intake of fruits and vegetables is low. Positive correlation between consumption of sugar and BMI and abdominal circumference (AC) was observed. In summary, was found that morbidly obese patients that looking for nutritional counseling presents increased body fat, poor eating habits and sedentary lifestyle.

Relationship between body mass index with dietary fiber intake and skinfolds-differences among bodybuilders who train during morning and nocturne period

Background: The prevalence of overweight individuals has increased in recent years. Moreover, the importance of a healthy diet is associated with the practice of physical activity and attempt to verify the achievement of physical exercise influences on food choice. However, it relationship between food intake and physical activity have not been studied. Aim: To evaluate if the period in which the trainings are conducted, morning and nocturne, interfere qualitatively and quantitatively in food consumption as well as verify possible associations between anthropometric profiles and dietary habits. Methods: We collected data from 33 adult volunteers, between men and women, practitioners of bodybuilding. Results: A total of 33 volunteers were interviewed (18 (54.5%) were men and 15 (45.5%) were women). Regarding anthropometric data, it turns out that that the volunteers of the two periods had similar characteristics, differentiating only weight. The consumption of nutritional supplements was observed in 30.77% of the practitioners in the morning period vs. 35% for the nocturne. Considering macronutrient intake, there was a significant difference in the consumption of protein between the periods. The consumption during nocturne period was greater (126 +/- 5% of the daily requirement) than the morning period (115.7 +/- 2%). As for micro-nutrients, calcium intake was greater among men when compared to women. There was a positive correlation between the BMI, and arm circumference for practitioners of the morning period. Conclusion: This study show that the practitioners who train in the morning have quietly better eating habits than those in the nocturne period, however both are inappropriate.

Eating behavior and nutritional status in patients who underwent coronary angioplasty

Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty). It was realized comparison of averages by analysis of variance or Student's test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04), higher consumption of calories (p = 0.04), meat/eggs (p = 0.01) and sweets (p = 0.03) in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13), although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.

Antioxidant intake among Brazilian adults - The Brazilian Osteoporosis Study (BRAZOS): a cross-sectional study

Abstract Background Antioxidant nutrient intake and the lesser formation of free radicals seem to contribute to chronic diseases. The aim of the present study was to evaluate the intake profile of the main dietary antioxidants in a representative sample of the adult Brazilian population and discuss the main consequences of a low intake of these micronutrients on overall health. Methods The sample comprised 2344 individuals aged 40 years or older from 150 cities and was based on a probabilistic sample from official data. The research was conducted through in-home interviews administered by a team trained for this purpose. Dietary intake information was obtained through 24-h recall. The Nutrition Data System for Research software program was used to analyze data on the intake of vitamins A, C and E, selenium and zinc, which was compared to Dietary Reference Intakes (DRIs). Differences in intake according to sex, anthropometrics, socioeconomic status and region were also evaluated. The SPSS statistical package (version 13) was used for the statistical analysis. P-values < 0.05 were considered significant. Results Higher proportions of low intake in relation to recommended values were found for vitamin E (99.7%), vitamin A (92.4%) and vitamin C (85.1%) in both genders. Intake variations were found between different regions, which may reflect cultural habits. Conclusion These results should lead to the development of public health policies that encourage educational strategies for improving the intake of micronutrients, which are essential to overall health and prevention of non-communicable diseases.

Nutritional strategies of physically active subjects with muscle dysmorphia

Abstract Background The aim of this study was to identify dietary strategies for physically active individuals with muscle dysmorphia based on a systematic literature review. Method References were included if the study population consisted of adults over 18 years old who were physically active in fitness centers. We identified reports through an electronic search ofScielo, Lilacs and Medline using the following keywords: muscle dysmorphia, vigorexia, distorted body image, and exercise. We found eight articles in Scielo, 17 in Medline and 12 in Lilacs. Among the total number of 37 articles, only 17 were eligible for inclusion in this review. Results The results indicated that the feeding strategies used by physically active individuals with muscle dysmorphia did not include planning or the supervision of a nutritionist. Diet included high protein and low fat foods and the ingestion of dietary and ergogenic supplements to reduce weight. Conclusion Physically active subjects with muscle dysmorphia could benefit from the help of nutritional professionals to evaluate energy estimation, guide the diet and its distribution in macronutrient and consider the principle of nutrition to functional recovery of the digestive process, promote liver detoxification, balance and guide to organic adequate intake of supplemental nutrients and other substances.

Validation of models for predicting milk urea nitrogen concentrations, estimating dry matter intake by the NRC (2001)

The objective of this study was to validate three different models for predicting milk urea nitrogen using field conditions, attempting to evaluate the nutritional adequacy diets for dairy cows and prediction of nitrogen excreted to the environment. Observations (4,749) from 855 cows were used. Milk yield, body weight (BW), days in milk and parity were recorded on the milk sampling days. Milk was sampled monthly, for analysis of milk urea nitrogen (MUN), fat, protein, lactose and total solids concentration and somatic cells count. Individual dry matter intake was estimated using the NRC (2001). The three models studied were derived from a first one to predict urinary nitrogen (UN). Model 1 was MUN = UN/12.54, model 2 was MUN = UN/17.6 and model 3 was MUN = UN/(0.0259 × BW), adjusted by body weight effect. To evaluate models, they were tested for accuracy, precision and robustness. Despite being more accurate (mean bias = 0.94 mg/dL), model 2 was less precise (residual error = 4.50 mg/dL) than model 3 (mean bias = 1.41 and residual error = 4.11 mg/dL), while model 1 was the least accurate (mean bias = 6.94 mg/dL) and the least precise (residual error = 5.40 mg/dL). They were not robust, because they were influenced by almost all the variables studied. The three models for predicting milk urea nitrogen were different with respect to accuracy, precision and robustness.