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.

Effect of incorporation of amaranth on the physical properties and nutritional value of cheese bread

At the present celiac disease has no known cure, and its only treatment is a strict lifelong adherence to a gluten-free diet. Cheese bread is a traditional Brazilian product and a safe option for celiacs. However, like other gluten-free breads, it has inherent low levels of fibers and minerals. The objective of this study was to evaluate the effect of incorporation of whole amaranth flour on the physical properties and nutritional value of cheese bread. Amaranth flour was incorporated at 10, 15, and 20% proportions in different formulations. The increasing amaranth levels darkened the product, reduced specific volume, and increased compression force. Ten percent amaranth-content cheese breads exhibited slight differences in physical properties compared with the controls. These results demonstrated the possibility of incorporating 10% of whole amaranth flour in the formulation of cheese bread resulting in a product with higher dietary fiber and iron contents and the same level of acceptance as that of the conventional formulation. The aim of this approach is to increase the availability of gluten-free bakery products with added nutritional value contributing to increase the variety of the diet of celiac patients.

Possibilities for the healthy and nutritional improvement of confectionery and sweet products.

The overall objective of this PhD was to investigate the possibility to increase the nutritional value of confectionary products by the use of natural ingredients with healthy functions. The first part of the thesis focused on the possible substitution of the most characteristic component of confectionary products, i.e. refined sugar. Many natural whole sweetening alternatives are available, though not widely used; the use of molasses, the byproduct of sugar beet and cane production, still rich in healthy components as minerals and phytochemicals is hereby discussed; after having verified molasses effectiveness in oxidative stress counteraction on liver cultured cells, the higher antioxidant capacity of a sweet food prepared with molasses instead of refined sugar was confirmed. A second step of the project dealt with another main ingredient of various sweet products, namely wheat. Particularly, the exploitation of soft and durum wheat byproducts could be another sustainable strategy to improve the healthy value of confectionery. The isolation of oligosaccharides with bioactive functions form different fractions of the wheat milling stream was studied and the new ingredients were shown to have a high dietary fiber and antioxidants content. As valid alternative, product developers should consider the appealing and healthy addition of ancient grains flour to sweet baked goods. The possibility of substituting the modern whole durum wheat with the ancient Kamut® khorasan was considered, and the antioxidant and anti-inflammatory effects of these grains were evaluated and compared both in vitro and in vivo on rats. Finally, since high consumption of confectionery is a risk factor for obesity, a possible strategy for the counteraction of this disease was investigated. The ability of three bioactives in inhibiting adipocytes differentiation was investigated. In fact, theoretically, compounds able to influence adipogenesis could be used in the formulation of functional sweet products and contribute to prevent obesity.

Listeria monocytogenes infection in ruminants: Is there a link to the environment, food and human health? A review.

Listeria (L.) monocytogenes is widely distributed in the environment, but also has the ability to cause serious invasive disease in ruminants and humans. This review provides an overview of listeriosis in ruminants and discusses our insufficient understanding of reservoirs and possible cycling ofL. monocytogenes between animal and human hosts, food and the environment. It indicates gaps in our knowledge of the role of genetic subtypes in L. monocytogenes ecology and virulence as well as risk factors, in vivo diagnostics and pathogenesis of listeriosis in ruminants. Filling these gaps will contribute to improving the control of L. monocytogenes and enhancing disease prevention. As the prevalence of listeriosis in ruminants in Switzerland is likely to be underestimated, propositions concerning improvement options for surveillance of listeriosis in ruminants are provided.

AN ANALYSIS OF THE RELATIVE INFLUENCE OF RACE, INCOME, EDUCATION, AND FOOD STAMP PROGRAM PARTICIPATION/NONPARTICIPATION ON THE FOOD AND NUTRIENT CONSUMPTION OF A NORTH FLORIDA URBAN CLINIC POPULATION IN CONJUNCTION WITH A SURVEY OF NUTRITION RELATED HABITS AND ATTITUDES

The relative influence of race, income, education, and Food Stamp Program participation/nonparticipation on the food and nutrient intake of 102 fecund women ages 18-45 years in a Florida urban clinic population was assessed using the technique of multiple regression analysis. Study subgroups were defined by race and Food Stamp Program participation status. Education was found to have the greatest influence on food and nutrient intake. Race was the next most influential factor followed in order by Food Stamp Program participation and income. The combined effect of the four independent variables explained no more than 19 percent of the variance for any of the food and nutrient intake variables. This would indicate that a more complex model of influences is needed if variations in food and nutrient intake are to be fully explained.^ A socioeconomic questionnaire was administered to investigate other factors of influence. The influence of the mother, frequency and type of restaurant dining, and perceptions of food intake and weight were found to be factors deserving further study.^ Dietary data were collected using the 24-hour recall and food frequency checklist. Descriptive dietary findings indicated that iron and calcium were nutrients where adequacy was of concern for all study subgroups. White Food Stamp Program participants had the greatest number of mean nutrient intake values falling below the 1980 Recommended Dietary Allowances (RDAs). When Food Stamp Program participants were contrasted to nonparticipants, mean intakes of six nutrients (kilocalories, calcium, iron, vitamin A, thiamin, and riboflavin) were below the 1980 RDA compared to five mean nutrient intakes (kilocalories, calcium, iron, thiamin and riboflavin) for the nonparticipants. Use of the Index of Nutritional Quality (INQ), however, revealed that the quality of the diet of Food Stamp Program participants per 1000 kilocalories was adequate with exception of calcium and iron. Intakes of these nutrients were also not adequate on a 1000 kilocalorie basis for the nonparticipant group. When mean nutrient intakes of the groups were compared using Student's t-test oleicacid intake was the only significant difference found. Being a nonparticipant in the Food Stamp Program was found to be associated with more frequent consumption of cookies, sweet rolls, doughnuts, and honey. The findings of this study contradict the negative image of the Food Stamp Program participant and emphasize the importance of education. ^

Evaluating sustainability and food security of peasant farming systems in Mesoamerican highlands

En las últimas décadas, la agricultura sostenible ha sido objeto de gran interés y debate académico, no sólo en términos conceptuales, sino también en términos metodológicos. La persistencia de la inseguridad alimentaria y el deterioro de los recursos naturales en muchas regiones del mundo, ha provocado el surgimiento de numerosas iniciativas centradas en revitalizar la agricultura campesina así como renovadas discusiones sobre el rol que juega la agricultura como motor de desarrollo y principal actividad para alivio de la pobreza. Por ello, cuando hablamos de evaluar sistemas campesinos de montaña, debemos considerar tanto la dimensión alimentaria como las especificidades propias de los sistemas montañosos como base fundamental de la sostenibilidad. Al evaluar la contribución que han hecho alternativas tecnológicas y de manejo en la mejora de la sostenibilidad y la seguridad alimentaria de los sistemas campesinos de montaña en Mesoamérica, surgen tres preguntas de investigación: • ¿Se está evaluando la sostenibilidad de los sistemas campesinos teniendo en cuenta la variabilidad climática, la participación de los agricultores y las dinámicas temporales? • ¿Podemos rescatar tendencias comunes en estos sistemas y extrapolar los resultados a otras zonas? • ¿Son inequívocamente positivas las alternativas propuestas que se han llevado a cabo? En este trabajo se presentan tres evaluaciones de sostenibilidad que tratan de poner de manifiesto cuáles son los retos y oportunidades que enfrentan actualmente los sistemas campesinos de montaña. En primer lugar, se evalúan tres sistemas de manejo agrícola bajo dos años meteorológicamente contrastantes. Se determinó que durante el año que experimentó lluvias abundantes y temperaturas moderadas, los sistemas de bajos insumos, basados en el uso de abonos orgánicos y rotación de cultivos, obtuvieron los mejores resultados en indicadores ecológicos y similares resultados en los económicos y sociales que el sistema de altos insumos químicos. En el segundo año, con heladas tempranas y sequía invernal, la productividad se redujo para todos los sistemas pero los sistemas más diversificados (en variedades de maíz y/o siembra de otros cultivos) pudieron resistir mejor los contratiempos climáticos. En segundo lugar, se evalúa el grado de conocimiento (percepción) campesino para determinar los factores claves que determinan la sostenibilidad de sus sistemas y su seguridad alimentaria. Se determinó que los principales puntos críticos identificados por los campesinos (tamaño de parcela y pendiente del terreno) afectan de forma significativa a cuestiones de índole económica, pero no son capaces de explicar los desequilibrios alimenticios existentes. Realizando un análisis comparativo entre comunidades que presentaban buenos y malos resultados en cuanto a aporte energético y proteico, se determinó que la seguridad alimentaria estaba relacionada con la sostenibilidad de los sistemas y que concretamente estaba ligada a los atributos de equidad y autonomía. Otro resultado destacable fue que las comunidades más marginales y con mayor dificultad de acceso mostraron mayores niveles de inseguridad alimentaria, pero la variabilidad intergrupal fue muy alta. Eso demuestra que la seguridad alimentaria y nutricional forma parte de un complejo sistema de estrategias de autoabastecimiento ligada a la idiosincrasia misma de cada uno de los hogares. En tercer lugar, se evaluó el desempeño de las escuelas de campo de agricultores (ECAs) en la mejora de la sostenibilidad y la seguridad alimentaria de un sistema campesino de montaña. Para ver el efecto del impacto de estas metodologías a largo plazo, se estudiaron tres comunidades donde se habían implementado ECAs hace 8, 5 y 3 años. Encontramos que el impacto fue progresivo ya que fue la comunidad más antigua la que mejores valores obtuvo. El impacto de las ECAs fue rápido y persistente en los indicadores relacionados con la participación, el acceso a servicios básicos y la conservación de los recursos naturales. El estudio demostró un claro potencial de las ECAs en la mejora general de la sostenibilidad y la seguridad alimentaria de estos sistemas, sin embargo se observó una relación directa entre el aumento de producción agrícola y el uso de insumos externos, lo que puede suponer un punto crítico para los ideales sostenibles. ABSTRACT During the last decades, sustainable agriculture has been the subject of considerable academic interest and debate, not only in conceptual terms, but also in methodological ones. The persistence of high levels of environmental degradation and food insecurity in many regions has led to new initiatives focused on revitalizing peasant agriculture and renewed discussions of the role of sustainable agriculture as an engine for development, environmental conservation and poverty alleviation. Therefore, to assess mountain farming systems, we must consider food dimension and taking into account the specificities of the mountain systems as the foundation of sustainability. When evaluating contribution of technological and management alternative proposals in achieving sustainability and food security for peasant farming systems in Mesoamerican highlands, three research questions arise: • Is sustainability of peasant-farming systems being evaluated taking into account climate variability, participation of farmers and temporal dynamics? • Can we rescue common trends in these systems and extrapolate the results to other areas? • What alternative proposals that have been conducted are unequivocally positives? In this document, we present three evaluations of sustainability that try to highlight the challenges and opportunities that currently face mountain farming systems in Mesoamerica. First, we evaluate the sustainability of three agricultural management systems in two contrasting weather years. We determined that during the first year that exposed heavy rains and moderate temperatures, low-input systems, which are based on the use of organic fertilizers and crop rotation, provided better results in terms of ecological indicators and equal results in terms of economic and social indicators than those achieved using a high chemical input system. In the second year, which featured early frosts and a winter drought, productivity declined in all systems; however, the most diversified systems (in terms of the maize varieties grown and the sowing of other crops) more successfully resisted these climatic adversities. Second, we evaluate the farmers’ perception to determine the key drivers for achieving their sustainability and food and nutritional security. We determined that the key factors identified by farmers (landholding size and slope of cropland) exerted significant impacts on economic disparities but did not explain the malnutrition levels. We compared two contrasting hamlets according to their energy and protein supply, one namely Limón Timoté (LT), which did not present food problems and Limón Peña Blanca (LP), which did exhibit food insecurity. The results showed that FNS is linked to sustainability, and it is primarily related to the sustainability attributes of self-reliance and equity. Although the more marginated and inaccessible community exhibited more food insecurity, food and nutritional security depend upon a complex array of self-sufficiency strategies that remain linked to individual household idiosyncrasies. Third, we evaluated the impact of farmer field schools for improving the sustainability and food security of peasant mountain systems. In order to appreciate the long-term impact, we studied three communities where FFSs were implemented eight, five and three years ago, respectively. We found that FFSs have a gradual impact, as the community that first implemented FFSs scores highest. The impact of FFSs was broad and long-lasting for indicators related to participation, access to basic services and conservation of natural resources. This study demonstrates the potential of FFSs, but more attention will have to be paid to critical indicators in order to scale up their potential in the future. We observed a direct relationship between the increase in agricultural production and the use of external inputs, which is a critical point for sustainable ideals.

Food and nutrition security and the eradication of hunger CELAC 2025: Furthering discussion and regional cooperation

The region of Latin America and the Caribbean can boast a successful track record in the process of eradicating hunger: it is the only region in the world that has halved both the proportion of people who suffer from hunger (the target set in the Millennium Development Goals) and their absolute number (the target set at the World Food Summit of 1996). This publication aims to provide the region’s countries with up-todate and timely information on the status of food and nutrition security; on the role in eradicating hunger played by the different areas such as agriculture, agrifood trade and natural resources management; and on the possibility of successfully addressing the twin burden of malnutrition, in a context where the effects of climate change could threaten the progress achieved in Latin America and the Caribbean thus far. The CELAC Plan for Food and Nutrition Security and the Eradication of Hunger 2025 is a cross-cutting tool for achieving the Sustainable Development Goals of the 2030 Agenda for Sustainable Development; and it thus encourages the countries of Latin America and the Caribbean to redouble their efforts to identify key policy areas that will make it possible to speed up and consolidate the process of eradicating hunger and tackle the twin burden of malnutrition in the region, in which overweight and obesity are increasingly adding to that scourge.

Insights on food and nutrition in the Federated States of Micronesia: a review of the literature

Background: Nutrition-related disorders, including vitamin A deficiency (VAD) and chronic diseases, are serious problems in the Federated States of Micronesia (FSM). Many suggest that these disorders are new problems related to dietary and lifestyle changes. In the past four decades, imported foods, such as white rice, flour, sugar, refined foods and fatty meats, have increasingly replaced local foods in the diet. Aim: A literature review was conducted to understand underlying issues related to dietary change and obtain insights for nutrition research and interventions. Method: Published and unpublished papers from different disciplines were reviewed and collated for information on food and nutrition in FSM. Topics covered were historical background, local foods, infant and child feeding, dietary assessment, and nutritional status. Particular focus was on information and data relating to VAD, the primary topic that led to the review of the literature. Conclusions: FSM, a tropical country of abundant agricultural resources, has suffered a great loss in production and consumption of local foods. Inconsistent external and internal government policies and food aid programmes have contributed to the problem. Further research on the nutrient content of local foods and factors affecting production, acquisition and consumption is needed, as well as a broad, well-planned, intersectoral intervention aimed at dietary improvement for all age groups in the population.

Environmental influences on helminthiasis and nutritional status among Pacific schoolchildren

This paper describes a study undertaken to: (1) determine the prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworm infections and nutritional status among Pacific Island school children; (2) identify factors influencing helminthiasis; (3) identify interventions to improve school health. A total of 3,683 children aged 5-12 years attending 27 primary schools in 13 Pacific Island countries were surveyed along with school environmental data. Stool samples were collected from 1996 children (54.2%) and analysed for ova and helminths. Total prevalence of helminthiasis was 32.8%. Anaemia prevalence was 12.4%. Children with helminthiasis and anaemia were found to be 8.7 times more likely to be stunted and 4.3 times more likely to be underweight than non-anaemic and non-infected children. Four significant environmental influences on helminthiasis were identified: (1) an inadequate water supply; (2); availability of a school canteen; (3) regular water/sanitation maintenance regimes; and (4) overcrowded classrooms. Helminthiasis was found to be strongly associated with anaemia, stunting and underweight and environmental influences identified. Although mass anti-helminthic drug administrations (MDA) have been taking place, reinfection is common as drug therapy alone is not enough. Programme effectiveness depends upon upgrading school environments to include an adequate water supply, controlled food preparation/provision, well-maintained water/sanitation facilities and class sizes of 30 students or less.

Dietary analysis and nutritional behaviour in people with and without age-related macular disease

Background and Aims: Consumption of antioxidant nutrients can reduce the risk of progression of age-related macular degeneration (AMD) - the leading cause of visual impairment in adults over the age of 50 years in the UK. Lutein and zeaxanthin (L&Z) are of particular interest because they are selectively absorbed by the central retina. The objectives of this study were to analyse the dietary intake of a group of AMD patients, assess their ability to prepare and cook healthy food, and to make comparisons with people not affected by AMD. Methods: 158 participants with AMD were recruited via the UK charity The Macular Society, and fifty participants without AMD were recruited from optometric practice. A telephone interview was conducted by trained workers where participants completed a 24 hour food diary, and answered questions about cooking and shopping capabilities. Results: In the AMD group, the average L&Z intake was low in for both males and females. Those able to cook a hot meal consumed significantly more L&Z than those who were not able. Most participants were not consuming the recommended dietary allowance of fibre, calcium, vitamin D and E, and calorific intake was also lower than recommendations for their age-group. The non-AMD group consumed more kilocalories and more nutrients than the AMD group, but the L&Z intake was similar to those with AMD. The main factor that influenced participant’s food choices was personal preference. Conclusion: For an ‘informed’ population, many AMD participants were under-consuming nutrients considered to be useful for their condition. Participants without AMD were more likely to reach recommended daily allowance values for energy and a range of nutrients. It is therefore essential to design more effective dietary education and dissemination methods for people with, and at risk of, AMD.

Breads Fortified with Freeze-Dried Vegetables : Quality and Nutritional Attributes. Part II: Breads Not Containing Oil as an Ingredient

Acknowledgments: Funds for the study were provided by the Scottish Government's Rural and Environment Science and Analytical Services Division and conducted as part of the Scottish Government Strategic Research programme (Diet and Health Theme of the Food Land & People Programme). The authors are grateful to Phillip Morrice, Vivian Buchan, and Donna Henderson for helping with the nutritional analysis of the breads. The authors declare no conflicts of interest.

Food and fuel microalgae applications: insights from portuguese experience [Resumo]

Microalgae have a wide range of application fields, from food to fuels, to pharmaceuticals & fine chemicals, aquaculture and environmental bioremediation, among others. Spirulina and Chlorella have been used as food sources since ancient times, due to their high and balanced nutritional value. Our research group in Lisbon has developed a range of food products (emulsions, gelled desserts, biscuits and pastas) enriched with freshwater and marine microalgae (Spirulina, Chlorella, Haematococcus, Isochrysis and Diacronema). The developed products presented attractive and stable colours, high resistance to oxidation and enhanced rheological properties. Some of these products will be prepared at the Post-Congress Course “Functional Foods Development” at the University of Antofagasta. More recently, a great interest has arisen on using microalgae for biofuel production. The same group has also been exploring several marine and freshwater species for biofuel production (e.g., biodiesel, bioethanol, biohydrogen and biomethane) within a biorefinery approach, in order to obtain high and low-value co-products using integral biomass maximizing the energy revenue. Namely, supercritical fluid extraction of Nannochloropsis sp. allowed the recovery of valuable carotenoids and lipids, prior to bioH2 production through dark fermentation of the residual biomass. Also, Scenedesmus obliquus residues after sugars (for bioethanol) and lipids (for biodiesel) extraction has been anaerobically digested attaining high biomethane yields. Regarding sustainability issues, the current trend of our group is now focused on using liquid effluents and high CO2 levels for low cost microalgae growth, contributing to a lower water demand, primary energy consumption and global warming potential by reducing the need for potable water and fertilizers (P, N) and increasing CO2 mitigation. Microalgae biomass has been successfully used for urban wastewater treatment with subsequent bioH2 production, in a biorefinery approach. Presently, ammonium-rich raw effluents from piggeries and poultry industry are being effectively used for microalgae growth avoiding any pre-treatment step.

Ontogeny and nutritional programming of mitochondrial proteins in the ovine kidney, liver and lung

This study investigated the developmental and nutritional programming of two important mitochondrial proteins, namely voltage dependent anion channel (VDAC) and cytochrome c in the sheep kidney, liver and lung. The effect of maternal nutrient restriction between early to mid gestation (i.e. 28 to 80 days gestation, the period of maximal placental growth) on the abundance of these proteins was also examined in fetal and juvenile offspring. Fetuses were sampled at 80 and 140 days gestation (term ~147 days), and postnatal animals at 1 and 30 days and 6 months of age. The abundance of VDAC peaked at 140 days gestation in the lung, compared with 1 day after birth in the kidney and liver, whereas cytochrome c abundance was greatest at 140 days gestation in the liver, 1 day after birth in the kidney and 6 months of age in lungs. This differential ontogeny in mitochondrial protein abundance between tissues was accompanied with very different tissue specific responses to changes in maternal food intake. In the liver, maternal nutrient restriction only increased mitochondrial protein abundance at 80 days gestation, compared with no effect in the kidney. In contrast, in the lung mitochondrial protein abundance was raised near to term, whereas VDAC abundance was decreased by 6 months of age. These findings demonstrate the tissue specific nature of mitochondrial protein development that reflects differences in functional adaptation after birth. The divergence in mitochondrial response between tissues to maternal nutrient restriction early in pregnancy further reflects these differential ontogeny’s.

[strategies For Integration Of Health Care Practices And Sanitary Surveillance In The Context Of The Implementation Of Rede Cegonha - A Brazilian Mother And Infant Health Care Network].

Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.

[factors Impacting The Growth And Nutritional Status Of Cystic Fibrosis Patients Younger Than 10 Years Of Age Who Did Not Undergo Neonatal Screening.]

The aim of this study was to evaluate by clinical and laboratory parameters how cystic fibrosis (CF) affects growth and nutritional status of children who were undergoing CF treatment but did not receive newborn screening. A historical cohort study of 52 CF patients younger than 10 years of age were followed in a reference center in Campinas, Southeast Brazil. Anthropometric measurements were abstracted from medical records until March/2010, when neonatal screening program was implemented. Between September/2009 and March/2010, parental height of the 52 CF patients were also measured. Regarding nutritional status, four patients had Z-scores ≤ -2 for height/age (H/A) and body mass index/age (BMI/A). The following variables were associated with improved H/A ratio: fewer hospitalizations, longer time from first appointment to diagnosis, longer time from birth to diagnosis and later onset of respiratory disease. Forced vital capacity [FVC(%)], forced expiratory flow between 25-75% of FVC [FEF25-75(%)], forced expiratory volume in the first second [FEV1(%)], gestational age, birth weight and early respiratory symptoms were associated with IMC/A. Greater number of hospitalizations, diagnosis delay and early onset of respiratory disease had a negative impact on growth. Lower spirometric values, lower gestational age, lower birth weight, and early onset of respiratory symptoms had negative impact on nutritional status. Malnutrition was observed in 7.7% of cases, but 23% of children had nutritional risk.