Navegando por Palavras-chave "estado nutricional"

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    Alteração do estado nutricional na população geral e em pacientes com dpoc em três cidades da américa latina - estudo platino seguimento
    (Universidade Federal de São Paulo (UNIFESP), 2016-05-31) Luize, Ana Paula Bauermann Tfardowski [UNIFESP]; Jardim, Jose Roberto de Brito Jardim [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: PLATINO is a populational-based longitudinal study that may help to understand the natural history of nutritional status in real life. Objective: Evaluate the nutritional status according to body mass índex (BMI) and addomen circumference (AC) of a same population of three large cities in Latin America including COPD patients after 6 to 9 years of follow up in Montevideo, Santiago and São Paulo. Methods: Population was submitted to pre and post-BD spirometry, answered a clinical questionnaire and had the BMI and AC measured. Results: 2107 individuals out of 3116 of Basal PLATINO were re-evaluated. There was a reduction in the proportion of individuals with low BMI in São Paulo (20.2% to 15.9%) and Montevideo (from 15.4% to 11.7%) and increase in the proportion of subjects with obesity in São Paulo (26.4% to 32.6%) and Montevideo (35.1% to 39.0%). COPD patients increased weight in São Paulo (70.0 ± 2.8kg to 71.0 ± 2.8kg), while decreased in Montevideo (74.3 ± 2.2kg to 73.3 ± 2.2kg) and Santiago (73.6 ± 1.3kg to 72.7 ± 1.3kg). AC increased in all three cities. Factors at the PLATINO Basal associated to weight gain and abdominal circumference increase were female gender, lower age, higher FEV1 and living in São Paulo. Conclusion: Overall there was an increase in overweight and obese individuals; factors at Basal PLATINO associated to weight gain were be a woman, to have better lung function and younger age. COPD patients lost weight in Montevideo and Santiago but increased abdominal circumference in all three cities; this finding make us to believe that these patients lost muscle mass.
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    Análise da presença de conflitos de interesses na produção de evidências sobre vegetarianismo
    (Universidade Federal de São Paulo (UNIFESP), 2018-12-12) Almeida, Iara dos Santos [UNIFESP]; Martins, Paula Andrea [UNIFESP]; http://lattes.cnpq.br/1364300323959453; http://lattes.cnpq.br/5390183653434219
    Conflito de interesses pode ser definido como um choque entre os interesses pessoais e as obrigações precípuas de um indivíduo que exerce um cargo de confiança (1) ou, mais especificamente, como um conjunto de condições que fazem com que o julgamento profissional relativo a um interesse primário, como o bem estar do paciente ou a validade de uma pesquisa, tenda a ser afetado impropriamente por um interesse secundário, como ganho financeiro (2). No âmbito da pesquisa científica, o surgimento de conflito de interesses possui grande potencial de incidência, seja incluindo interesses de origem financeira direta ou indireta, ou ainda interesses do tipo prestígio profissional, relações interpessoais, necessidade de afirmação científica sobre determinado assunto, interesses políticos, entre outros. Diversas áreas de pesquisa relacionadas à alimentação são alvo de conflito de interesses, como é possível ser observado acerca dos alimentos ultraprocessados. Estudos internacionais constatam que publicações patrocinadas pela indústria de alimentos ultraprocessados apresentam desfechos favoráveis em quatro a oito vezes mais quando comparados às publicações não patrocinadas pela indústria (3). A influência sobre os resultados pode ser manifestada de diferentes formas, pela omissão ou não consideração de evidências relevantes para afirmações de conclusão ou por conclusões e interpretações de dados baseadas em resultados insuficientes ou pouco expressivos, por exemplo. Para além do patrocínio direto à produção de evidências, há também o financiamento de eventos científicos e das palestras apresentadas nestes, assim como o fornecimento de brindes, de forma a garantir que determinados produtos sejam fornecidos pelo profissional para o paciente ou ao menos vistos em seu ambiente de atendimento (4). Buscando favorecer da indústria da carne, estudos sobre dietas vegetarianas são alvos iminentes de conflito de interesses, uma vez que o número de vegetarianos, somente no Brasil, quase dobrou nos últimos seis anos, subindo de 15,2 milhões em 2012 (5) para mais de 29 milhões em abril de 2018 (6). Como possível causa dessa expansão do vegetarianismo, múltiplas hipóteses podem ser levantadas, como as evidências sobre a associação do consumo de carne ao surgimento de alguns tipos de câncer e à prejuízos ao meio ambiente. Evidências de diferentes grupos de especialistas concluem que o consumo de carne vermelha está relacionado ao aumento do risco de câncer colorretal. O aumento diário de 100 gramas de toda a carne e carne vermelha está associado a um aumento significativo de 12% a 17% para o risco de câncer colorretal. Destaca-se ainda um aumento significativo de 49% de risco de câncer colorretal quando há um aumento diário de 25 gramas de consumo de carne processada (7). De acordo com Springmann et al (8), uma das opções para reduzir os efeitos ambientais dos sistemas alimentares seriam mudanças na dieta para o que os autores consideram escolhas mais saudáveis, uma dieta baseada em plantas. Como exemplos da dimensão da indústria mundial da carne, é possível se observar duas grandes indústrias presentes no Brasil, JBS E BRF. A JBS, empresa produtora de carne com sede no Brasil, atualmente é a maior produtora de carne bovina e frango do mundo, após a aquisição da Seara Brasil em 2013. Entre as dez principais empresas internacionais de alimentos e bebidas, JBS teve um faturamento de 51,5 bilhões de dólares em 2014. Em todo o mundo, a empresa conta com uma capacidade para abater 85 mil cabeças de gado bovino, 70 mil porcos e 12 milhões de aves diariamente. Sua produção é distribuída para 150 países (9). A BRF, fundada em 299 como Brasil Foods após a fusão entre Sadia e Perdigão, obteve um faturamento de 12,4 bilhões de dólares em 2014. A empresa possui 60 instalações industriais no Brasil e está presente em 110 países (9). Evidências, ainda que não oriundas de estudos científicos, possuem impacto direto sobre as escolhas alimentares de indivíduos, como visto em uma pesquisa do instituto DataFolha onde cerca de 30% da população paulista consumidora de carne declarou ter diminuído seu consumo após investigação da Polícia Federal que levou a público fraudes na qualidade de carnes comercializadas pelas maiores empresas do ramo (10).
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    Anemia do lactente: etiologia e prevalência
    (Sociedade Brasileira de Pediatria, 2002-01-01) Hadler, Maria Claret C.m. [UNIFESP]; Juliano, Yara; Sigulem, Dirce Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Goiás Faculdade de Nutrição; Universidade Santo Amaro
    Objective: To verify the prevalence of anemia, iron deficiency anemia and iron deficiency in infants, at a Public Health Unit in the city of Goiânia - Brazil; to analyze and to correlate the hematologic and biochemical variables. Methods: A cross-sectional study was carried out. One hundred and ten full-term infants of the 120 mothers interviewed were included. The infants aged between six and twelve months and there were not twins. Socioeconomic and hematologic data was obtained. Venous blood was taken from fasting infants in order to carry out a complete hemogram through electronic cell counting, serum iron, serum ferritin and C-reactive protein, which were used in the evaluation of the etiology of iron deficiency in the anemic infants. Children with hemoglobin < 11g/dL were considered anemic. Results: The prevalence of anemia was 60.9%. In the diagnosis of the iron deficiency etiology in infants without an inflammation process, when considering the alteration of hemoglobin plus two more indices among mean corpuscular volume (MCV) or mean corpuscular hemoglobin (MCH) or serum ferritin or serum iron, the prevalence of the iron deficiency was 87%. Nevertheless, when red cell distribution width (RDW) was included in the indices, the prevalence was 97.8%. In the non-anemic infants, considering ferritin and RDW, the prevalence of iron deficiency observed was 28%. The best correlation among hematologic and biochemical variables were between hemoglobin and hematocrit (r = 0.946), and MCH with MCV (r = 0.950). Conclusions: The main etiology in infants was iron deficiency anemia and its prevalence varied according to different parameters and criteria.
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    Aspectos nutricionais e epidemiológicos de pacientes com doença renal crônica submetidos a tratamento hemodialítico no Brasil, 2010
    (Sociedade Brasileira de Nefrologia, 2012-09-01) Biavo, Bárbara Margareth Menardi; Tzanno-martins, Carmen; Cunha, Lucas Maciel; Araujo, Melissa Luciana de; Ribeiro, Márcia Machado Cunha; Sachs, Anita [UNIFESP]; Uezima, Clarissa Baia Bargas; Draibe, Sergio Antonio [UNIFESP]; Rodrigues, Cibele Isaac Saad; Barros, Elvino José Guardão; Grupo CINE-HDC-RENALCLASS; CENEMGE; CLINEMGE; Universidade Federal de São Paulo (UNIFESP); SPDM PROHDOM; PUC Faculdade de Ciências Médicas e da Saúde; SBN Departamento de Hipertensão Arterial; UFRGS
    INTRODUCTION: The Nutrition Committee of the Brazilian Society of Nephrology (SBN) held in 2010 the first Brazilian Nutrition Census in hemodialysis patients. Multicenter data contribute to clinical development and nutritional intervention. OBJECTIVE: To describe epidemiological and nutritional aspects of hemodialysis patients. METHOD: Cross-sectional study in 36 dialysis clinics and 2,622 randomly selected participants. Socio-demographical, clinical, biochemical and anthropometric records were collected. RESULTS: 60.45% of the patients lived in the Brazilian Southeast. 13.53% came from Northeast region, while 12.81% from South, 10.33% from Midwest and 2.86% from North regions. Approximately 58% were male and 63.1% were below 60 years old. 58.5% of patients were married or in cohabitation. Around 80% of them depended on the government Unified Health System. Smoking showed a difference between gender and age. Presumptive etiologies were Hypertensive Nephrosclerosis (26.4%), Diabetic Nephropathy (24.6%), unknown/undiagnosed causes (19.9%), Glomerulopathies (13.6%) and others (11.2%). Both Hypertension and Diabetes Mellitus affect approximately 30% of patients, especially over 60 years. Body Mass Index did not differ between genders, although it differed between age groups and when used different evaluation criteria. Men and women average waist circumference were respectively 90.5 and 88.0 cm. Lipid profile did not differ between age groups, but it did between genders. Albumin values were lower in women and in patients older than 60 years. CONCLUSION: This study characterized Brazilian hemodialysis patients in 2010, and may support further studies to monitor nutrition and epidemiological transitions of the population.
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    Comparação entre as curvas de crescimento do Centers for Disease Control and Prevention e da Organização Mundial da Saúde para lactentes com idade de seis a 12 meses
    (Sociedade de Pediatria de São Paulo, 2010-12-01) Pires, Bianca Sant'Anna [UNIFESP]; Akutsu, Rita de Cássia [UNIFESP]; Castro, Lucíola Sant'Anna de [UNIFESP]; Asakura, Leiko; Sachs, Anita [UNIFESP]; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Coca, Kelly Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Brasília Departamento de Nutrição da UnB; Universidade de São Paulo (USP)
    OBJECTIVE: Compare the nutritional status of male and female infants classified according to the growth curve proposed by the Center for Disease Control and Prevention (CDC-2000) and the new growth curve proposed by the World Health Organization (WHO-2006). METHODS: This longitudinal study enrolled children of 6-12 months old of both genders. They were born at term and exclusively or predominantly breastfed. A single researcher collected demographic, anthropometric and nutritional data. The Wilcoxon test was used to compare curves and the Friedman test was used to analyze the variance. RESULTS: Among the 55 followed children, 51% (n=28) were males. The percentages of normal weight-for-age and proper height-for-age in both genders were above 80%. The nutritional status classification according to both growth curves was similar. Agreement between the two curves regarding weight and height was 98.2 and 96.4%, respectively. CONCLUSIONS: CDC-2000 and WHO-2006 growth curves were similar regarding nutritional status classification of 6-12 months old breastfeed infants.
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    Densidade energética da dieta e sua relação com a presença de doenças crônicas não transmissíveis em idosos
    (Universidade Federal de São Paulo (UNIFESP), 2015-06-23) Pimenta, Sabrina Pessoni [UNIFESP]; Ramos, Luiz Roberto Ramos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The energy density (ED) is defined as the amount of energy (kcal) per weight of food (grams). A decrease in the consumption of foods with high ED may help to reduce the total caloric value of the diet, preventing weight gain and the onset of chronic noncommunicable diseases (NCDs). Objectives: To assess the energy density of the diet and its relation to nutritional status, diabetes mellitus, dyslipidemia and hypertension and socio-demographic variables in the elderly, as well as to analyze the prevalence of NCD and identify the nutritional status and point out which meal higher and lower energy density. Methods: Cross-sectional study with the elderly, part of a cohort of Epidoso.Foi assessed the diets of 345 elderly through the Food Recall 24 hours. The ED of diet was calculated with all solid and liquid food, excluding drinks energy value less than 5 kcal/100g. To examine the relationship between ED diet and the presence of NCD used the chi-square test or Fisher's exact test extension. Results: There was no significant variation between the DE into tertiles and NCD, nutritional status, sex, age and education. The total energy of the diet is lower in older age groups and higher for men. DE was very similar in all age groups and both sexes. The highest and lowest average DE were found in the breakfast and evening snack, respectively. Most seniors who consumed a diet with amount of lipids above the recommended carbohydrate and lower than recommended, was the last tertile of energy density. Conclusions: We found a high prevalence for NCDs and females was significantly related to low birth weight and obesity. The average found DE was 1.14 kcal/g, showing no association with the NCD, nutritional status and sociodemographic variables. Most DE meal was breakfast.
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    Densidade mineral óssea, composição corporal e ingestão alimentar de adolescentes modelos de passarela
    (Sociedade Brasileira de Pediatria, 2009-12-01) Rodrigues, Alexandra Magna [UNIFESP]; Cintra, Isa de Pádua [UNIFESP]; Santos, Luana Caroline; Martini, Ligia Araújo; Mello, Marco Tulio de [UNIFESP]; Fisberg, Mauro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais Escola de Enfermagem; Universidade de São Paulo (USP)
    OBJECTIVE: To evaluate the bone mineral density (BMD) and to relate it to the food intake and body composition of adolescent runway models. METHODS: Cross-sectional study evaluating 33 models and 33 non-models aged from 15 to 18 years, paired by age and body mass index (BMI). BMD of spine (L1-L4) was evaluated using the dual-energy X-ray absorptiometry technique (Lunar® DPX Alpha), and body composition was assessed by means of plethysmography. Food intake was evaluated by a 3-day-food record. RESULTS: The subjects mean age was 16.75±1.04 years, and 24% had BMI below ideal value for their age. BMD values (g/cm2) were similar between models (1.108±0.080) and non-models (1.096±0.102) (p > 0.05), and 6% of the participants had low BMD for age. We found that the mean energy intake was lower among models as compared to non-models (1,480.93±582.95 vs. 1,973.00±557.63 kcal) (p < 0.05) and that most of the adolescents in both groups presented an inadequate consumption of micronutrients, with emphasis to the low calcium intakes. There was only significant correlation between BMD and lean body mass (kg) (r = 0.362 for models and r = 0.618 for non-models) (p < 0.05). CONCLUSION: Although no association was found between BMD, BMI, and intake of nutrients which are important for the bone mineralization process, inadequacies of food intake have an adverse influence on the acquisition of bone mass, which is more effective at this stage of life.
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    Diagnóstico do estado nutricional de escolares: comparação entre critério nacional e internacional
    (Sociedade Brasileira de Pediatria, 2008-12-01) Silva, Henyse G. Valente da; Chiara, Vera Lucia; Barros, Maria Elisa [UNIFESP]; Rêgo, Ana Lúcia; Ferreira, Adriana; Pitasi, Bruna A.; Mattos, Thaís; Universidade Federal do Rio de Janeiro Faculdade de Medicina; Universidade Federal do Rio de Janeiro Instituto de Medicina Social; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual do Rio de Janeiro Instituto de Nutrição; UERJ Faculdade de Ciências Médicas; UERJ Instituto de Nutrição
    OBJECTIVE: To compare Brazilian and international criteria for assessing the nutritional status of schoolchildren. METHODS: This was a cross-sectional study that enrolled 160 schoolchildren from a public school in the city of Rio de Janeiro, 91 boys and 69 girls, aged 7 to 9 full years. Body mass index (BMI) for sex and age was used to diagnose underweight, healthy weight and overweight, according to Cole et al., Conde & Monteiro, and the World Health Organization (WHO) criteria. Student's t test, the chi-square test, the Kendall concordance test and the chi-square test for tendencies were used to analyze the data; graphs were plotted demonstrating BMI by age, according to the nutritional diagnosis at each set of criteria. RESULTS: Mean BMI did not differ by sex (t = 0.2845, p = 0.7789). According to the first two sets of criteria, none of the children were underweight, whereas, according to the WHO criteria, one of the boys was underweight. The Kendall test did not demonstrate any significant difference between the three sets of criteria (coefficient of concordance for boys was W < 0.0004 and for girls it was W < 0.0008, with p = 1.00). There was a greater proportion of assessments that did not agree among the boys, at 15.13%, while for the girls this figure was 13.04%. A significant tendency was observed for the difference between the criteria to increase with age among the boys (chi-square for tendencies = 6.552, p = 0.0105), which was evident on the graph and was independent of nutritional status. CONCLUSIONS: The criteria used here converged on the same result, without discrepancies between them or advantages for either. Nevertheless, among the boys there was a significant tendency for the diagnoses to differentiate and BMI to increase with age, which is a warning to take care when choosing among criteria.
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    Espessura do músculo adutor do polegar como preditor da força de preensão manual nos pacientes em hemodiálise
    (Sociedade Brasileira de Nefrologia, 2013-09-01) Pereira, Raíssa Antunes [UNIFESP]; Caetano, Alex Lopes [UNIFESP]; Cuppari, Lilian [UNIFESP]; Kamimura, Maria Ayako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Recently, the adductor pollicis muscle thickness (APMT) has been suggested as a new nutritional marker in several population. OBJECTIVE: In view of the scarce data regarding the use of this marker in CKD patients, we aimed to evaluate APMT and its association with nutritional parameters in patients on hemodialysis. METHODS: We evaluated 73 hemodialysis patients (52.3 ± 17 years, without residual renal function). The APMT was assessed in the non vascular access arm by means of skinfold caliper. Body composition (bioelectrical impedance), handgrip strength (HGS, dynamometer), nutritional status (subjective global assessment), and laboratory parameters (creatinine, total protein and albumin) were also evaluated. RESULTS: Subjects with APMT values above the median were in greater proportion black/ brown, younger and had higher HGS. The APMT correlated positively with HGS, albumin and body cell mass (%), and negatively with age. In the linear regression analysis adjusted for sex, age and length on hemodialysis, APMT was independently associated with HGS. CONCLUSION: APMT was able to predict HGS in hemodialysis patients, suggesting APMT as a promising nutritional marker in this population.
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    Estado nutricional de crianças atendidas na rede pública de saúde do município de Santos
    (Sociedade de Pediatria de São Paulo, 2009-06-01) Damaceno, Rafael Jeferson P. [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Devincenzi, Macarena Urrestarazu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Evaluate the nutritional status of children with 6 to 24 months of age assisted by the public health service in the city of Santos, Brazil, and its relation with socioeconomic status, health and nutritional conditions. METHODS: This cross-sectional study enrolled 95 children who attended regular pediatric visits in 5 units of public primary health centers. Weight and height were measured and parents were requested to answer a questionnaire with health, nutrition and socioeconomic information of their children. Nutritional status was assessed by the NCHS (1977), CDC (2000) and WHO (2006) child growth standard curves. Weight for age, height for age and weight for height Z scores were calculated. Values of the these indices below -2.0 Z score defined malnutrition and values of weight for height above +2.0 Z score defined overweight. RESULTS: The frequency of malnutrition according to the different indices were: weight for age 4.2%, 9.5% and 3.2%; height for age 2.1%, 2.1% and 4.2%, and weight for age 2.1%, 4.2% and 1.0%, respectively, according to the NCHS (1977), CDC (2000) and WHO (2006) reference curves. Overweight was found in 4.2%, 3.2% and 5.3% by the NCHS (1977), CDC (2000) and WHO (2006) reference curves, respectively. CONCLUSIONS: There was a low frequency of malnutrition. The WHO curve detected less patients with nutritional deficits than the other NCHS (1977) and CDC (2000) curves.
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    Estado nutricional de crianças e adolescentes hospitalizados em enfermaria de cirurgia pediátrica
    (Sociedade de Pediatria de São Paulo, 2010-03-01) Simões, Ana Paula B. [UNIFESP]; Palchetti, Cecília Zanin [UNIFESP]; Patin, Rose Vega [UNIFESP]; Mauri, Juliana Ferreira [UNIFESP]; Oliveira, Fernanda Luisa Ceragioli [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the nutritional status, duration of hospital stay and clinical specialties of patients hospitalized in the Pediatric Surgery Unit of São Paulo Hospital, UNIFESP-EPM. METHODS: This cross-sectional retrospective study enrolled 749 children and adolescents of both genders admitted to the Pediatric Surgery Unit during the period of August 2007 to July 2008. The following data were collected: anthropometric variables, duration of hospital stay and surgical procedures. For nutritional status classification, the Z score for body mass index (Z BMI) and height-for-age (Z H/A) were used according to the World Health Organization growth chart (WHO, 2007). The children were classified according to the surgical procedures performed. Results were compared by ANOVA followed by Bonferroni multiple comparisons test, being significant p<0.05. Statistical analysis was carried out through STATA 8.0 software. RESULTS: Patients' mean age was seven years old (0 to 18), 59% were males and 18% had ear, neck or throat surgery. Among the hospitalized patients, 66% had appropriated height for age, 43% were eutrophic and 31% obese/overweight. The malnourished patients presented longer hospital stay than the obese/overweight patients (7.2 versus 4.1 days; p=0,035). Infants had prolonged hospital stay (p=0,006) and less Z BMI values in comparison to the other age groups. (p=0,001). Infants that needed cardiac surgery presented lower Z BMI in relation to the others (p=0,002). CONCLUSIONS: The patients profile in the Pediatric Surgery Unit followed the nutritional pattern observed in Brazil, with increasing prevalence of obesity together with malnutrition. However, malnutrition is still an aggravating factor for prolonged hospital stay
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    Estado nutricional e consumo alimentar de crianças menores de dois anos atendidas em unidades básicas de saúde da cidade de Diadema, São Paulo, Brasil
    (Universidade Federal de São Paulo (UNIFESP), 2014-07-07) Castro, Lucíola Sant'Anna de [UNIFESP]; Gimeno, Suely Godoy Agostinho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objetivo: Avaliar o estado nutricional e o consumo alimentar de crianças menores de dois anos atendidas em Unidades Básicas de Saúde (UBS) da cidade de Diadema, SP, Brasil. Métodos: Estudo transversal, realizado de abril a dezembro de 2012, que avaliou lactentes frequentadores de 6 UBS da cidade de Diadema, SP. Foram coletados dados antropométricos (peso e comprimento atuais) e de consumo alimentar dos lactentes, conforme o Formulário de Marcadores de Consumo Alimentar para Indivíduos Menores de 5 anos do Sistema de Vigilância Alimentar e Nutricional, e dados sociodemográficos maternos. O estado nutricional, em escore z, foi classificado com base nos pontos de corte recomendados pela Organização Mundial da Saúde e o consumo alimentar foi categorizado de acordo com o formulário. Com o objetivo de identificar perfis socioeconômicos maternos, empregou-se a técnica estatística de análise fatorial exploratória, encontrando-se dois perfis socioeconômicos: Perfil 1: mães com menor renda, menor escolaridade e beneficiárias do Programa Bolsa Família (PBF); Perfil 2: mães com mais idade, com maior número de filhos e com maior número de residentes no domicílio. Empregaram-se estatísticas qui-quadrado e t de Student nas análises inferenciais, considerando o nível de significância ? igual a 5%. Resultados: Entre as 350 crianças incluídas no estudo, 51,7% das crianças eram do sexo feminino e 68% tinham idade entre 6 e 23 meses. Observou-se elevada prevalência de excesso de peso (17,4%) entre as crianças de 6 a 23 meses (p=0,000), principalmente entre aquelas que faziam uso de mamadeira (p= 0,020) e eram beneficiárias do PBF (p= 0,045). O déficit ponderal foi de menor magnitude, porém importante nas crianças menores de seis meses (IC95%= 1,14; 19,9), enquanto que o déficit de estatura para idade foi moderado (11,6%). Em relação ao consumo alimentar, 56% do total de crianças recebia leite materno por ocasião da coleta de dados. Dentre as crianças com menos de 6 meses (n= 112), as prevalências de aleitamento materno exclusivo, predominante e complementado foi de 41,1%, 21,4% e 21,4%, respectivamente; a introdução dos alimentos complementares foi precoce com maior freqüência de água ou chá (58,6%), fórmula infantil (49,2%) e leite de vaca (25%). Dentre as crianças de 6 a 23 meses, a maioria não recebia mais o leite materno (55,6%), tinha consumo insuficiente de frutas, legumes/verduras, carnes e feijão, tendo recebido açúcar, mel ou melado (32,4%) e papa salgada antes dos seis meses de idade (45,2%); e as práticas alimentares inadequadas, mais frequentes, foram o consumo de suco ou refresco industrializado no último mês (60,8%), não ter recebido leite materno no dia anterior (56,9%), consumo de leite com espessante no dia anterior (54,3%), refrigerante no último mês (54,2%), ter realizado alguma refeição assistindo TV (33,3%). Dos perfis socioeconômicos maternos encontrados, o Perfil 1 foi associado estatisticamente com o excesso de peso nas crianças (p=0,011) e com o consumo de água/chá (p= 0,047), leite de vaca (p= 0,030) e papa salgada (p= 0,019), enquanto o Perfil 2 foi associado estatisticamente com os déficits de estatura e peso e o excesso de peso (p= 0,024, p=0,003 e p= 0,025, respectivamente) e com o consumo de leite materno (p= 0,048). Conclusão: Com este estudo pôde-se concluir que as crianças menores de dois anos, atendidas nas UBS da cidade de Diadema estudadas, apresentaram elevada prevalência de excesso de peso, principalmente as beneficiárias do PBF, e consumo alimentar inadequado. Os resultados indicam a necessidade de qualificação e conscientização dos profissionais de saúde para a promoção das ações de alimentação e nutrição, bem como, para a vigilância alimentar e nutricional no cotidiano de trabalho.
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    Estado nutricional e consumo de energia e nutrientes de pré-escolares que frequentam creches no município de Manaus, Amazonas: existem diferenças entre creches públicas e privadas?
    (Sociedade de Pediatria de São Paulo, 2012-01-01) Tavares, Bruno Mendes; Veiga, Gloria Valeria Da; Yuyama, Lucia Kiyoko O.; Bueno, Milena Baptista; Fisberg, Regina Mara; Fisberg, Mauro [UNIFESP]; Universidade Federal do Amazonas Instituto de Saúde e Biotecnologia; UFRJ Instituto de Nutrição Josué de Castro; Instituto Nacional de Pesquisa da Amazônia; Universidade Paulista; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To assess the nutritional status and dietary intakes of children attending public and private day care centers in Manaus, Brazil. METHODS: The study assessed children aged 24 to 72 months, enrolled at two public (n=217) and two private (n=91) day care centers in Manaus. Nutritional status was classified according to Z scores for weight-for-age, weight-for-height, height-for-age and BMI-for-age. Dietary intakes were measured using the direct food-weighing method for 1 day. A 1-day dietary recall was administered to parents to assess dietary intakes outside the day care centers. The frequencies of children with nutrient intakes above and below the Estimated Average Requirements (EAR) or Adequate Intake (AI) cutoffs were calculated. RESULTS: There proportion of overweight children was higher at the private day care centers, according to both weight-for-height and BMI-for-age indexes. Children from the public day care centers had higher intakes of polyunsaturated fat, trans fat, omega-6, vitamin C and sodium, and lower zinc intake when compared to those at private centers. Elevated energy intake and a high proportion of children with vitamin A, vitamin C, zinc and sodium intakes over the Tolerable Upper Intake Levels were observed at both types of day care center. There was a higher proportion of children with inadequate calcium intake at the public centers (27.6 vs. 7.9%, p<0.001). CONCLUSION: Energy and sodium intakes were above recommended levels at both types of day care center. Calcium intakes were below recommended, especially at the public day care centers. Children's diets should be monitored more closely to prevent diseases later in life.
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    Estado nutricional e níveis hematológicos e séricos de ferro em pré-escolares de municípios com diferentes índices de desenvolvimento infantil
    (Sociedade de Pediatria de São Paulo, 2008-09-01) Oliveira, Wilson Luis de; Oliveira, Fernanda Luisa Ceragioli [UNIFESP]; Amancio, Olga Maria Silverio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate nutritional status and iron hematological and serum levels of preschool children from cities with different child development indexes (CDI). METHODS: This cross-sectional study enrolled 34 preschool children aged between three to six years from two municipalities of Brazil: Laranjal, Paraná, with a low CDI, and Presidente Prudente, São Paulo, with a medium CDI. Children of both cities were matched by age and gender. The nutritional status was evaluated by Z score for weight/height and height/age. The biochemical evaluation included hemoglobin, hematocrit, seric iron and ferritin levels. The following tests were used for statistical analysis: t test, Mann-Whitney, chi-square and Fisher's exact test. RESULTS: The weight, height and Z score of the anthropometric relationships were significantly lower in the group of Laranjal children. Anemia was present in 8.8% of the children studied in both cities, without significant differences in the prevalence of iron deficiency or in the ferritin levels. CONCLUSIONS: The preschool children from the city with low CDI presented mainly malnutrition, while overweight and obesity were more prevalent on preschool children from the city with a medium CDI. Hematimetric values, iron and ferritin levels were similar between the preschool children of both cities.
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    Estado nutricional e teste do hidrogênio no ar expirado com lactose e lactulose em crianças indígenas terenas
    (Sociedade Brasileira de Pediatria, 2002-04-01) Alves, Gildney Maria Dos Santos; Morais, Mauro Batista de [UNIFESP]; Fagundes-neto, Ulysses [UNIFESP]; Universidade Federal do Mato Grosso do Sul Departamento de Pediatria; Universidade Federal de São Paulo (UNIFESP)
    Objective: to evaluate the nutritional status, absorption and tolerance of lactose and the occurrence of small-bowel bacterial overgrowth. Methods: a cross-sectional study including all 264 Terena Indian children younger than 10 years from two tribes (Limão Verde and Córrego Seco) in Mato Grosso do Sul. The nutritional status was assessed based upon weight and height, using NCHS data as reference. The breath hydrogen test after an oral lactose (18g) administration was used for evaluation of lactose absorption and tolerance. The occurrence of bacterial overgrowth was evaluated using the breath hydrogen test after the administration of lactulose (5g). Results: the median z scores of weight-for-age, weight-for-height and height-for-age were, respectively, in infants under 1 year (n=34): -0.66, +0.60 and -0.85. Between 1 and 5 years (n=111), the values were: -0.50, +0.28 and -1.17. Between 5 and 10 years (n=119), these anthropometric values were, respectively: -0.09, +0.50 and -0.60. Deficient lactose absorption or malabsorption was verified only after the fourth year of age in 89.3% of the 197 evaluated children. Lactose intolerance was found in 37.1% of them. Small-bowel overgrowth was detected in 11.5% of the Terena Indian children (n=252). Conclusions: the prevalence of recent malnutrition was low, but the median height-for-age was lower than the NCHS reference. The prevalence of ontogenetic lactase deficiency was high. Bacterial overgrowth may be considered as evidence of the occurrence of nonsymptomatic environmental enteropathy in Terena Indian children.
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    Evolução nutricional de crianças hospitalizadas e sob acompanhamento nutricional
    (Pontifícia Universidade Católica de Campinas, 2005-06-01) Oliveira, Ana Flávia de [UNIFESP]; Oliveira, Fernanda Luisa Ceragioli [UNIFESP]; Juliano, Yara; Ancona-Lopez, Fábio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo Amaro Faculdade de Medicina
    OBJECTIVE: This study aimed at evaluating the nutritional evolution of hospitalized children with infectious diseases, who were put under nutritional orientation. METHODS: Evaluate the effect of therapeutic nutritional orientation on 125 children between 6 and 36 months of age, who were admitted at the Pediatric Infectology Ward of the Hospital São Paulo, São Paulo, Brazil, between March 2001 and December 2002. The evaluations of nutritional status and energetic intake were based on data obtained from inquiry-forms on feeding-patterns and anthropometric measurements. RESULTS: Of the children being evaluated, 53,6% (67) were male. The mean age was 17 months, and the average period spent in the hospital was 10 days. At admission, 24,8% (31) of the children were undernourished and 10,0% (23) were overweight or obese. The diagnosis of acute diseases affected 69,6% (87) of the children. Nutritional support was provided for 21.6% (27) of the children, out of which, 81.5% (22) received nutritional support orally. The undernourished group presented a significant improvement of the Z-score of Weight over Height - Z W/H (p=0.001); the eutrophic group had no significant change of the Z-score Weight over Height (p=0.651), and the group overweight/obese showed a significant reduction of the Z-score Weight over Height (p=0.026). No significant associations were found between nutritional support therapy and improvement of the nutritional status (p=0.37). The children who had an energy intake higher than the one recommended for their age, had a significant improvement of the Z-score Weight over Height (p<0.001). CONCLUSION: The children followed up in this study had their nutritional condition significantly improved, making it evident that nutritional orientation, or diet therapy, can improve the treatment of hospitalized children.
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    Excesso de sódio e déficit de ferro em alimentos de transição
    (Sociedade Brasileira de Pediatria, 2010-08-01) Portella, Márcia Bitar [UNIFESP]; Morais, Tania Beninga de [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade do Estado do Pará; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To determine, by chemical analysis, the macronutrient, energy, sodium, and iron contents of homemade foods prepared for infants in two socioeconomic classes in Belém, state of Pará, Brazil. METHODS: Cross-sectional study of 78 infants (aged 6 to 18 months) distributed into two groups according to socioeconomic status (high or low). Chemical analyses were performed on samples of homemade complementary foods prepared for each infant's lunch. Daily food intake was estimated on the basis of two 24-hour dietary intake recall. RESULTS: Chemical analyses showed that the energy content of some food samples was lower than recommended, both in the low socioeconomic status (SES) group (29.8% of samples) and in the high-SES group (43.0%; p = 0.199). The iron content of all samples, regardless of group, was lower than minimum recommended levels (6.0 mg/100 g). On the other hand, excessive sodium levels (200 mg/100 g) were found in 89.2 and 31.7% of samples in the low- and high-SES groups, respectively (p = 0.027). Dietary recalls showed that energy intake exceeded 120% of the Estimated Energy Requirement in 86.5% of infants in the low-SES group and 92.7% of those in the high-SES group (p = 0.483). Lunch and dinner provided 35.2±14.6 and 36.4±12.0% of daily energy intake in the low- and high-SES groups, respectively (p = 0.692). CONCLUSION: Homemade complementary foods for infants were found to be low in iron. A significant portion of samples had excessive sodium content, most frequently those prepared for infants in low-SES status families.
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    Fatores associados ao crescimento linear e ao peso atingido no primeiro ano de vida em Cruzeiro do Sul, Acre
    (Universidade Federal de São Paulo (UNIFESP), 2019) Paghi Dal Bom, Juliana [UNIFESP]; Lourenço, Bárbara Hatzlhoffer [UNIFESP]; http://lattes.cnpq.br/9838866267589607; http://lattes.cnpq.br/6878298132929268; Universidade Federal de São Paulo (UNIFESP)
    Objective: To investigate the associated factors with linear growth and weight attained in the first year of life in the municipality of Cruzeiro do Sul, Acre. Methods: The present study is part of the MINA Study, a population-based birth cohort whose baseline data collection occurred between July 1, 2015 and June 30, 2016, from all hospital admissions for delivery of residents in the municipality, with assessment of sociodemographic and health history information. At 10-15 months, follow-up interviews were conducted to collect data on maternal and infant characteristics, as well as perform an anthropometric evaluation. Outcomes of interest were length for age and body mass index (BMI) for age Z-scores according to the World Health Organization growth standards. From a hierarchical conceptual model with determinants at distal, intermediate and proximal levels and adjustment for the child’s age and sex, multiple linear regression models were fitted for length for age and BMI for age Z-scores, as well as multiple logistic regression models for overweight (BMI for age Z-score >2.0). Results: A total of 772 babies were followed-up at 10-15 months, 52.2% female. At baseline, 39% of participants were beneficiaries of the Bolsa Família Program, 30% reported up to 9 years of schooling, and 31% of the mothers did not attend the minimum recommended number of 6 prenatal appointments. At 26 (SD: 6.6) years of age, mean maternal height was 157.5 cm (SD: 6.0) and 45% were overweight. At birth, mean weight and length for gestational age Zscores were 0.19 (SD: 0.99) and 0.11 (SD: 1.05). During the first year, 2.7% of the children were affected by malaria. Regarding nutritional status, 2.0% of girls and 2.4% of boys were stunted while 6.7% of girls and 6.0% of boys were overweight, with no differences between the sexes. In multiple models for the length for age Z-score, a positive ossociation with wealth index quintiles and maternal height (p for trend <0.01) was observed. An increase of 1 Z-score of birth weight and length for gestational age corresponded to a mean length for age 0.17 (95% CI: 0.07; 0.27) and 0.15 (95% CI: 0.05; 0.25) Z-score higher in the first year. Children with malaria in the first year had a linear growth -0.58 (95% CI: -1.05, -0.11) Z-score lower in comparison with those unaffected. In adjusted analyzes for BMI for age Z-score, there was an inverse relationship with receipt of the Bolsa Família Program (-0.16 Z-score, 95% CI -0.31; -0.00) and maternal age (-0.25 Z-score, 95% CI -0.49, -0.02 for infants born to mothers aged ≥30 years). There was a positive association with maternal BMI and birth weight Z-score (p for trend <0.01). In multiple models for overweight, there was a positive association with wealth index quintiles (p for trend <0.01). An increase of 1 Z-score of birth weight resulted in a 37% greater chance of being overweight in the first year (95% CI 1.03, 1.81). Conclusions: Positive associations of socioeconomic context, intergenerational influences and birth size with linear growth and weight attained in the first year of life were confirmed. In addition, there was a relevant and consistently negative impact of the occurrence of malaria on linear growth of infants. Strategies involving potentially modifiable factors associated with nutritional status at 10-15 months may be particularly relevant from the perspective of a critical window of opportunity up to one thousand days of life.
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    Fatores de risco para o baixo peso ao nascer em gestantes de baixa renda
    (Pontifícia Universidade Católica de Campinas, 2003-06-01) Franceschini, Sylvia do Carmo Castro [UNIFESP]; Priore, Silvia Eloiza [UNIFESP]; Pequeno, Nila Patrícia Freire [UNIFESP]; Silva, Danielle Goes da [UNIFESP]; Sigulem, Dirce Maria [UNIFESP]; Universidade Federal de Viçosa Departamento de Nutrição e Saúde; Universidade Federal de São Paulo (UNIFESP)
    This paper assessed 77 pregnant women undergoing the last three months of gestation, in order to analyze their exposure to risk factors for low birth weight. They lived in slums in the region of Vila Mariana, a district in the city of São Paulo, and were followed up by the Projeto Favela, developed by the Federal University of São Paulo/School of Medicine. The maternal variables which most influenced birth weight were the mother's number of pregnancies and height. Primiparous women gave birth to newborns with lower birthweight, presenting an average difference of -264g when compared with infants born to multiparous mothers. Women whose height did not exceed 150cm also delivered infants with lower birth weight, demonstrating an average difference of -287g when compared with neonates born to taller mothers. Only 2.6% of the infants presented low birth weight, despite the high exposure of the studied population to risk factors.
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    Fatores de risco para perda ponderal de crianças frequentadoras de berçários em creches do município de São Paulo
    (Sociedade de Pediatria de São Paulo, 2009-03-01) Toloni, Maysa Helena de Aguiar [UNIFESP]; Konstantyner, Tulio [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To identify and quantify risk factors related to the aggravation of nutritional condition from birth until the date of the study. METHODS: Cross-sectional study with 270 children attending nurseries of eight public and non-for-profit daycare centers in the city of São Paulo, Brazil. Ponderal loss was considered when children presented negative difference of Z score for weight-for-age (W/A) from birth until the date of the present inquiry. Chi-square was used to test associations and considered significant if p<0.05. Multivariate logistic regression model adjusted Odds Ratio estimates for confounding variables and/or covariables. RESULTS: Anthropometric analysis showed 7.1% prevalence of malnutrition (W/A<-2 Z score) at birth and 4.4% by the time of measurement. Ponderal evolution with unfavorable Z score was present in 50.7% of studied children (n=137). In the bivariate analyses, the variables: birth weight (OR=5.35; p<0.001), anemia (OR=1.81; p=0.019) and age less than 19 months (OR=1.67; p=0.036) were statistically significant. CONCLUSIONS: Ponderal loss in Z score during the first months of life has not been often used in epidemiological studies. However, future researches might identify weight loss as an indicator of risk for sociobiological vulnerability. Development of health programs in order to reduce the prevalence of nutritional aggravation targeting the younger population with anemia is strongly recommended.