Title: ELABORAÇÃO, CARACTERIZAÇÃO E AVALIAÇÃO DA BIOATIVIDADE DE BEBIDAS FERMENTADAS (KOMBUCHA) A PARTIR DE SUBPRODUTOS DA CADEIA PRODUTIVA DO CAFÉ
Author: Amanda Luísa Sales
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: High amounts of byproducts are generated during coffee harvesting and processing to obtain green coffee beans. These byproducts, when improperly disposed of, can cause undesirable environmental impacts. Recently, coffee cascara and leaves have been studied due to their high content of bioactive compounds. One of the alternatives for reusing is to develop beverages. This study aimed to elaborate fermented beverages like kombucha through a symbiotic culture of bacteria and yeasts from by-products of the coffee processing, evaluating its chemical, physicochemical, microbiological, and sensory characteristics and evaluate its bioactivity. The results were presented in four studies. In the microbiological analysis, was observed a high proportion of acetic acid bacteria belonging to the Komagateibacter genera and yeasts from Pichia genera. During the fermentation process, were observed a decrease in soluble solids content (12.2-9.0 °Brix), sucrose (70%, on average), and pH (4.0-3.4), associated with the increase in titrable acidity (0.04-0.9 mEq/L). Fermentation caused the release of bound phenolic compounds from the infusions, especially total chlorogenic acids, with an average increase 98%, 30%, 47% and 26% in coffee cascara (CCK), black tea (BT), coffee leaves (CLK) and coffee-mate leaves kombuchas, respectively, up to day 9. Concerning antibacterial activity, BTK, CCK, and CLK exhibited higher inhibition zone against E.coli and S.enteritidis. In the volatile compounds profile analyzed, were identified an increase in acids and esters, and a decrease in alcohols and aldehydes along fermentation. In CCK, 1-dodecanol, 1-heptanol, hexadecanol, isopulegol, (E)- linalool oxide, (Z)-linalool oxide, ethyl butyrate, ethyl hexanoate, isoamyl acetate, and γ-nonalactone were formed from the infusions, while in CLK and also in coffee leaf with yerba mate kombuchas were observed 4-heptadienal, tetradecanal, tridecanal, undecanal (S)-2-heptanol, ethyl (Z)-3-hexenoate, methyl dihydrojasmonate and 3,2- octadien-2-one. The kombuchas with high acceptance means were those made with coffee cascara from Nicaragua (7.0 ± 0.15) and coffee leaves with yerba mate (6.6 ± 2.0) fermented for 3 days. There was also an association between volatile compounds and sensory attributes. In relation to bioactivity, black tea and coffee cascara infusions and kombuchas were able to decrease reactive oxygen species in proximal tubular cells (41%, on average) and decreased uric acid in cell supernatant (10%-55%). Infusions and kombuchas exerted anti-inflammatory activity, decreasing oxide nitric content (81%- 90%). The cell viability was not affected. It can be concluded that coffee cascara and coffee leaves are promising raw materials for kombucha production with good 19 acceptance, with potential health benefits. Therefore, it is a sustainable alternative for the reusing these byproducts, improving the coffee chain sustainability.
Keywords: coffee; industry byproducts; coffee husk; coffee leaf; kombucha; fermented beverage; fermentation; bioactive compounds; antioxidant activity; anti-inflammatory activity
Title: MARCADORES DE CONSUMO ALIMENTAR DE ACORDO COM A PARTICIPAÇÃO NO PROGRAMA BOLSA FAMÍLIA EM CRIANÇAS BRASILEIRAS DE 6–23 MESES DE IDADE: DADOS DO SISTEMA DE VIGILÂNCIA ALIMENTAR E NUTRICIONAL, 2015-2019
Author: Andreia Andrade da Silva
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: Introduction: The Bolsa Família program (BFP) has contributed to alleviating hunger by improving access to food and has become an important tool for promoting food and nutrition security. However, there is no information on the impact of the program on children’s nutrition in the first two years of life. Objectives: (1) To evaluate the trend of complementary feeding indicators among Brazilian children according to participation in the BFP and sociodemographic characteristics; (2) To analyse the effect of the BFP on the frequency of food consumption markers in Brazilian children. Methods: We used secondary data on Brazilian children aged 6–23 months, collected from primary health care routines and available in Food and Nutrition Surveillance System between 2015 and 2019. For the first objective, data from 506,511 children were used in a time-series study of complementary feeding indicators proposed by the Ministry of Health and the World Health Organization. Prevalence rates and 95% confidence intervals (95%CI) were calculated for indicators stratified by BFP service use and sociodemographic characteristics. Prais-Winsten regression was used to assess the temporal trend, with prevalence of each indicator as the outcome and the year of evaluation as the independent variable. For the second objective, linear mixed models were used to analyze the effect of the BFP (predictor variable) on the score of markers of food consumption (outcome) of 508,944 children. The score ranged from -4 (less healthy) to 10 (more healthy) points and was calculated as the difference between the frequencies of markers of healthy (MAS) and unhealthy (MANS) food consumption. Results: There was a stationary trend for the healthy complementary feeding indicators. Children under 1 year of age and BFP beneficiaries living in the North and Northeast regions had lower prevalence rates for the indicators of food introduction, minimum meal frequency and appropriate consistency, minimum dietary diversity and vitamin A-rich foods consumption and higher prevalence rates for zero vegetable and fruit consumption in all years. The prevalence of ultraprocessed foods consumption was around 50% throughout the period, with a downward trend for both BFP beneficiaries (-10.02%) and non-beneficiary children (-9.34%). Regarding the second objective, the linear mixed models showed a positive effect of the BFP on the score over time (BFP*age= 0.0002; 95%CI 0.00005; 0.0003; p<0.05), independent of the children’s sex and macroregion of residence. Conclusions: The prevalence of healthy complementary feeding indicators and the score of food consumption markers remained lower among BFP children compared to non-beneficiary children. However, there was a positive effect of the BFP on markers of food consumption over time. The findings highlight the importance of the BFP’s effect on diet and point to the need for public policies that promote greater access to healthy foods among the beneficiary group.
Keywords: Food consumption; Food and Nutritional Surveillance; Child; Nutrition Programs and Policies; Food Security; Primary Health Care
Title: DESIGUALDADES SOCIAIS E INSEGURANÇA ALIMENTAR E SUA RELAÇÃO COM DESPESA COM ALIMENTAÇÃO NA POPULAÇÃO BRASILEIRA
Author: Camilla Christine de Souza Cherol
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: The purpose of this thesis was to evaluate social inequalities and household food insecurity (FI) in the country and the relationship between FI and expenditure on food acquisition in Brazilian families. Information from two nationally representative surveys was used: (i) National Household Sample Survey (2013), which examined a sample of 110,750 households and (ii) Household Budget Survey (2017-2018), which investigated a sample of 57,920 households. FI was assessed using the Brazilian Food Insecurity Scale. In the first manuscript, the association of social indicators with the increase in the proportions of FI (outcome) between 2013 and 2017-2018 was evaluated, disaggregated by the regions of the country. Multinomial logistic regression models were applied. In the second manuscript, the association of FI (exposure) with the average per capita expenditure (in reais) was evaluated, through estimates of household food purchases (outcome) in 2017-2018. Demographic characteristics (region and area), as well as those responsible for the household (gender, age, education and skin color/race) were considered as adjustments in the final analysis model. To verify the magnitude of the association between FI and covariates with expenditure on food acquisition, generalized linear models were used. The results of the first manuscript presented that, although the North and the Northeast regions have higher proportions of FI, the Southeast and the Midwest regions presented the greatest increases in FI in 2013 and 2018. Income was the indicator with the greatest association with food insecurity. There was an association between the presence of three or more residents under the age of 18 in the household and a higher risk of FI in the North and the South regions. FI increased unevenly across regions during the period investigated. The second manuscript evidenced that, among household expenses with food, families in a situation of moderate or severe FI had higher expenses with the acquisition of rice, beans, cassava flour and salt bread when compared to those in food security. And lower acquisition of fruits, vegetables, milk and dairy products, cookies, soft drinks and sweets and desserts. Families with residents under 5 years of age purchased more milk and derivatives when compared to those without the presence of these residents. This study intended to contribute to the debate on hunger and household FI in the country and to the understanding of the issue of the social inequalities that affect access to food and better living conditions for Brazilians, especially among low-income families.
Keywords: household food security, food insecurity, social indicators, social inequality, poverty, diet surveys, diet
Title: CAPACIDADE PREDITIVA DOS INDICADORES ANTROPOMÉTRICOS E DO ÍNDICE DE ADIPOSIDADE VISCERAL NO RASTREIO DE FATORES DE RISCO CARDIOMETABÓLICOS EM ESCOLARES
Author: Flávia Erika Felix Pereira
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: Introduction: The childhood obesity pandemic in recent decades has contributed to the increase in cardiometabolic risk factors in the pediatric population, including arterial hypertension, dyslipidemia, hyperglycemia. The use of anthropometric indicators to predict these factors in school-aged children seems to be useful. Objective: To evaluate the predict ability to BMI/age, waist circumference (WC), waist-to-height ratio (WHtR) and body fat percentage (%BF) in the screening of cardiometabolic risk factors systemic arterial hypertension (SAH), dyslipidemia isolated and hyperglycemia in Brazilian school-aged children. Methods: This cross-sectional study was carried out in the State of Rio de Janeiro, Brazil, from 2013 to 2014. A total of 501 children aged 6 to 9 years old composed the sample. Information on demography, anthropometry, blood pressure and biochemical parameters was collected by trained and experienced researchers. The resulting data were analyzed using descriptive statistics, receiver operation characteristic curve analysis and binary logistic regression. Results: The mean age of 7.83 years (SD 1.05) and most were girls (56.4%; n=282). The area under the curve (AUC) showed a different significance of 0.5 for the 4 indicators tested (BMI/age, WHtR, WC and %BF) in the prediction of systemic arterial hypertension (SAH), total cholesterol (TC) and triglycerides (TG). For SAH, AUC ranged from 0.61 to 0.64, with the highest AUC [95%CI] identified in BMI/age (0.64 [0.595; 0.703]) and lowest in %BF (0.61 [0.558; 0.669]). For CT, AUC ranged from 0.59 to 0.61, with the highest AUC observed in BMI/age (0.61 [0.550; 0.687]) and lowest in %BF (0.59 [0.526; 0.663]). In TG prediction, the highest AUC was for PC (0.584 [0.534; 0.634]) and the lowest in WHtR (0.552 [0.502; 0.603]). In the prediction of elevated non-HDL-c, the AUC for BMI/age and WHtR were significantly different from 0.5, AUC= 0.64 [0.511; 0.779] and 0.63 [0.517; 0.759], respectively. The AUC of BMI/age was also significant in predicting altered glycemia AUC= 0.59 [0.511; 0.675], and the AUC of WC was significant in predicting altered LDL-c, AUC=0.58 [0.506; 0.665]. In the analysis of the ROC curve, the cutoff points obtained by the Youden index for z-score of BMI/age, WHtR, WC and %BF ranged from low to high sensitivity (0.41% to 0.85%) and very low to high specificity (0.29 to 0.83%). BMI/age, WHtR, WC and %BF adjusted for age and gender were positively associated with SAH, CT, TG and non-HDL-c. BMI/age, WHtR and WC were also positively associated with LDL-c. No anthropometric indicator was associated with plasma glucose and low HDL-c. Conclusion: The anthropometric indicators BMI/age, WC, WHtR and %BF have low ability to predict cardiometabolic risk factors SAH, isolated dyslipidemia and hyperglycemia in school-aged children, however, they were positively associated with most of these factors.
Keywords: Schoolchildren; childhood obesity, association, anthropometry, dyslipidemia, cardiometabolic risk, hypertension, ROC curve
Title: POTENTIAL OF JABOTICABA POWDER CONSUMPTION TO MODIFY UROLITHIN EXCRETION AND METABOTYPE: A CLINICAL STUDY CONTROLLED BY PLACEBO
Author: Iris Batista Leite
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: The stratification of individuals into metabotypes in clinical studies becomes increasingly important to observe the effect of a dietary intervention on health outcomes. Jaboticaba, a Brazilian berry, has about 40% to 50% of its weight represented by peel and seed, with a high content of phenolic compounds such as ellagitannins. This jaboticaba residue has previously been used to investigate ellagitannins metabolization in the Brazilian population but with high doses incompatible with regular consumption. The objective of this thesis was to characterize and evaluate the stability of the phenolic compounds in the powdered jaboticaba peel and seed (JPSP) and to evaluate whether their consumption for three weeks could modify the initial characterization of the urolithins metabotype (A, B, or 0), as well as the degree of excretion of urolithins. The jaboticaba powder was obtained after dehydration of the jaboticaba peel and seed in a forced air circulation oven (75 °C/22 h). Then, the dry residue was milled, encapsulated in an opaque capsule, and stored at 25 °C and 5 °C for 57 days. The content of phenolic compounds was evaluated after 57 days by HPLC-DAD. For the clinical study, volunteers (n = 59), of both sexes, with a body mass index (BMI) between 18.5 and 40 kg/m2 were recruited. The study consisted of the daily consumption of four capsules containing placebo (2 g of corn starch) or four capsules of JPSP (3 g of powder, containing 35.2 mg of vescalagin + ellagic acid) for three different periods of three weeks in the following order: 1) placebo consumption; 2) JPSP consumption; 3) placebo consumption. To verify possible alterations in the individuals’ metabotypes and the amount of urolithin excretion, the volunteers consumed 3 g of JPSP just before the beginning of each measurement and after the last measurement (urine 1, urine 2, urine 3, and urine 4). Urine samples (between 24 h and 36 h after ingestion) were collected before and after all interventions to analyze the metabotype and degree of urolithin excretion. Considering all volunteers (n = 59), the distribution of metabotypes in urine 1 was 32.2% of metabotype A (UM-A), 52.5% of metabotype B (UM-B), and 15.3% of metabotype 0, which differed from those already reported in the literature in different populations. No statistical difference was found between the sexes regarding the distribution of UM-A and UM-B. Considering BMI, volunteers with eutrophy had a higher frequency of UM-B (p = 0.04) than UM-A. In contrast, overweight/obese volunteers had a similar distribution of UM-A (43%) and UM-B (40%). With increasing age, there was an increase in the percentage of UM-B and a decrease in the percentage of UM-A. After consumption of JPSP, six metabolites were identified in the urine: urolithin A 3/8-glucuronide, isourolithin A 3-glucuronide, isourolithin A 9-glucuronide, isourolithin A, urolithin Bglucuronide and urolithin B. The glucuronidated forms were the most abundant, representing 93-99% of the total excreted in all stages of the study. Interindividual variability was also observed in the total excretion of urolithins (0.06 µmol to 15.39 µmol). No significant differences were observed when the volunteers were separated by sex and % body fat. However, when the volunteers were classified according to BMI, it was observed that the intervention with the JPSP led to an increase (p = 0.04) in the urinary excretion of urolithins in volunteers with eutrophy. In contrast, for the overweight/obese volunteers, this alteration was not observed. Therefore, it was possible to observe that the daily consumption of JPSP increased the excretion of urolithins after three weeks of exposure to a dietary source of ellagitannins in individuals with eutrophy
Keywords: ellagitannins; metabotypes; normoweight; obesity
Title: ASSOCIAÇÃO ENTRE A RADIODENSIDADE DO TECIDO ADIPOSO, CARACTERÍSTICAS MORFOLÓGICAS TUMORAIS E SOBREVIDA GLOBAL DE PACIENTES COM CÂNCER COLORRETAL
Author: Julio Cezar Sillos André
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: Colorectal cancer (CRC) ranks as the third most prevalent neoplasia among different types of cancer on a global scale. According to the National Cancer Institute, it is estimated that there will be 45,630 new cases of CRC in Brazil in 2023. Changes in nutritional status, often observed in cancer patients, can negatively impact quality of life and increase mortality. In this context, computed tomography (CT) is a tool that enables a more precise evaluation of body composition, which has prognostic implications for CRC. Adipose tissue radiodensity has been identified as a new prognostic marker for malignancies. Lower radiodensity indicates larger adipocytes with higher lipid content, while higher density may reflect atrophied adipocytes. In addition, inflammatory markers have been shown to be useful in predicting unfavorable outcomes in cancer. Furthermore, histopathological findings, such as the presence of desmoplasia, have been associated with an unfavorable prognosis in CRC. Therefore, studies investigating the intrinsic relationship between visceral and subcutaneous fat distribution, inflammation, and histopathological characteristics are of great importance in elucidating the clinical outcomes in surgical CRC patients. Thus, his study aims to evaluate the association between radiodensity of adipose tissue, morphological tumor characteristics, and their predictive power for overall survival (OS) in patients with CRC. It is a retrospective cohort study conducted between 2007 and 2015, involving adult patients with CRC. Body composition was assessed using CT of the third lumbar vertebra. Visceral adipose tissue radiodensity (VATd) and subcutaneous adipose tissue radiodensity (SATd) were categorized into tertiles. Inflammatory status was assessed using the neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and systemic inflammatory response index (SIRI). Five-year OS was calculated. Correlations were analyzed using Spearman’s correlation coefficient. Logistic regression was used to analyze the association between variables, calculating the odds ratio with 95% confidence intervals (CI) . The Cox proportional hazards model was used to evaluate the predictive power of the variables using hazard ratios with 95% CI. In an initial analysis, a group of 278 patients was considered eligible for the study. No significant correlations were found between SATd or VATd and SIRI. It was observed that the second tertile of VATd was an independent protective factor for OS. The first and second tertiles of SATd were identified as protective factors for OS in the presence of adjuvant chemotherapy and adjuvant chemotherapy combined with radiotherapy. In a second analysis, which included 231 patients and considered histopathological data, stage II and III CRC and low VATd were identified as independent risk factors for the development of desmoplasia. Stage III, the presence of moderate to high desmoplasia, the third tertile of NLR, and the third tertile of IRIS were identified as independent risk factors for lower OS. The results suggest that lower SATd, indicating a higher fat content, may alter the prognosis of OS in CRC patients undergoing adjuvant treatment with antineoplastic agents. In addition, increased visceral fat is a significant predisposing factor for the development of desmoplasia. Higher levels of desmoplasia, NLR, and SIRI are significantly associated with reduced OS rates over a five-year period.
Keywords: body composition, inflammatory markers, chemotherapy, colorectal cancer, prognosis, desmoplasia, overall survival
Title: INFLUÊNCIA DAS TENDÊNCIAS ATUAIS DE CONSUMO DE CAFÉS ESPECIAIS NA CAFEICULTURA DO RIO DE JANEIRO
Author: Mariana Gonçalves Corrêa
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: Coffee is one of the most popular drinks around the world. However, the way coffee is seen and consumed has changed considerably throughout history, mainly due to technological innovations in its production process and the ever-increasing demands of the consumer market. The worldwide dissemination of coffee is closely associated with the configuration and transformation of the geopolitical scenario, having shaped global history and determined the development of several countries. Coffee consumption trends reflect the particularities of lifestyles and society’s technological advances, which helps us understand how we attribute values to things in the contemporary world. Since coffee spread in Europe during the 17th century, its consumption in the West has always been associated with stimulation, socialization rituals, politics, and even religion. Coffee arrived in Brazil in the 18th century, through the city of Belém, in Pará. That same century, the first coffee plants arrived in Rio de Janeiro, native to the southwest forests of the Ethiopian plateau that came from Pará. Consumption trends from the 19th century were conceptualized in 2002 by the North American Trish Skeie as consumption waves that mark sets of priorities and philosophies in different experiences. This thesis aims to assess how current trends in specialty coffee consumption reflect coffee growing in Rio de Janeiro and identify characteristics that may define the current consumption trend in the context of the history of coffee in Rio de Janeiro. It is based on the hypothesis of a new trend in coffee consumption in the United States and the European Union, considered the fourth wave, and how the consumption trend in these countries reflects in the consumption of the Brazilian middle and high-income population of large urban centers and production for export. Most consumers worldwide already recognize that coffee contains several substances besides caffeine and their benefits to human health. The theoretical framework of the research included authors from the fields of Food and Nutrition, Sociology, Anthropology, and Communication and Consumption, such as Pierre Bourdieu, Mary Douglas, and Byung-Chul Han, among others. The theoreticalmethodological procedure adopted was the content analysis according to Bardin’s perspective. The categories were analyzed after semi-structured interviews with specialty coffee producers. During the interviews, the producers spoke about resuming coffee production and innovations to improve the product since the soil is the same as back when coffee was classified as inferior. Specialty coffees were associated with the arrival of harvest and postharvest technology, courses, and competitions held by entities, coffee associations in the state, and the return of the new generation to farms and certifications, mainly regarding sustainability and organicity.World trends in coffee consumption reached Rio de Janeiro, improving the quality of coffee produced here and fostering sustainable systems and economic and cultural growth in producing regions, in line with a supposed fourth wave. Health, however, is still not the focus among these coffee growers.
Keywords: Coffee. Consumption. Waves. Sustainability. Trends
Title: NÃO BASTA SER SUSTENTÁVEL, TEM QUE SER SAUDÁVEL: ESTUDO DE INICIATIVAS DE PRODUÇÃO E CONSUMO DE ALIMENTOS PARA A REDUÇÃO DE ALIMENTOS DE ORIGEM ANIMAL NA DIETA HUMANA
Author: Paula Albuquerque Penna Franca
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: The prospect of a new dietary transition aimed at reducing the consumption of foods of animal origin reveals many challenges. Given this scenario, this thesis proposed investigating food production and consumption initiatives to reduce animal products in the transition to healthy and sustainable food systems. For this purpose, the “plant-based” products in the Brazilian and global markets were analyzed regarding their ingredient profile, nutritional characteristics, technological development stage and market positioning. The results found were systematized in three independent manuscripts. Among the main results, it is highlighted that “plant-based” products can be used within a healthy diet by consumers in search of practicality. These consumers, however, must observe the product label, as many of the products contain high amounts of sodium, saturated fat and sugar. Furthermore, most of them are classified as ultra-processed foods and should not be the basis of the diet. Additionally, the Meat Free Monday campaign (MFM) was investigated as an example of an initiative to raise consumer awareness, the subject of the fourth manuscript of this thesis. Most MFM campaign posts address the ethical aspects of consuming meat and preparing tasty and practical preparations. The initiatives analyzed in this study point to trends towards a more sustainable diet that, without losing healthiness, can promote a new nutritional transition.
Keywords: sustainable food, plant-based foods, meat substitutes, meat-free Monday
Title: ANÁLISE DA SITUAÇÃO DE PESO DA POPULAÇÃO BRASILEIRA EXPOSTA A INSEGURANÇA ALIMENTAR
Author: Talita Barbosa Domingos
Conclusion Paper: THESIS
Date of Defense: 2023
Abstract: Frequency of adult overweight has been gradually increasing over the years in the Brazilian population, increase also being observed among those living in households with food insecurity (FI). The aim of this study was to analyze the relationship between weight status and food consumption with FI levels among Brazilian adults. This is a cross-sectional study, based on data from the National Dietary Survey (NDS), administered by the Brazilian Office of Geography and Statistics (IBGE) from 2017 to 2018 as part of the Household Budget Survey (POF). The present study uses a representative subsample of 28,112 adults (20-59 years). Food security and FI levels were measured using the Brazilian Food Insecurity Scale. To classify nutritional status, body mass index (kg/m2 ) was estimated from selfreported weight and height. Short stature was used as an indicator of malnutrition in early life, characterizing metabolic alterations resulting from the presence of FI in childhood (women≤149cm; men≤160cm cutoff points). Based on the 24-hour recall, the average intake of energy (kcal), protein (grams), carbohydrate (grams) and lipids (grams) was estimated, and 17 food categories were generated for analysis of the average intake in grams, comparing eutrophic and overweight individuals. Women with severe FI were more than twice as likely (Odds Ratio [OR] = 2.36) to be underweight and had a higher frequency of obesity (OR = 1.39). Among men, severe FI in families was a protective factor for overweight (OR = 0.58) and obesity (OR = 0.61). Men and women with obesity and FI had significantly short stature. The prevalence of obesity 1 increased significantly with FI among women. There was a trend towards short stature among obese women from families with FI, as well as lower energy intake. Between men and women, the lowest protein intake and the highest carbohydrate intake were observed in the underweight group. In both genders, lower consumption of pizzas, snacks and sandwiches was observed in overweight individuals, in line with the trend towards increased FI levels. In men in all weight status and in eutrophic women, there was greater consumption of cereals, legumes and lower fruit. Sugar beverages showed lower consumption in overweight men from families with severe FI. It is concluded that FI was a risk factor for underweight and obesity among women, but not among men. Obesity may depend on the metabolism in women, as those with FI develop obesity have short stature and lower energy intake. Traditional food consumption, based on rice and beans, was prioritized x by overweight adults exposed to FI, probably influenced by income and satiety. Overweight women show a different consumption pattern, with a smaller increase in the consumption of energy foods (cereals and legumes) compared to eutrophic women and men, reinforcing the indication of metabolic alterations
Keywords: Food insecurity, Body Mass Index, Body Height, Eating
Title: RELAÇÃO ENTRE COMPOSIÇÃO CORPORAL, VARIÁVEIS BIOQUÍMICAS E FENÓTIPOS METABÓLICOS, EM PRATICANTES DE EXERCÍCIOS DE RESISTÊNCIA, DURANTE A MENOPAUSA
Author: Ana Carla Leocadio de Magalhães
Conclusion Paper: THESIS
Date of Defense: 2022
Abstract: Introduction: Menopause is related to body and biochemical changes that contribute to the development of the metabolically unhealthy phenotype (MUH) and increased mortality. The practice of resistance training (RT) is a strategy to mitigate the consequences of this phase by promoting a reduction in body adiposity, increase in fat-free mass and improvement of cardiometabolic parameters. Objective: To evaluate the relationship between body composition, biochemical variables, metabolic phenotypes and RT in menopausal women. Methods: Observational study with RT practitioners at a gym in the city of Belo Horizonte, Minas Gerais, Brazil. Blood pressure (BP), fasting blood glucose and lipid profile, thyrotropin, body mass index (BMI), abdominal and visceral adiposity and percentage of body fat (% BF) were evaluated. The %BF was estimated by predictive equations of %BF – Deurenberg (%BF); CUN-BAE (%BF); relative fat mass (RFM) (%BF) and Palafolls (%BF) – and by DEXA. Metabolic phenotypes were classified by the Comorbidity Criteria. Information on time in years, weekly time (min/week) and weekly frequency (days/week) of RT were obtained using a questionnaire previously prepared and validated intra-researchers. Results: The sample consisted of 31 women. There was a 74.2% prevalence of the metabolically healthy (MH) phenotype. MH were younger (51.26 ± 4.44 years; 55.25 ± 3.73, p-value =0.03), had more years in RT (11.70 ± 13.60; 3.81 ± 3.66, p-value=0.01); higher concentrations of high-density lipoprotein cholesterol (HDL-c) (72.13 ± 13.59; 48.37 ± 7.55, p-value<0.01); lower visceral adiposity index (VAI) (0.81 ± 0.37; 1.63 ± 0.85, p-value = 0.03) and android/gynoid ratio (A/G) (0.79 ± 0.15; 0.98 ± 0.22, p-value = 0.01) than MUH. No association was identified between thyrotropin and metabolic phenotypes. Women with inadequacy of A/G and VAI showed prevalences of 5.20 (CI 95%: 1.90 – 14.16) and 3.12 (IC 95%: 1.07 – 9.04) times higher, respectively, of presenting the MUH phenotype than those with adequacy of these components. Women with longer years and weekly frequency of RT had lower mean of trunk fat mass (15.33 ± 7.56; 10.57 ±4.87, p=0.04; 16.31 ± 7.46; 10.98 ± 5.49, p=0.03, respectively) than those with the shortest time in years and weekly frequency of RT. There was a inverse correlation between time in years and weekly frequency of RT with body adiposity variables and between the time in years of RT with HDL-c. The %BF predictive equations showed a positive correlation with systolic blood pressure (p-value ≤ 0.01). Among these, CUN-BAE (%BF) and Deurenberg (%BF) showed greater agreement with %BF_DEXA (ICC: 0.89, p<0.01, both), when compared to MGR (%BF) and Palafolls (%BF). Conclusion: Findings from this thesis indicate that visceral adiposity is related to MUH phenotype and that there is a dose-response relationship between RT practice and body composition in menopausal women. In addition, in the absence of DEXA for body assessment, CUN-BAE (% BF) and Deurenberg (% BF) can be used to assess % BF to estimate cardiometabolic risk in this population.
Keywords: menopause; body composition; cholesterol; resistance training; cardiometabolic risk factors.
Title: INFLUÊNCIA DE POLIMORFISMOS NOS GENES FTO E ADRB2 NO EFEITO DA DIETA DASH VERSUS DIETA TRADICIONAL SOBRE O GANHO DE PESO GESTACIONAL, PRESSÃO ARTERIAL SISTÊMICA E SÍNDROMES HIPERTENSIVAS DA GESTAÇÃO EM GESTANTES COM DIABETES MELLITUS PRÉ-EXISTENTE
Author: Karina dos Santos
Conclusion Paper: THESIS
Date of Defense: 2022
Abstract: Introduction: Genetic polymorphisms may modify the effect of diet on obstetric and perinatal outcomes. Aim: To evaluate the influence of genetic polymorphisms in the FTO (rs9939609 / rs17817449) and ADRB2 (rs1042713 / rs1042714) genes on the effect of DASH diet versus traditional diet on gestational weight gain (GWG), systemic blood pressure, and hypertensive disorders of pregnancy (HDP) in pregnant women with pregestational diabetes mellitus (DM). Methods: Randomized clinical trial, carried out in Rio de Janeiro/Brazil. The participants were randomized to one of the study groups: traditional diet (n=41) or DASH diet (n=29), before 28 weeks of pregnancy, followed until the childbirth. Body weight and blood pressure measures were performed in the prenatal visits, during all pregnancy. GWG was defined as (weight in the admission to the childbirth – pre-pregnancy weight) and the excessive GWG as the total GWG above the upper limit of the recommendation according to pre-pregnancy BMI (pre-pregnancy weight/heigh²), considering the Institute of Medicine guidelines. The HDP diagnoses followed the American College of Obstetricians and Gynecologists criteria. DNA samples were extracted from buccal cells and genotyped by real time PCR. Comparisons of medians and frequencies, linear mixed-effect models for blood pressure trajectory, and time-to-event analyses for the outcomes excessive GWG and HDP were performed. Results: The median of age was 32 years (IQR 25.7-36.0); 28.6% of the participants had normal pre-pregnancy BMI, 35.7% overweight, and 35.7% obesity. The medians of GWG were 13.7 kg (IQR 11.5-17.5), 11.8 kg (IQR 7.5-16.4) e 11.0 (IQR 5.9- 14.1), respectively, with no difference between the diet groups and genotypes. The incidence of GWG was 52.9%, with no effect of DASH diet on the risk of progression, compared to the traditional diet (aHR 1.32, CI 95% 0.62;2.79, p = 0.46). The polymorphisms rs9939609 (FTO) and rs1042713 (ADRB2) influenced the risk of progression to excessive GWG: AT vs. TT (aHR 2.44, CI 95% 1.03;5.78, p = 0.04); AT/AA vs. TT (aHR 2.55, CI 95% 1.14;5.69, p = 0.02) e AA vs. GG (aHR 3.91, CI 95% 1.12;13.70, p = 0.03); AG/AA vs. GG (aHR 2.37, CI 95% 1.01;5.52, p = 0.04), respectively, and the haplotype rs9939609:rs17817449 (AG) (aHR 1.79, CI 95% 1.04;3.06, p = 0.02), regardless the type of diet. There was no statistically significative effect of diet, genotypes nor gene-diet interaction on the blood pressure trajectory. The incidence of HDP was 22.9%, with no effect of DASH diet on the risk of progression, compared to the traditional diet (aHR 0.81, CI 95% 0.25;2.61, p = 0.72). There was no significant effect of the genotypes on the development of HDP. Conclusion: Polymorphisms in the FTO and ADRB2 genes had no influence on the effect of DASH diet vs. traditional diet on the evaluated outcomes, but were risk factors for earlier exceeding GWG, regardless the type of diet.
Keywords: DASH Diet; Diabetes Mellitus; High-Risk Pregnancy; Gestational Hypertension; Pre-Eclampsia; Gestational Weight Gain
Title: DESIGUALDADE DE GÊNERO NA INSEGURANÇA ALIMENTAR E O CONSUMO DE ALIMENTOS NOS DOMICÍLIOS BRASILEIROS
Author: Lissandra Amorim Santos
Conclusion Paper: THESIS
Date of Defense: 2022
Abstract: Introduction: Gender inequalities contribute to making women more vulnerable to poverty and food insecurity (FI) in its various manifestations. As with AI, the culture that establishes the social roles developed by women also determines what they eat, even in contexts of supposed greater empowerment, such as the female head of the household. Other determinants such as income and race/skin color can enhance the influence that these factors exert on female nutrition. Objectives: (i) Describe changes in the proportions of Brazilian households that report FI according to the gender of the reference person in the household and its intersection with race/skin color and marital status from 2004 to 2018; (ii) Investigate the intersections of gender with the race/skin color of the reference person in the household in the occurrence of FI in different regions of Brazil; (iii) Compare the average consumption of macro and micronutrients between female and male household heads. Methods: Crosssectional study in which microdata from the Household Budget Survey (POF) carried out from July 2017 to July 2018 (POF 2018) by the Brazilian Institute of Geography and Statistics were used. For comparison purposes, data collected in the National Household Sample Surveys (PNADs) in 2004 and 2013 were also used. Information collected in the various POF 2018 questionnaires that provide data on the characteristics of households and their residents, on work and income, food security information and AI levels (PNAD and POF data) and personal food consumption data (POF). The variables used in this project include the sex/gender of the reference person of the household, the FI situation, assessed using the Brazilian Food Insecurity Scale; and food consumption, which was evaluated through the average estimate of amounts of energy, macronutrients and some micronutrients for men and women heads of the household. Results: Household FI varied according to gender, race/skin color and marital status of the reference person in the household, in addition to the presence of children in the household and, most importantly, the combination of these factors. Additionally, it was shown that, although the North and Northeast regions had a higher prevalence of households with moderate/severe FI, the condition of being a woman and having black or brown race/skin color was associated with a higher risk of moderate or severe FI in the Southeast and South regions compared to households in other regions. Comparing food consumption between men and women heads of households and the level of Food Security (FS)/FI, men had higher intake of calories, macronutrients, and micronutrients, except for the vitamin A, which was higher among women from households in FS. Conclusion: The results of this thesis support the hypothesis that households headed by women are more vulnerable to poverty and FI and that these conditions interfere with their diet. Therefore, public policies that encourage female empowerment and reduce social restrictions that impact women’s vulnerability, poverty and malnutrition are urgent.
Keywords: Food and Nutritional Security, Gender, Race, Intersectionality, Inequities, Food Intake.
Title: AVALIAÇÃO METABÓLICO-NUTRICIONAL DE ATLETAS DE VOLEIBOL: UM CORTE TRANSVERSAL
Author: Taillan Martins de Oliveira
Conclusion Paper: THESIS
Date of Defense: 2022
Abstract: Volleyball is a sport with aerobic and anaerobic characteristics that require intense intermittent effort from the practitioner. Changes in metabolic, biochemical, and body behavior occur naturally through the practice of exercise, adding to this psychological overload. The study of these metabolic-nutritional alterations and the emotional state of athletes is necessary for a better understanding and diagnosis of the athlete’s health and physical performance, aiming at optimal nutritional and training planning. This study aimed to investigate the interaction between food intake, degree of motivation and mood, body composition, and biochemical and metabolic in volleyball athletes of both sexes. This is an observational and cross-sectional study with the assessment of body composition, food intake, state of motivation, and mood profile. In addition to the comparison of biochemical indicators in the moments immediately before and after the practice of exercise. Fifteen female athletes with a mean age of 28 years (± 4.44), a weight of 74.74 kg (± 7.09), a height of 1.80 m (± 0.05), and a BMI of 24.15 kg were evaluated. /m² (±2.23), fat mass 21.24 kg (±8.60), lean mass 49.99 kg (±4.80). The professional volleyball athletes did not show changes in food intake and biochemical profile before and after physical exertion. In the analysis of metabolites variation, there was a significant decrease in amino acids and lipid compounds in the post-exercise moment, as well as an increase in glutamate and LDL/VLDL. In the study with thirteen male athletes, they had an average age of 21 years (±3.54), a height of 202 (±3.74 cm), a weight of 87.21 (±2.86 kg), a fat mass of 18, 41 (±3.26 kg). No significant difference was found in the concentrations of the analyzed biochemical variables (p>0.05). As for the metabolites, a negative variation of essential amino acids was found. There was no association between metabolites and dietary intake. To evaluate the interaction between motivation and mood profile with food intake, the thirteen male athletes were allocated into motivation groups: less motivated and more motivated. And it was found that the less motivated athletes had a greater sense of fatigue than the more motivated ones (p=0.04). The energy intake and energy balance of the less motivated group were higher than the more motivated group.
Keywords: volleyball, metabolomics, amino acids, mood profile, motivation, nutrition, exercise.
Title: NOVAS CURVAS DE GANHO DE PESO GESTACIONAL PARA MULHERES BRASILEIRAS
Author: Thaís Rangel Bousquet Carrilho
Conclusion Paper: THESIS
Date of Defense: 2022
Abstract: Background: Gestational weight gain (GWG) is the most important indicator of nutritional status during pregnancy. In Brazil, the Ministry of Health (MoH) adopts the combination of two methods to monitor the nutritional status of pregnant women: Atalah et al. body mass index (BMI) charts and the GWG recommendations of the American Institute of Medicine from 2009. Objectives: (1) Identify studies conducted in Brazil with GWG data, harmonize those and describe the distribution of GWG in the harmonized data; (2) evaluate the agreement between self-reported pre-pregnancy weight and weight measured during the first trimester of pregnancy and identify the best option to calculate pre-pregnancy BMI and GWG; (3) create national GWG charts and assess the internal and external validity of those charts. Methods: In the first step, a systematic literature review was conducted to identify observational studies conducted in Brazil between 1990 and 2018 with pre-pregnancy BMI and measurements of weight during pregnancy. The Brazilian Maternal and Child Nutrition Consortium (BMCNC) was created based on this pool of harmonized data. In the second step, the agreement between self-reported pre-pregnancy weight and weight measured during the first trimester of pregnancy was assessed using intraclass correlation coefficient, Lin’s and kappa coefficient, and Bland and Altman plots. In the third step, the Brazilian GWG charts were created using generalized additive models for location, scale, and shape. Estimates from the models were used to produce BMIspecific charts. The models were validated internally, by comparing the observed and expected values above/below selected percentiles of the curves, and externally, by adopting the same procedure and using data from the “Birth in Brazil” study. Results: The pool of harmonized data from the BMCNC included 21 Brazilian studies and 17,344 women. GWG, birth weight, and gestational age were similar across the studies. The agreement coefficients between selfreported pre-pregnancy weight and first-trimester weight were above 0,90 in all the evaluated scenarios indicating the possibility of using self-reported pre-pregnancy weight to calculate both pre-pregnancy BMI and GWG. The GWG curves presented excellent internal and external validity. The predicted medians (interquartile ranges) for GWG according to pre-pregnancy BMI at 40 weeks were: underweight, 14.9 (11.5 – 18.4); normal weight, 14.7 (11.4 – 18.2); overweight, 13.0 (9.3 – 16.8); obesity, 9.4 kg (4.9 – 14.1). Conclusions: These curves are the first initiative of a low- and middle-income country to create a system to monitor and assess the nutritional status of women during pregnancy. To be used in the primary healthcare services, the MoH needs to incorporate and disseminate the curves, and optimal GWG ranges to reduce the occurrence of maternal and infant adverse outcomes need to be defined.
Keywords: gestational weight gain; prenatal care; gestation; pregnancy; nutritional status.
Title: ASSOCIAÇÃO ENTRE OS OLIGOSSACARÍDEOS DO LEITE HUMANO, A MICROBIOTA INTESTINAL E O DESENVOLVIMENTO INFANTIL: ESTUDO PROSPECTIVO NOS PRIMEIROS DOZE MESES DE IDADE
Author: Amanda Caroline Cunha Figueiredo
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: Human milk oligosaccharides (HMO) are important bioactive compounds associated with infant gut microbiota (GM), and recent studies observed the association between GM and adequate infant growth and development. The main goals of the study were to estimate the association between HMOs and infant GM, and to evaluate the association between infant GM and infant growth and development throughout the first year of life. Prospective cohort was conducted at Rio de Janeiro, Brazil, with mother-infant dyads with 28-35 gestational weeks (baseline) and four follow-ups: 2-8 days (visit 1), 28-50 days (visit 2), six months (visit 3) and twelve months (visit 4) after birth. Milk samples and infant stool were collected at visit 2. HMOs were quantified using liquid chromatography with fluorescence detection. HMO hierarchical clustering analysis was performed to identify groups of women based on their HMO profile. Infant GM was evaluated using the amplification of the bacterial 16S rRNA gene. Infant growth was evaluated using the weight/age, length/age, and BMI/Age z score. Rapid infant growth was defined as a weight/age z score > 0.67 between visits 2-3 and 2-4. The infant development was evaluated by Age and Stages Questionnaire scale translated to Portuguese (ASQ-BR). Anthropometric and infant development were assessed at visits 2, 3, and 4. Infant GM was characterized by Bifidobacterium, Bacteroides, Escherichia, Clostridium genus, and Enterobacteriaceae family. Three HMO clusters were identified: cluster 1, non-secretor women; clusters 2 and 3 both based on secretor women. HMO cluster 1 had a lower relative abundance of Bacteroides and Bifidobacterium and a higher relative abundance of Proteus than clusters 2 and 3. LNnT and DFLac were positively associated with the Bifidobacterium genus, and LNH and FLNH were positively associated with Akkermansia. Infants with rapid growth (1-6months) had a higher relative abundance of Enterococcus and Proteus in GM than those with adequate growth. Positive associations were found between the abundance of Eubacterium and Coprococcus with the fine motor skills score at one month. This same domain at six months was also associated with a higher abundance of Sutterella. Alpha diversity (Chao1 index) was positively associated with fine motor skills scores throughout the first year of life. Beta diversity 24 (Unweighted UniFrac) was associated with this same domain at one month. In conclusion, secretor status substantially impacts the composition of the infant GM, affecting the relative abundance of important bacterial taxa associated with infant health, such as Bifidobacterium. In contrast, HMO differences among secretor women were responsible for few changes in the infant GM composition.There were relevant associations between the individual concentrations of OLHs and a higher abundance of beneficial bacteria, such as Bifidobacterium and Akkermansia. Infant GM in early life was associated with infant growth and development, mainly rapid infant growth, and the fine motor skills score.
Keywords: breastfeeding, human milk, infant gut microbiota, infant development, infant growth.
Title: Efeito da cafeína na melhoria da performance atlética, fisiológica e metabólica de ciclistas
Author: Anderson Pontes Morales
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: Introduction: The present study investigated caffeine supplementation for 4 days in tolerance to ergogenic effects promoted by acute ingestion in physiological, metabolic, and performance parameters. Caffeine (1,3,7-trimethylxanthine) has been described as a licit ergogenic resource, which can increase performance in cyclists. However, current recommendations do not address the impact of usual caffeine consumption, as well as whether supplementation for consecutive days could generate tolerance to the ergogenic effects promoted by acute ingestion. Objectives: The present study investigated whether the caffeine supplementation for four days would induce tolerance to the ergogenic effects promoted by acute intake on physiological, metabolic, and performance parameters of cyclists. Methods: A double-blind placebo-controlled cross-over design was employed, involving four experimental trials; placebo (4-day)-placebo (acute)/PP, placebo (4- day)-caffeine (acute)/PC, caffeine (4-day)-caffeine (acute)/CC and caffeine (4-day)-placebo (acute)/CP. Fourteen male recreationally-trained cyclists ingested capsules containing either placebo or caffeine (6 mg∙kg-1) for 4 days. On day 5 (acute), capsules containing placebo or caffeine (6 mg∙kg-1 ) were ingested 60 min before completing a 16 km time-trial (TT). Results: CC and PC showed improvements in time (3.54%, ES = 0.72; 2.53%, ES = 0.51) and in output power (2.85%, ES = 0.25; 2.53%, ES = 0.20) (p < 0.05) compared to CP and PP conditions, respectively. These effects were accompanied by increased heart rate (2.63%, ES = 0.47; 1.99%, ES = 0.34), minute volume (13.11%, ES = 0.61; 16.32%, ES = 0.75), expired O2 fraction (3.29%, ES = 0.96; 2.87, ES = 0.72), lactate blood concentration (immediately after, 29.51% ES = 0.78; 28.21% ES = 0.73 recovery (10 min), 36.01% ES = 0.84; 31.22% ES = 0.81), and reduction in expired CO2 fraction (7.64%, ES = 0.64; 7.75%, ES = 0.56). Conclusion: These results indicate that caffeine, when ingested by cyclists in a dose of 6 mg∙kg-1 for 4 days, does not induce tolerance to the ergogenic effects promoted by acute intake on physiological, metabolic, and performance parameters.
Keywords: caffeine; endurance; exercise; fatigue.
Title: USO DE FARINHAS DE CASCAS DE FRUTAS CÍTRICAS PARA SABORIZAÇÃO DE CAFÉS EM DIFERENTES GRAUS DE TORREFAÇÃO
Author: Angela Galvan de Lima
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: The habit of enjoying quality coffees with different aromas has been growing all over the world. In addition to being the largest coffee producer, Brazil also stands out in the production of various citrus fruits, which have several bioactive and their by-products can be more explored to formulate new products potentially important for the country’s economy and for consumers health and satisfaction. This thesis aimed to produce and to evaluate chemically and sensorially coffee blends at different roasting degrees flavored with citrus peel flours. Moisture contents ranged from 7.2% to 13.3%, within the standards established by ANVISA. The lipid contents ranged from 1.2% to 3.4%, protein from 4.1% to 6.6%, ash from 2.6% to 4.6% and crude fiber from 5.3% to 13.6%. The pH values ranged from 3.6 to 5.4 and total acidity from 1.1 to 2.5 g/100 g. The rounds kinkan orange had the highest concentration of reducing sugars (34.6 g/100 g), and the Tahiti acid lime, the lowest (11.8 g/100 g). The concentrations of total phenolic antioxidants compounds ranged from 596.8 to 1117.1 mg EAG/100 g, the highest content being found in oval kinkan. As for the volatilomic profile of the flours, 69 compounds were identified in the different samples, from the classes of monoterpenes (48-97% of the total area of the chromatogram), aldehydes (0.2-16.1%), monoterpenes alcohols (0.4-11.8%) and esters (0.0- 7.7%). Although some compounds such as limonene, β-myrcene, linalool and α-pinene were detected in all citrus, the volatile profiles showed specific patterns, making it possible to characterize and distinguish each citrus from these profiles. In addition, the volatile and nonvolatile profiles of a sample of specialty arabica coffee at different roasting intensities and their respective beverages were characterized. Moisture content varied from 2.1 to 2.6 in the powder, and caffeine content remained constant with roasting degree, in the powder, 1.2 to 1.3 g/100 g and increased from 54 to 87 g/100 mL in the beverages, demonstrating greater extraction in dark roasting. Trigonelline content decreased with roasting, ranging from 0.8 to 1 g/100g in powders, and from 52 to 63 g/100 mL in the beverages. Total chlorogenic acids content was also reduced with roasting, from 2.5 to 1.6 g/100g in powdered coffees and from 146 to 121 mg/100 mL in beverages. Seventy volatile compounds were identified, of which furans, pyrazines and aldehydes represented 64.1% of the total relative area of the powdered coffee chromatograms, while in beverages they represented 84.7%. Furan-2-carbaldehyde and 2- furanmethanol acetate considered to have an impact on aroma, acetic acid and 1- hydroxypropan-2-one were the most discriminating compounds regarding roast degree in the powdered coffee samples. In the beverage, 2-furanmethanol acetate, 2-carbaldehyde furan and limonene, all considered to have an impact on the aroma, were the most discriminating. Flavored coffee blends were sensorially characterized by a panel of professional evaluators, according to SCA’s Cupping analysis. The addition of some citrus peel flours improved significantly the final score of the beverages at both roasts when compared to the control coffee. However, different roasts harmonized better with different types of citrus. Scores for the unflavored control samples ranged from 80.7 to 82.3. In the flavored samples, on the moderately light roast, the highest score was for Tahiti acid lime (83.9) and sweet kinkan (83.3). On medium roast, Bahia orange (83.0) stood out and in the moderately dark roast, Tahiti acid lime (81.9). The addition of citrus flour to a basic specialty coffee contributed to improve the final evaluation. The same samples were evaluated by consumers. Considering the average scores, citrus flours, in general, increased the acceptance of flavored coffees in relation to the control samples, especially in the dark roast. Tahiti acid lime and round kinkan and Bahia oranges received the best scores. In Brazil, female consumers, with high family income and high educational level, and who do not sweeten coffee are a market niche with greater consumption potential and their scores agreed with those of the professional evaluators. A study evaluating the chemical stability of these products need to be performed, as well as the effect of their consumption on health.
Keywords: Specialty coffee; quality; citrus; chemical composition; sensory analysis.
Title: COMPOSIÇÃO NUTRICIONAL DOS EPISÓDIOS DE COMPULSÃO ALIMENTAR E CARACTERÍSTICAS PSICOPATOLÓGICAS EM INDIVÍDUOS COM TRANSTORNOS ALIMENTARES
Author: Carla Loureiro Mourilhe Silva
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: The definition of the binge eating episode (BEE) is essential for the diagnosis of eating disorders (EDs). Thesis objectives: a) Characterize the energy content of BEEs and its relationship with psychopathology in individuals with ED, through a systematic literature review and meta-analysis; b) Identify the energy content and macronutrient composition of BEE, and its contribution (%) to the daily intake in individuals with binge eating spectrum disorders (BSD) attended at a specialized outpatient clinic; c) Verify the association of caloric intake in BEE with psychopathological characteristics. The systematic review and metaanalysis were carried out following the guidelines of the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA). The meta-analysis was performed using random effects and meta-regression models. In the clinical study, 114 participants with BSD were sequentially evaluated – 57 with bulimia nervosa (BN) and 57 with binge eating disorder (BED). Food consumption in each episode was obtained applying the Eating Disorder Examination (EDE) questions and through the 7-day food diaries. The energy value (kcal) and the centesimal composition of proteins, lipids and carbohydrates of BEEs were estimated using both methods. Standardized instruments were used to assess psychiatric comorbidities and general and eating related psychopathology. Statistical analysis was performed with independent Student’s t test and Pearson’s correlation. In the systematic review, 43 studies were included. In studies with participants with BN, carried out in laboratory settings, the caloric intake of BEE was significantly higher than in studies in clinical settings. In articles with participants with ED, differences in the caloric intake did not vary by the environment. In the meta-analysis, we found that symptoms of depression were significantly associated with the energy intake of the episode. In the clinical study, BEEs were characterized by a large caloric intake [BN, 2263 (SD, 1353); TCA, 1949 (SD, 1293) kcal]. The macronutrients composition of BEEs was characterized by a high content of lipids and proteins in both groups, according to the EDE. Considering food diaries, it was observed that the energy consumed during the BEE corresponded to more than half of the energy consumed on binge days. Individuals with BN tended to consume a greater amount of calories than those with BED [2117 (SD, 2001) kcal, vs. 1447 (SD, 778) kcal, p = 0.06]. In those with BN, the frequency of BEEs was correlated with higher caloric and macronutrients intake during the episode. Participants with BSD and depressive disorder consumed more calories than those without this diagnosis [2323.6 x (SD = 1490.8) vs. 1770 (SD = 965.4) kcal, p = 0.02] and those with high levels of impulsivity had a significantly higher caloric intake during the episode compared to those with less severity. In the case of BN, participants with high disease severity consumed significantly more calories during the episode versus those with less severity and BN symptoms were directly correlated with caloric intake. Based on the literature review, BEEs in individuals with BSD were characterized by the intake of extremely large amounts of calories, which varied depending on the assessment method. The energy intake during BEE was correlated with depression severity. Based on the clinical study, the nutritional composition of BEEs of individuals with BSD varied depending on the method employed. In addition, episodes contributed to more than half of the daily consumption of calories and macronutrients. Finally, the presence of depression and high levels of impulsivity were associated with a higher caloric intake during BEEs in individuals with BSD, and in those with BN, disease severity may play an additional role in caloric intake during the episode.
Keywords: Eating disorder; Binge eating disorder; Bulimia nervosa; Food consumption; Psychopathology.
Title: TENDÊNCIAS DE CONSUMO NAS PRÁTICAS ALIMENTARES E CULINÁRIAS MIDIÁTICAS: UMA ANÁLISE DE DISCURSOS SOBRE ALIMENTAÇÃO SAUDÁVEL
Author: Manuela de Sá Pereira Colaço Dias
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: In contemporary society, the intense flow of content on healthy eating in the digital medias is permeated with consumer tendencies, codes and values which edit the discourse and continually (re)construct perceptions of what a “good diet” is. The objective of this thesis was to comprehend the dynamics of producing meaning and significance for a healthy diet in culinary audiovisual media. This was done from the perspective of broadening knowledge on the processes and mechanisms by which society and media intertwine, transforming daily practices, including those of diet and culinary. We therefore chose the channel Panelinha on YouTube, presented by Rita Lobo, and its culinary videos as the corpus of this study. The theoretical reference of this study includes authors from the Food and Nutrition, Sociology, Anthropology and Communication and Consumption fields, such as Pierre Bourdieu, Livia Barbosa, Mary Douglas, Maria Aparecida Baccega, Néstor García Canclini, Stig Hjarvard, Byung-Chul Han, among others. The theoretical methodology adopted was the French approach to discourse analysis. We call the context of this discourse Healthy society and describe the socio-historical conditions in the field of Food and Nutrition. The analytical categories which emerged were “Gourmetization of domestic cuisine and healthy eating” and “Politicization of food consumption”. We realized that the media discourse analyzed is invested with strategies of persuasion and credibility, essential to position and distinction in the field of digital medias in which the digital influencer is a trendsetter. In this context, consumption tendencies, principally those of public policies in the field of Food and Nutrition, are central intertextual elements in shaping the significance of healthy. The fluctuation of meanings regarding healthy eating both nurtures the uncertainties and anguish of citizenconsumers with formulas to resolve their food and culinary questions while at the same time convoking them to take a stand and act in defense of a “good diet”.
Keywords: Healthy Eating, Food Consumption, Culinary, Discourse, VideoAudio Media.
Title: EFEITO DA RESTRIÇÃO ALIMENTAR INTERMITENTE APÓS CONSUMO DE DIETA HIPERENERGÉTICA SOBRE A DINÂMICA MORFOLÓGICA DOS DEPÓSITOS DE GORDURA E A VIA INFLAMATÓRIA HIPOTALÂMICA EM RATAS
Author: Mariana Alejandra Rosas Fernández
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: Introduction: The global increase in obesity prevalence has motivated the investigation of different energy restriction protocols, including intermittent food restriction (IFR), characterized by both flexibility and inducing short-term weight loss, gaining an increasing number of adepts. Although the literature shows benefits on biochemical and anthropometric markers, there is still no consensus on these results, and there is little evidence of the repercussions of this treatment on the central nervous system. Objective: To evaluate in Wistar females the effect of IFR alternated with obesity-inducing diet (DIO) on the morphological dynamics of white (WAT) and brown (BAT) adipose tissue and on the hypothalamic inflammatory response. Methods: Young females (45 days old) were randomly divided into 4 groups: Standard Control (ST-C) treated with standard feed and filtered water ad libitum; DIO Control (DIO-C) treated with a hyperenergetic diet during the first and last 15 days of the intervention and standard ration between the 16th and 45th days; Standard Restricted (ST-R) treated with standard feed in the first and last 15 days of the intervention, followed by IFR at 50% of the ST-C between the 16th and 45th days; and DIO Restricted (DIO-R) treated with a hyperenergetic diet during the first and last 15 days of the intervention and was submitted to RAI under the same conditions as the ST-R. Results: Article 1: Food consumption, energy efficiency, visceral, and BAT deposits were higher in groups with IFR compared to their respective controls. Groups with IFR showed hypertrophy of WAT and BAT and fibrosis was observed in BAT. Article 2: The groups ST-R and DIO-R, compared to ST-C, showed greater expression of the PPARα, JNK, SOCS3 and NFκB genes, while the expression of the CCL5 gene was higher in the DIO-R group, compared to all groups. Conclusion: IFR can establish prospective resistance to loss of body mass by favoring changes in adipose tissue morphology, increased consumption and energy efficiency, indicating that IFR was able to exacerbate the damage caused by the restriction, whereas in the hypothalamus, the intercalated IFR or not with DIO, it worsened the hypothalamic inflammatory profile, associated with impaired anorectic response caused by marked SOCS3 expression with possible repercussions on the central response of insulin and leptin. The changes observed in the adipocyte and thermogenic morphological mechanisms in WAT and BAT suggest that IFR does not promote healthy weight loss and impairs the hypothalamic inflammatory response in Wistar rats.
Keywords: intermittent fasting, adipose tissue, energy efficiency, hypothalamus, inflammation, energy homeostasis.
Title: FATORES ASSOCIADOS ÀS CONCENTRAÇÕES DAS VITAMINAS DO COMPLEXO B E COLINA NO LEITE HUMANO: UM ESTUDO PROSPECTIVO NO RIO DE JANEIRO
Author: Mônica Araujo Batalha
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: Background: Little is known regarding how maternal characteristics and milk B-vitamin and choline concentrations in the first postpartum days could be related to changes in their concentrations throughout lactation. Additionally, there is still limited evidence on the relationship between maternal mental health and maternal vitamin B-12 status, and, to our knowledge, no study investigated how these factors could be related to milk B-12 concentrations. Objective: To evaluate factors associated with the trajectories of B-vitamin and choline concentrations in human milk and to assess the association between depressive and anxiety symptoms, maternal nutritional status of vitamin B-12 and B-12 milk concentration. Methods: Prospective cohort with baseline between 28th and 35th gestational weeks and milk samples collected at least one of several time point (TP) follow-up visits at: 2-8 (TP1), 28-50 (TP2), and 88-119 (TP3) days postpartum. Longitudinal linear mixed-effects models with interaction terms were used to evaluate changes in B-vitamin and choline concentrations in milk over time. Linear regression analyses assessed the association of maternal mental health and serum B-12 and homocysteine concentration; and the association between maternal mental health and B-12 milk concentrations. Results: The women with higher early postpartum milk concentrations of niacin, pantothenic acid, B-12, and choline exhibited a decrease in their concentrations throughout lactation. The participants with overweight and obesity prepregnancy experienced an increase in milk B-12 concentrations over time. In contrast, a decrease in B-12 concentration was observed among women with B-12 intake below the recommended daily allowance (RDA) during pregnancy. The women with niacin intake below the RDA during lactation experienced an increase in milk concentrations over time. A gestational age at birth >40 weeks was associated with an increase in milk choline concentration throughout lactation. Each unit higher in anxiety state score at baseline were associated with higher serum homocysteine concentrations, and lower milk B-12 concentration at TP2. Conclusions: Early days concentrations of milk micronutrients, maternal prepregnancy BMI, dietary intake during pregnancy and lactation, gestational age at delivery could be associated with changes in trajectories of B-vitamin and choline milk concentrations during lactation. Maternal anxiety in the end of pregnancy could be associated with maternal serum homocysteine concentrations and B-12 milk concentrations.
Keywords: Pregnancy, Lactation, Human milk, B vitamin, Choline, Nutritional Status, Depression, Anxiety.
Title: AVALIAÇÃO DO STATUS DE VITAMINA D E EFEITO DA SUPLEMENTAÇÃO EM DESFECHOS PERINATAIS EM GESTANTES COM DIABETES GESTACIONAL: um ensaio clínico controlado
Author: Nathalia Ferreira Antunes de Almeida
Conclusion Paper: THESIS
Date of Defense: 2021
Abstract: Inadequate 25 hydroxyvitamin D [25(OH)D] status is a condition present in the world population, especially during pregnancy. Women with gestational diabetes mellitus (GDM) are at increased risk of 25(OH)D insufficiency and deficiency, which may favor unfavorable perinatal outcomes. The study aimed to assess vitamin D status in pregnant women with GDM, as well as the effect of a supplementation protocol on perinatal outcomes. This is a controlled clinical trial with adult pregnant women, diagnosed with GDM up to 28 gestational weeks and with a single fetus, assisted in a public maternity hospital in Rio de Janeiro. Clinical, sociodemographic, obstetric, and anthropometric data were evaluated using a structured questionnaire. Pregnant women included in the survey were allocated to one of three groups according to their baseline serum 25(OH)D status: Group 1 – adequate vitamin D, who received dietary and lifestyle change guidance; Group 2 – vitamin D insufficiency, who received dietary and lifestyle change advice, associated with supplementation (2000UI/day of cholecalciferol) for 8 weeks; Group 3 – vitamin D deficiency, who received dietary and lifestyle change advice, associated with supplementation (7000UI/day of cholecalciferol) for 8 weeks. Predictive factors for 25(OH)D at baseline and the effect of the intervention on clinical and obstetric parameters were evaluated. Statistical analyzes included descriptive measures (mean, median, standard deviation, interquartile range, proportion), as well as Chi-Square or Fisher’s Exact tests for categorical variables and Kruskall-Wallis for continuous variables. The identification of predictors of 25(OH)D at baseline was performed using multiple linear regression. To assess whether supplementation altered vitamin D status at the end of pregnancy, the Wilcoxon signed-rank test was used. The assessment of the proportion of women who changed category in terms of vitamin D status was performed using contingency tables, with the calculation of the kappa coefficient. The statistical packages used were R version 4.0.3 and SPSS for Windows 21.0. 59 women participated in the study, with a median age of 33.0 years (IQR, 29.0, 38.5), a high prevalence of prepregnancy obesity (57.6%) and a median of vitamin D at baseline of 23 .6ng/dL (IQR, 17.1, 30.5). The factors that best correlated with baseline 25(OH)D were summer season (β = 14.6; 95% CI = 7.8 -21.5; p<0.001), total cholesterol (β = 0.1; 95% CI = 0.01-0.3; p=0.034) and regular exercise practice (β = -9.4; 95% CI = -17.9 – -1.0; p= 0.028). Vitamin D status changed in 70% of the sample between exams, but no relationships were identified with glycemic control (p=0.096) and total gestational weight gain (p=0.250). The neonatal variables were not related to the maternal 25(OH)D status. The high prevalence of inadequate vitamin D status during pregnancy, as well as the effectiveness of the supplementation protocol, configure promising results for clinical practice. More comprehensive studies focusing on prenatal nutritional assistance to pregnant women with GDM are recommended.
Keywords: Vitamin D; Pregnancy; Gestational Diabetes; Nutritional Supplements; Nutritional Deficiencies.
Title: Associação entre as concentrações e a diversidade de oligossacarídeos do leite humano e o desenvolvimento infantil até 12 meses de vida da criança
Author: Ana Lorena Lima Ferreira
Conclusion Paper: THESIS
Date of Defense: 2020
Abstract: Background: Human milk oligosaccharides (HMO) are unconjugated glycans, which promote child health. Objectives: 1) To describe the variation of HMO concentrations in the postpartum period and to verify which maternal characteristics may be associated with this composition; 2) To estimate the association between concentration and ɑ-diversity of HMOs at 28-50 days postpartum and infant development (ID) until 12 months of infant’s life. Methods: Prospective cohort, with 147 participants at baseline (28-35 gestational weeks) followed in five visits: 2-8 (visit 1), 28-50 (visit 2), 88-119 (visit 3), 180-223 (visit 4) and 365-404 days after birth (visit 5). Human milk samples were collected at visits 1 (n = 52), 2 (n = 75) and 3 (n = 46). The HMOs were analyzed by high performance liquid chromatography with fluorescence detection. The ID was evaluated by Age and Stages Questionnaire translated to Portuguese (ASQ-BR) at visits 2 (n=73), 4 (n=51) and 5 (n=45). 1) Friedman test with posthoc for the variation of HMOs over time and non-negative matrix factorization for the HMO profile according to maternal characteristics were performed. 2) Cox regressions and competing risk according to Fine & Gray models were performed to estimate the association of HMOs with a cumulative risk of infants in the monitoring zone, considering domains of infant development as competitive events. Results: 1) Most women were secretor (89.1%). Lower total HMO concentrations (g/L) were found at 88-119 days. Pre-gestational weight and body mass index (BMI), parity and gestational weight gain were moderately correlated with HMOs. Normal-weight mothers had Normal-weight mothers had a sialyl-lacto-N-tetraose c (LSTc) and those with overweight or primiparous or who were with their second child had 2ꞌfucosylactose (2ꞌFL) as the major contribution to the HMOs profiles. 2) The increase of one unit of 3-fucosylactose (3FL) (95% CI 0.003-0.830) and lacto-N-hexaose (LNH) (95% CI 0.004-0.530) reduced in 5% the subdistribution risk ratio (SHR) of being in monitoring zone for communication. An increase in fucosyllacto-N-hexaose (FLNH) (95% CI 0.01-0.96) and in disialyllacto-Ntetraose (DSLNT) (95% CI 0.10-0.65) reduced, respectively, 12% and 25% in the SHR of being in the monitoring zone for fine motor skills. Additionally, lacto-N-tetrose (LNT) (95%CI 0.02-0.47) and Shannon (95%CI 0.05-0.78), reduced, respectively, 10% and 21% in the SHR of being in monitoring zone for ≥ 2 domains. Conclusion: Lower total HMOs concentrations in g/L were found in 88- 119 days compared with other visits, and pre-pregnancy BMI and maternal parity were associated with HMO composition. Higher concentrations of LNT and LNH, fucosylated (3FL and FLNH) and sialylates (DSLNT) HMOs and the Shannon diversity reduced the SHR of infants to be in the monitoring zone of infant development throughout first year, when competitive events are considered.
Keywords: Breastfeeding; Human Milk; Oligosaccharides; Survive analyses, Infant development, Pre-pregnancy BMI.
Title: Associação entre vitamina D e marcadores do metabolismo glicídico na gestação e desfechos neonatais: resultados de uma coorte brasileira
Author: Camila Benaim Rodriguez
Conclusion Paper: THESIS
Date of Defense: 2020
Abstract: Background: Inadequate serum concentrations of vitamin D have been associated with maternal and neonatal undesired outcomes such as increased insulin resistance, gestational diabetes and such as lower birth weight, small for gestational age (SGA) newborns and prematurity. Objectives: 1. To assess the association between vitamin D status in the first trimester of gestation and rate of change of serum concentrations of glucose, insulin, adiponectin and leptin and homeostatic model assessment of insulin resistance (HOMA-IR) throughout pregnancy; 2. To evaluate the association between serum vitamin D concentrations in each gestational trimester and its weekly variation throughout pregnancy and birth weight and length, Apgar score, SGA or large for gestational age (LGA) newborns and prematurity. Methods: Data from a prospective cohort with women attended at a Municipal Health Center in Rio de Janeiro in four moments, three during pregnancy and one at postpartum. For objective 1, serum glucose concentrations (analyzed by enzymatic colorimetric method), insulin, adiponectin and leptin (analyzed by the method enzyme-linked immunosorbent assay – ELISA) and HOMA-IR (calculated) were the gestational outcomes. For objective 2, the neonatal outcomes were data on birth weight (BW, in g) and length (BL, in cm), Apgar Index (score), obtained from the child vaccination booklet. In addition, BW and BL z-scores were calculated based on the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) curve. The BW percentiles (INTERGROWTH-21st) were used to classify SGA (<P10) and LGA (<P90). Prematurity was defined as gestational age at delivery <37 weeks. In both objectives, the exposure was serum vitamin D [25(OH)D], which was measured by the high efficiency liquid chromatography coupled to mass spectrometry. For objective 1, vitamin D status was classified as sufficient or insufficient according to the Institute of Medicine cut-off points (>50 nmol/L and ≤50nmol/L, respectively) and the Endocrine Society (>75nmol/L and ≤75nmol/L, respectively). For objective 2, vitamin D was considered as absolute serum concentration. Statistical analyzes included mixed-effect linear regression models for longitudinal data (objective 1) and linear and Poisson regression models considering vitamin D continuously, trimester by trimester, and also its weekly variation, ie, longitudinally (objective 2). This variation is estimated by the best unbiased linear prediction model. Results: Objective 1: pregnant women with concentrations of 25(OH)D <75nmol/L presented lower concentrations of insulin (β=-0,12; IC95% -0,251, 0,009; P=0,069) and adiponectin (β=-0,070; IC95% -0,150, 0,010; P=0,085) during pregnancy than those with 25 (OH) D levels ≥75 nmol/L. Pregnant women with 25(OH)D <50 nmol/L at baseline had significantly higher leptin concentrations than those with 25 (OH) D levels ≥50 nmol/L (β=-2.532; 95% CI -0.436, 5.551; P=0.094). Objective 2: Vitamin D was directly associated with the risk of preterm birth in all gestational trimesters [1st trimester: incidence-rate ratios (IRR) 1.018; IC95%1.002; 1.033; 2nd trimester: IRR 1.051, IC95%1.034; 1.068; 3rd trimester: IRR 1.037, IC95% 1.018; 1.056]. Weekly vitamin D variation was directly associated with BW z-score (β: 0.350, IC95% 0.062; 0,638), LGA (IRR: 1.975, IC95% 1.075; 3.628) and prematurity risk (IRR: 7.050, IC95% 3.035; 16.378). Conclusion: Pregnant women who begin pregnancy with vitamin D insufficiency (<75 nmol/L) have lower serum insulin and adiponectin concentrations throughout pregnancy than those with sufficiency. Considering the 50 nmol/L cutoff point, insufficient pregnant women in the first trimester of pregnancy present higher serum leptin concentrations throughout pregnancy. Regarding neonatal outcomes, as higher vitamin D concentrations in each gestational trimester, greater the chance of premature neonates. And the higher weekly variation of vitamin D during pregnancy, higher the BW scores, chance of LGA and prematurity.
Keywords: Pregnancy; Glucose Metabolism; Vitamin D; Cohort studies, Birth weight, Preterm birth.
Title: CAQUEXIA DO CÂNCER: PROPOSTA DE UM NOVO MÉTODO DE AVALIAÇÃO PARA A PRÁTICA CLÍNICA
Author: Emanuelly Varea Maria Wiegert
Conclusion Paper: THESIS
Date of Defense: 2020
Abstract: The determination of cancer cachexia (CC) is complex due to its pathophysiological and multifactorial etiology. For this reason, its diagnosis requires the evaluation of several domains which makes its identification and classification challenging in clinical practice. The choice of the most appropriate CC assessment method with methodological facilities and that can be incorporated into the oncology care routine is important to allocate patients in the closest possible stages to the clinically ideal considering the severity of the disease. Each stage of CC should identify a specific phenotype, thus permitting individualized care planning. The main objective of this thesis was to develop a new method for the classification of CC and to verify its clinical applicability in individuals with advanced cancer. The sample consisted of data from a prospective cohort of patients evaluated consecutively in the first visit to the palliative care unit of the National Cancer Institute José Alencar Gomes da Silva, in the city of Rio de Janeiro, Brazil. The total participants collection period was from July 2016 to March 2019. A total 1,614 patients were included. To develop the CC classification method, logistic regression analyzes were performed to identify the most important explanatory factors associated with the syndrome. Then, based on the selected explanatory variables, cluster analysis was employed to determine how many different groups of CC could be identified. After determining the groups (clusters), the independent factors associated with them and their respective cut-off points were verified by ordinal logistic regression and construction of ROC (receiver operator characteristic) curves, respectively. The new proposed system can classify patients into three stages: pre-cachectic, cachectic and refractory cachectic according to the combination of the following factors: a) percentage of weight loss in the last six months, b) muscle mass, assessed by mid-upper-arm muscle area, and c) serum concentration of C-reactive protein. It can be observed that the severity of CC, assessed using the developed method was related with poorer quality of life (QoL), lower mean values of muscle strength, higher prevalence of low skeletal muscle mass, reduced probability of survival, and higher risk of 90-day mortality. In conclusion, the CC classification system proposes the use of simple and easily available indicators in clinical practice, permitting to adequately discriminate patients in three different risk groups in relation to all evaluated outcomes measures including prognostic and QoL.
Keywords: Nutritional status; nutritional assessment; cachexia; neoplasms; palliative care; prognosis.
Title: Efeito de probiótico (Bifidobacterium lactis) e simbiótico (Bifidobacterium lactis e frutooligossacarídeo) sobre a microbiota intestinal, perda de peso corporal e parâmetros metabólicos de mulheres com obesidade
Author: Louise Crovesy de Oliveira
Conclusion Paper: THESIS
Date of Defense: 2020
Abstract: Obesity is a complex, multifactorial and difficult to control disease. Change in gut microbiota composition has been associated with the development of obesity, through energy extraction from food increased, metabolic endotoxemia, and changes in host metabolism. Microbiota modulation by probiotics and symbiotics could balance the bacteria, leading weight loss, improvement inflammation and parameters associated with disease. The aim of the study was to evaluate the effects of probiotic (Bifidobacterium lactis (B. lactis)) and symbiotic (B. lactis and fructooligosaccharide (FOS)) on the gut microbiota composition, metabolic profile, body weight, blood glucose, lipid profile and blood pressure in women with obesity, and whether the effects on weight loss and gut microbiota were maintained 15 days after end of the intervention. A double-blind, parallel, randomized, controlled clinical trial was performed with 32 women with class I and II obesity received capsules containing 109 colony forming units (CFU) of B. lactis and sachets containing 5g of maltodextrin (PG), capsules containing 109 CFU of B. lactis and sachets with 5g FOS (SG) or capsules and sachets placebo (CG) associated with lowcaloric diet for 60 days. Anthropometric, dietary, laboratorial, clinical, gut microbiota composition and metabolomic profile variables were analyzed before and after intervention. Anthropometric, dietary, clinical and gut microbiota composition also were evaluated 15 days after end of the intervention. After 60 days of intervention, there was reduction in triglycerides (142.5 ± 40.8 vs 111.2 ± 33.4, p=0.028) in PG, body weight (93.0 ± 8.6 vs 90.8 ± 8.4, p=0.027) and BMI (36.3 ± 10.1 vs 35.5 ± 2.1, p=0.033) in SG, compared to the baseline. SG had increase in Verrucomicrobia, compared to T75, and greater distinction of metabolites. SG showed reduction in glycerol, branch-chain amino acids (BCAA), citrate and isoleucine decreased, and increase in pyruvate, arginine, glutamine and alanine, while in PG lipid associated to metabolites decreased. PG showed negative correlation of Verrucomicrobia with lactate and (CH2)n lipids, Firmicutes with VLDL/LDL and (CH2)n lipids, and positive correlation between Verrucomicrobia and isoleucine, Firmicutes with isoleucine and BCAA. In SG there was positive correlation between Bacteroidetes and glycerol, and negative correlation between body fat mass, glutamine and arginine. Fifteen days after the end of the intervention, PG showed increase in γ-Proteobacteria, compared to the other groups and times, and lower calorie (T0:1791.88 ± 613.35 vs. T75:1254.81 ± 358.76, p=0.027) and carbohydrate intake (PG:46.10±10.61 vs. SG:62.76±13.54, p=0.040), compared to baseline and SG, respectively. Probiotic associated to low-calorie diet for 60 days decreased triglycerides and metabolites associated to lipids. While, symbiotic furthers discreet weight loss, increased in Verrucomicrobia, and greater changes in host metabolism.
Keywords: obesity, probiotic, symbiotic, Bifidobacterium lactis, fructooligosaccharide, weight loss, lipemia, glycemia, blood pressure, gut microbiota, metabolomic.
Title: ESTUDO DAS CONDICIONALIDADES EM SAÚDE DO PROGRAMA BOLSA FAMÍLIA E SUAS REPERCUSSÕES NO CUIDADO À SAÚDE DE GESTANTES ATENDIDAS EM UM CENTRO MUNICIPAL DE SAÚDE DO RIO DE JANEIRO
Author: Ana Alice Taborda
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: The purpose of this thesus was to analyze the impacto f the Bolsa Familia Program (BFP) health condionality on the health care practices of pregnant women intertwined with the actions performed by professional of the Family Health Satrategy (FHS). For its development was selcted a Municipal Health Center Plannina Area 3.1 located in the city of Rio de Janeiro. This is an exploratory study that used the qualitative methodoly as its approach. Individual semi-structured interviews were conducted with health professional (community health agentes and other professional) in order to understand how health care actions were performed with pregnant women participating in the Bolsa Familia Program. Content Analysis (CA) was the technique employed adapted by discursive practices proposed by Mary Jane Spink (2013). The results showed that prenatal follow-up health conditionality did not allow differentiaded health care practices for pregnant women participating in the BFP since the actions are the same as those already performed by the FHS. We evidenced that the misrepresantation caused by the Descentralized Management Index, redirects the professionals health care practices. In the other words, “doing” health condionality aroused greater servisse demand for CHAs who guided their actions in meeting the goals set by the BPF. Still, we realized that the actions related to oral health were diferente to the participants of the program, differently from what is recommended by health conditionalities. This study aimed to contribute to the reflection on the ways of evaluating the health conditionalities of the program as a way to raise autonomy in the health care of participants and to question the requirement of health conditionality in the desing of the BPF
Keywords: conditional cash transfer program, health conditionality, primary health care, Family health strategy, health care practices, community health agents, oral health.
Title: EXPANSÃO DO UNIVERSO ALIMENTAR DE PRÉ-ESCOLARES: ESTUDO DE INTERVENÇÃO
Author: Camila Pinheiro Coura
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: This thesis presents the results of the study “Expansion of Preschoolers` Food Universe: Intervention Study”, conducted from June to December 2018, which aimed to evaluate the effect of intervention aimed at promoting fruit and vegetable consumption in preschoolers. This is a nonrandomized community trial conducted in two municipal preschools units in Rio de Janeiro, selected for convenience, with children from 4 to 6 years old. The intervention included the baseline study, with questionnaire application and measurement of children’s weight and height, the intervention consisted of five sessions of sensory workshops based on the Sapere Method; and post-intervention data collection. Data collection was performed using a structured questionnaire to obtain information on sociodemographic characteristics, eating habits of the child and family, parenting feeding style and food intake of the child. Parental feeding style was assessed by the Parental Feeding Style Questionnaire translated and adapted. Food intake was assessed using a specific Qualitative Food Frequency Questionnaire to assess the consumption of vegetables, fruits, legumes and unhealthy foods. The weight condition was classified according to the World Health Organization criteria. The intervention size effect was calculated. Changes in food group consumption between the baseline and after intervention studies were assessed by McNemar test and using the Generalized Method of Moments (GMM), having as an independent variable the time-school interaction term, allowing to estimate changes in outcomes and to compare the control and intervention schools. The model was selected based on the AIC. The analysis performed was by intention to treat. It was considered p-value
Keywords: Food and Nutrition Education; Workshops; Child Nutrition; Preschoolers
Title: INSATISFAÇÃO COM A IMAGEM CORPORAL, COMPORTAMENTOS ALIMENTARES DESORDENADOS E ALTERAÇÕES DE PESO EM ADOLESCENTES: ESTUDO LONGITUDINAL DE AVALIAÇÃO NUTRICIONAL DE ADOLESCENTES (ELANA)
Author: Danilo Dias Santana
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Adolescents are vulnerable to body and appearance concerns that make them more likely to develop body image dissatisfaction (BID). Such dissatisfaction may lead to disordered eating behaviors such as binge eating episodes, restrictive diet or fasting, and purging, leading to a vicious cycle with nutritional and general health impairment, particularly in phases of big changes such as adolescence. The aim of this study was to evaluate the associations between body image dissatisfaction, disordered eating behaviors (DEB) and body mass index (BMI) trajectory over time in two cohorts of students from private and public schools in the metropolitan region of Rio de Janeiro. This project is part of the Adolescent Nutritional Assessment Longitudinal Study (ELANA) funded by CNPq, FAPERJ and CAPES. The evaluation of BID was performed by the body silhouettes scale, based on the difference between the silhouette that the adolescents considered the most similar to their current one and the one they wanted to have. Disordered eating behaviors were assessed using a simplified questionnaire. Based on the measures of weight and height, the BMI (weight/height2 ) was calculated. Analyzes were performed according to demographic variables such as sex and type of school. Three articles were developed as results of this thesis. In the first paper, girls from private middle schools who wanted to have smaller and bigger silhouettes gained fewer BMI units (BID levels −1: 1.7 kg/m² and 1: 1.9 kg/m²) than those who were satisfied with their body image (2.8 kg/m², p < 0.05). In the high school cohort, girls from private schools who wished to have bigger (BID level −2: 1.2 kg/m²) and smaller silhouettes (BID levels 1: 1.1 kg/m² and 2: 1.4 kg/m²) experienced greater BMI increase than girls who were satisfied with their body image (0.5 kg/m², p < 0.05). Boys from high school cohort in public schools who wished to have smaller (BID level 1: 0.3 kg/m²) and bigger silhouettes (BID levels −1: 0.9 kg/m² and −2: 0.5 kg/m²) experienced smaller BMI increase than boys who were satisfied with their body image (1.3 kg/m², p < 0.05). In the second paper, girls that presented positive change of body image gained fewer BMI units (1.3 kg/m²) compared to girls who had positive maintenance of their body image (2.2 kg/m², p < 0.05). In the third paper was noted that more than half of the students presented episodes of binge eating (57.1%), 29.9% were on restrictive diets, and 7.4% used compensatory behaviors. Binge eating and restrictive dieting were associated with excess of weight at baseline but longitudinal analyzes of the association of DEB with the BMI trajectory did not show significant results. In view of the above, it is noted that these issues are extremely relevant in this age group. Such problems related to body image and eating may have unfavorable outcomes to the adolescent’s health. More attention needs to be given to those issues that require a differentiated approach by parents and health and education professionals at this stage of life.
Keywords: Adolescent, body mass index, longitudinal research, body image dissatisfaction, disordered eating behaviors.
Title: SUPLEMENTAÇÃO COM ÓLEO DE PEIXE EM ADOLESCENTES COM ACNE VULGAR: ENSAIO CLÍNICO RANDOMIZADO
Author: Felipe De Souza Cardoso
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Objetive. To review the literature on dietary interventions in acne vulgaris to support the development of more effective treatments in clinical practice and to investigate, in adolescent, male gender, the effects of fish oil consumption on the clinical improvement of vulgar acne lesions, body composition, biochemical mediators, associated with lipid metabolism and glycemic homeostasis, inflammatory markers, nutritional status of micronutrients and hormonal parameters. Material and methods. Systematic literature review of clinical trials in the last five years, available in Pub Med and SciELO, selected and analyzed according to the Jadad scale, CONSORT and risk of bias using the Cochrane protocol. The clinical trial included twenty adolescents, male gender, with acne vulgaris, evaluated in a randomized, double-blind, placebo-controlled study. The supplemented group (OP) (n = 10) received fish oil capsules (1 g containing docosahexaenoic fatty acids (DHA, 700 mg) and eicosapentaenoic acid (EPA, 100 mg), while the placebo group ) and capsules containing 1 g of mineral oil, all of which were given for daily consumption over a period of 60 days, to assess total body mass, body mass index (BMI), visceral fat, waist circumference and total body fat), using standardized techniques and Dual Energy X-ray Absorptiometry (DEXA and 24-hour recall and food frequency questionnaire were applied at the beginning and at the end of the study. The serum content of lipoproteins, glucose, insulin, testosterone, fructosamine, glycated hemoglobin, tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), magnesium, cobalamin, folate, homocysteine in, retinol, plasma zinc and 25 (OH) cholecalciferol, using specific commercial kits. Plasma samples were used for analysis of the GA profile by means of gas chromatography. The clinical evolution of the acneic lesions was evaluated through the visual analogue scale and the use of the global classification system for acne vulgaris severity, before and after the supplementation. The study was approved by the Research Ethics Committee of the State Health Department of Rio de Janeiro (1.558.238), published in the Brazilian Registry of Clinical Trials (RBR-5csqm4) and registered at the National Research Ethics Council (CAAE): 48827615.1.0000.5279). The data were organized and analyzed using the Statistical Package for Social Sciences software version 19.0 for Windows (SPSS Inc Chicago). Intergroups (OP vs P) and intragroup (before vs after 60 days of intervention) were performed using the Mann Whitney and Wilcoxon tests, with a significance level lower than 5% (P value < 0.05). Results. The review indicated that supplementation with n-3 fatty acids, Camellia sinensis, Berberis vulgaris, chromium, selenium and probiotics was significant, but the results were limited for the treatment of acne vulgaris. The consumption of foods with higher glycemic load and chocolate indicated a correlation with the increase of acneiform lesions. CONSORT indicated that most of the evidence score was attributed to titles, abstracts, and some of the methods. The methods of the studies evaluated, when missing details, received reduced scores. The clinical trial indicated that supplementation with fish oil promoted a significant reduction in total body mass (P = 0.035) and BMI (P = 0.005) and serum TNF-α (P = 0.035), followed by reduced cholesterol, triglyceride, glycemia, insulinemia and elevated serum concentrations of 25(OH) cholecalciferol, zinc and magnesium. In addition, there was a significant increase in the plasma content of total n-3 GA and reduction of arachidonic acid as well as a 50% reduction in the number of acne vulgaris lesions (P < 0.001) in the OP group compared to P. Conclusion. There is a need to increase the quantity and quality of scientific evidence on the nutritional treatment of acne vulgaris to more effectively and safely guide the nutritional actions of current clinical practice. Considering the clinical study developed, supplementation of adolescents with acne vulgaris, corresponding to 700 mg of DHA and 100 mg of EPA, promoted reduction of acneic lesions and serum testosterone, improvement in parameters related to body composition, lipid metabolism, glycemic homeostasis and inflammation as well as increase in the concentration of circulating micronutrients involved in the reduction of oxidative stress and inflammation. These findings are suggestive of the good applicability of the dietary supplement, in daily clinical practice, in adolescents with acne vulgaris.
Keywords: n-3 fatty acids, acne vulgaris, inflammation, dietary supplementation, adolescents, nutrition, dermatology.
Title: Efeito da dieta DASH na prevenção da Pre-eclâmpsia e de desfechos perinatais desfavoráveis em gestantes com Diabetes Mellitus
Author: Gabriella Pinto Belfort Araujo
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: This thesis aimed to investigate the effect of the DASH diet on obstetric and perinatal outcomes in pregnant women with diabetes mellitus (DM) previously. A randomized controlled trial, simple-blind, with two arms was developed, which had the effect of the DASH diet, adapted for Brazilian pregnant women, with pre-existing DM. Fifty pregnant women who attended prenatal care at the public maternity hospital in Rio de Janeiro between 2016 and 2019 participated in the study. Twenty-one women were allocated to the standard group (SG) and 29 to the DASH group (DG). The SG receives a standard diet, containing 45 to 55% of the total energy value (VET) of carbohydrates, 15 to 20% to VET proteins and 25 to 30% to VET lipids. The DG received an adapted DASH diet, with a distribution of macronutrients similar to the standard diet, but with greater variations in fibers, unsaturated fats, calcium, magnesium, potassium, in addition to a lower saturated fat content. The follow-up of pregnant women occurred from 28th gestational week and occurred until birth, lasting an average of 18 weeks. As statistical statistics were not performed in the SPSS 21.0 program, the significance level of 5% was adopted. The DG has a proportion 2,7 times smaller of pre-eclampsia (PE – 10.3% vs. 27.8% without SG, p = 0.230). There was no difference between the blood pressure groups, oxidative stress markers, serum lipids, with the exception of LDL cholesterol, which did not suffer an increase only in DG (p = 0.42). Small changes occur in both groups in serum lipids, mainly for triglycerides, which in SG increased on average 42.2 ± 33.1 mg / dl and in DG 44.6 ± 32.4 mg / dl (comparison between groups p = 0.86). Both research groups showed a reduction in glycated hemoglobin during the intervention (SG = – 0.77 ± -1.0%, p = 0.01 and DG = – 1.03 ± 1.04%, p 0,05). Both applied diets had beneficial effects on glycemic control, however, the present research suggests that the DASH diet has a greater effect protection on the variation of gestational BMI, contributes to a shorter hospital stay for mothers and newborns and seems to provide protection for PE. It was also observed that adequate glycemic control should be encouraged for prevention of PE and that this can be achieved, regardless of the adopted dietary strategy.
Keywords:
Title: CONSUMO E FONTES DE AÇÚCARES DE ADIÇÃO E SUA ASSOCIAÇÃO COM FATORES DE RISCO PARA AS DOENÇAS CRÔNICAS NÃO TRANSMISSÍVEIS EM ADOLESCENTES BRASILEIROS – ESTUDO DE RISCOS CARDIOVASCULARES EM ADOLESCENTES (ERICA)
Author: Isabela Escórcio Augusto Da Matta Polycarpo
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Introduction: Intake of sugars added to food and preparations during adolescence has been associated with poor dietary quality and chronic diseases. In Brazil, there are few populational studies that have investigated such association, particularly regarding metabolic changes in cardiovascular risk. Objective: To evaluate the intake and identify the sources of sugars added into the diet of adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA) and to examine the association of this consumption with metabolic alterations of cardiovascular risk. Method: Cross-sectional school-based study. Random sample, n=71,971 for the first objective, and n=36,956 for second objective, of students (12 to 17 years) of public and private schools, representative of Brazilian cities with 100,000 inhabitants or more. 95% (95% CI) of total energy intake (TEI) (kcal) and added sugar consumption (% of total energy) were calculated according to sex, age group and type of school. The prevalence of metabolic alterations and their respective 95% CIs, as well as the average intake of added sugar (grams and %, average and 95% CI), according to the metabolic changes, were calculated by gender and age group. Linear regression was used to investigate the association between glycemia, glycated hemoglobin, triglycerides, HOMA-IR and sugar intake, by sex, and adjusted for age, total energy intake and body mass index (BMI). Results: The highest energy intake was observed among boys from 15 to 17 years of age in the Northeast (2,733 kcal, 95% CI 2,638-2,827). However, the average of sugar intake was higher among girls in all the Brazilian regions. The average percentage of TEI from added sugar was higher in the South (19.8%, CI95% 18.9-20.6) and lower in the North (15.3%, CI95% 14.8-15.7). Only in the North region was observed a difference in sugar consumption among types of school, being higher in the private than in the public. The food groups that most contributed to the consumption of added sugar were sugary drinks (soft drinks: 22.5% and juices: 21.6%). The consumption of added sugar is above the WHO recommendation for all age groups, sexes, regions and types of schools. The average prevalence of changes in glycated hemoglobin and triglycerides did not differ between sexes and age groups. On the other hand, boys aged 15 to 17 years had a higher prevalence of hyperglycemia than girls of the same age group. While, the prevalence of HOMA-IR changes is higher in girls than in boys. Intake averages (grams/ day) and percentage of total caloric intake of added sugar were not significantly different among girls, with or without metabolic changes. The percentage of total caloric intake of added sugar was higher among boys 15 to 17 years old, without changes in blood glucose, when compared to boys of the same age group with change in this parameter. Younger boys, with no change in the HOMA-IR index, had a higher mean intake of added sugar than boys from the same age group with changes in this index. There was no association between intake of added sugar and markers of metabolic alterations. Conclusion: Brazilian adolescents presented high consumption of added sugar, mainly related to sweetened beverages. However, no association was found between this consumption and the markers of metabolic alterations. Regardless of this, measures to prevent and control this poor eating habit should be encouraged in the school environment to prevent future illnesses.
Keywords: Adolescents, Added sugar, 24-hour recall, Biochemical examinations, School-based cross-sectional study
Title: EFEITO DA PIPERINA SOBRE MECANISMOS DE RESISTÊNCIA A QUIMIOTERÁPICOS EM UM MODELO EXPERIMENTAL DE LEUCEMIA MIELOIDE CRÔNICA
Author: Julia Quarti Cardoso
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Multiple drug resistance (MDR) is the main obstacle to the treatment of chronic myeloid leukemia (CML) in blast crisis. Different mechanisms may be induced during the development of the MDR phenotype, among them: overexpression of drug efflux pumps, such as P-glycoprotein (P-gp); cell cycle alteration; cell death inhibition and increased xenobiotics metabolism. One promising strategy is the identification of compounds whose action is selective on MDR cells, the phenomenon known as collateral sensitivity (CS). Piperine, phytochemical present in black pepper, has anti-cancer and anti-MDR effects, however, its effect on CS induction was not investigated yet. The aim of this study was to investigate the effects of piperine on different mechanisms of drug resistance in CML cells in blast crisis. The MTT reduction assay showed that piperine promoted a greater cytotoxic effect on the leukemia cells with the MDR phenotype, Lucena1 and FEPS than on the drug-sensitive cells, K562, characterizing the occurrence of CS. In contrast, the cytotoxic effect of piperine on mouse peritoneal macrophages was lower than in MDR cells. Rapid panoptic staining and flow cytometry indicated that piperine caused significant morphological changes in leucemia cells, such as induction of cytoplasmic vacuoles formation, which, in turn, may increase cellular granularity, to a greater degree in FEPS. Flow cytometric experiments indicated that although piperine did not undergo a change in the cell cycle, piperine induced only MDR cells to apoptosis and the effect was more pronounced on FEPS cells. These data were confirmed by immunofluorescence of cleaved caspase3. MDR cells overexpress a glycolytic enzyme glycerol dehydrogenase-3-phosphate dehydrogenase (GAPDH), by real-time RT-PCR and Western blotting, suggesting a caspase-independent cell death (CICD) resistance. However piperine was not able to induce CICD via inhibition of GAPDH in these cell lines. Poly (ADP-ribose) polymerase-1 (PARP-1) has several survival and cell death-related functions. Western blotting analyzes indicated that FEPS cells presented a small amount of this protein, as well as the lower activity (inferred by the levels of the polymer Poly (ADP-ribose) – PAR). In addition, it was detected only in FEPS cells the PARP-1 24 kDa fragment, suggesting the development of a mechanism capable of preventing the overactivation of PARP-1, which could protect these cells from death by necrosis. Piperine reduced the levels of PARP-1 and its 24 kDa fragment, establishing a relationship with the induction of CS. In order to investigate whether PARP-1 levels is correlated with the MDR phenotype, analysis of the P-gp expression was performed by flow cytometry. Although piperine increased P-gp expression in both MDR cells, only in FEPS would have a possible correlation between the decrease in PARP-1 expression and the increase in P-gp expression after incubation with piperine. We also investigated the possibility that piperine is undergoing metabolism in MDR cells, generating metabolites with even more cytotoxic potential. First, we analyzed the level of genes related to phase I metabolism of xenobiotics by real time RT-PCR. The cell lines showed no detectable levels of CYP3A4, CYP1B1 and PXR. However, FEPS cells presented the highest expression of CYP3A5, followed by Lucena-1, and piperine was able to further induce expression of this gene in these MDR cells and also demonstrated to interact with the CYP3A5 protein by molecular docking. Next, we evaluated the metabolism of piperine by HPLC-DAD. However, no differences were observed among leukemia cells, suggesting that CYP3A5 would probably not be metabolizing this phytochemical. Thus, piperine appears to promote CS by different signaling pathways, such as modulating PARP-1 (in FEPS), P-gp and CYP3A5. The identification of mechanisms related to CS induction may help in the design of strategies against cells with MDR phenotype.
Keywords: Chronic Myeloid Leukemia, Multiple Drug Resistance, Piperine, Collateral Sensitivity, PARP-1, P-glycoprotein, CYP3A5.
Title: ANÁLISE NACIONAL E REGIONAL DA RELAÇÃO ENTRE INDICADORES SOCIAIS E INSEGURANÇA ALIMENTAR
Author: Juliana de Bem Lignani
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Studies conducted in Brazil, which evaluated the relationship between food insecurity (FI) and social indicators (SI), identified that people living in social inequalities were more likely to be in FI. Although these relations have been described the analyzes performed do not consider the multiple relationships between the SI. In able to understand these relations the objective of this thesis was to analyze the relation between SI and FI. At first a systematic review was done to identify the SI that are associated with FI in Brazilian households and how these relationships are explained. This review gave rise to a conceptual model that supported the elaboration of an analysis model that was later tested. For the following analysis PNAD 2013 was used as database. The tested models had as outcome variable the latent variable food insecurity (created by Confirmatory Factor Analysis) and as explanatory variables: head of household race, years of study, sex and employment stability; household per capita income; presence of piped water in one room; and for households with residents under 18 years old, number of residents under18 years old. Mean, standard error, proportion and 95% confidence intervals, Chi-square test to compare proportion, and t-Student test to compare means were calculated for descriptive analysis; and for the analysis of the relations between IS and AI Structural Equation Models (SEM) were done. SEM analysis for national data were disaggregated into households with residents under 18 years old and for households with only adults residents; households with residents under 18 years old were than tested disaggregated into the five Brazilian regions. Were calculated the total, direct and indirect effects between the SI and FI. The national results showed that household per capita income was the SI had the greatest total effect over FI. For Brazil, only income and employment stability had a direct effect higher than the indirect one. Of all the indirect paths, the income only mediated path was the most important for all SI. In the regional analysis, household per capta income and head of household years of study were the SI that had the greatest effects on FI in all regions. Only in Northeast region income did not present the greatest total effect, in this region years of study was the main one. There were differences between regions regarding mediation by another SI. In most regions income was the main intermediate variable for all FI determinants. Income was confirmed as a key FI determinant and employment stability stood out as a relevant point in FI determination. The thesis also identified that the FI determination does not occur uniformly across country, although there are some similarities between some regions.
Keywords:
Title: MARCADORES DO METABOLISMO ÓSSEO E SUA RELAÇÃO COM A DOENÇA HEPÁTICA GORDUROSA NÃO ALCOOLICA EM INDIVÍDUOS COM OBESIDADE CLASSE III CLASSIFICADOS SEGUNDO O FENÓTIPO METABOLICAMENTE SAUDÁVEL
Author: Ligiane Marques Loureiro
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Obesity negatively affects the relationship between markers of bone and hepatic metabolism, according to different degrees of Staging of Non-Alcoholic Fatty Liver Disease. The hypothesis that the metabolically healthy obesity phenotype, when present, could protect individuals from the described changes, was the aim of this study. Objective: To evaluate the association between markers of bone and hepatic metabolism with the staging of NAFLD according to the MHO and MUHO phenotypes. Methods: A cross-sectional study was carried out in adults with class III obesity. To classify the Metabolically Healthy Obese (MHO) and Metabolically Unhealthy Obese (MUHO), the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults criteria was proposed. Anthropometric parameters, Visceral Adiposity Index (VAI), biochemical, including the liver enzymes and clinical variables (blood pressure and diagnosis of NAFLD) were analyzed in the study. HOMA-IR (homeostatic model assessment insulin resistance) was calculated to determine insulin resistance. To evaluate bone metabolism, markers (alkaline phosphatase (AP) and parathormone (PTH) and related nutrients (vitamin D, calcium, phosphorus, magnesium, potassium, zinc and vitamin B12) were analyzed. The diagnosis and staging of NAFLD was determined by total abdomen ultrasonography and biopsy respectively. Continuous variables were expressed as mean and standard deviation. Categorical variables were compared using Pearson’s Chi-square test. Continuous Variables according to the MHO and MUHO phenotypes were compared using Student’s t-test. Two-way ANOVA analyzes were performed and the Tukey test, to verify the difference between the groups. Multiple logistic regression analysis was performed to determine the odds ratio (odds ratio) of markers of bone metabolism altered by phenotypes. All statistical analyzes were performed using Statistical Package for Social Sciences for Windows version 21.0. The level of significance was set at 5%. Results: A total sample was comprised of 223 adults with class III obesity aged 41.20 ± 10.15 years, 32,73% OMS. The HOMA-IR showed elevation in the MUHO group (p = 0.003). In the MUHO group, the anthropometric variables were correlated with the bone markers (BMI vs Phosphorus: r = 0.31, p
Keywords: obesity, metabolically healthy phenotype, bone metabolism, non-alcoholic fatty liver disease;
Title: ESTADO NUTRICIONAL, PARÂMETROS INFLAMATÓRIOS E, INFILTRAÇÃO TUMORAL DE LINFÓCITOS T CD4+ E T CD8+ NO PROGNÓSTICO DE PACIENTES COM CARCINOMA ESPINOCELULAR DE LARINGE
Author: Luana Dalbem Murad
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Background: Among head and neck cancer (HN), laryngeal squamous cell carcinoma (LSCC) is the most frequent histological type, presenting significant impact on nutritional status. Malnutrition has been recognized as an indicator of poor prognosis, related to worsening immunity. Increased systemic inflammation may represent an unfavorable prognostic factor. Since inflammation and nutritional status are intrinsically related, they may reflect the immune response to cancer. Studies have shown T lymphocyte dysfunction in areas infiltrated by tumors in patients with head and neck LSCC. The high density of tumor infiltrating lymphocytes (TILs) has been recognized as a good prognostic marker. However, recent studies do not explore the relationship between nutritional status, inflammatory parameters and TILs in LSCC patients. Objective: Evaluate the relationship between nutritional status and inflammatory parameters and CD4+ and CD8+ T lymphocyte tumor infiltrate in LSCC patients. Methods: Retrospective cohort study with LSCC patients, enrolled at National Cancer Institute, from January 2006 to December 2011. Pretreatment body mass index (BMI) was used to assess nutritional status. Characteristic (ROC) curves was used to determine the optimal cutoff point for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR). Overall survival (OS) was assessed by the Kaplan-Meier method and the log-rank test. Tumoral CD4+ and CD8+ T lymphocyte infiltration was assessed by immunohistochemical analysis. Contingency tables and Pearson’s Chi-square test (χ 2 ) were used to identify relationships between BMI, clinical factors, inflammatory parameters and TILs. The Receiver Operating The association between TILs and the independent variables was verified using the odds ratio (OR) calculation. Cox proportional hazards model was used for univariate and multivariate analyses. The p value < 1.55. Conclusion: NLR, PLR and LMR are associated with the prognostic of LSCC and NLR is an independent prognostic factor for OS. Reduced BMI values could adjust PLR and LMR prognostic value. Nutritional status depletion may impairs the intratumoral CD4+ T lymphocytes infiltration and may contribute to a poor prognosis.
Keywords: nutritional status, head and neck squamous cell carcinoma, tumor lymphocytes infiltrating, survival, nutritional sciences.
Title: TENDÊNCIAS TEMPORAIS DA OBESIDADE, COMPORTAMENTO SEDENTÁRIO E PRÁTICA DE ATIVIDADE FÍSICA DE ESCOLARES DE NITERÓI, RJ 2010 E 2017
Author: Marcelo Barros de Vasconcellos
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: This thesis had as general objective to analyze changes in behavior patterns over time, 2010 and 2017, in obesity, sedentary behavior and physical activity practice among adolescents from Niterói, Rio de Janeiro. In addition, the objective was to verify if the adolescents Niterói, Rio de Janeiro who receive social support practice more physical activity. To achieve these goals, two manuscripts were developed: the first describes the changes in the prevalence of obesity, sedentary behavior and physical activity in adolescents students of public schools in Niterói, RJ, in a period of 7 years. The prevalence of obesity increased in boys (6.2% to 15.6% P =
Keywords: Obesity. Sedentary behavior. Adolescents. Temporal Trends. Physical activity. Social support.
Title: EFEITO DE PROGRAMAS GOVERNAMENTAIS NA REDUÇÃO DA INSEGURANÇA ALIMENTAR: ESTUDO LONGITUDINAL EM MUNICÍPIO DO SEMIÁRIDO NORDESTINO
Author: Poliana de Araújo Palmeira
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: Introduction: Despite decades of efforts Food Insecurity (FI) remains the most important social and public health in the world, showing government challenges to implement public policies in this topic. Therefore, it’s important longitudinal and empirical studies to analyze the impact of Food Security and Nutrition (FSN) public policies on FI overcoming, especially in areas of extreme social vulnerability. Objective: this study aimed analyze the set governmental initiative related to FSN (GI-FSN) and its effect on household FI status of families in a municipality located in the semi-arid region of Northeast Brazil. Methods: this study utilized data from 2 researches. First, we analyzed building process of scenario GI-FSN in place on municipality at 2014. We mapped GI-FSN and we interviewed managers of these. Second, we performed a population-based longitudinal cohort study of families at municipality. We investigated 358 families in baseline (2011) and 326 in followup (2014), reaching 92% of households. The effects of socioeconomic determinants and access of 27 GI-FSN on changes in household FI status were estimated using logistic regression models and predict probabilities to compare data from baseline to follow-up. Results and discussion: Regarding local FSN policy analysis, the results revealed a promising and diversified scenario to deal with FI formed by 33 GI-FSN. The most of GIs were implemented between 2003 and 2014 by the national government at a local level, and the decentralization design promoted an increase in local government capacity. Populationbased study showed reduction in severity and prevalence of FI across with 24.5% of families overcame the FI. Both family income and cash transfer amount were associated with persistent FI across time. Among 27 GI-FSN investigated 15 was accessed by more than 5% of families at follow-up. More than 90% of families accessed at least one GI-FSN at 2011, and there was increment on number of GI-FSN accessed per family over time. The access to GI-FSN to health protection, food and water assistance, tackling poverty and rural development showed positive effects on guarantee access to food and FI overcoming. Conclusion: National government implemented coordinated interventions that encouraged the FSN governance and improved the politic-administrative local capacity. This scenario promoted access to GI-FSN from different governmental areas which effect was positive for both guarantee to food security and overcoming FI in an area of extreme climatic and social vulnerability.
Keywords:
Title: MONITORAMENTO DA QUALIDADE DO CAFÉ POR MEIO DE ANÁLISE MOLECULAR USANDO PCR EM TEMPO REAL
Author: Thiago Ferreira dos Santos
Conclusion Paper: THESIS
Date of Defense: 2019
Abstract: It is well known that coffee is one of the main food products commercialized in the world. During processing, coffee can be intentionally adulterated with cheaper materials, including grains and cereals, such as barley, corn and rice, as well other coffee species with lower value market (eg.Coffea canephora). In addition, the non-compliance with production standards may lead to intrinsic defects such as bored coffee.Many techniques have been developed in order to establish suitable parameters and markers to assess coffee authenticity and quality. However, these methods may present low sensitivity and specificity. Molecular Biology Techniques have efficacy and are a promising alternative to determine the authenticity of roasted and ground coffee.The goal of the present thesis was the development system of detection (primers and probes) to identify coffee adulteration, to discriminate the main coffee species and the methods to detect and estimate the concentrations of contaminants commonly found in commercial Brazilian coffees, using qPCR technique. Using bioinformatics tools, it was possible to identify and select three sequences (NM_001049010.2, AB016121.1, and NM_001112418.1, for rice, barley, and corn, respectively. The detection and quantification limits for rice, barley and maize were 4.0 x 10-2ng / μL and 1.31 x 10-1 ng / μL; 4.0 x 10-4 ng / μL and 9.76 x 10-4 ng / μL; 4.0×10-4 and 3.25×10-2ng / μL, respectively. Regarding the differentiation between the coffee species, the Ara primer was able to differentiate C. arabica from C. canephora. It was possible to develop a specific species detection system for coffee borer (H. hampei) by using selectivity and specificity analysis – in silico and in vitro.
Keywords:
Title: TRIAGEM NUTRICIONAL EM PACIENTES IDOSOS ONCOLÓGICOS: ESTUDO MULTICÊNTRICO
Author: Cristiane Aline D’Almeida
Conclusion Paper: THESIS
Data da Defesa: 06/12/2018
Abstract: Background: Screening and nutritional assessment through a fast, simple and easy instrument play an important role in the treatment of elderly cancer patients. Objective: (1) To evaluate the prevalence of malnutrition and the association with clinical and nutritional variables in hospitalized older cancer patients in Brazil by the Mini Nutritional Assessment-Short Form (MNA-SF). (2) To verify if there is a significant association between clinical variables and nutritional status and the ability of MNA-SF to predict 30-day mortality. Methods: A multicenter, hospital-based cohort study that included 44 institutions in Brazil. A total of 3061 elderly individuals with cancer hospitalized between September and October 2014, submitted to MNA-SF within 48 hours after the date of admission, and registered in their own form. Patients of both sexes, over 65 years old, with diagnosis of malignant tumors, regardless of the location or staging of the disease, were included. The Kolmogorov Smirnov test was used to test the sample distribution; considering gender, age, calf circumference (CP), body mass index (BMI), score and MAN-VR classification. Data were expressed as the frequency (n) and percentage (%) for categorical data, or mean and standard deviation and compared by the X2 or Tukey test. Univariate analysis was performed to identify explanatory factors related to the death outcome in up to 30 days. The relative risk (RR) was calculated according to logistic regression. The ROC curves of the MAN-VR and CP score were illustrated to identify the best cut-off point in the evolution to death. Results: (1) According to MNA-SF, 33.4% of the patients were malnourished, while 39.3% were at risk of malnutrition and 27.3% were classified normal nutritional status. We observed a significant increase in hospitalization time with worsening nutritional status was observed (Malnourished: 7.07±7.58 days; At risk of malnutrition 5.45±10.73 days; normal status 3.9±5,84 days; p <0.001). (2) Was observed by multivariate regression a significant higher risk 30-day mortality in older patients classified as malnourished according MNA-SF (RR 9.06; 95% CI: 4.81-17.06; p < 0.0001). The ROC curve showed a cut-off point of 7 by MNA-SF (AUC 0.81) and 31.5 cm by CC (AUC 0.67) correlated with a higher 30-day mortality. Conclusions: (1) The prevalence of malnutrition and nutritional risk is high in elderly patients hospitalized with cancer in Brazil, and the worst nutritional status was associated with a longer hospital stay. The use of a low cost and effective nutritional screening tool for elderly cancer patients allows specialized nutritional intervention. (2) Our findings suggest that MNA-SF should be considered not only as a nutritional screening tool, but also as a predictor of 30-day mortality in this group of patients.
Keywords: geriatrics, 30-day mortality, malnutrition, cancer, nutritional screening, nutritional assessment.
Title: PLACENTAL TRANSCRIPTOME: A GLOBAL ANALYSIS IN OBESE MICE AND FATTY ACID TRANSPORT IN INTRAUTERINE GROWTH RESTRICTION AND ADOLESCENT PREGNANCY
Author: Daniela de Barros Mucci
Conclusion Paper: THESIS
Data da Defesa: 19/06/2018
Abstract: In the present thesis, placental gene expression was investigated using a high-throughput RNA-seq approach in a mouse model of maternal diet-induced obesity or a targeted approach using quantitative polymerase chain reaction (qPCR) to explore fatty acid transport in intrauterine growth restriction (IUGR) and adolescent pregnancy. Maternal obesity led to a dysregulation of transcripts related to placental vasculature and structure, which was accompanied by a reduction in labyrinth zone size. Fetal growth restriction as well as changes in tissue morphology and expression of genes associated with labyrinth development were already detected at mid-pregnancy, regardless of fetal sex. Disruption of placental labyrinth structure and consequent nutrient transfer capacity could represent an underlying cause of IUGR in obese pregnancies. In the human studies, lower concentrations of specific long-chain polyunsaturated fatty acids (LCPUFA) were found in maternal erythrocytes, both in IUGR and adolescent pregnancies, in comparison to controls. In IUGR, there was a concomitant upregulation of several genes implicated in placental fatty acid transfer, however this failed to sustain normal fatty acid supply and fetal growth. In adolescent pregnancies, part of the fatty acid transporters analyzed in placenta were found downregulated. Surprisingly, LCPUFA levels were mostly preserved in cord blood. The placenta is not only imperative for adequate fetal development and survival but it is now also recognized as a programming agent of adult health and disease. Understanding the molecular and phenotypic adaptations of placenta in different obstetric conditions is pivotal to identify relevant therapeutic targets and ultimately improve offspring lifelong health.
Keywords: Placenta; Gene expression; Obesity; Intrauterine growth restriction; Adolescent pregnancy.
Title: INFLUÊNCIA DOS POLIMORFISMOS DOS GENES FTO E MC4R NAS SENSAÇÕES DE FOME/SACIEDADE; CONCENTRAÇÕES PLASMÁTICAS DE GRELINA, LEPTINA, IL6 E TNFα PRÉ E PÓS PRANDIAIS; COMPORTAMENTO E CONSUMO ALIMENTAR EM MULHERES COM OBESIDADE MÓRBIDA
Author: Fernanda Cristina Carvalho Mattos Magno
Conclusion Paper: THESIS
Data da Defesa: 20/02/2018
Abstract: Introduction: Obesity is a chronic disease and has become an epidemic throughout the world. Its etiology is complex involving mainly environmental and genetic factors. The FTO genes (rs9939609) and MC4R (rs17782313) have been related to increased body weight, where the presence of the risk alleles represented by the letters A and C of the FTO and MC4R genes, respectively, are positively associated with increased mass index body (BMI) and obesity. Objective: To evaluate the influence of single nucleotide polymorphisms (SNPs) of FTO (rs9939609) and MC4R (rs17782313) genes on hunger/satiety sensations; plasma concentrations pre and postprandial of ghrelin, leptin, interleukin 6 (IL6) and tumor necrosis factor alpha (TNFα); behavior and food intake in women with morbid obesity. Methods: The study included 70 women (BMI between 40 and 60 kg/m 2 ) and age between 20 and 48 years. Anthropometric, biochemical, hormonal and inflammatory cytokines data were collected. Sensations of hunger and satiety were evaluated through the Visual Analogue Scale (VAS). The Binge Eating Scale (BES) questionnaire was completed to evaluate the presence or absence of binge eating behavior. Dietary records of 3 days were used to evaluate habitual food intake and were calculated and analyzed in the AVANUTRI 4.0 program. Variants of polymorphisms were genotyped using real-time PCR. For the comparison between FTO genotypes, the additive model was used (TT versus TA versus AA) and the recessive model (TT versus TC / CC) was used for MC4R. Results: or FTO (rs9939609), women with the AA genotype were found to have lower plasma concentrations of ghrelin and IL6 and elevated leptin levels when compared to TT and TA in the postprandial period. TT presented reduced values for leptin and increased for IL6 postprandial. Postprandial hunger sensations were lower in AA compared to TT. Women with TT genotype consumed fewer amoutns of proteins (PTN / g / kg of body weight), B3, B12 and potassium when compared to TA and AA. According to the autorelato of the food registry of 3 days, women with the presence of two risk alleles consumed more cholesterol, B5, B6, selenium and sodium purchased with TT and TA. For MC4R, comparing the groups with (TC / CC) and without (TT) polymorphism, there was a reduction of postprandial ghrelin and leptin in patients with polymorphism, ie, less one allele at risk. There was an increase of IL6 in the postprandial period in both groups and lower plasma concentrations were found in women with polymorphism. There was a higher prevalence of severe periodic binge eating in more than half of the patients with at least one risk allele (C). Conclusion: Changes in FTO and MC4R genes may influence hormones related to food intake and IL6 control, but there was only change in the feelings of hunger and satiety for the FTO. There was a high prevalence of periodic binge eating in women with both FTO and MC4R polymorphism, suggesting that these genes may influence food behavior.
Keywords: rs9939609; rs17782313; morbid obesity, ghrelin, leptin, IL6, TNFα, hunger, satiety, food behavior, food intake.
Title: ARQUITETURA DE ESCOLHAS COMO ESTRATÉGIA PARA A PROMOÇÃO DA ALIMENTAÇÃO SAUDÁVEL EM UM RESTAURANTE COMERCIAL DO TIPO “SELF-SERVICE”
Author: Mara Lima De Cnop
Conclusion Paper: THESIS
Data da Defesa: 15/03/2018
Abstract: This thesis objectived to evaluate the impact of interventions involving the architecture of choices to promote the healthy consumption in diners of a commercial restaurant of the type “self-service”. The study included two stages: the initial pre-intervention phase, which analyzed all the preparations offered by the restaurant and elaborated and evaluated a validity and reproducibility of an instrument designed to evaluate food consumption in a self-service restaurant (QCR); and the intervention stage consisted in the development and evaluation of the impact of the use of nudge on the eating choices of diners. All the cataloged preparations (n=689) of the restaurant were categorized into food groups according to the main ingredients. The QCR included 85 items associated with a standardized portion and the option to report consumption of one or two or more servings; there was also an open question about the total weight of the dish. We investigated 85 individuals in the validity study and 76 in the reproducibility study. The estimated weight of the plate (PW) was measured to be tested calculated by the sum of the reported portions, and the final weight of the plate (FW), reference measure informed by the participant and the concordance between them was obtained by the Intraclass Correlation Coefficient (ICC) and 95% confidence interval (95%CI). We used simple, weighted kappa and PABAK to evaluate the concordance of the consumption of food groups. For the uncontrolled intervention study, conducted from September to December 2016, participated of 147 individuals in the baseline study, the first intervention based on the use of suggestive images and the second in the implementation of caloric information of the portion of the preparations offered in the establishment to encourage the consumption of fruits and vegetables. A QCR was applied at each stage of intervention to assess consumption. The differences in the consumption of the food groups and the percentage of contribution of the groups in relation to the weight and total calorie of the dish between the stages were estimated. More than 50% of the preparations evaluated in the pre- intervention stage presented high or very high energy density. The ICC of the validity study between PW and FW was 0.48 (95%CI: 0.20-0.66). The Kappa values for the food consumption report ranged from 0.18 to 0.68 and the weighted Kappa and PABAK for the proportion reporting between 0.17 and 0.64 and 0.21 and 0.89, respectively. In the intervention study, it was observed an increase in the frequency of consumption of the Leafy, Mixed Salad and Rice and Bean (p <0.05) groups with the nudges implementation. The data indicated the reduction of the contribution of Raw Vegetables in relation to the total calorie of the plate with the use of suggestive images and the contribution of Fruits in relation to the weight and total calorie of the dish with the use of caloric information. The proposed questionnaire presented acceptable validity and reproducibility to estimate food consumption in a self-service restaurant. The use of architectural strategies of choices in a self-service restaurant had a discreet impact on the eating choices of the diners.
Keywords: restaurant; nudge; food choices; architecture of choices.
Title: ELABORAÇÃO E CARACTERIZAÇÃO DE UM PRODUTO ALIMENTÍCIO COM POTENCIAL PROBIÓTICO A PARTIR DO MICROENCAPSULAMENTO DE KEFIR POR “SPRAY DRYING”
Author: Maria Claudia Novo Leal Rodrigues
Conclusion Paper: THESIS
Data da Defesa: 28/02/2018
Abstract: Kefir is a fermented dairy beverage with diverse microbiota (lactic acid bacteria (LAB), acetic acid bacteria (AAB) and yeast), which makes it difficult to obtain a standardized product with a long shelf life. Aiming to preserve the probiotic and functional potential of kefir and increase its stability, without adversely affecting the survival of microorganisms, this study proposes to elaborate and characterize kefir microparticles, using spray drying technology, widely used in dairy industry, and this is one of the first studies about kefir microencapsulation. Fermentation occurred at 25 °C / 24 h, and maturation at 4 °C / 24 h. Six microencapsulation processes were carried out without encapsulating matrix (130 to 180 °C), three with maltodextrin 1:1 and three with Capsul® 1:1 (140 to 160 °C). Spray drying reduced the survival of kefir microorganisms in all treatments, regardless the use of encapsulating matrices, which did not confer significant protection. LAB and lactobacilli survived at all temperatures with and without encapsulating matrices: BAL showed variation of 9.9 Log CFU / g in dry matter (d.m.) (130 °C) at 8.4 Log CFU / g (d.m.) (180 °C); LAB showed variation of 9.9 Log CFU / g (d.m.) (130 °C) at 4.6 Log CFU / g (d.m.) (180 °C). Yeasts and mesophiles were not viable within the detection limit (2 Log CFU / g (d.m.) in treatments from 150 ° C (yeasts) and 170 ° C (mesophiles). Temperature of 150 ° C marked the beginning of the reduction in the counting of the groups of microorganisms analyzed. Moisture (4.40 to 18.55 %), water activity (0.224 to 0.315) and hygroscopicity (18.59-23.20 % DM) were in the proper range to prevent the growth of pathogenic microorganisms, while solubility (47.91 to 78.21 %), dispersibility (ΔAbs -0.067 to 0.067), color, morphology and particle size (0.786 to 1.104 μm) presented adequate values for technological applications. Processing did not alter the proportion of nutrients present in milk. The particles produced at 140 °C presented the best physical and chemical characteristics, maintaining the original chemical composition and preserving the main microorganisms in high counts. Processing did not affect the richness of the bacterial communities originally present in kefir, but the bacterial profile of grains differed from the profiles of the fermented milk and microparticles. Samples processed at 140 °C without matrix and at 150 °C with Capsul® showed the best survival after processing. At 150 °C with encapsulating matrices, the temperature had a more positive influence on Capsul® samples than on those with maltodextrin, with better protection to bacterial community after drying.
Keywords: Kefir. Microencapsulation. Spray Drying. Functional Foods. Probiotics.
Title: CONSUMO ALIMENTAR DE GESTANTES E SUA ASSOCIAÇÃO COM
CONCENTRAÇÕES PLASMÁTICAS DE LEPTINA, ADIPONECTINA E
DESFECHOS PERINATAIS
Author: Nadya Helena Alves Santos
Conclusion Paper: THESIS
Data da Defesa: 15/03/2018
Abstract: Background: The dietary intake during pregnancy is described as an important factor for maternal and fetal health. Objective: (1) To estimate food intake changes from pre-conception to gestational period according to the degree of food processing. (2) To evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. (3) To evaluate the association between pre- pregnancy dietary patterns (DPs) and perinatal outcomes. Methods: A prospective cohort of pregnant women followed at the 5th –13th, 20th –26th, and 30th –36th gestational weeks and 30-40 days postpartum was conducted in a Public health care center in Rio de Janeiro. A food frequency questionnaire was administered at the first (5th –13th) and third (30th –36th) gestational trimesters. To achieve objective 1 the food items were classified according to characteristics of food processing in four groups: unprocessed/minimally processed foods; sugar/fat; processed foods and ultra-processed foods. The variation of food intake according to the degree of processing between the pre-conception and gestational period was calculated and compared using paired Student’s t-test. Linear regression models were performed to estimate the association of mother ́s characteristics on the variation (difference between food intake from the 3 rd and 1st trimester) of food group contribution to the total intake between periods. The objective 2 was achieved using the reduced rank regression (RRR) procedure. The RRR was employed to identify DP that explains response variables (dietary fiber, total fat, and carbohydrates) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The objective 3 RRR procedure was used to identify DPs at the first trimester that explain the following response variables (fibre density (g/kcal), dietary energy density (kcal/g), and % energy from saturated fat related to perinatal outcomes [type of delivery, premature infant’s, birth weight (BW), birth length (BL) and Apgar at the first minute]. The associations between tertiles of DPs and perinatal outcomes were tested using multiple logistic regression models. Results: (1) Women presented a mean (SD) age of 26.7 (5.6) years and a total energy intake of 2,415 (813) kcal in the pre-conception period. The contribution of unprocessed or minimally processed food group to total energy intake during pregnancy when compared to Abstract 26 the pre-conception period was higher [50.5 (14.1) vs. 48.8 (12.4), p-value=0.048], while the caloric share of ultra-processed food group was lower [41.3 (14.6) vs. 43.1 (12.5), p- value=0.032]. Moreover, we verified a negative association of age (β=-0.488; 95%IC: -0.853– -0.122; p-valor=0.009) and a positive association of pre-pregnancy BMI (β=0.449; 95%IC: – 0.019–0.918; p-valor=0.060) with the variation of ultra-processed food intake. (2) The mean (SD) daily energy intake during pregnancy was 2,415 (773) kcal, and GWG was 11.9 kg (4.2). Forty percent of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34.7% of pregnant women and 56.6% were overweight/obesity at postpartum. The ‘common-Brazilian’ DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (β=1.07, 95%CI: 0.17–1.98). The ‘western’ DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (β=-1.11, 95%CI: -2.00– -0.22) and positively associated with leptin concentrations (β=6.49, 95%CI: 2.28–10.70) throughout pregnancy. (3) At baseline, the pregnant women had a mean (SD) age of 26.7 (5.5) years, a prepregnancy BMI of 25.1 (4.5) kg/m2 and 8.7 (2.9) years of education. The mean daily energy intake in the first trimester was 2,422 (822) kcal and the frequency of normal delivery was 56.7% (n=106). The mean BW (n=190) was 3277.1 (SD 529.7) g and BL (n=187) 49.6 (SD 3.1). BW and BL adequacy were observed among 67.6% (n=125) and 78.7% (n=148) infants’, respectively, and Apgar <7 at the first minute in 14.2% (n=24). Three DP were identified. Women with the highest adherence ‘vegetables and dairy’ (characterized by high intakes of green vegetables/legumes, dairy products, fish, tea, fruits/fruit juices, and candies/desserts; and low intakes of bread, sodas, and table sugar); DP had lower risk for premature infant (OR=0.26, 95%CI: 0.06–1.09). Women with the highest adherence to the ‘fast food and candies’ (characterized by high intakes of fast food and snacks, cakes/cookies/crackers, and candies/desserts; and low intakes of rice, beans, vegetables spices, and green vegetables/legumes) DP presented BL>90th percentile occurrence (OR=4.38, 95%CI: 1.32–14.48) and higher chance of LGA (OR=4.81, 95%CI: 1.77–13.07). The highest adherence to the ‘beans, bread and fat’ (characterized by high intakes of beans, cakes/cookies/crackers, bread and fats used as spreads; and low intakes of fish, fruit/fruit juices, and noodles/pasta/roots or tubers) DP was inversely associated with Apgar <7 at the first minute (OR=0.14, 95%CI: 0.03–0.70). Conclusions: (1) Ultra-processed food intake decreased, while minimally or unprocessed food intake increased from the pre-conception to gestational period, indicating that the studied women improved their food intake profile during pregnancy. (2) The higher adherence to the ‘common-Brazilian’ DP was positively associated with adiponectin. The ‘western’ pattern was negatively and positively associated with adiponectin and leptin concentrations throughout pregnancy, respectively. (3) Higher adherence to a ‘fast food and candies’ prepregnancy DP increased the chance of LGA infants, and the higher adherence to the‘vegetables and dairy’ DP decrease to the odds of premature infant.
Keywords: pregnant women, ultra-processed food, dietary pattern, adiposity indicators, adipokines and perinatal outcomes.
Title: DESENVOLVIMENTO DE UM PRODUTO EM PÓ DE CERVEJA ARTESANAL POR MICROENCAPSULAMENTO PELO MÉTODO DE SPRAY DRYING: ANÁLISE DOS COMPOSTOS NUTRICIONAIS, BIOATIVOS, FUNCIONALIDADE E ASPECTOS SENSORIAIS
Author: Paola Daianne da Silva Maia
Conclusion Paper: THESIS
Data da Defesa: 27/02/2018
Abstract: Bioactive compounds (BACs) found in food have been associated with the reduced risk of developing chronic non-communicable diseases, requiring the use of new technologies in the elaboration of products with functional health action. The purpose of microencapsulation is to concentrate and stabilize BACs and, in addition, when it comes to the development of beers, it evaporates the alcohol, making a product with possible claims of functional and health properties. The aim of this work was to evaluate the microencapsulation of five trials of a Pale Ale craft beer by spray drying in different proportions (wall material/core) using maltodextrin at the same concentration of total solids (ST), 18%. The microparticles were evaluated for yield, solubility, mean particle size, water activity, percentage of retention, total phenolic compounds contents and antioxidant activity. The solubility showed average values of 94.91, 0.279 of water activity and 967.64 mg EAG/g of phenolic compounds. The best results according to the planning were the microparticles with pure beer (test 2) and maltodextrin (test 5, 1:1%), characterized in relation to wettability (76.8 s), hygroscopicity (14.38%), and dispersibility (-0.33 ΔAbs, x 10)3, both products showed satisfactory results for the characterization of powdered food products. In the stability study, no significant statistical difference was observed in the phenolic compounds reduction and antioxidant activity, both showed 100% in beer microparticles retention with and without maltodextrin (tests 2 and 5) over 180 days, showing potential in the development of products for food applications and relevance to human health. The sensory analysis performed with 230 tasters showed good acceptance regarding overall appearance, taste and purchase intent for both products. Ten organic acids and ten phenolic compounds were identified and quantified in the in natura beer, which remained in the powdered products in a concentrated way, in addition, the volatile compounds were not lost with the process. At the bioactivity study, the groups that received supplementation with phenolic beer extract (EF) and beer powder fortified with phenolic extract (CPEF) had the clinical symptoms of colitis attenuated when compared to the non-supplemented group, conferring an anti-inflammatory effect on the product of powdered beer in vivo model. In this work we expose the use of technology in products with functional potential, since there are no studies with craft powdered beer. The product also showed the phenolic compounds bioactivity in mice with colitis, conferring its benefits in the prevention of inflammatory bowel diseases (IBD).
Keywords: Craft beer; spray drying; Phenolic Compounds; Organic acids; Stability; Sensory Analysis and Bioactivity.
Title: MUDANÇA NO ESTILO DE VIDA DE ESTUDANTES INGRESSANTES EM UMA UNIVERSIDADE PÚBLICA BRASILEIRA
Author: Patricia Simone Nogueira
Conclusion Paper: THESIS
Data da Defesa: 13/03/2018
Abstract: The present thesis is centered in the subject of the health of the university and uses data from the Longitudinal Study on Lifestyle and Health of University Students (ELESEU). Admission to the university favors changes in lifestyle behaviors, both by insertion in a new environment and by exposure to new challenges and health risks. This thesis is composed of three manuscripts. The aim of the first manuscript was to systematically review the literature to identify changes that occur in lifestyle behaviors between high school and university, considering eating habits, physical activity, sedentary behaviors, alcohol consumption and smoking, as well as changes in the students’ weight status. Sixteen articles were included in the study. In the transition period from high school to university, the body weight gain varied, on average, from 1.51 to 3.0kg. There was an increase in the time of use of the computer and the sitting time devoted to studies, as well as in the quantity and frequency of consumption of alcoholic beverages and daily use of tobacco. On the other hand, the daily consumption of fruits, vegetables, milk and dairy products and fiber-rich products decreased, and there was also a reduction in vigorous physical activity. The second manuscript describes the design of the study and the methodological procedures adopted in ELESEU. It is a dynamic cohort of students of full-time courses at a public university in the state of Mato Grosso, Brazil. This study will have four years of follow-up, begun in 2015, with an expected end in 2018. The information is obtained through a self-administered questionnaire, containing questions about demographic, socioeconomic characteristics and information about conditions, injuries and health risk factors, such as: lifestyle characteristics, stress perception, depression symptoms, perception of body image, risk behaviors for eating disorders, self- assessment of health and diet quality, among other aspects related to nutrition and health. Anthropometric measures and blood pressure are measured. In 50% of the students, two 24-hour dietary reminders are collected and capillary dosages of cholesterol, triglycerides and glucose are collected. The third manuscript analyzed changes that occur in lifestyle behaviors before and after university admission, considering eating habits, physical activity practice, alcohol consumption and smoking. We evaluated 1,038 students, who are part of ELESEU. After admission to university, there was an increase in the frequency of breakfast consumption and a decrease in the level of physical activity. Students from public schools, who declared themselves to be black, brown, yellow or indigenous, belonging to the economic classes C, D or E and the quotaters showed an increase in the frequency of consumption of meals, however, they decreased the practice of physical activity. Thus, it was found that admission to university seems to contribute to changes in students’ lifestyles and that the changes that occur with university admission are positively associated with students who had access to university through policies that made possible the democratization of the university access.
Keywords: Students. Universities. Life Style. Weight condition. Longitudinal studies.
Title: ASPECTOS PSICOSSOCIAIS ASSOCIADOS AO CONSUMO DE FRUTAS E HORTALIÇAS EM ADOLESCENTES
Author: Thais Meirelles de Vasconcellos
Conclusion Paper: THESIS
Data da Defesa: 16/03/2018
Abstract: This thesis presents results from two manuscripts, developed based on the analysis of the psychosocial aspects associated to the consumption of fruits and vegetables in Brazilian adolescents. Data from a cross – sectional study developed in the year 2015, carried out with 5th – 9th grade students from a public school in Niterói, Rio de Janeiro were analyzed. In the first manuscript the objective was to conduct a test-retest study to evaluate the reproducibility of the questionnaire on the psychosocial aspects associated with the consumption of fruits and vegetables. A study was carried out with 92 adolescents with a mean age of 13 years (SD = 1.52). Firstly, the cross-cultural adaptation of fruit and vegetable consumption issues (n = 46) the questionnaire “Psychosocial Aspects Associated with Nutrition and Physical Activity of Adolescents” was carried out, which evaluated, by means of affirmative that described positive and negative behaviors, related to the influence of self-efficacy, family, peers, body image and media on the consumption of fruits and vegetables in adolescents. The reproducibility of the questionnaire was evaluated by the kappa statistic and the intraclass correlation coefficient (ICC). The analyzes showed that 60% of the statements presented significant kappa statistic (p-value ≤ 0.05) and, in 55% of them, the agreement ranged from reasonable to moderate (kappa 0.21-0.60). The most significant psychosocial aspects were self-efficacy (ICC = 0.75), family influence (ICC = 0.59), body image (ICC = 0.47) and peer influence (ICC = 0, 30). The analyzes allowed to observe acceptable reproducibility of the questionnaire and that it allows to evaluate the psychosocial aspects related to the consumption of fruits and vegetables in adolescents. In the second manuscript, the association between psychosocial aspects and the consumption of fruits and vegetables in adolescents was evaluated. A total of 328 adolescents with a mean age of 12.7 years (SD = 1.64) were analyzed. The psychosocial aspects were evaluated by the questionnaire developed for adolescents, food consumption was evaluated with the application of two 24-hour reminders and food frequency questionnaire. Self-efficacy and peer influence were the factors that had the greatest influence on adolescents. It was observed that adolescents who are most influenced by these aspects increase both the quantity and the frequency of consumption of fruits and vegetables. The findings of the present thesis show that the questionnaire evaluated can be used in Brazilian adolescents and that special attention should be given to the studies of the psychosocial aspects related to eating habits, emphasizing self efficacy and peers.
Keywords: Adolescents, psychosocial aspects, questionnaire, reproducibility, translation, fruits and vegetables.
Title: EXCESSO DE PESO, GANHO PONDERAL E DESFECHOS PERINATAIS
EM MULHERES ADULTAS BRASILEIRAS
Author: Thelma Brandão
Conclusion Paper: THESIS
Data da Defesa: 13/03/2018
Abstract: The growth of overweight (OW), obesity (OB) and excessive weight gain among pregnant women has been the subject of academic debate and government policies regarding the deleterious effects on the health of women and children in the short and long term. Specific gestational weight gain (GWG) proposals for the Brazilian population capable of contemplating the different categories of nutritional status, including degrees of obesity, are necessary. Thus, the objective was to analyze maternal adverse outcomes from OW and OB in studies involving Brazilian women; propose and analyze GWG ranges associated with favorable neonatal outcomes and evaluate association of weight gain according to body mass index (BMI) classes in the adverse maternal outcomes selected from data from a representative cohort of women. For this, a systematic review (SR) was conducted based on the GRADE guidelines, which were the guide for this review and the evaluation of the degree of evidence from included studies. We analyzed anthropometric data from the National Survey on Born in Brazil (2011-2012), to identify the GWG ranges associated with favorable neonatal outcomes, based on the percentile distribution of the sample, as well as to identify maternal adverse outcomes (hypertensive pregnancy syndromes – HPS, gestational diabetes mellitus – GDM and cesarean section) associated with the inadequacy of GWG, considering the median of the distribution as 100% adequacy. HPS, GDM, caesarean section and marked GWG were the most frequent adverse conditions reported by the studies included in the SR. Results of the survey indicated that GWG values between the 30th and 70th percentiles of the distribution among low-weight and eutrophic pregnant women associated with favorable neonatal outcomes were closer to the recommendations by the Institute of Medicine, unlike those presented by the categories of OW and OB, who expressed greater amplitude of variation. Thus, GWG ranges associated with favorable neonatal outcomes were 12 to 18 kg, 11 to 16 kg, 9.7 to 15 kg, 5 to 12 kg, 6 to 12.2 kg, 4 to 10 kg and 2.2 to 7 kg , 9 kg for low weight, eutrophication, OW, OB, OB 1, OB II and OB III, espectively. Unfavorable maternal outcomes associated with GWG inadequacy were observed in eutrophic women with OW and OB. GWG was strongly associated with HPS, especially among eutrophic patients with excessive gain (OR = 3.36, 95% CI 2.46-4.59). On the other hand, insufficient GWG was a protective factor for such outcome in pregnant women with OW (OR = 0.36, 95% IC 0.23- 0.56) and OB (OR = 0.50, 95% IC 0.35 -0.72). For the occurrence of cesarean section, there was an insufficient GWG protective effect in eutrophic women (OR = 0.57, 95% IC 0.46- 0.71) and OW (OR = 0.56, 95% IC 0, 41-0,76), and this effect does not occur in pregnant women with OW. However, excessive GWG increased the chance of this occurrence for women with OW (OR = 1.76, 95% CI 1.23-2.53) and OB (OR = 1.92, 95% CI, 1.34-2.74). On the other hand, there was no association of GWG with the occurrence of GDM in any category of pre-gestational BMI. Thus, it was concluded from the SR performed that the HPS, GDM, cesarean section and high GWG were the outcomes most referred to by articles associated with overweight, being this pioneering review to include only studies with Brazilian women. In addition, the use of anthropometric data from a representative survey of the maternal population in the country allowed the identification of GWG ranges associated with favorable neonatal outcomes, as well as their performance in the prediction of adverse maternal outcomes. These findings represent an advance for the discussion about the GWG proposition for Brazilian women as well as for the identification of more specific ranges according to obesity classes. Finally, it is hoped that the present study may guide actions to control and prevent the effects of excess weight and excessive weight gain on the health of women and children.
Keywords: Pregnancy. Obesity. Gestational weight gain. Perinatal outcomes.
Title: EFEITO DO CONSUMO DE AÇÚCARES SOBRE O EIXO LEPTINA-SEROTONINA E O FATOR DE TRANSCRIÇÃO FOXO1 NO HIPOTÁLAMO DE RATOS
Author: Viviane Wagner Ramos
Conclusion Paper: THESIS
Data da Defesa: 09/08/2018
Abstract: The high consumption of Added sugars is related to different metabolic alterations, as well as changes in central mechanisms of control of energy homeostasis and to the development of obesity. In this study, we hypothesized that the chronic and high consumption of different sugars would be able to interfere on hypothalamic leptin- serotonin axis, compromising cerebral anorectic pathways, affecting the control of food intake in rats. At 30 days of age, male Wistar rats were divided into four groups, treated for eight weeks with commercial chow and water (control group, C) or commercial chow and solution containing fructose (fructose group, F) or glucose (glucose group, G) or sucrose (sucrose group, S), all at 20%. Visceral fat deposits were dissected, weighed and morphometry was performed on retroperitoneal tissue (RET). Analyzes of blood lipid profile and glycemic homeostasis were also conducted. Feeding response to intracerebroventricular infusion (ICV) of leptin and serotonin was investigated after submission of the animals to stereotactic surgery. The gene expression of the leptin (LepR) and serotonin (5-HT1B and 5-HT2C) receptors, the Foxo1 and the supressor cytokine signaling suppressor (SOCS3) in the hypothalamus were assessed by q-PCR and by Western blotting, the hypothalamic levels of 5-HT2C, SOCS3 and the serotonin transporter were quantified. High-performance liquid chromatography was employed in the analysis of hypothalamic serotonin concentrations. Despite similar values in the body mass, at the end of the eight weeks of treatment, the F, G and S animals showed a higher amount of visceral adipose tissue, compared to C, although only the F and S groups showed RET hyperplasia. There was no change in glycemic homeostasis. Animals F and S did not respond to central leptin injection, differently from C and G. Similar response was observed after serotonin infusion. Increased gene expression of LepR in group G, increase of 5-HT2C content in group S and of SOCS3 and Foxo1 in group F. Hypothalamic concentration of 5-HT was lower in group F compared to S. It is suggested that prolonged intake of fructose and sucrose stimulates lipogenic processes in the visceral adipose mass and limits the action of the leptin-serotonin axis by inhibiting anorectic response. Regulation of the leptin pathway by fructose as well as serotonin by sucrose seem to constitute processes resulting from the chronic consumption of these sugars, whereas glucose seems to perpetuate itself as endogenous sugar without negative implications in energy homeostasis.
Keywords: sugars, glucose, fructose, sucrose, leptin, serotonin, Foxo1.
Title: Óleo de Bertholletia excelsa H.B.K.: composição centesimal, análises físico-químicas e avaliação de dieta à base do óleo na patogênese da inflamação relacionada à obesidade em ratos Wistar
Author: Carolina Croccia
Conclusion Paper: THESIS
Date of Defense: 11/07/2017
Abstract: Bertholletia excelsa H.B.K., also known as Brazil nut is the nut that comes from Brazil nut tree, a typical tree from the north of the country, mainly in the state of Pará. Rich in nutrients, Brazil nut is an oleaginous fruit where more than 70% of its oil contains monounsaturated fatty acids. Physical-chemical analyzes are necessary to elucidate the existing discrepancies in the literature, and therefore, the objective of the first chapter is the physical-chemical characterization of both the almond and the nut oil. All the analyzes agree with the one recommended by the Brazilian legislation, although there are differences with the data of the literature. Such differences are considered acceptable by the nature of the raw material. Obesity is a worldwide epidemic and is strongly associated with inflammation through the secretion and regulation of inflammatory markers. Monounsaturated fatty acids are capable of lowering total cholesterol and increasing HDL-c, but it is necessary to evaluate whether these fatty acids can affect the improvement and regulation of some inflammatory markers.The objective of this work was to evaluate if a hyperlipid diet in Brazil nut oil is capable of modulate the inflammatory effects caused by an obesity induced hyperlipid diet based on lard in Wistar rats. Sixty males were used from the 60 days of life that received diet based on lard, Brazil nut oil and soybean oil as control ration until 120 days of age. Biometry, lipidogram and hepatogram were performed and a difference was observed for the left ventricle size, LV/TL, total cholesterol, AST, ALT, GGT and alkaline phosphatase among the groups that received a hyperlipidic diet of lard and the groups that received a hyperlipidic diet of Brazil nut oil. Body composition was analyzed by DEXA and there was no difference between control and experimental groups when evaluated in the same period (60, 90 and 120 days). The plasma concentrations of the cytokines IL6, IL10 and TNF-α were elevated in the presence of a diet of lard, while when offering the diet based on Brazil nut oil, they were equal to the control group (p<0,001). The same occurred when the density and diameter of the adipocytes were analyzed. It is suggested that Brazil nut oil may have acted as an anti-inflammatory agent capable of modulating plasma concentrations of cytokines and hyperplasia and hypertrophy of adipocytes in the obesity process, although a longer exposure time of the diet was necessary for evaluate biochemical changes in the HDL-cholesterol fraction in the long term in the group that received diet with Brazil nut oil.
Keywords:
Berthollettia excelsa, brazil nuts, obesity, cytokines, hyperplasia.
Title: CONCENTRAÇÕES SÉRICAS DE RETINOL, BETA-CAROTENO E ZINCO EM UMA COORTE DE MULHERES COM CÂNCER DE MAMA SEGUNDO ESTÁDIO E TOXICIDADE DO TRATAMENTO
Author: Cíntia Letícia da Silva Rosa Alvarinho
Conclusion Paper: THESIS
Date of Defense: 29/03/2017
Abstract: Introduction: The procedures used to treat breast cancer are able to raise free radical production, increase oxidative stress and deplete antioxidants. Objective: To analyze the serum concentrations and synergism between retinol, β-carotene and zinc in women with breast cancer, according to the stage of the disease and the acute and late toxicity of the radiotherapy, considering different modalities of treatments prior to radiotherapy. Methods: This is a longitudinal study in a cohort of women with breast cancer evaluated at the pre-treatment periods, 7 and 120 days after radiotherapy. Patients were divided into 3 groups: G1 undergoing conservative surgery, G2 undergoing chemotherapy, and G3 undergoing conservative surgery and chemotherapy. The serum concentrations of retinol and β-carotene were quantified by high performance liquid chromatography with ultraviolet detector, and zinc by atomic absorption spectrophotometry. Staging of breast cancer was based on the classification of malignant tumors TNM, proposed by the International Union Against Cancer (UICC). Radiotherapy treatment was performed using teletherapy using linear accelerator with 6Mv energy with total dose ranging from 50-50.4 Grays (Gy). Acute toxicity was assessed according to the acute toxicity scale of the Radiation Therapy Oncology Group (RTOG) and late toxicity RTOG / EORTC (European Organization for Research and Treatment of Cancer). The toxicities were divided into groups I and II, composed of groups of toxicities grades 0 and 1 and 2 and 3, respectively. Results: A total of 230 patients were evaluated, with a mean age of 63.6 years (SD + 9.3). In the sample, stage II of breast cancer predominated. It was observed that serum concentrations of the micronutrients evaluated were reduced as the level of disease staging increased. At all stages and in all groups, the highest percentages of deficiency occurred in serum concentrations of zinc and retinol. Surgery alone had a greater negative impact on serum retinol concentrations. Surgery combined with chemotherapy had a greater negative effect on the serum concentrations of β-carotene and zinc. Considering the groups studied at T0, the highest percentage of retinol deficiency was in G3 with 21.3%, beta- carotene in G1 38.5% and zinc also in G1 corresponding to 30.8%. A statistically significant reduction was observed in the mean of all the micronutrients studied, when T0 was compared one week after the radiotherapy treatment (T1). After 120 days all the nutrients evaluated increased significantly when T1 and T2 were compared. Acute toxicity was observed in 67.2% of the cases and the late toxicity of 100% of the sample, both belonging to group I. Considering the acute toxicity, there were higher serum concentrations of retinol, beta-carotene and zinc in group I when compared to Group II. With regard to late toxicity, there was a significant difference in the majority of treatment groups prior to radiotherapy, with the exception of zinc. Conclusion: Among the treatments prior to radiotherapy, surgery combined or not with chemotherapy exerted a greater negative impact on all micronutrients studied. There was a significant reduction of all micronutrients in T1, regardless of the type of previous treatment. In acute and late toxicity, there was a reduction of antioxidants in the groups at the highest grade, demonstrating the need for monitoring and maintenance of the nutritional status of these antioxidants throughout cancer treatment.
Keywords:
Breast cancer, staging, surgery, chemotherapy, radiation therapy, toxicity, vitamin A, zinc.
Title: DESENVOLVIMENTO DE PRODUTO FUNCIONAL FERMENTADO DE SOJA, CONTENDO CAFÉ, PROBIÓTICOS E CASCA DE SOJA
Author: Giselle Duarte de Oliveira
Conclusion Paper: THESIS
Date of Defense: 28/08/2017
Abstract: Considering the many potential benefits reported for soy, coffee and probiotics, along with the current consumer trend for healthier alternatives in food products, the present doctoral thesis aimed to develop a potentially functional fermented soy-coffee product containing probiotic bacteria, and soybean hull. The acceptance of 11 formulations evaluated by 129 adults from Rio de Janeiro and Curitiba – Brazil, was evaluated using hedonic scale and preference mapping. Formulations were elaborated according to experimental design that considered as variables the content of sugar, soybean hull and soluble coffee. Samples containing 0.5 or 1.5% coffee, 1% of soybean hull and 15% of sucrose presented higher acceptance (mean score = 6,3, on a scale of 1 to 9, indicating good acceptance for products based on soybean) from consumers, with no difference between the groups from the two cities. The 129 consumers were divided into three groups according to different acceptance patterns determined by preference mapping. Higher scores (average 6,8 ± 1,20) were mostly given by young consumers who drank coffee regularly. Lower scores (average of 4,0 ± 1,57) were obtained by consumers who drank it less and with lower regularity. The final product containing 1% coffee, 1% fibers and 15% sucrose was physico-chemically characterized and hygienic-sanitary evaluation and the viability of the probiotic microorganisms were carried out along 21 days storage under refrigeration (7oC). During storage, Lactobacilli were affected by physical-chemical factors such as water activity, low pH and acidity. Coffee corroborated to the decline of their viability during storage, while the bifidobacteria showed a growth inhibition in the first seven days of storage, probably due to competition with lactobacilli. The product can be considered probiotic as it has an average count between 106 to 107 for L. acidophilus and 107 to 108 for B. animalis subsp. Lactis per 100 g portion of the product within 14 days of storage. Or, 107 to 108 of B. animalis subsp. Lactis per 100 g portion of the product up to 21 days storage. A functional product, well accepted, containing polyphenols, fibers and probiotics, in addition to other bioactive compounds and developed. A bioavailability of the bioactive compounds should be evaluated not in the future.
Keywords:
functional food, soy, probiotic, coffee, lactose-free, dairy-free, hull, by- products, fiber.
Title: ÁCIDOS GRAXOS SÉRICOS, VITAMINA D E SUA ASSOCIAÇÃO COM A PRESSÃO ARTERIAL SISTÊMICA, CONCENTRAÇÕES PLASMÁTICAS DE ADIPOCINAS E LIPÍDIOS SÉRICOS DURANTE A GESTAÇÃO
Author: Jaqueline Lepsch da Costa
Conclusion Paper: THESIS
Date of Defense: 22/06/2017
Abstract: Introduction: Fatty acids (FAs) and vitamin D appear to act as endocrine mediators, which have been associated with important cardiovascular outcomes, such as changes in systemic blood pressure (BP) and dyslipidemia. However, little is known about these relationships during gestation. Objective: (1) To investigate the association between the concentrations of total saturated FA (SFAs), polyunsaturated fatty acids (PUFAs) and fractions with plasma adiponectin and leptin. (2) Evaluate the association of FAs, PUFAs and monounsaturated fatty acids (MUFA) with BP. (3) To investigate the relationship between the concentrations of 25(OH)D in the first trimester and changes in HDL-c, LDL-c, total cholesterol (TC), triglycerides (TG) concentrations and TG/HDL-c and HDL-c/TC ratios, throughout gestation. Methods: Prospective cohort with 223 pregnant women who were followed at 5°-13°, 20°-26 ° and 30°-36 ° weeks of gestation. Blood samples were collected on all three visits. Serum FAs were determined using gas chromatography. Plasma concentrations of adiponectin (ug /mL) and leptin (ng /dL) were assessed using commercial ELISA kits. Statistical analyzes included (1) median adipokines concentrations and (2) mean BPs according to the distribution tertiles of FAs (3) mean concentrations of 25(OH)D in the first trimester of pregnancy and multiple linear models of effects (1) BMI, gestational age, total energy intake, alcohol consumption and smoking, (2) maternal age, schooling, energy intake, gestational weight gain, leptin, pre gestational BMI and leisure physical activity, and (3) maternal age, HOMA-IR, BMI in the first trimester, physical activity prior to gestation, energetic intake and gestational age. Results: (1) Total SFAs and 16:0 were negatively associated with plasma adiponectin concentrations. Total n-6 and 18: 2 n-6 PUFAs were positively associated with adiponectin; AGS 14:0 and 20:3 n-6 were positively associated with plasma leptin concentrations. (2) In the adjusted multiple model, concentrations of total SFAs and fractions 16:0 and 18:0 showed a positive and significant association with SBP throughout gestation. Likewise total AGMI, fractions 16:1 n-7, 18:1 n-9 and total PUFAs n-6 and 18:2 n-6, 20:3 n-6 were positively associated with SBP. A positive and significant association was observed between the 18:0 fraction and the DBP. (3) Adjusted models showed direct associations between the state of 25(OH)D in the first trimester and changes in CT, LDL-c and TC/HDL-c ratios during gestation. Conclusions: (1) Serum total SFAs and 16:0 fraction were negatively associated with plasma adiponectin and positively associated with leptin concentrations. (2) SFAs 18:0 and 20:0 concentrations were significantly associated with SBP and DBP throughout gestation. However, given the paucity of studies evaluating these associations and the importance of the issues, more clinical and epidemiological studies are needed. (3) The inadequacy of 25(OH)D in the first trimester was associated with higher TC, LDL and TC/HDL concentrations throughout gestation. Changes in these cardiovascular markers suggest the importance of ensuring adequate vitamin D concentrations in early pregnancy.
Keywords:
adiponectin, leptin, fatty acids, systemic arterial pressure, vitamin D, gestation, cohort studies.
Title: Nutrição escolar consciente: introdução da educação nutricional no contexto do Programa Nacional de Alimentação Escolar em escolas públicas municipais de Duque de Caxias-RJ
Author: Margareth Xavier da Silva
Conclusion Paper: THESIS
Date of Defense: 06/02/2017
Abstract: The school is the place of integration of various knowledges, among them, health related topics. It is the opportune environment to make students aware of the importance and benefits of adopting healthy feeding, since it has characteristics favorable to the development of continuous work. The National School Feeding Program allocates resources to guarantee the supply of meals in all Brazilian public schools in order to meet the nutritional needs of schoolchildren during school hours, as well as favor the formation of better food choices. Although there are many resources involved in this Program, acceptance of school meals is below of objective. This study deduces that the introduction of nutrition education in the context of The National School Feeding Program in public schools in Duque de Caxias-RJ could favor uptake of school meals. The research was carried out in two phases. The first was descriptive and the sample of 426 students, aged between eight and fifteen years, enrolled in six elementary schools, from 3rd to 5th grade. The students were characterized, analysis of menus, diagnosis of acceptance of school meals and evaluation of knowledge of healthy eating. In the second phase, 243 students from 3 schools to educational intervention were selected, which did not reach the percentage of acceptance of school feeding defined by the National School Feeding Program or whose scores on knowledge evaluation achieve were below grade 7.0 (seven). The evaluation of anthropometric nutritional status indicated 10% of students with obesity. It was found that school children purchased many unhealthy foods to consume at school, whether at the school canteen, or brought from home. The evaluation of the menus showed that most nutritional requirements were met, except for calcium, below the National School Feeding Program recommendation. The intervention obtained students’ participation in educational activities and there was an improvement, both in the acceptance of school meals and in the increase of the score in the evaluation of knowledge about healthy eating, reinforcing the role of the school as a space to promotion of healthy eating habits.
Keywords:
School, student, feeding, education.
Title: DESENVOLVIMENTO DE SUCOS TROPICAIS E DE GELEIAS DE BURITI (MAURITIA FLEXUOSA L.): AVALIAÇÃO FÍSICO-QUÍMICA, SENSORIAL E CAPACIDADE ANTIOXIDANTE EM CÉLULAS DE CÂNCER DE MAMA
Author: Mariana Silva Pelosi
Conclusion Paper: THESIS
Date of Defense: 22/09/2017
Abstract: Buriti (Mauritia flexuosa L.) is a fruit from Amazonia little known as raw material for the food industry. The objective of this work was to formulate products based on buriti pulp (BP), such as juices and jams containing refined sugar, demerara sugar or sucralose. The following analyzes were conducted: centesimal composition, soluble solids content, pH, colorimetry, carotenoids, phenolic compounds, antioxidant capacity (AC), cell viability, AC of tumor cell treated with BP extract, hygienic-sanitary quality and sensory evaluation of the products. The results showed that the nutritional composition of buriti pulp, juices and jams were similar to other studies. In addition, dietary buriti juice and jam presented higher levels of carotenoids, phenolic compounds and AC in comparison with other formulated products containing refined sugar. To evaluate the cellular AC, the buriti extract was added to MDA-MB-231 breast cancer cells. Cell viability did not decrease and antioxidant action did not increase in the experimental conditions applied. With regard to hygienic sanitary quality, all products were according to the legislation. Although dietary jam had shown higher AC, it was not the most suitable. The sensory analysis for sugar products were the most accepted. In addition, jams were more accepted than juices. Therefore, demerara sugar jam can be the better choice among formulated products considering all aspects evaluated.
Keywords:
buriti, nutritional value, antioxidant capacity, sensorial analysis.
Title: RISCO DE DESNUTRIÇÃO DE PACIENTES COM CÂNCER: RESULTADOS DO INQUÉRITO BRASILEIRO DE NUTRIÇÃO ONCOLÓGICA, UM ESTUDO MULTICÊNTRICO E DE BASE HOSPITALAR
Author: Nivaldo de Pinho Barroso
Conclusion Paper: THESIS
Date of Defense: 05/12/2017
Abstract: Cancer is a global public health problem and malnutrition of these patients is associated with reduced quality of life, tolerance and efficacy of treatment, increased risk of complications and hospital costs, constituting an important risk factor for disease progression and mortality. The objective of this study was to evaluate the prevalence and the independent risk factors for malnutrition in hospitalized patients with cancer, the different regions of Brazil, using the Patient-Generated Subjective Global Assessment (PG-SGA). 4783 cancer patients were evaluated, aged ≥ 20 years, in multicenter study, analytical and hospital-based cross, during the first 24 hours after hospitalization. With the implementation of PG-SGA patients were classified in well nourished (A), risk of malnutrition or moderately undernourished (B) and severely malnourished (C). Multivariate analysis was composed of the odds ratio (OR) estimated by ordinal polytomic logistic regression with the confidence interval (CI) of 95%. We found that 45.3% of the patients were malnourished, with 11.8% with severe malnutrition and 45.2% with need for nutritional intervention. The variables that presented greater RC to malnutrition were: dysphagia (OR 2.75, 95% CI 2.22-3.41, p < 0.001), anorexia (OR 1.93, 95% CI 2.28-1.64, p < 0.001), vomiting (OR 1.84, 95% CI 1.48 – 2.29, p < 0.001), presence of more than 3 symptoms of nutritional impact (OR 8.34, 95% CI 5.8-12, p < 0.001), thoracic tumor sites (OR 4.59, IC 95% 3.18-6.63, p < 0.001), abdomen (OR 3.70, IC 95% 2.66-5.15, p < 0.001) and head and neck (OR 3.70, IC 95% 2.66-5.15, p < 0.001) and hospitalization in the northern region of Brazil (OR 5.02; 95% CI 3.37-7.47; p < 0.001). The D-box score: SGA-PPP tool that represents the physical assessment of compartments of fat, muscle and water retention, higher association with malnutrition (OR 7.31 95% CI 8.16-6.55, p < 0.001). In patients aged ≥ 65 years the prevalence of moderate and severe malnutrition (stage B and C) was 55% and 40.8% presented of the 1-3 symptoms of nutritional impact. Among the symptoms with higher chances of occurrence in the elderly as compared with individuals aged ≤ 50 years were: anorexia (OR 1.90, 95% CI 1.62-2.22, < p 0.05) and xerostomia (OR 1.40, 95% CI 1.18-1.67 < p 0.05). In the age range between 51 to 64 years, compared to individuals aged ≤ 50 years: anorexia (OR 1.45, 95% CI 1.23-1.69 < p 0.05), xerostomia (OR 1.22, 95% CI, 1.02-1.45 < p 0.05) and weight loss (OR 1.21, 95% CI 1.05-1.39 < p 0.05) which presented higher probability of severe malnutrition (OR 1.55 95% CI, 1.23-1.94, p < 0.05). (D) Malnutrition was highly prevalent in cancer patients in Brazil and is more strongly associated with the presence of more than 3 symptoms of nutritional impact of tumors location in thorax, abdomen high and head and neck, hospitalization in the northern region of Brazil and age more than 65 years. It was observed higher chances of occurrence of the signs and symptoms of nutritional impact, namely, anorexia, xerostomia, dysphagia, weight loss and reduction in intake in patients over the age of 50 years. The results suggest the need for application of nutritional screening in the first 48 hours of hospitalization, in order to enable the diagnosis and multidisciplinary early intervention.
Keywords:
Malnutrition, Nutrition Assessment, Cancer, symptoms, multicenter study, Brazil, prevalence, PG-SGA.
Title: AVALIAÇÃO HIPOTALÂMICA DE FATORES LIPOGÊNICOS E INFLAMATÓRIOS EM RATOS WISTAR APÓS A INGESTÃO PROLONGADA DE SOLUÇÃO DE FRUTOSE
Author: Leandro Oliveira Batista
Conclusion Paper: THESIS
Date of Defense: 11/11/2016
Abstract: Evidence shows the direct relationship between high consumption of fructose with peripheral changes consistent with the metabolic syndrome and increased lipogenic and pro-inflammatory factors, however there is little evidence of these effects in hypothalamic tissue. We evaluated whether fructose intake for 8 weeks affects enzymes and transcription factors levels of the lipogenic and inflammatory pathways in the hypothalamus of Wistar rats. After 30 days old the animals were divided into groups: control (C) and fructose (F) and maintained with free access to food and filtered water (C) or aqueous solution of fructose at 20% (F). We evaluated weekly: water intake, feed and body mass. At 90th day, glycaemia and triacilglicerolemia were analyzed and hypothalamus was collected for quantification of proteins acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS) and nuclear factor kappa-B (NFkB) by Western Blotting, and qPCR expression of the target gene: Sterol Regulatory Element Binding Protein (SREBP1c, SREBP-2), ACC, FAS and NFkB. The results shown lower feed intake in F group, increased blood glucose levels (F: 146.20+6.09 vs. C: 102.32+4.58; n= 9) and triacilglicerolemia (F:191,65+13,51 vs. C:131,69+6,49; n=9) and no difference in water and energy intake. We identify high ACC content (F: 133,93+5,58 vs. C: 100+0,0; n=9- 10), NFkB (F: 125,5+8,85 vs. C: 100+0,0; n=14) and SREBP-1c (F: 4,08+0,44 vs. C: 1,13+0,15; n=5-6) in F group, while FAS was lower (F: 85,90+4,81 vs. C: 100+0,0; n=4- 6). The genes for ACC, SREBP-2 and NFkB were not different between groups. We conclude that fructose was capable of stimulating the early steps of the hypothalamic lipogenic and inflammatory pathway similarly to peripheral tissues, in addition, such changes occur before actual changes in food intake, suggesting action in the regulation of food intake.
Keywords: levulose – lipogenic enzymes – inflammation – hypothalamus – SREBP – obesity
Title: O LÚDICO NA EDUCAÇÃO ALIMENTAR E NUTRICIONAL DE IDOSAS INSTITUCIONALIZADAS
Author: Andrea Abdala Frank Valentim
Conclusion Paper: THESIS
Date of Defense: 7/21/2016
Abstract: This thesis presents its results in the form of two scientific articles and it aims at assessing the effects of food and nutritional education with emphasis in ludic activities, in promotion of knowledge about healthy feeding in elderly living at a long-stay institution that is managed by federal and philanthropic funds in the city of Rio de Janeiro – Brazil, and furthermore, we analyzed the menus prepared by the nutrition service and food service company. This is a study of longitudinal, descriptive, quantitative and interventional approach that was developed with 15 eligible elderly from 60 to 95 years old, residing in the Pavilhão São José do Abrigo Cristo Redentor – RJ. The investigation was carried out within the period from 2013 to 2014, including a pilot project previous to this investigation that was developed in the following phases: The election and acceptance from the institution directorate where the research would be performed and the most representative sample according to the needs of preparation, planning and execution of conclusive stages which are inherent to the study, with aims at the final results and conclusions. From this moment, it was performed evaluations of the nutritional status and cognitive functions in the elderly; application and evaluation of ludic and education games before and after each intervention, educational techniques with approaching of basic concepts about foods and healthy feeding and health promotion. Lecture, culinary workshop and gymkhana were instruments used for the transmission of basic knowledge about food and healthy feeding, between the first and second evaluation moment by the didactic ludic games. In parallel, there occurred the quantitative and qualitative evaluation of macronutrients and micronutrients of meals that were offered to the institutionalized elderly. The educational practices used with ludic elements were able to foster knowledge about healthy feeding, being relevant in the promotion of health and disease control, though within the context of institutionalization where they are more fiscally and emotionally affected. Within other perception, it has been found inadequacy in the offer of food and nutrient groups with high-lipid and protein content meals and low offer of fruits and 13 vegetables; such facts where not in agreement with the purpose of a healthy aging, regardless the elderly person is found either or not institutionalized.
Keywords: Elderly, Institutionalized Elderly, Healthy Feeding, Elderly Health, Food and Nutritional Education, Aging.
Title: MUDANÇAS NO PERFIL ANTROPOMÉTRICO E NA COMPOSIÇÃO CORPORAL DE UMA COORTE DE ADOLESCENTES DO ENSINO FUNDAMENTAL – ESTUDO LONGITUDINAL DE AVALIAÇÃO NUTRICIONAL DE ADOLESCENTES (ELANA)
Author: Milena Miranda De Moraes Ferreira
Conclusion Paper: THESIS
Date of Defense: 7/8/2016
Abstract: This thesis aimed to evaluate the influence of socioeconomic and lifestyle behaviors on the trajectories of adiposity indicators in students who were in the first phase of adolescence. We used data from the Adolescent Nutritional Assessment Longitudinal Study (ELANA), composed of 809 students (mean age 11.8 years) who were in the 6th grade of elementary school in four private schools and two public schools in the metropolitan area of Rio de Janeiro in 2010, evaluated annually by 2013. To achieve the objectives of the thesis were developed two manuscripts. The first one describes the trajectories of body mass index (BMI) and body fat percentage over four years, according to sociodemographic variables, and the associations between sociodemographic variables and excessive gain in BMI and body fat percentage at the end of follow-up. Girls from private schools (p = 0.003) and white boys (p = 0.041) showed a higher increase in BMI than public school girls and non-white boys, respectively. White boys were also more likely to have excessive gain in BMI (OR = 3.28, 95% CI 1.13 – 9.52) and percentage of body fat (OR = 3.32, 95% CI 1.38 – 8.01) at the end of follow-up than non-white boys. On the other hand, white girls were less likely (OR = 0.42, 95% CI 0.18 – 0.96) to experience excessive gain in the percentage of body fat than non-white girls. The second manuscript aimed to identify, through cluster analysis, patterns of energy balance related behaviors and its cross-sectional and longitudinal relationship with overweight and abdominal or total body fat, as well as excessive gains in weight, abdominal fat and total body fat over the study period. Four groups of behaviors were identified: (1) “neutral”, in that none of the evaluated behaviors stood out; (2) “sedentary”, characterized by high time devoted to the habit of watching television; (3) “mixed” with high consumption of both fruits and vegetables, as sugar-sweetened beverages; and (4) “active”, identified by the practice of moderate and vigorous physical activities. Among boys, the prevalence of overweight was higher in the “sedentary” group than in others and, although the trajectories of adiposity indicators did not differ between groups, boys in this group were more likely to have a high body fat percentage at the end of follow-up (OR = 3.18, 95% CI 1.43 to 7.10) and excessive gain in BMI over four years (OR = 2.92, 95% CI 1.04 to 8.20). In contrast, girls in the “active” group were more likely to have high waist circumference of the end of follow-up (OR = 2.87, 95% CI 1.01 to 8.16). In the population studied, the practice of sedentary behaviors and better socioeconomic conditions were associated with weight and body fat gain, especially in males, while physical activity was inversely related to adiposity among boys. The results of this thesis contribute to the understanding of the etiology of overweight in this age group in the context of the metropolitan area of Rio de Janeiro, especially for males.
Keywords: Adolescents. Body mass index. Waist circumference. Adiposity. Socioeconomic factors. Health behavior. Lifestyle. Food consumption. Longitudinal studies.
Title: AVALIAÇÃO DO ESTADO NUTRICIONAL DE VITAMINA D E SUA RELAÇÃO COM O PERFIL ÓSSEO E METABÓLICO EM ADOLESCENTES OBESOS GRAVES ANTES E UM ANO APÓS O BYPASS GÁSTRICO EM Y DE ROUX
Author: Jacqueline De Souza Silva
Conclusion Paper: THESIS
Date of Defense: 6/14/2016
Abstract: The aim of this study was to evaluate the nutritional status of vitamin D in severe obese adolescents before, 6 and 12 months after the Gastric Bypass Roux en Y Roux (RYGB) and its relation to bone and metabolic changes. Longitudinal prospective study of severely obese adolescents of both sexes, aged between 15 and 20 years and body mass index (BMI)/age in the upper percentile to 99.9. The adolescents were assessed before and after 6 and 12 months after RYGB the Multidisciplinary Center for Metabolic and Bariatric Surgery, in the municipality of Rio de Janeiro, and in the postsurgical period were supplemented with 1.800UI of vitamin D and 250 mg calcium carbonate. The laboratory tests were obtained 25 (OH) D data, calcium, phosphorous, magnesium, alkaline phosphatase, parathyroid hormone (PTH), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL c), triglycerides, serum leptin, glucose, Homeostatic Model Assessment (HOMA-IR) and C-reactive protein (CRP). We evaluated bone age by radiography, BMD by DXA (Dualenergy X-ray absorptiometry) and hepatic steatosis by total abdominal ultrasound. Waist circumference; weight and height and calculated BMI were obtained. It was also evaluated the relationship between the success of the surgery and the vitamin A status D. The level of significance for the study was 5%. The sample consisted of 64 adolescents and 65.6% female, with a median age of 17.5 years. The median bone age preoperatively was 16.4 years for girls and 17.2 years for boys. A decrease over the time periods, the variables weight, BMI, PC, fatty liver, metabolic syndrome, hypertension and dyslipidemia (p <0.0001). The prevalence of vitamin D deficiency (VDD) was elevated preoperatively (43.7%) at 6 months decreased to 23.4%, but at 12 months there was an increase to 70.0% (p = 0.001). Calcium deficiency preoperatively was 65.6%, with improvement at 6 months, but with significantly worse at 12 months (p <0.0001). Serum concentrations of PTH had increased throughout the follow-up time, reaching inadequacy 70.0% at the end of 1 year (p <0.001). There was decrease in femoral neck BMD of 2.5% (p <0.0001) and lumbar spine by 3.5% (p <0.0001) 6 months to 12 months. The reduction in lumbar spine BMD was higher in those with inadequate PTH (p = 0.015). The improvement of EH was related to increased serum vitamin D. There was a negative correlation between serum vitamin D with PTH (r = -0.327; p = 0.008); LDL-C (r = – 0.274; p = 0.028) and CRP (r = -0.202; p = 0.021). Surgical success was achieved by 82.8% of adolescents in the study period. Those who did not achieve surgical success presented at the end of 12 months, serum concentrations of vitamin D higher compared to those who lost weight more quickly. The serum PTH values were higher at 12 months, especially those who obtained surgical success. The VDD was raised in RYGB preoperative worsening after 12 months postoperatively, and with a significant reduction in BMD at the end of this period, despite the existence of daily oral supplementation of vitamin D and calcium despite vitamin supplementation and increased sun exposure. The success of surgery had a negative impact on the nutritional status of vitamin D and bone profile, however, positive in reducing weight, BMI, PC, EH, hypertension, metabolic syndrome and dyslipidemia. It is recommended to VDD research in severely obese adolescents before and after RYGB and monitoring for longer than one year after surgery.
Keywords: Severe Obese adolescents; Gastric Bypass; Roux-en-Y bypass; vitamin D deficiency; obesity; bariatric surgery; bone mineral density; hepatic steatosis.
Title: ESTUDO DE FÓRMULAS ALIMENTARES ARTESANAIS COM BAIXO TEOR DE FENILALANINA
Author: Rosana Posse Sueiro Lopez
Conclusion Paper: THESIS
Date of Defense: 4/26/2016
Abstract: Phenylketonuria (PKU) is an error on aminoacids metabolism and it’s the most common and documented one in medical literature. The objective was to develop homemade formulas with low phenylalanine (Phe) supplemented with B12 vitamin and tirosyne. The focus was on dietary technique, emphasizing therefore the scientific aspect of culinary. The selection of foods was based by enquire on the food composition tables. The foods combinations resulted in five homemade formulas. Chemical analysis techniques were used to say the total amount of Phe and the calories of each formula. The process was made at food analysis laboratory. The acceptability of the formulas was verified by non-trained tasters, with PKU syndrome, at the reference center to PKU carriers on IEDE/RJ. An affective test type escale facial hedonic hybrid was used. On the analysis were used fifteen carriers (n=15), aged between 9 and 12 years, with 33% ♂ and 66.7% ♀. Most of the volunteers are from lower classes and live outside to Rio de Janeiro city, 68% of those had the diagnosis and dietetic intervention with less than one month of life. With the assertive that educative practices on nutrition must have transmission of objective information to day to day life, the applicability of the formulas was addressed promoting cooking workshop with 18 volunteers. The proposed portion was 250mL suggested to be consumed with small meals, (VET up until 5%) according to recommendations of FAO/OMS for gender and age group. The analysis by liquid chromatography revealed that the formulas represented only values of Phe matching the allowed amount for carriers consummation. The sensorial test pointed a good acceptability of the formulas (p=0,05). Going against the results from the analysis of the Phe values with the ones at the chemical composition tables verified, was found that the tables underestimates the total amount of Phe on the formulas. This data highlights the possibility of a higher consumption of Phe on the diet that estimated, seeing that the tables are the main tool to control and adjust the patient’s diet. The differences may be related to several coefficients, however, the relevance of the data found points to the necessity of a more profound study to the referred reasons of discrepancy. The high level of satisfaction of the participants of the cooking workshop revealed that this practice shows itself as an instrument of value to promote incentive to adhesion to the diet therapy for this group of patients.
Keywords:
Title: PREMATURIDADE E BAIXO PESO AO NASCIMENTO E SUA ASSOCIAÇÃO COM FATORES DE RISCO CARDIOVASCULAR EM ADOLESCENTES
Author: Aline Bull Ferreira Campos
Conclusion Paper: THESIS
Date of Defense: 3/29/2016
Abstract: Introduction: Cardiovascular diseases (CD) are responsible for the highest number of deaths in the world population and among its risk factors, the conditions at birth have been focused due to the positive correlation with their development into adulthood. Objective: To evaluate the association between weight and gestational age at birth with anthropometric, clinical, biochemical and behavioral variables of cardiovascular risk in adolescents, as well as the behavior of these associations considering the family history of cardiovascular disease and obesity. Methods: A total of 153 adolescents between 10 and 19 years old, seen in Adolescent Reference Center, Macae, RJ. The degree of sexual maturation was assessed through the pubertal stages of Tanner. Anthropometric measurements were weight, height, waist circumference (WC), arm circumference (AC), arm muscle circumference, arm muscle area, arm fat area, triceps skinfold, subscapularis and biceps, waist-to-height ratio (WHtR) and percentage of body fat (%BF). Were considered overweight those with body mass index (BMI) between the 85th and 97, and obese, those in the percentile > 97. Were considered excessive body fat values ≥ 20% for boys and ≥ 25% for girls. Biochemical measurements of total cholesterol and its fractions (LDL-C and HDL-C), triglycerides, glucose and serum leptin levels and blood pressure (BP) measurement were carried out. Information on weight and gestational age at birth were collected from the adolescents’ child health and development records. Information on family history of cardiovascular disease and obesity, physical exercise, alcohol consumption and cigarette smoking was collected. Statistical Analysis, Student’s t-test compared of, chi-squared test, and multivariate logistic regression. Results: The prevalence of low birth weight was 21.6% and prematurity, 17%. Excess weight was significantly higher among adolescents with low birth weight (60.6%). The prevalence of preterm infants with inappropriate BMI was 57.6% compared with those born at term (37.7%; p = 0.06). Girls with low birth weight had higher average of the sum skinfolds thickness and % BF (p <0.05), while those born premature had mean higher BMI, % BF, skinfold thickness and circumferences, with the exception of the WC (p <0.05). The low birth weight was considered a predictor variable of BMI and inadequate % BF in girls. Adolescents born preterm had a two times greater risk of inadequate subscapular skinfold. Adolescents with severe obesity who were born premature and underweight, had a significantly higher average of WHtR and WC when compared to adolescents born with appropriate weight and gestational age (p <0.01). In girls born preterm were observed significantly higher mean BMI and leptin levels (p <0.05), and the boys who were born preterm averages greater LDL-C and diastolic BP. The average leptin concentration was higher in adolescents with unfavorable birth outcomes to a higher %BF and severely obese. Leptin showed a higher correlation with BMI (r = 0,52; p = 0,01), and WC (r = 0,49; p = 0,00), in adolescents with low birth weight (p = 0,01). A family history of cardiovascular risk was observed in 77% of the adolescents, and was higher in those with excess weight (p = 0,04). The prevalence of alcohol consumption, cigarette smoking and physical inactivity was present in 24.8%, 13.7% and 52.6% respectively, regardless of conditions at birth. Conclusion: It was observed association between birth outcomes with excess weight and body composition. Gestational age at birth was associated with BMI and LDL-C and leptin concentrations in adolescents. The findings put into perspective a prenatal nutritional assistance in the routine prenatal care, andpreparation of clinical nutritional protocols aimed at children and adolescents in hospitals and school routines aiming thus the contribution to the prevention and reduction the development of cardiovascular risk factors.
Keywords: birth weight, prematurity, body composition, cardiovascular risk, fetal programming, adolescent.
Title: MODIFICAÇÕES DOS INDICADORES SOCIAIS, INSEGURANÇA ALIMENTAR E CONSUMO ALIMENTAR DE CRIANÇAS MENORES DE TRINTA MESES RESIDENTES EM UMA REGIÃO METROPOLITANA DO RIO DE JANEIRO NOS ANOS 2005 E 2010
Author: Marina Maria Leite Antunes
Conclusion Paper: THESIS
Date of Defense: 2/26/2016
Abstract: The aims of this study were (1) to describe the change in social indicators and their association with food insecurity (FI) among families with children in two household surveys in Rio de Janeiro; (2) assess changes in dietary patterns of children under thirty months in the metropolitan area of Rio de Janeiro state, in 2005 (n = 391) and 2010 (n = 443) and to estimate the association of dietary intake with social indicators in each year of study. Two household surveys data conducted in Duque de Caxias city in 2005 and 2010 were used. The socioeconomic information of the families were obtained by questionnaire. The FI was estimated by the Brazilian Food Insecurity Scale. Dietary intake was assessed by 24-hour recalls and dietary patterns were generated by principal components analysis. The frequencies were compared by chi-square test and the FI associations with social indicators was adopted multinomial logistic regression (Odds ratio – OR) and linear regression to estimate the association of dietary patterns with socioeconomic variables. Statistical significance was considered p <0.05. There was a reduction in FI prevalence, increased education of the householder, reduced household crowding and greater access to the filter for drinking water. In 2005, the family income was inversely associated with all FI levels and the education of the householder had an OR of 3,08 (CI 95% 1,09-8,15) for light FI and 5,24 (CI95% 1,2 – 22,89) for moderate and severe FI. In 2010, the presence of filter for water consumption (OR=4,01 CI95% 1,91-8,54), the per capita monthly income (OR=0,99 CI95% 0,98-0,99) and the socioeconomic classification of the family in categories D and E (OR=6,81 IC% 1,15-40,09) remained significantly associated with the most severe forms of FI. As for food intake, different patterns were identified in the two surveys are: (i) in 2005, three dietary patterns in children under 18 months of age ( “Traditional”, “Milk and Flour Child” and “Mixed”) and two dietary patterns in children 18-30 months (“Traditional” and “Mixed”) and (ii) in 2010, three patterns in both age groups assessed “Snacks”, “Mixed-drab”, “Mixed” for those under 18 months and “mixed traditional”, “monotonous” and “mixed” among children 18-30 months. In 2005, the “Traditional” pattern was negatively associated with the FI and the socioeconomic classification of families. The “Mixed” pattern was positively associated with per capita monthly income and the treatment of water used for consumption and negatively correlated with the number of household members between the age of 18 months. Among children 18 to 30 months, the “Traditional” pattern was negatively associated with the treatment of drinking water, while the “Mixed” pattern is negatively associated with the FI and the family socioeconomic classification. In 2010, among children under 18 months the “monotonous Mixed” pattern showed a positive association with receiving the the Bolsa Família benefit and the “Mixed” pattern was negatively associated with the treatment of drinking water. Among children older than 18 months, the “mixed Traditional” pattern was negatively associated with FI. The “Mixed” pattern was negatively associated with the number of household members, however, some changes in the population studied consumption patterns were not associated with any socioeconomic variable. The results show an important advance in population social indicators, however reinforce as evaluated determinants impact the FI and food intake in this age group . Thus, the results of this thesis contribute to the discussion about the need for action to ensure greater access to adequate food, through social investment and actions that encourage healthier food choices.
Keywords: Food insecurity, social indicators, Child nutrition , Dietary Patterns.
Title: CUIDADO NUTRICIONAL PRÉ-NATAL NA ATENÇÃO PRIMÁRIA À SAÚDE A ÁREA DE MANGUINHOS, RIO DE JANEIRO
Author: Beatriz Della Libera Da Silva
Conclusion Paper: THESIS
Date of Defense: 2/23/2016
Abstract: This thesis, whose results are presented in the form of four scientific papers, aimed at assessing the effect of a proposal for prenatal nutritional care on the perinatal outcome of pregnant women attended at a family clinic in Manguinhos area, Rio de Janeiro, in the context of Primary Health Care (PHS). It is a study of quantitative and qualitative approach that sought to reveal biomedical and sociocultural dimensions, through complementarity between methodologies. The research took place in the period between February/2011 and August/2015 and was developed in three distinct stages: investigation of the health and nutrition profile of pregnant women and their newborns in the socio-historical context of users assisted in the region; implementation of the intervention; evaluation of the effect of the proposed prenatal nutritional care in perinatal outcome and the senses and meanings given by pregnant women to the implemented intervention. The nutritional care protocol consisted in monitoring pregnant women through three collective meetings during the prenatal appointments, called “conversation circles”, where the necessary quantitative evaluations were performed (anthropometric, biochemical, dietary, functional, socio-demographic and clinical) and educational activities were developed, based on the principles of nutrition and dietary advice. The results show that despite scientific evidence indicating the effectiveness of prenatal and nutritional care on the improvement of perinatal outcomes, there are few studies about the health and nutrition profile of pregnant women and the quality of care, as well as about nutritional care proposals specifically structured for pregnant women and mothers assisted within the scope of primary health care. Women who received care based on the nutritional and dietary advice, structured through collective consultations and offered to pregnant women during the prenatal care, had lower proportions of pregnancy complications and inadequacy of the total gestational weight gain as compared to those that did not receive it, reinforcing the importance of organizing the nutritional care offered to the maternal and child group within the PHC. The socio-historical analysis allowed the reflection about care actions aiming the potential and the needs of the population. Interpretation of the speeches of pregnant women revealed that this structured nutritional care developed in family clinics through educational activities of conversation circles represents an important strategy for promoting health in pregnancy period through the possibility of access to information and the exchange of experiences, and constitutes an environment of humanization, citizenship and social inclusion.
Keywords: pregnancy; prenatal nutrition; primary health care; intervention studies; food and nutrition education; qualitative research.
Title: INFLUÊNCIA PÓS-PRANDIAL DA INGESTÃO DE FRUTOSE OU GLICOSE NA GLICEMIA, GLUCAGON, TRIGLICERIDEMIA, URICEMIA E MALONDIALDEÍDO PÓS-PRANDIAL DE INDIVÍDUOS COM DIABETES MELLITUS TIPO 1
Author: Debora Lopes Souto
Conclusion Paper: THESIS
Date of Defense: 11/18/2015
Abstract: OBJECTIVE: To test the influence of fructose and glucose solutions in the blood glucose, glucagon, triglycerides, uricaemia, and malondialdehyde levels in the postprandial state in patients with type 1 diabetes. METHODS: The study was a simple-blind, randomized, twoway crossover design in which 2-7 week washout period, including sixteen patients with type 1 diabetes, seven women and nine men, with a mean age of 25.1 ± 8.8 years old, a mean duration of disease of 14.8 ± 4.7 years, a mean body mass index of 24.7 ± 3.6 kg/m2 , and a mean glycated hemoglobin of 8.1 ± 1.8%, without diabetes complications or other chronic diseases. In each study day, volunteers received an oral test solution (75g glucose or fructose) in random order, and then complete questionnaires assessing the sweetness and palatability of the solution. Venous blood samples were drawn after 8h fasting and at 180 min postprandial to obtain results of the glucose, glucagon, triglycerides, uric acid, lactate, and malondialdehyde levels. Statistical analyzes were performed in SPSS software version 17.0, with significance level of 5%. RESULTS: Although the glucose present lower dilution (p<0.01), the palatability of the solutions was similar. Glucose solutions resulted in greater postprandial glycemia when compared to fructose (12.9 ± 4.1 mmol/L; and 4.4 ± 5.5 mmol/L, respectively; p<0.01). Uric acid levels increased after fructose solution (0.4 ± 0.8 µmol/L; p<0.01) and reduced after glucose solution (-0.2 ± 0.1 µmol/L; p<0.01) (p<0.01). Fructose solution increase the malondialdehyde (1.4 ± 1.6 µmol/L; p<0.01), while glucose solution did not change the malondialdehyde levels (-0.2 ± 1.6 µmol/L; p=0.40). Other variables did not significantly differ between solutions. CONCLUSION: Both solutions had similar palatability. Fructose resulted in lower glucose concentrations compared to glucose, however, increased uric acid and malondialdehyde levels. The intake of these monosaccharides by individuals with DM1 did not change postprandial triglycerides, glucagon, and lactate levels.
Keywords: type 1 diabetes mellitus; fructose; glucose; oxidative stress; glycaemia; triglycerides; uricaemia
Title: COMPOSTOS BIOATIVOS DE ESPECIARIAS E SEUS EFEITOS ISOLADOS E COMBINADOS EM CULTURAS DE CÉLULAS DE CÂNCER DE MAMA
Author: Renata Madureira Polinati Da Silva
Conclusion Paper: THESIS
Date of Defense: 10/15/2015
Abstract: In Brazil the cancer estimative for 2015 year indicates the occurrence of 576.000 new cases, reinforcing the magnitude of this disease. Breast cancer is a cancer type that affects more women worldwide and 57.120 new cases are estimated while 8.380 only to the Rio de Janeiro state. Carcinogenesis process present three steps, this includes iniciation, promotion, and progression tumor and it has already been demonstrated that dietary bioactive compounds (BCs) may act at these different stages. Spices have been used for thousands years and have a lot of BCs responsible for chemopreventive and chemotherapeutic properties. Thus, the aim of this study was to investigate the effect of curcumin, piperine, [6]-gingerol, and melphalan, alone and/or combined, in breast cancer cell cultures MCF-7 and MDA-MB-231. For cell viability analyzes was performed MTT reduction method and the cells were treated with bioactive compounds concentrations isolated from 1 to 300µM and 0.5 to 150µM of melphalan chemotherapy. It was observed that, according to IC50 values, MDA-MB-231 line was more resistant to all treatment types when compared to MCF-7 line. After 24 hours of treatment, the IC50 values for the most resistant line were 24µM, 280µM, and 190µM to curcumin, piperine and melphalan, respectivily. The [6]-gingerol showed no effect in this cell culture. A combination curve of the compounds with IC50 values in concentrations ranging from 0.25 to 1.25 x IC50, in order to enhance the action of the compounds, on the most resistant line was performed. The combination of the compounds reduced cell viability in a dose-dependent manner and that reduction was more significant when the 1 x IC50 amounts were combined. The cell cycle analysis demonstrated a blockade only at G2/M phase, especially to curcumin isolated, but in its association with piperine when compared to the control. In the MDA-MB-231 cells treated for 24 hours, the melphalan plus curcumin association generated a higher numberof apoptotic cells and curcumin plus piperine combination led cells to necrosis. After 48 hours the necrotic cell death was more significant in all treatments. No differences were observed between isolated or combination BCs treatments, showing a similarity in these action. However, to determination of synergism, additive, or antagonistic, the avaliation of Combination Index (CI) (CalcuSyn softwareversion 2.0, Biosoft) demonstrated that all combinations presents antagonic effect, with lower intensity to piperine plus melphalan treatment (CI = 1.21). Analyzing the cytotoxic effect of these compounds on peripheral blood mononuclear cells (PBMC), it observed that the piperine with melphalan combination showed no significant toxic effect on this line in any concentrations combined used. Considering that there no differences between the action of compounds individualy or combined and that piperine with melphalan combination had cytotoxic effects on breast cancer but not in the normal cells, this association can emerge a possible trial proposal, mainly from synergistic associations.
Keywords: breast cancer, curcumin, piperin, melphalan, MDA-MB-231, antagonism.
Title: RESVERATROL, CURCUMINA, PIPERINA E Α-OXALDEÍDOS: BIOATIVIDADE EM CÉLULAS DE ADENOCARCINOMA MAMÁRIO HUMANO MCF-7
Author: Betina Schmidt
Conclusion Paper: THESIS
Date of Defense: 10/7/2015
Abstract: Currently, breast cancer is the most common cancer among women. Advanced Glycation End-Products (AGEs) has as precursors for its formation the substances glyoxal, methylglyoxal e 3-deoxyglucosone, obtained exogenously through rich amino acids and sugar foods subjected to elevated temperatures, but it can also be generated endogenously by persistent hyperglycemia and high glucose utilization pathways, such as the metabolism of cancer cells. The precursors of AGEs are harmful to healthy cells, but also for tumor cells, and for this reason, these cells optimize their enzymatic detoxification system of these compounds, known as glyoxalase system, which requires reduced glutathione (GSH) as a cofactor for action of the first system enzyme, glyoxalase 1 (GLO1). The bioactive compounds (BCs), such as resveratrol, curcumin and piperine, has been associated with chemotherapeutic and chemopreventive effects and may influence the route of training and detoxification of AGEs in cancers cells. The aim of this study was to evaluate the effects of resveratrol, curcumin and piperine on the glyoxalase system and the action of these compounds and the precursors of AGEs in human mammary adenocarcinoma cells, MCF-7. Both curcumin and resveratrol, as piperine reduced the viability of MCF-7 cells by the MTT assay generating IC50 values respectively equal to 131 µM, 24.5 µM and 94.5 µM, in 24 hours of treatment, and 83.9 µM , 11.4 µM and 38.3 µM in 48 hours of treatment. These data were confirmed by trypan blue assay. Methylglyoxal and glyoxal generated, in 24 hours of treatment, an IC50 value equal to 2.8 mM. This increased value may be associated with the improvement on the ability of the detoxification of theses compounds by glyoxalase system in MCF-7 cells. 3-deoxyglucosone did not demonstrate citotoxic effects to MCF-7 in this study. When MCF-7 cells were treated with IC50 values of each BCs, the mitochondrial membrane potential decreased. This change may indicate mitochondrial damage and generating of reactives oxygen species (ROS). By pre-incubating the cells with antioxidants as GSH and Nacetylcysteine (NAC), we observed that both generate protective effects on MCF-7 to the cytotoxic effect of CBs. It was also observed that treatment with isolated CBs decreases the activity of GLO1, and this decrease was dose-dependent. When cells were pre-treated with GSH, the decrease of the enzyme has been protected in the groups treated with resveratrol and curcumin, but not with piperine. Curcumin also decreased the expression of GLO1. In the assesment of the lactate formation, the final product of glyoxalase pathway, we observed and impaired of this production in groups treated with CBs, and we may associated this data to the deleterius effect of CBs to MCF-7’s mitochondria. When we evaluated the cytotoxicity of CBs in combination, it was observed that treatment with resveratrol and curcumin, curcumin and piperine, and piperine and resveratrol, generated a synergistic toxic effect. Incubation in a more concentrated glucose medium did not alter the effect of isolated CBs on MCF-7 cells. The results obtained in cell culture indicate the potential for clinical research to support the use of adjuvant agents such as CBs for breast cancer therapy
Keywords:
Title: PADRÕES ALIMENTARES E SAÚDE MENTAL MATERNA E DESENVOLVIMENTO NEUROPSICOLÓGICO INFANTIL: RESULTADOS DE ESTUDOS DE COORTE PROSPECTIVA DO RIO DE JANEIRO E BRISTOL/REINO UNIDO
Author: Ana Amelia Freitas Vilela
Conclusion Paper: THESIS
Date of Defense: 10/2/2015
Abstract: Background: The adherence to dietary patterns may influence the maternal mental health during pregnancy and postpartum, and the infant development. Objective: 1. To identify dietary patterns in pre-pregnancy and to associate them with the depressive symptoms during pregnancy. 2. To verify the association between dietary patterns and the anxiety symptoms from mid-pregnancy to postpartum. 3. To obtain dietary patterns during pregnancy, to examine the nutrients intake of them, and to compare the dietary patterns of mothers and their children. 4. To associate the maternal dietary patterns and intelligence quotient (IQ) children at childhood. Methods: To achieve the objectives 1 and 2 we used data from a prospective cohort of pregnant assessed at 5-13, 20-26, and 30-36 gestational weeks, and 30-45 days postpartum. The dietary intake was obtained using a food frequency questionnaire (FFQ), it had the six months before pregnancy as the time frame. The dietary patterns were obtained by principal component analysis. The depressive symptoms were measured by Edinburg Postnatal Depressive Scale during three gestational trimesters, and the anxiety symptoms were assessed by State-Trait Anxiety Inventory, and it was applied to mid-pregnancy to early postpartum. Longitudinal mixed effects models were employed, and were adjusted for obstetric, socioeconomic, demographic factors, and energy intake. The objectives 3 and 4 were achieved using the dataset of Avon Longitudinal Study of Parents And Children (ALSPAC), a longitudinal birth cohort conducted in the former county of Avon/UK. The dietary intake was assessed by a FFQ at 32 weeks’ gestation. The cluster analysis was applied to obtain the dietary patterns. The absolute and energy-adjusted nutrient intakes were described according to each clusters obtained. The cross-tabulating and multinomial regression were used to compare and to verify the association between the maternal and children dietary patterns. The IQ was assessed at 8 years of age by Wechsler Intelligence Scale for Children-III. Models of imputation were performed to the missing data. Unadjusted and adjusted linear regression models were applied. Results: 1. Three pre-pregnancy dietary patterns were identified from 248 women: ‘common-Brazilian’, ‘healthy’, and ‘processed’. The ‘healthy’ dietary pattern was negatively associated with depression symptoms during pregnancy. 2. A total of 196 women were evaluated in this study. The ‘common-Brazilian’ and the ‘healthy’ patterns were negatively associated with anxiety symptoms during pregnancy and postpartum. 3. Three clusters dietary patterns were obtained of 12,195 pregnant women, which were labeled ‘fruit and vegetable’, ‘meat and potatoes’ and ‘white bread and coffee’. The ‘fruit and vegetable’ cluster showed the better profile of almost all nutrients after energy adjustment. The children at childhood adhered similar dietary patterns that the mothers adhered during pregnancy, it was verified mainly between the dietary patterns composed by healthy foods. 4. The pregnant women who adhered the ‘meat and potatoes’ and ‘white bread and coffee’ clusters had children with lower IQ at 8 years of age, when compared with mothers who adhered the ‘fruit and vegetables’ clusters. Conclusions: The higher adherence to dietary patterns characterized by healthy foods, as ‘commonBrazilian’, ‘healthy’ and ‘fruit and vegetables’ patterns reduce the risk of depressive and anxiety symptoms during pregnancy and postpartum, and lower IQ scores at childhood.
Keywords: Depression; Anxiety; Intelligence Quotient; Dietary patterns; Pregnancy; Children; Cohort study.
Title: EXCESSO DE PESO E ACÚMULO DE GORDURA ABDOMINAL EM ADULTOS DE BAIXA RENDA: EVOLUÇÃO E ASSOCIAÇÃO COM INSEGURANÇA ALIMENTAR E PADRÕES DE CONSUMO ALIMENTAR
Author: Erica Guimaraes De Barros
Conclusion Paper: THESIS
Date of Defense: 8/21/2015
Abstract: The aims of this study were: (1) to describe overweight and high waist circumference (WC) variations, according to socio demographic features, in lowincome adults; (2) to assess factors related to overweight, obesity and high WC, in particular, food insecurity (FI) and dietary patterns, in the same population. We evaluate data from two household surveys conducted in Duque de Caxias city, Rio de Janeiro state, in 2005 (n=1.085) and 2010 (n=1.121). Overweight and obesity were defined as a body mass index (BMI) ≥ 25 kg/m² and ≥ 30 kg/m², respectively. High WC was defined as a waist measurement ≥ 88cm for women and ≥ 102cm for men. Sociodemographic data, alcohol consumption, cigarette smoking and physical activity leisure (PAL) were obtained by means of a questionnaire. The FI was estimated by the Brazilian Food Insecurity Scale. Dietary consumption was evaluated using a semi-quantitative food frequency questionnaire and dietary patterns were generated by principal components factor analysis. Frequencies were compared by chi-square test and associations were made using Poisson regression and hierarchical logistic regression model, with overweight, obesity and high WC as outcomes. A p-value <0.05 was admitted for statistical significance. Between 2005 and 2010, there was a significant increase in the global prevalence of overweight and high WC and decrease in FI prevalence. Overweight increased in both sexes, while high WC increased only in women. Poisson regression analysis revealed that overweight and high WC were positively associated with age and inversely associated with education. Women had a higher odds for high WC. There was no relationship between FI and overweight or high WC. In 2010, three dietary patterns were identified, named as mixed, western and traditional. Unfavorable socioeconomic conditions resulted in a lower odds of being obese and having high WC among men, while in women, there was an opposite trend. Men whose diet is composed by a mixed pattern had more odds of being overweight while those with moderate/severe FI had less odds of high WC. Among women the western pattern increased the odds of being overweight and obese, as well as the mixed pattern for high WC. On the other hand, the practice of PAL was a protective factor for overweight and obesity and the traditional pattern was a protective factor for high WC. There was no association between FI and the outcomes among women. These results show women’s vulnerability in low-income populations, it is important to implement prevention and control strategies for obesity that consider features and difficulties experienced by poor women.
Keywords: Key-words: overweigh, obesity, abdominal obesity, food insecurity, food consumption.
Title: TEORES DE ÁCIDOS GRAXOS TRANS EM ALIMENTOS PROCESSADOS HABITUALMENTE CONSUMIDOS POR ADULTOS RESIDENTES EM ÁREA URBANA DO RIO DE JANEIRO E SUA ASSOCIAÇÃO COM BIOMARCADORES DE ÁCIDOS GRAXOS NO PLASMA E TECIDO ADIPOSO
Author: Flavia Da Silva Lima Dias
Conclusion Paper: THESIS
Date of Defense: 5/8/2015
Abstract: Inadequate dietary intake is considered one of the most important environmental factors for the early development of chronic diseases. Thus, some dietary strategies have been proposed, such as reducing food intake of saturated fats and trans fats and encouraging the intake of polyunsaturated fats. Additionally, several Latin American governments have made efforts to eliminate industrially produced trans fats and replace them with unsaturated fatty acid cis configuration. Given the complexity measure dietary intake, it is important to choose valid and more accurate methods. As a resource, fatty acid biomarkers have been used as predictors of chronic diseases. This project aimed to study trans fatty acid content in processed food frequently consumed by adults living in urban areas and the profile of fatty acids in plasma and adipose tissue of them. Adults living in Duque de Caxias, RJ were selected and were obtained sociodemographic, anthropometric, biochemical and dietary data in addition to the collection of biological materials. The fatty acids content of food, plasma and subcutaneous adipose tissue were obtained by gas chromatography. The trans fatty acids (TFA) content was compared with data available in literature. It was observed that TFA content in food vary from 0 to 12 g%, identifying that there was a reduction of this type of fatty acids in recent years, since, according to the current resolution, most foods can be classified as TFA free. From the analysis of biological material, there were higher concentrations of saturated fatty acids in plasma and monounsaturated fatty acids in adipose tissue, suggesting the unsaturation of stearic acid plasma. Low concentrations of trans fatty acids were found in plasma and adipose tissue of volunteers, which agrees with the low levels of this type of fat in processed foods consumed by them. From these results, it can be concluded that there was a reduction of trans fatty acids in processed foods, whose consumption was reflected in lipid profiles of plasma and adipose tissue of the group investigated. Finally, the high content of saturated fatty acids (SFA) found in plasma indicates the recent use of this type of fatty acids that has been associated with increased risk of developing cardiovascular disease. Studies aiming to investigate the impact of TFA consumption reduction with a consequent increase in SFA consumption by individuals and populations are required.
Keywords: Keywords: fatty acids, biomarkers, gas chromtography.
Title: CONSUMO DE CÁLCIO E DE LATICÍNIOS E ADIPOSIDADE: UM ESTUDO LONGITUDINAL EM ADOLESCENTES
Author: Anelise Bezerra De Vasconcelos De Moraes
Conclusion Paper: THESIS
Date of Defense: 4/7/2015
Abstract: This thesis is based on the hypothesis that the consumption of calcium and dairy products may be associated with indicators of adiposity in adolescents. In this thesis, the database of the 10th grade high school cohort from the Longitudinal Study of Nutritional Assessment of Adolescents- ELANA, conducted between 2010 to 2012, in four private and two public schools, from the metropolitan region of Rio de Janeiro. Data of 962 teenagers from schools participating in the ELANA study were analyzed. Anthropometric measurements of body weight, height, waist circumference (WC) and body composition were assessed at baseline and on follow-up periods by a team of trained professionals, under the supervision of nutritionists. Body composition was assessed by electrical impedance at baseline and during the first year of follow-up, the other anthropometric measures were evaluated in the three years of the ELANA study. Calcium intakes (mg) and dairy products (g / day) were evaluated from a qualitative short version of a food frequency questionnaire (FFQ), self-administered, developed and validated specifically for teenagers, containing 72 food items, with eight options of frequency. Dairy intake (g / day) was obtained from the sum of the amount (in grams) daily milk, cheese, cream cheese and yoghurt. The first article describes the association between the intake of calcium and dairy products with overweight, abdominal obesity and excessive body fat at baseline. Means of Body Mass Index (BMI), WC, body fat mass (BF) and percent of body fat (%BF) were the lowest at the highest quintile of calcium intake. For dairy consumption, means of BMI, BF and %BF were lower only for the fourth quintile. Inverse associations were observed for the risk of overweight (OR=0.42; 95%CI= 0.24-0.84), abdominal obesity (OR=0.16; 95%CI=0.05-0.46) and excess of body fat (OR=0.37; 95%CI= 0.21-0.46) for the 5ºquintile of calcium intake, compared to the first quintale and no significant associations were observed for dairy products. The second article describes the associations between calcium and dairy products with the longitudinal changes in BMI measurements, WC, BF and %BF, using linear mixed models. Calcium intakes below 700mg/day (β= 0. 45 p=0.01) and between 700 to < 1300mg/day (β= 0.36 p=0.03) were associated with an increase in waist circumference measures overtime. For the others anthropometric measures, no significant temporal changes were observed in relation to calcium and dairy products intakes. This thesis corroborates with the hypothesis that the low calcium intake, but not dairy, is associated with measures of obesity and temporal changes in the deposition of body fat in adolescents.
Keywords: Adolescents. Longitudinal study. Calcium. Dairy. Obesity. Body fat.
Title: RESVERATROL E CÂNCER DE MAMA: ASSOCIAÇÃO ENTRE ESPÉCIES REATIVAS DE OXIGÊNIO E CASEÍNA CINASE 2
Author: Paula Seixas Da Costa
Conclusion Paper: THESIS
Date of Defense: 2/28/2015
Abstract: It is estimated that in 2020, the worldwide incidence of cancer will be about 15 million. Currently, the breast cancer is the second most deadly cancer among women. Resveratrol (RV) is a polyphenol found in grapes and red wine, which is known to play a role as chemopreventive and chemotherapeutic agent; however, the mechanisms of action has not been fully elucidated. Casein kinase 2 (CK2) is a serine/threonine protein kinase found in all eukaryotes cells that plays a critical role in cell proliferation and oncogenesis, therefore it candidates as a molecular target for the treatment of several types of cancer. In the present study, we demonstrate that RV produces reactive oxygen species (ROS) leading to an inhibition of CK2 on MCF-7 breast cancer cells. Cells were treated with different concentrations of resveratrol during 24h and 48h of growth. MCF-7 cellular viability decreased in a time and dose dependent manner with an IC50 of 238mM and 151 µM for 24h and 48h, respectively. In addition, 4, 5,6,7-Tetrabromobenzotriazole (TBB), a specific inhibitor of CK2, decreased MCF-7 cellular viability in a dose-dependent manner with IC50 of 106 µM during 24h of growth. ROS production was not increased when MCF-7 was treated for 3h hours but its production increased on 50% when treatment for 24h with 200 mM of RV. However, TBB inhibited the generation of ROS with 3h of treatment and did not increase the ROS production in 24h. The pre-incubation with antioxidants such as NAC, GSH and PEGcatalase protected cellular viability from the effect of RV, but not from TBB effect. In relation with these results, the pre-incubation with PEG-Catalase favored the reduction to about 50% of ROS production observed on MCF-7 cells treated with RV for 24h. RV was able to decrease the MCF-7 mitochondrial membrane potential after the 3h and 24h treatments. However, when pre-treated with PEG-Catalase it was observed no mitochondrial dysfunction in both tested times, even after the addition of RV. When RV was substituted for TBB, there was also a decrease of the mitochondrial membrane potential for 3h and 24h but the pretreatment with PEG-Catalase did not modify the effect of TBB. In relation to CK2, RV, and TBB inhibited the enzyme activity after the 24h treatment. Nonetheless, the PEG-Catalase utilization kept the CK2 activity close to the control MCF-7 cells even after the addition of RV. The same was not observed with the addition of TBB. Interestingly, RV exhibited favorable ADMET properties and fulfilled Lipinski’s “Rule of five” showing it is wellabsorbed, permeable, bioavailable and an orally viable compound. Taken together, the results contribute to elucidate the effect of RV over ROS production on MCF-7 and its relation to the inhibition of CK2 activity and, in addition, with the in silico results, we propose that this polyphenol may be a possible compound used in breast cancer treatment.
Keywords:
Title: TRAJETÓRIA DO ÍNDICE DE MASSA CORPORAL DE ADOLESCENTES E ASSOCIAÇÃO COM FATORES DEMOGRÁFICOS, SOCIOECONÔMICOS E DE ESTILO DE VIDA: ESTUDO LONGITUDINAL DE AVALIAÇÃO NUTRICIONAL DE ADOLESCENTES – ELANA.
Author: Naiara Ferraz Moreira
Conclusion Paper: THESIS
Date of Defense: 2/5/2015
Abstract: The main objective of this thesis was to evaluate if demographic, socioeconomic and lifestyle behaviors in body composition indicators are associated with body composition indicators and with the mass index trajectory during the intermediate and late adolescence. To achieve these objectives were developed three scientific papers, using ELANA data (the Adolescent Nutritional Assessment Longitudinal Study). This study followed up two cohorts, one conducted with elementary school students and other with high school students at two public and four private schools from the metropolitan region of Rio de Janeiro, Brazil. This thesis was developed with data from 1,039 adolescents from high school, aged from 13.5 to 19 years at baseline of the study. These adolescents had their data collected for three consecutive years (between 2010 and 2012). The first scientific paper of this thesis described the body mass index trajectory of adolescents according to demographic and socioeconomic variables and found that male adolescents, attended private schools, with white skin color and that mothers studied more than eight years had higher rate of increase in body mass index at follow-up. Additionally, boys attended private schools are more likely to have excessive weight gain than their peers in the three years period. In the second scientific paper was identified, through principal component analysis, three patterns of energy balance related behaviors (consumption of fast foods, soft drinks, cookies, vegetables, fruits, rice and beans, screen time, moderate and vigorous physical activity time and cardiorespiratory fitness): 1- unhealthy pattern; 2- Vegetable and fruits patterns; 3 Traditional eating and physical active pattern. These patterns were not associated with the increase in BMI during the three years of follow-up. In the third scientific paper was evaluated, through cluster analysis, clustering of energy balance related behaviors (sweetened beverages consumption, fruits and vegetables consumption, moderate and vigorous physical activity time and television time) and the association with anthropometric measurements and composition body in Brazilian (ELANA) and European adolescents (Healthy Lifestyle in Europe by Nutrition in Adolescence – HELENA study. Five-cluster solutions were identified and there was an association between high body composition indicators and clusters characterized by elevated TV time; elevated practice of moderate and vigorous physical activity in European boys and Brazilian girls. The xiv elevated sweetened beverage consumption was also associated with anthropometric measurements in Brazilian girls. We conclude that socioeconomic variables were positively associated with increased in body mass index among boys, but patterns of energy balance related behaviors were not associated with the body mass index trajectory. The third manuscript results showed that Brazilian and Spanish adolescents have similar clusters of lifestyle behaviors, at least in parts and these clusters were associated with body composition indicators, especially among Brazilian girls.
Keywords: Adolescent. Body Mass Index. Weight gain. Longitudinal studies. Socioeconomic conditions. Risk behaviors. Associated factors.
Title: EVOLUÇÃO DAS CONCENTRAÇÕES SÉRICAS DA PROTEÍNA C-REATIVA DURANTE A GESTAÇÃO E SUA ASSOCIAÇÃO COM O PESO AO NASCER
Author: Livia Costa De Oliveira
Conclusion Paper: THESIS
Date of Defense: 12/16/2014
Abstract: Introduction: During pregnancy, there is an increase in serum concentrations of C-reactive protein (CRP). However maternal serum CRP concentrations can be altered in the presence of certain factors. Even may be associated with birth weight (BW). Objective: To describe the evolution of serum concentrations of CRP in pregnancy, identify factors associated with the changes and to investigate its association with BW. Methods: Study cohort, in which adult pregnant women were interviewed between 5th -13th, 20th -26th and 30th -36th weeks of pregnancy and 30-45 days postpartum. CRP (mg/L) was determined with ultra-sensitive kits by immunoturbidimetry. The BW (g) was obtained in the child vaccination card. We used longitudinal linear mixed effects regression and linear regression [coefficient of variation (β) and confidence interval (CI) of 95%]. Results: Serum CRP concentrations increased during pregnancy, with average values of 5.69 mg/L in the 1 st, 6.09 mg/L in the 2 nd and 8.85 in the 3 rd trimester of pregnancy (p value <0.001). Parity (β = 1.59; 95% CI = 0.73 – 2.43) and body mass index (BMI) pre-pregnancy (β = 0.32; 95% CI = 0.05 – 0 58) were positively associated and the dietary glycemic load (GL) negative (β = -0.20, 95% CI = -0.38 – -0.03) with serum CRP concentrations. The mean BW was 3,369.1 (34.6) g. CRP was positively associated with BW in the 1st trimester (β = 20.56; 95% CI = 2.38 – 38.74) and negatively on the 3rd (β = – 17.21, 95% CI = -31.64 – -2.78). Pregnant women who had a higher relative percentage change in the CRP from the 2nd to the 3rd trimester, had children with lower BW (β = -223.02, 95% CI = -454.72 – -8.69). Conclusion: In adult pregnant women, CRP concentrations increased during pregnancy. The evolution of CRP concentrations varied with parity, prepregnancy BMI and the CG diet. The serum CRP concentration in the 1st trimester of pregnancy may not be a good marker of BW. However, serum CRP concentrations in the 3rd trimester and the relative change from the 2nd to the 3rd trimester of pregnancy were associated with the birth of children with lower weight.
Keywords: C-reactive protein; birthweight; pregnancy; nutritional status; parity; dietary glycemic load.
Title: ANÁLISE ESTRATÉGICA DOS SERVIÇOS DE ALIMENTAÇÃO PERMISSIONÁRIOS DO CENTRO DE CIÊNCIAS DA SAÚDE DA UNIVERSIDADE FEDERAL DO RIO DE JANEIRO: UMA APLICAÇÃO DA MATRIZ SWOT
Author: Maria Eliza Assis Dos Passos
Conclusion Paper: THESIS
Date of Defense: 12/8/2014
Abstract: The licensed food services examined in this study are situated onsite at the Federal University of Rio de Janeiro’s campus. The strategic analysis of these food services allows an examination of how they operate as well as the identification of any possible distortions, aiming at their improvement and thus minimizing any possible harm to consumer health. The aim of this study was to strategically analyse the licensed food services at the Centre For Health Sciences, which is part of the Cidade Universitária campus on the island of Fundão. The research method was field study. The SWOT matrix, a tool that relates the internal and external conditions of a service, was used to carry out the strategic analysis. Each of the three different axes used to collect data for the matrix had a different focus: the food services’ consumers (n=300); the food services’ managers and characteristics of the running of said services (n=14); and members of the university’s administrative staff. The following tools were used to collect data for the matrix: questionnaires completed by consumers and managers; a check-list that was developed based on RDC 216/2004; a focus group with food services managers; and surveys and interviews with high-level university staff. The food services managers questioned were mostly male (73%) and had completed secondary education (43%). As for consumers, 24%, 72% and 73% of those interviewed used the food services for breakfast, lunch, and snacks (or light meals) respectively, highlighting the community’s strong dependence on these services. Although there is no form of control over the running of the food services the importance of monitoring these services to guarantee quality for consumers is recognised by senior university staff. The food services’ compliance levels in relation to current legislation varied from zero up to 66%. In order to complete the SWOT analysis the data collected were then classified as threats or opportunities for the catering services when they came from assessments of the external environment, or strengths and weaknesses when from the internal environment. The analysis highlighted as weaknesses the small amount of communication between food services and the university administration, and the food services managers’ lack of control in relation to consumer satisfaction; as threats the analysis noted the absence of any investment in the food services, which worsens consumer perceptions of the catering services, and the distance that exists between university staff and the food services. The SWOT matrix had a positive outcome with respect to its application in the analysis of these services, showing an innovation in the areaThe food services’ positioning in the SWOT matrix fell into the “high risk” quadrant, demonstrating the food services’ critical operating conditions. The strategic analysis reveals a gaping hole in the food services’ management that both the catering services managers and the university are responsible for. This study reinforces the need to implement emergency measures that can rectify weaknesses and minimise the impact of threats, as well as the necessity of drafting an intervention program for the managers of the licensed catering services based at CCS/UFRJ.
Keywords: Food services; Licensees; Checklist; Food safety; SWOT matrix; Strategic analysis.
Title: ANTROPOMETRIA, COMPOSIÇÃO CORPORAL E MATURAÇÃO SEXUAL DE ATLETAS ADOLESCENTES DE PENTATLO MODERNO
Author: Sidnei Jorge Fonseca Junior
Conclusion Paper: THESIS
Date of Defense: 11/24/2014
Abstract: The anthropometry, body composition and sexual maturation are important in order to profile athletes and ensure the identification of changes that occur with specific diets or during a season of training teenagers. However, studies about modern pentathlon are scarce. The research had the overall goal of investigate anthropometry, body composition and sexual maturation among adolescent athletes of modern pentathlon. In the first study, we aimed to analyze the validity between dual-energy x-ray absorptiometry (DXA) and predictive equations based on skinfolds to estimate body fat among modern pentathlon adolescent athletes. We examined 27 males (mean age =15.1;SD=1.5 years) and 24 females (mean age=14.2;SD=2.5 years old). The Durnin and Rahaman (1967) and Durnin and Womersley (1974) body density equations, which involved the Siri equations, showed better agreement for females (difference between means=-2.03;2SD=8.44) and males (difference between means = 0.98;2SD= 7.30)compared to DXA. TheWeststrate and Deuremberg(1989) equations for evaluating body composition also showed low mean difference for males (difference between means = -1.2;2SD=8.34). In the second study, the objective was to analyze the anthropometry, body composition and sexual maturation in adolescents pentathletes using a mixed-longitudinal model according to male and female categories. Athletes could be evaluated once, twice or three times. The description of the data and statistical comparisons between “highlights athletes” and “non highlights athletes” were conducted. In males participants were 59 athletes with 24 athletes that were evaluated in the first and second year in the category relating to their age group. Significant differences between the “highlights” and “non-highlights” were observed in the young D category (11.0 to 13.0 years old) in height (p=0.001), envergadure (p=0.001), body mass (p=0.007), lean mass (p=0.002) and chest circumference (p=0.020). A descriptive analysis of sexual maturation demonstrates benefits of advanced maturational state in this category. In the other categories no significant differences(p>0,05) were found. However, the description of the data showed that low percentage of fat, greater height, somatotype with higher values of mesomorphy followed by ectomorphy and low values endomorphy shown to be specific characteristics of adolescent men athletes of modern pentathlon. Among female the descriptive results showed that relative age and anthropometric somatotype should be consider in the evaluating of these athletes. The menarche age was low for athletes in a sport that requires intense training. Smaller proportions of menarche in the categories “highlights athletes” Young D and C show the trend of maturational delay. The values found in body fat were higher for the demands of this sport. In conclusion, the equations that had a better agreement with gold standard had the largest validity being the best alternatives for assessing body composition in adolescent athletes of themodern pentathlon. In addition, initial subsidies in the anthropometry, body composition and sexual maturation were presented which could be applied in modern pentathlon.
Keywords: crossed validity, maturational status, puberty, somatotype, menarche.
Title: DA UVA AO SUCO: ANÁLISES SENSORIAL, DE COMPOSTOS BIOATIVOS E DE CAPACIDADE ANTIOXIDANTE E ESTABILIDADE MICROBIOLÓGICA
Author: Maria Lucia Mendes Lopes
Conclusion Paper: THESIS
Date of Defense: 10/24/2014
Abstract: Grapes are rich in phenolic compounds which possess health promoting properties. The cultivars Isabel and Concord are among the most commonly used for juice processing in Brazil. Juice production on the farm or in cooperatives is an alternative to generate income for producers. Extraction procedure, however, can affect bioactive compounds and antioxidant activity in the final product. The aim of this study was to evaluate the content of total phenolics, anthocyanin content and profile, antioxidant capacity, physicochemical characteristics and colorimetric parameters of the products of different varieties of grapes and the effect of extraction of grape juice on these parameters. Isabel grape juices prepared by different methods were evaluated for polyphenols content, total anthocyanins, antioxidant capacity, physicochemical characteristics and color. Acceptance of steam extracted juices and chemical and microbiological stability of steam extracted juice were also evaluated. In Isabel grapes, its skin and pulp, steam extracted juice and pomace obtained after juice extraction, the content and profile of anthocyanins and the antioxidant capacity were investigated. Organic and conventional Concord grape juices were evaluated for colorimetric parameters, phenolic compounds content, antioxidant capacity. It was also investigated the effect of high hydrostatic pressure (HHP) in grapes on the content of phenolic compounds in steam extracted juice and in pomace. The steam extracted juice showed a higher content of soluble phenolic compounds and anthocyanins and higher antioxidant capacity when compared to juices prepared by other methods. The extension of the extraction process to 5h reduced soluble solids and acidity, as well as the content of anthocyanins, while the content of soluble phenolic compounds and antioxidant capacity increased, especially between the first and second hour of extraction. Although the steam extracted juice has remained microbiologically stable during storage, there was a reduction in the content of phytochemical compounds, especially in the first five months. Fifteen anthocyanins were identified in the skin, juice and residue of Isabel grape, being malvidin derivatives present in greater quantity. The pomace showed higher levels of phenolic compounds and antioxidant capacity when compared to other samples. The steam extraction caused change in the profile of anthocyanins in the juice and pomace. The colors of organic and conventional Concord juices were different. The content of anthocyanins was higher in conventional juice and the content of total phenolic compounds, similar in the juices. Pressurization of Isabel grapes at 600 MPa increased the extraction of phenolic compounds from grape residue in comparison to 400MPa. Our results demonstrate the influence of different extraction methods on the quality of grape juice, as well as the effect of storage and extraction steam on characteristics of quality. They also demonstrated that the pomace from steam extracted grape juice has the potential to be used as a source of bioactive compounds.
Keywords: Grape juice. Steam extraction. Bioactive compounds. Antioxidant capacity. Grape pomace.
Title: EXPRESSÃO DE PROTEÍNAS PLACENTÁRIAS ENVOLVIDAS NA TRANSFERÊNCIA DE ÁCIDOS GRAXOS DE CADEIA LONGA E ESSENCIAIS PARA O FETO EM GESTAÇÕES COM RETARDO DE CRESCIMENTO INTRAUTERINO
Author: Renata Pereira Assumpcao
Conclusion Paper: THESIS
Date of Defense: 10/23/2014
Abstract: Suitable placental transport of fatty acids (FA) is crucial for normal growth and development of the fetus. The aim of this study was to investigate in mothers and their newborns with and without intrauterine growth restriction (IUGR), the AG’s profile in the placenta and in erythrocyte maternal-fetal compartments as well as gene expression of proteins involved in the uptake and / or transport of long-chain polyunsaturated fatty acids (LC-PUFAs) and essential fatty acids (EFA). 23 pregnant women participated in the study: 15 were in the control group and 8, whose newborns were diagnosed with IUGR, without associated diseases and clinical complications, integrated IUGR group. Sociodemographic, anthropometric and obstetric data were obtained from hospital records or interview. Esters AG, obtained after extraction, saponification and methylation of lipids in blood and placental samples were quantitated by gas-liquid chromatography. The expression of genes that encode proteins involved in the uptake and / or transport of LC-PUFAs and AGE was assessed by RT-PCR of placenta in both groups. Results were expressed as mean ± standard deviation in mg / 100 mg of total AG. The content of the AG were correlated with the expression of proteins associated with the carriers and indicative anthropometric variables of newborn growth. The results showed that IUGR pregnant women gained less weight during pregnancy compared pregnant women control (final weight = 9.76 ± 4.0kg versus 15.3 ± 2.4 kg, respectively). Placental weight was also lower in IUGR patients (464 ± 39g) compared to controls (645 ± 100 g, p <0.0001). The weight and head circumference at birth were lower in IUGR group compared to the control group (p <0.0001). In IUGR placentas of pregnant women, we observed increased expression of FATP (1, 2 and 4), FABP (3 and 4), FABPpm, CD36 and LPL, no change in the concentration of AGE and LC-PUFAs in the total lipids in this tissue. In erythrocytes of pregnant women and newborn IUGR group, we identified lower arachidonic acid (AA) concentrations, docosahexaenoic acid (DHA) as well as reason DHA/linolenic lower compared to the control group. These results indicate that in pregnancies involving IUGR maternal diet composition and, consequently, of FA concentration in erythrocytes of these women may influence the availability of fetal LCPUFAs. Furthermore, it was observed that lower concentrations of LC-PUFAs in the maternal circulation increased the mRNA of the proteins responsible for the uptake of these fatty acids in the trophoblasts, as well as the intracellular cytoplasmic mRNA transport proteins which facilitate its transport to the fetal circulation. Further investigations are required to check the amount of protein translated from the mRNA transcripts and the mechanism that promotes such regulation.
Keywords: fatty acids, protein mRNA carriers of fatty acids, intrauterine growth restriction.
Title: FATORES DE RISCO E PROTEÇÃO PARA DOENÇAS CRÔNICAS NÃO TRANSMISSÍVEIS EM ADULTOS DE CUIABÁ-MT, 2006-2009
Author: Solanyara Maria Da Silva
Conclusion Paper: THESIS
Date of Defense: 8/6/2014
Abstract: In Cuiaba, the capital of the state of Mato Grosso, Brazil, more than half of the deaths are due to chronic non communicable diseases (NCDs), as well as, much of the spending on health care. The VIGITEL system (Surveillance of Risk and Protective Factors for Chronic Diseases – Survey by Telephone), is the main source of data on risk and protective factors for these diseases in the country. This study aims to (1) analyze time variations and the distribution of risk and protective factors for NCDs and (2) examine the association between sociodemographic characteristics and indicators of lifestyle with selfrated health. The study was based on cross-sectional population-based studies, carried out by VIGITEL. Sample size was around 2000 individuals ≥18 years old and the response rate was over 70% in all years. To write the first manuscript, temporal analysis was performed to assess changes in the prevalence of risk and protective factors for NCDs between 2006 and 2009, according to sex, age and education level. Binary logistic regression models were developed having the analyzed risk factors as dependent variables (absent = 0, present = 1) and the year of the survey as independent variable. The changes were considered significant when the regression coefficient for the variable “year of survey” was statistically different from zero (p <0.05). In the second manuscript, we only used data obtained in 2009. Chisquare test was applied to assess the association between sociodemographic and lifestyle characteristics with self-rated health. It was observed an increase in the proportion of men who reported never having smoked (from 53 to 61%, p = 0.04) and, in general, the frequency of regular soda consumption was reduced by 23% (p <0.01 ) and the consumption of Fruits and Vegetables increased by 19% (p = 0.02), and this increase was more evident in men (49%, p <0.01). There was a reduction in physical activity at home (p <0.01) and leisure physical activity in women (from 14 to 10%, p = 0.02), however, there was an increase in the proportion of women and individuals with > 40 years old who did active commuting daily. Positive self-rated health was reported by ⅔ of adults in Cuiabá, being more frequent in men, in individual under 40 years old and among those with ≥8 years of schooling. Cigarette smoking and physical inactivity were associated with a lower proportion of positive self-rated health while frequent fruit and vegetable consumption was associated with positive self-rated health. In contrast, female, > 40 years old, <8 years of schooling, smoking, low fruit and vegetable consumption, and physical inactivity were the characteristics that were associated with negative self-rated health. This work allows identifying groups with greater chance of presenting NCDs risk factors among adults from Cuiaba. It also provides indications of how this population self rated health in relation to major risk factors for these diseases. This study provides scientific basis for the formulation of health promotion and NCD prevention public policies in Cuiabá.
Keywords: Risk factors, Chronic Disease, Epidemiology, Self Assessment Diagnostic, Cardiovascular Diseases, epidemiologic survey, Food Habits, Nutrition, Risk Factor Surveillance System Behavior.
Title: QUALIDADE DA DIETA E HÁBITOS ALIMENTARES DOS ADOLESCENTES BRASILEIROS
Author: Luana Silva Monteiro
Conclusion Paper: THESIS
Date of Defense: 6/10/2014
Abstract: This thesis presents the results of two manuscripts, which were based on the analysis of breakfast habits and diet quality of Brazilian adolescents. Data were obtained in the first National Dietary Survey (2008-2009). Food consumption was estimated based on oneday of food record obtained from a probabilistic sample of individuals between 10 and 19 years old (n=7,425), after excluding pregnant and breast feeding girls. The objective in the first manuscript was to characterize breakfast among Brazilian adolescents. Breakfast was defined as the first occasion of food consumption reported between 4 and 11 o’clock A.M. that did not included staple foods usually consumed at lunch and dinner, like rice, beans, and pasta. Ninety-three percent of the adolescents had breakfast, on average at 7 o’clock A.M.. On average, breakfast contributed with 18% of daily energy intake. Coffee, milk, bread and butter / margarine were the most eaten foods at breakfast. There were variations in foods included in the breakfast according to income and subtle differences were observed according to Brazilian regions, thus indicating that there is uniformity in the breakfast eating habits in the country. In the second manuscript were evaluated differences in the adolescents’ diet quality considering the gradient of consumption of foods high in saturated and trans fat and added sugar (SoFAS). Applying the ROC curve method and recommended based on the saturated fat intake, the cut-off limit for excessive SoFAS intake was 40% of daily energy intake. Seventy-two percent of Brazilian adolescents presented high intake SoFAS and, on average, SoFAS foods provided 53% of daily energy intake. Among adolescents with high intake of SoFAS, it was observed reduced consumption of fish, poultry, roots and corn-based preparation and higher consumption of candies & chocolates, hamburger, pizza, ready-to-eat cereals, sandwiches & “salgados”, salad dressings, cheese, yogurt, cookies & cakes, milk, fruit juices, sugar sweetened beverages, chips, and preserved meats. Conversely, adolescents with moderate intake of SoFAS, presented higher consumption of rice, beans, coffee or tea, bread, fish, poultry, roots, and corn-base dishes when compared to those with elevated intake of SoFAS. The findings of this thesis highlight the need for special attention to the inappropriate dietary habits of adolescents, given the negative impact from the point of view of public health, such as increasing obesity and development of metabolic disorders, precursors of chronic diseases.
Keywords:
Title: ASSOCIAÇÃO DO ESTADO NUTRICIONAL DE VITAMINA A COM ÍNDICE DE MASSA CORPORAL, ADIPOSIDADE CORPORAL, ESTRESSE OXIDATIVO E FATORES DE RISCO CARDIOVASCULAR EM MULHERES COM INGESTÃO DIETÉTICA RECOMENDADA DE VITAMINA A
Author: Claudia Teresa Bento
Conclusion Paper: THESIS
Date of Defense: 6/4/2014
Abstract: Introduction: Obesity is a universal disease and has acquired epidemic proportions. Evidence point to the involvement of vitamin A in the regulation of adipose mass, oxidative stress, influencing obesity, type 2 diabetes mellitus (DM2) and in cardiovascular diseases. Objective: To investigate the nutritional status of vitamin A through biochemical and functional indicators and their association with body mass index (BMI) and body adiposity, T2DM and oxidative stress in women with recommended dietary intake of vitamin A. Methodology: This was a case-control study of 200 patients, who were divided into control group (n = 80): normal weight (I) and 3 groups – cases (n = 40 / each): overweight (SP ), obesity grade 1 (O1) and grade 2 (O2). BMI was classified according to the cutoff points recommended by the WHO classification and waist circumference (WC) was used for the proposed International Diabetes Federation. Serum concentrations of retinol and β-carotene were analyzed by High Performance Liquid Chromatography with UV detector with cutoff <1.05 mmol / L and <40 mg / dL, respectively. Night blindness (CN) was assessed using a standardized interview and validated by the Pan American Health Organization and World Health Organization The cutoff adopted for recommended dietary intake of vitamin A was 700 mg / day (Institute of Medicine) . The DM2 diagnosis was made according to the guidelines of the American Diabetes Association. Lipid, glucose and oxidative stress was assessed by the concentrations of uric acid, glutathione peroxidase (GSH-Px) and thiobarbituric acid reactive substances (TBARS) was measured profile. Results: It was observed in the absence of CN eutrophic women and their percentage gradually increased as excess weight, reaching 25% in the group with grade 2 obesity negative correlation was found between serum concentrations of retinol and ß-carotene and variables. lipid profile and oxidative stress markers in both groups. Serum retinol deficiency was associated with 14, 35.3 and 65.4 times the chance of occurrence of overweight, obesity class 1 and 2, respectively. A deficiency of β-carotene was associated with 5, 17 and 26.7 times the chance of occurrence of overweight, obesity grade 1 and 2 respectively, Women with SP, O1 and O2 showed that inadequate concentrations of retinol and ß-carotene serum had higher odds ratio for CC inadequate, the diagnosis of type 2 diabetes, high blood concentrations of LDL – cholesterol, triglycerides, TBARS, uric acid and low concentrations of HDL – cholesterol and glutathione peroxidase, compared to normal weight women with retinol concentrations and appropriate β-carotene. Conclusion: In the present study, the inadequate nutritional status of vitamin A was associated with overweight, obesity, adiposity and oxidative stress. Thus knowledge of the nutritional status of vitamin A may contribute to subsidize new effective dietary strategies for better control of body weight, while contributing to the increase in antioxidant capacity and the prevention of cardiovascular risk factors.
Keywords: Overweight, obesity; retinol; β-carotene; night blindness, lipids, oxidative stress.
Title: FATORES ASSOCIADOS ÀS CONCENTRAÇÕES PLASMÁTICAS DE LEPTINA E AO GANHO DE PESO MATERNO AO LONGO DA GESTAÇÃO SEGUNDO O IMC PRÉ-GESTACIONAL
Author: Ana Beatriz Franco Sena Siqueira
Conclusion Paper: THESIS
Date of Defense: 2/25/2014
Abstract: Background: Leptin concentrations increase throughout pregnancy but little is known about factors that influence this physiological change and if they differ according to pregestational nutritional status. Additionally, this hormone has been associated to gestational weight gain (GWG), but no studies were identified on women with excessive pregestational body mass index (BMI). Objective: (1) To assess if biochemical, anthropometric and lifestyle factors influence longitudinal trends of leptin in pregnancy and also (2) to evaluate the effect of leptin and other selected variables on GWG in pregestational normal weight (NW), overweight (OW) and obese (OB) women. Methods: Prospective cohort of 232 pregnant women followed at 5-13th, 20-26th and 30-36 th gestational weeks. Longitudinal linear mixed-effect models, with β coefficients and their 95% confidence intervals were performed to assess the effect of independent variables on plasmatic leptin concentrations and GWG. Both analyses were stratified for pre-gestational BMI categories (NW: 18.5 kg/m2 ≤ BMI < 25 kg/m2 ; OW: 25.0 ≤ BMI < 30.0; OB: BMI ≥ 30.0 kg/m2 ). Results: (1) The multiple regression model for women with NW revealed associations of maternal body weight, serum HDL-cholesterol and C-reactive protein (CRP) with plasma leptin concentrations. Maternal body weight and serum HDLcholesterol concentrations were also associated to leptin in OW women. In OB women, serum HDL-cholesterol, maternal body weight, triglycerides concentrations and dietary carbohydrate were significantly associated to plasma leptin. (2) In the multiple model for pre-gestational NW women, the following covariates remained significantly associated with GWG: leptin, HDL-c concentrations, QUICKI values, maternal height and sleep duration. For OW women, the associated variables were leptin concentrations, maternal height and QUICKI. For pre-gestational OB women, HDL-c concentrations, maternal height, sleep duration, QUICKI, marital status and smoking habit were the variables associated to GWG. A negative interaction between leptin concentrations and sleep duration was found only in pre-gestational OW women. Conclusion: (1) Maternal body weight and serum concentrations of HDL-cholesterol were associated with leptin changes independent of pregestational BMI. Serum CRP concentrations were associated to leptin only in NW women, and serum triglycerides concentrations and dietary carbohydrate only in OB. These results indicate that factors that influence leptin concentrations differ according to pre-gestational BMI. (2) Leptin concentrations were positively associated with GWG in NW and OW women, but not in OB ones. However, in pre-gestational OW women, sleep duration decreased the effect of leptin on GWG. Other factors associated with GWG throughout pregnancy present effects specifically in some pre-gestational BMI categories. Results of the present thesis indicate that mechanisms associated to GWG are different among OB women and that this difference may be somehow attributable to a resistance to leptin’s action.
Keywords: leptin, weight gain, body mass index, pregnancy, longitudinal studies.
Title: HÁBITOS ALIMENTARES, ESTILO DE VIDA E ESTADO NUTRICIONAL DE ADOLESCENTES: UM ESTUDO DE BASE ESCOLAR EM CUIABÁ-MT
Author: Paulo Rogerio Melo Rodrigues
Conclusion Paper: THESIS
Date of Defense: 9/24/2013
Abstract: This thesis consists of four manuscripts, based on analysis of dietary habits, lifestylerelated risk behaviors and weight status of adolescents, to examine the use of simplified instruments for weight and eating assessment. For this purpose, we used data from a school-based cross-sectional study conducted in 2008, with students from public and private high schools, aged between 14 and 19 years old, in the city Cuiaba, Mato Grosso, Brazil. The adolescents were selected using probabilistic clustered sample and data were collected using self-administered questionnaire. The first manuscript examined the validity of self-reported weight and height and concluded that these measures can be used to estimate the weight status of adolescents because their excellent agreement with measured data. The second manuscript estimated the prevalence of lifestyle-related risk behaviors, the clustering of these behaviors, the associated risk factors and their relation to self-perceived health status. The risk behaviors that were more frequent were excessive sodium intake, an unsatisfactory meal pattern, excessive intake of saturated fat and alcohol consumption. Groups at higher risk for multiple risk behaviors were boys from families with higher income and girls students from public and private schools. The third manuscript evaluated the agreement between self-perceived diet quality and indicators of habits and food intake. Among boys, self-perceived diet quality as good was associated with vegetables intake, satisfactory meal pattern, and report that had knowledge about healthy eating. Among the girls, self-perceived diet quality as good was associated with fruits intake, satisfactory meal pattern, report that had knowledge about healthy eating, and greater adherence to “Mixed” dietary pattern, which included noodles, tubers and roots, fish, eggs, fruits and vegetables. However, for both groups, refer having good diet quality was not associated with saturated fat intake, consumption of chicken skin, visible fat from meat and “SoFAAS”, denoting that adolescents do not identify deleterious components that can affect the diet quality. Finally, we estimated the association between meal consumption habits and diet quality. Daily consumption of breakfast associated with better diet quality, higher consumption of fruits and dairy products, and lower sodium intake. Daily consumption of lunch was associated with greater consumption of vegetables, meats, eggs, and legumes, while the regular dinner consumption was associated with greater fruit consumption. Thus, regular habits of meals’ consumption, especially breakfast, can be considered an indicator of better diet quality.
Keywords: Adolescents. Self-perception. Diet quality. Meal consumption habits. Lifestyle. Risk behaviors. Socioeconomic status.
Title: IMPACTO DA SUPLEMENTAÇÃO COM ÓLEO DE PEIXE NA CONCENTRAÇÃO DE ÁCIDOS GRAXOS EM ERITRÓCITOS, NOS MARCADORES INFLAMATÓRIOS E NO ESTADO CLÍNICO E NUTRICIONAL EM CRIANÇAS E ADOLESCENTES COM FIBROSE CÍSTICA
Author: Ana Lucia Pereira Da Cunha
Conclusion Paper: THESIS
Date of Defense: 7/31/2013
Abstract: Impact of fish oil supplementation on fatty acid concentrations in erythrocytes, inflammatory markers and clinical and nutritional status in children and adolescents with cystic fibrosis. Rio de Janeiro, 2013. Tese (Doutorado em Ciências Nutricionais) – Instituto de Nutrição Josué de Castro, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 2013. Imbalances in the fatty acid profile were described in the plasma and tissues of Cystic Fibrosis (CF) patients. However by the time the pathophysiology of these alterations and the benefits of supplementation with n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) have not been clarified. The objective of this study was to investigate the effects of supplementation with fish oil, source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on fatty acids concentration in erythrocytes, inflammatory markers and clinical and nutritional status in children and adolescents with CF. Prospective controlled clinical trial was held, before and after study, divided into two periods of six months, whereby each subject served as his/her own control. Were studied patients with FC, between 5 and 19 years, enrolled in Rio de Janeiro CF reference center, between the years 2009 and 2010. In the first six months all patients were supplemented with fish oil capsules (20 to 30 mg/kg/day of EPA and DHA) and after this period the supplementation was suspended. Every three month, during one year, nutritional evaluation was performed, clinical data collected and were analyzed fatty acids in erythrocytes by gas chromatography and serum cytokines by ELISA. The sample consisted of 26 children and 31 adolescents, most female, heterezygous for DF508 and insufficient pancreatic. Adolescents showed higher severity of illness, infection by Pseudomonas aeruginosa and failure or nutritional risk compared with children. Before supplementation low concentration of DHA was observed in erythrocytes, which increased during supplementation (p < 0.05), while n-6:n-3 PUFA and AA:DHA ratios reduced. The EPA and DHA consumption also increased during the intervention (p < 0.05) and the recommended intake of these n-3 LCPUFAs were achieved in both groups only at this stage. Considering the deficiency, mainly DHA, and that recommendations for intake of EPA and DHA were not met with the usual diet, supplementation with fish oil should be considered in the nutritional treatment of these pediatric patients with CF. Despite evidence on the incorporation of n-3 LCPUFAs in erythrocytes, were not observed any statistically significant benefits in the inflammatory response, clinical and anthropometric supplementation of fish oil supplementation for six consecutive months.
Keywords: cystic fibrosis, fatty acids, erythrocytes, children, adolescent, controlled clinical trial.
Title: EFETIVIDADE DO ACOMPANHAMENTO NUTRICIONAL DE JOVENS ATLETAS DE PENTATLO MODERNO
Author: Leticia Azen Alves Coutinho
Conclusion Paper: THESIS
Date of Defense: 7/11/2013
Abstract: Introduction: The modern pentathlon combines five sports: fencing, swimming, equestrian and shooting sporting event combined with race. Despite the high energy demands of the sport, there are no studies to support the nutritional requirements of its athletes. Objectives: To characterize body composition, cardiorespiratory capacity, biochemical and food and dietary supplements intake from young athletes of modern pentathlon; and to evaluate the effects of individualized nutrition counseling on food intake and body composition of young modern pentathlon athletes, during six months. Methods: Were studied 50 athletes, 22 females and 28 males, mean age 16,0±3,5 years, weight 57,8± 16,3 kg and height of 1,6 ± 0,1 m, whose food intake was assessed by 24-hour dietary recall, three day food record and food frequency questionnaire. Body composition was estimated by anthropometric assessment protocols. Generalized recommendations for athletes were adopted for development of the individualized dietary plans, respecting the weekly progressive energy expenditure in training. Results: At baseline boys consumed less energy than recommended. Both girls and boys did not meet generalized carbohydrate recommendations for athletes. Moreover, lipids intake was in accordance with recommendation in both sex, insufficient intake of calcium was found, as well as low consumption of fruits and vegetables, while the use of soft drinks was frequent. At the end of the study, calcium and lipids contribution related to total energy intake were increased. The soft drinks became less referred to as one of the most commonly consumed beverages and there was a higher frequency of fruit and juice intake. Furthermore, there was a improve in lean body mass with no change in body fat. Conclusions: In general the young athletes of the modern pentathlon had inadequate eating habits as concern carbohydrates, energy and amounts of micronutrients intakes, especially calcium. However, this study has demonstrated that the nutritional status monitoring from young modern pentathlon athletes can promote important qualitative changes on food consumption, even in short time.
Keywords: Modern Pentathlon, adolescents, food consumption, body composition, nutrition.
Title: INATIVIDADE FÍSICA DE LAZER E SUA ASSOCIAÇÃO COM VARIÁVEIS DEMOGRÁFICAS E CONSUMO ALIMENTAR, ENTRE GÊNEROS, EM UMA POPULAÇÃO DE BAIXA RENDA
Author: Suzana Patricia De Sá Silva
Conclusion Paper: THESIS
Date of Defense: 2/21/2013
Abstract: This study aimed to evaluate the association of demographic, anthropometric, lifestyle, and food intake with physical activity leisure (LTPA), between genders in a low income population. This is a cross-sectional, population-based study conducted in Duque de Caxias, the metropolitan area of Rio de Janeiro, Brazil, in 2005. Data collection consisted of home visits in a sample of 1,246 adults. During home visits, questionnaires were administered to assess LTPA, demographic, anthropometric measurements (weight, height, waist circumference), dietary intake of adults aged between 19 and 86 years. The analyzes were performed considering physical inactivity as outcome (were considered physically inactive individuals who responded do not practice any LTPA). The results of the first article revealed that physical inactivity was high, with men more active than women. men practiced significantly more competitive LTPA and others sports activity related to this universe. Taking care of children was a factor that increased the likelihood of men engaging in LTPA, while among women, those who spend less time on household chores, did not smoke and who had greater accumulation of abdominal fat, were more likely to practice LTPA . In the second article, using hierarchical model, we found that physical inactivity among men was directly associated with increasing body mass index (BMI) and increased engagement in domestic physical activities, (DPA), and inversely associated for black and mulatto men. Among women, there was an association of physical inactivity with more years of education, lower BMI, smoking, increased practice of DPA and high consumption of soft drinks. In the third article, we observed a higher proportion of inactive men with age of 30 and 49 years, with more than 10 years of study, with lower waist circumference (WC), overweight, not reported having binge eating, not caring for children who did diet and who consumed five portions of fruits and vegetables per day. When comparing the averages of food groups between genders, there was a significant difference only among women, and those considered physically inactive with higher consumption of soft drinks and sugar. We conclude that: men repeated model choices LTPA considered male. Socio-demographic and anthropometric measures were associated with LTPA differently between genders. Women who practiced fewer leisure activities had unhealthy lifestyles, ie, smoked, consumed more soft drinks, and less fruits and vegetables.
Keywords: Leisure time physical activity, gender, lifestyle, population studies.