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Objectives The aim of this study was to estimate the incidence of metabolic syndrome (MetS) in individuals with a healthy weight (HWI), normal weight obesity (NWO), or overweight/obesity (OWO). Methods In all, 787 adults belonging to a 1978/1979 birth cohort from Ribeirao Preto were placed into one of three groups: HWI (body mass index [BMI] ≥18.5 and 90th percentile); and OWO (BMI ≥25 kg/m2 +∑skinfolds >90th percentile). Those diagnosed with MetS at the 23 to 25 y of age were excluded according to Joint Interim Statement criteria. The incidence of MetS and its components in individuals 37 to 39 y of age was evaluated by Poisson regression with robust estimation of variance, which was adjusted for family income; physical activity level; and daily intake of calories, lipids, and added sugar. Results MetS was detected in 279 adults at 37 to 39 y of age. NWO and OWO individuals showed higher risk ratios (RRs) for the development of MetS (RR,1.87; 95% confidence interval [CI], 1.36–2.57; RR, 1.61; 95% CI, 1.29–2.03), increased blood glucose levels (RR, 1.77; 95% CI, 1.12–2.79; RR, 1.51; 95% CI, 1.12–2.04), and increased waist circumferences (RR, 1.46; 95% CI, 1.32–1.61; RR, 1.50; 95% CI, 1.38–1.62). There was a higher risk for increased blood pressure (RR, 1.72; 95% CI, 1.35–2.19) among OWO individuals, but not among those with NWO. Conclusion Individuals with NWO have a risk ratio for MetS similar to individuals with OWO. This demonstrates the need to assess body fat percentages, even in BMI-designated normal weight individuals, both for prevention and management of obesity.

The present study investigated the association between preterm birth PT conditions, intrauterine growth restriction IUGR and the combination of both PT-IUGR with infant motor development. A cohort with 1006 children was monitored during prenatal, at birth, and two years of age. Bayley-III screening was used to evaluate of fine and gross motor skills. The data did not indicate an increased risk for motor delays in the PT or IUGR, composed mainly by mild cases. However, the combination of the conditions PT-IUGR increased the risk of delays in motor, which emphasizes the importance of monitoring the motor development of the group.

Background: Cesarean delivery (CD) perturbs the assembly of the neonatal gut microbiome and has been associated with child and adult obesity. However, it is still unknown whether CD is associated with metabolic risk factors in young adults. Objective: We investigated the association of CD and metabolic risk factors in young adults in a cohort study who were 23-25 y of age at follow-up. Design: We used data from a cohort study in Ribeirao Preto, Brazil. Baseline data on 6827 singleton pregnancies were collected in 1978-1979, and a sample of 2063 subjects were followed up 23-25 y later (2002-2004). Information on the type of delivery, birth weight, maternal age, parity, maternal schooling, and maternal smoking was obtained after birth. Anthropometric data, biochemical measure- ments, and information on participant schooling and smoking his- tory were collected at 23-25 y of age. A linear regression was performed to assess the association between CD and biochemical measurements in early adulthood, controlling for a minimum set of confounders that were identified in a directed acyclic graph. Results: The mean 6 SD age of the subjects was 23.9 6 0.71 y, and 51.8% of the sample were women. The CD rate was 32.0% and was more common in older (P , 0.001) and more educated mothers (P , 0.001). Compared with vaginal delivery, CD was associated with higher body mass index (BMI) after multivariable adjustment (P , 0.001) but not with glucose, homeostasis model assessment of insulin resistance, the quantitative insulin-sensitivity check index, total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides (all P. 0.05). Conclusion: In our sample of Brazilian adults, CD was associated with higher BMI but not with other metabolic risk factors. Am J Clin Nutr doi: 10.3945/ajcn.114.105205.

BACKGROUND: Obesity is epidemic worldwide and increases in cesarean delivery rates have occurred in parallel. OBJECTIVE: This study aimed to determine whether cesarean delivery is a risk factor for obesity in adulthood in a birth cohort of Brazilian subjects. DESIGN: We initiated a birth cohort study in Ribeirao Preto southeastern Brazil in 1978. A randomly selected sample of 2057 subjects from the original cohort was reassessed in 2002-2004. Type of delivery birth weight maternal smoking and schooling were obtained after birth. The following data from subjects were collected at 23-25 y of age: body mass index (BMI; in kg/m(2)) physical activity smoking and income. Obesity was defined as a BMI >/=30. A Poisson multivariable model was performed to determine the association between cesarean delivery and BMI. RESULTS: The obesity rate in adults born by cesarean delivery was 15.2% and in those born by vaginal delivery was 10.4% (P = 0.002). Adults born by cesarean delivery had an increased risk (prevalence ratio: 1.58; 95% CI: 1.23 2.02) of obesity at adulthood after adjustments. CONCLUSION: We hypothesize that increasing rates of cesarean delivery may play a role in the obesity epidemic worldwide.

Introduction Resveratrol is a compound presented in high quantity in red grapes that contribute to healthy endothelial function. We are exploring an in vitro model of preeclampsia incubating plasma with endothelial cell cultures. In this study we collected samples before clinical onset of preeclampsia that is relevant because a dietary intervention may reduce risk to develop preeclampsia. Objective To verify if resveratrol induces production of NO, improve cell viability and modulate expression of heme oxygenase-1 (HO-1, enzyme inducible by oxidative stress) in endothelial cells incubated with plasma from case and control pregnant. Methods We collected blood at 20–25 weeks of gestation from matched healthy pregnant during all gestation (control, n = 5) and pregnant who subsequently develop preeclampsia (case, n = 5). Plasma was incubated (10% v/v) for 24 h in HUVECs with or not 30 μM trans-resveratrol. Cellular viability was measured using MTT assay, HO-1 by ELISA and nitrite (NO metabolite) by Griess. P value Results We found similar levels of cell viability and nitrite levels between case and control, supplemented or not with resveratrol (all P > 0.05). Concerning HO-1 levels, we found that cultures incubated with plasma from case presented higher levels of HO-1 compared to control. When resveratrol was added, this difference diminished, although plasma from case induce higher HO-1 expression compared to control. Discussion Our study demonstrates that plasma from case induce expression of HO-1 suggesting presence of inducers such as oxidative stress even before clinical onset; and when resveratrol is added reducing of HO-1 expression in case cultures demonstrated lower cell-stress. Our results suggest that a diet rich in resveratrol may help to prevent endothelial injury decrease risk to develop preeclampsia, as supported by literature in cardiovascular diseases. This study was funded by FAPESP (grant #2015/20461-8) and CNPq (grant #2014-5/305587).

The interindividual variation in the activity of xenobiotic metabolizing enzymes and DNA repair genes could modify an individual's risk of recurrent malignancy and response to therapy. We investigated whether ALL outcome was related to polymorphisms in genes CYP2D6, MPO, EPHX1, NQO1, TS, XPD and XRCC1 in 95 consecutive ALL children by PCR or PCR-FRLP techniques. Polymorphisms in genes NQO1 and TS were associated with a significantly slow response to induction chemotherapy and NQO1 was also associated with a lower five-year event-free survival. This study suggests that polymorphisms of NQO1 and TS could be important for patient response to induction therapy and for treatment outcome.

Respiratory symptoms associated with smoking habit seem to be age dependent. However, there are few reports about the effect of tobacco in young populations. The objective of this study was to analyze the effect of smoking on respiratory symptoms and lung function in 23- to 25-year-old adults in Brazil. This study had a cross-sectional design and included 2063 young people in the city of Ribeirão Preto, São Paulo State.Subjects completed a questionnaire used by the European Community Respiratory Health Survey and underwent spirometry and bronchial challenge test with methacholine. Multiple logistic regression analysis and multiple linear regression analysis were carried out to assess the association between smoking and respiratory symptoms, bronchial hyperresponsiveness, forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC), adjusted for confounding variables.Prevalence of smoking habit was 17.2% with consumption (median) of 10 cigarettes per day (interquartile range 3-20). There was a significant association between smoking and respiratory symptoms. Smoking was associated to wheezing with odds ratio (95%CI) of 6.11 (4.03-9.28) among those smokingor=10 cigarettes per day and 3.36 (2.11-5.37) among those smoking10 cigarettes per day. Associations were found for other respiratory symptoms. Smoking was associated with lower FEV1/FVC ratio. No association was detected between smoking and FEV1 or bronchial hyperresponsiveness.These findings highlight the early health consequences of smoking among young adults. These results prompt the necessity to elaborate urgent programs to reduce tobacco habit in young populations.

Objectives The association between increased resistance to flow in the uterine artery and adverse pregnancy outcomes has been demonstrated, but there are no studies evaluating their relationship with outcomes after birth. Our aim was to evaluate the relationship of the pulsatility index of the uterine artery in the second trimester of pregnancy with the neurodevelopment of children in the second year of life. Methods A cohort study was performed involving 1370 women with singleton pregnancies. Pulsatility index of the uterine artery between 20 and 25 weeks was obtained. The psychomotor development of the children of these women was evaluated in the second year of life with the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III Screening). Results The mean age of pregnant women was 25.8 years and the mean gestational age of 23.6 weeks review. The average pulsatility index of the uterine artery was 0.89 and 1.47 for the 95th percentile. Evaluation of children, showed no increased risk associated with delay in pulsatility index of uterine artery greater than or equal to the 95th percentile development (cognitive performance: RR 0.76, 95% CI 0.3–1.96, receptive communication: RR 1.17, 95% CI 0.46–3.01, expressive communication: RR 0.66, 95% CI 0 0.67–1, 36, fine motor: RR 1.26, 95% CI 0.5–3.27, gross motor: RR 1.14 95% CI 0.44–2.94). Conclusions The high flow resistance of the uterine artery in the second quarter, without deleting other perinatal factors, cannot be considered as a risk factor for the delay in child development. Additional studies should be performed excluding the perinatal risk factors such as prematurity that may adversely affect psychomotor performance of children. Disclosures M.M. Okido: None. L.B. Martins: None. T.V. Bertagnolli: None. M.A. Barbieri: None. H. Bettiol: None. V.C. Cardoso: None. R.C. Cavalli: None.

Objectives Gestational hypertension and pre-eclampsia are important causes of perinatal morbidity. In this study we propose to study pregnant women between 20 and 25 weeks of gestation to evaluate the increase in relative risk for developing gestational hypertensive disorders, and correlating the findings with pregnancy outcome. Methods This was a prospective cohort study of convenience. A total of 1417 patients in this gestational age and greater were identified. Of these, 1306 patients were identified at birth. Results Relative risk assigned to each risk variable was calculated through log-binomial regression. Identified as major risk factors were: obesity, with a progressive increase in the relative risk according to the degree, (relative risk of overweight, grade 1, grade 2, and morbid obesity 2.58, 3.06, 5.84 and 7.28 respectively); maternal age above 35 years (2.8, 95% CI 1.58–5.03); parity greater or equal to 3 (1.68, 95% CI 1.17–2.40); chronic hypertension (5.35, 95% CI 4.18–6.85); increase in mean arterial pressure at 20–25 weeks of gestation (4.58, 95% CI 3.12–5.16), and increased pulsatility index of the uterine arteries (2.69, 95% CI 1.86–3.89). Conclusions This study concludes that the clinical evaluation of pregnant women predicts the development of hypertension during pregnancy. These results also demonstrate that even without advanced features, patients at risk can be predicted in order to establish adequate prenatal care. Disclosures L.B. Martins: None. M.M. Okido: None. M.A. Barbieri: None. V.C. Cardoso: None. H. Bettiol: None. M.S. Machado: None. S.M. Quintana: None. R.C. Cavalli: None.