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Objective:To estimate the prevalence of anaemia in Brazilian children up to 83·9 months old.Design:Systematic review and meta-analysis, using databases PubMed, Scopus, SciELO, Lilacs, Google Scholar, Periódicos Capes, Arca, Biblioteca Virtual em Saúde, Microsoft Academic Search and Cochrane Library using search terms: anaemia, prevalence, child and Brazil. PROSPERO Registration number: CRD42020208818.Setting:Cross-sectional, cohort, case–control and intervention studies published between 2007 and 2020 were searched, excluding those who assessed children with an illness or chronic condition. The main outcome was anaemia prevalence. Random effects models based on the inverse variance method were used to estimate pooled prevalence measures. Sensitivity analyses removed studies with high contribution to overall heterogeneity.Participants:From 6790 first screened, 134 eligible studies were included, totalling 46 978 children aged zero to 83·9 months analysed, with adequate regions representativeness.Results:Pooled prevalence of anaemia was 33 % (95 % CI 30, 35). Sensitivity analyses showed that withdrawal of studies that contributed to high heterogeneity did not influence national average prevalence.Conclusions:Childhood anaemia is still a serious public health problem in Brazil, exposing 33 % of Brazilian children to the anaemia repercussions. The main limitation of the study is the estimation of national prevalence based on local surveys, but a large number of studies were included, with representation in all regions of the country, giving strength to the results. In Brazil, more public policies are needed to promote supplementation, fortification and access to healthy eating to reduce the high level of anaemia among children.

Identifying dietary patterns that contribute to zinc (Zn) and fatty acids intake and their biomarkers that may have an impact on health of males and females. The present study was designed to (a) extract dietary patterns with foods that explain the variation of Zn and PUFAs intake in adult men and women; and (b) evaluate the association between the extracted dietary patterns with circulating levels of serum dihomo-γ-linolenic fatty acid (DGLA) or serum linoleic/dihomo-γ-linolenic (LA/DGLA) ratio in males and females. We used reduced rank regression (RRR) to extract the dietary patterns separated by sex in the NHANES 2011–2012 data. A dietary pattern with foods rich in Zn (1st quintile = 8.67 mg/day; 5th quintile = 11.11 mg/day) and poor in PUFAs (5th quintile = 15.28 g/day; 1st quintile = 18.03 g/day) was found in females (S-FDP2) and the same pattern, with foods poor in PUFAs (5th quintile = 17.6 g/day; 1st quintile = 20.7 g/day) and rich in Zn (1st quintile = 10.4 mg/day; 5th quintile = 12.9 mg/day) (S-MDP2), was found in males. The dietary patterns with foods rich in Zn and poor in PUFAs were negatively associated with serum LA/DGLA ratio. This is the first study to associate the LA/DGLA ratio with Zn and PUFAs related dietary patterns in males and females.

Introdução: A partir do início do século XXI, um novo conceito começou a emergir nos meios científicos e sociais: os primeiros 1.000 dias de vida. Nessa mesma linha um movimento internacional iniciado no mesmo período começou a discutir sobre a “origem desenvolvimentista da saúde e da doença”. Inúmeros problemas que acometem o ser humano em todo seu ciclo de vida têm seu início nos primeiros anos e, muitas vezes, podem ser evitados ou minimizados quando precocemente reconhecidos e abordados. O presente documento discute, com base na literatura científica, a ideia de expansão da janela de oportunidades para um período de 2.200 dias, englobando desde a fase préconcepcional até o final do quinto ano de vida. Métodos: Foram revisados de forma integrativa os artigos científicos publicados até o ano de 2022 nas bases de dados Pubmed/Medline, SciELO, Google Acadêmico e Lilacs, nas línguas portuguesa, inglesa e espanhola. A busca de artigos foi direcionada aos temas referentes a alvos de intervenção que pudessem impactar na saúde presente e futura da criança. Resultados: Foram estudados aspectos biológicos, sociais e psicológicos em cinco fases: préconcepcional, gestacional, primeiro ano, segundo ano e terceiro ao quinto ano de vida. Os dados obtidos mostram a importância de ampliação do período de maior atenção profissional no começo da vida. Conclusão: A Associação Brasileira de Nutrologia recomenda a janela de 2.200 dias (100 dias na pré-concepção + 270 dias de gestação + 1.830 dias do primeiro ao quinto ano de vida) como período ideal de atuação profissional com vistas à garantia de saúde presente e futura das crianças.

Objective: Brazilian national data show a significant deficiency in pediatric vitamin E consumption, but there are very few studies evaluating laboratory-proven nutritional deficiency. The present study aimed to settle the prevalence of vitamin E deficiency (VED) and factors associated among school-aged children attended at a primary health unit in Ribeirão Preto (SP). Methods: A cross-sectional study that included 94 children between 6 and 11 years old. All subjects were submitted to vitamin E status analysis. To investigate the presence of factors associated with VED, socioeconomic and anthropometric evaluation, determination of serum hemoglobin and zinc levels, and parasitological stool exam were performed. The associations were performed using Fisher's exact test. Results: VED (α-tocopherol concentrations

Objective: to present characteristics related to feeding difficulties (FD) in Brazilian children. Methodology: cross-sectional, observational, descriptive study with a quantitative approach that used a structured electronic questionnaire on FD, management and reaction of caregivers to these difficulties, family repercussions, source of knowledge on the subject and professional approach. Results: one thousand caregivers of children aged between 6 months and 10 years answered the questionnaire in full. FD initially manifested between 1 and 4 years of age in 62% of children. Rejection of trying new foods was the main FD (61%); 65% of the children consumed five or less types of food/day, with cooked foods being preferred by 79%; 33% of caregivers attributed the cause of FD to inadequate examples of family feeding and 32% admitted difficulties in keeping the child focused during feeding. Most caregivers reported that FD don’t affect or have little effect on the family dynamics or child’s school life. Caregivers reported offering another food to replace the refused one (42%), insisting on offering a new food (30%) and seeking guidance from a pediatrician (50%) or nutritionist (28%), who advise repeatedly offering new foods in different forms/preparations (41%); 70% of caregivers maintain appointment with the same pediatrician after diagnosis of FD. As a result of FD, 86% of caregivers fear that their children will develop “low immunity” and become sick. Conclusions: FD in the first years of life is prevalent in Brazil, causing concerns for caregivers of these children. Objetivo: presentar características relacionadas con las dificultades alimentarias (DA) en niños brasileños. Metodología: estudio transversal, observacional, descriptivo con enfoque cuantitativo que utilizó un cuestionario electrónico estructurado sobre DA, manejo y reacción de los cuidadores ante estas dificultades, repercusiones familiares, fuente de conocimiento sobre el tema y enfoque profesional. Resultados: mil cuidadores de niños de entre 6 meses y 10 años respondieron el cuestionario en su totalidad. La DA se manifestó inicialmente entre 1 y 4 años en el 62% de los niños. El rechazo a probar nuevos alimentos fue la principal DA (61%); El 65% de los niños consumió cinco o menos tipos de alimentos / día, siendo los alimentos cocinados preferidos por el 79%; El 33% de los cuidadores atribuyó la causa de la DA a ejemplos inadecuados de alimentación familiar y el 32% admitió dificultades para mantener al niño enfocado durante la alimentación. La mayoría de los cuidadores informaron que la DA no afecta o tiene poco efecto en la dinámica familiar o la vida escolar del niño. Los cuidadores informaron que ofrecieron otro alimento para reemplazar el rechazado (42%), insistieron en ofrecer un nuevo alimento (30%) y buscaron orientación de un pediatra (50%) o nutricionista (28%), quienes aconsejan ofrecer repetidamente nuevos alimentos en diferentes formas / preparaciones (41%); el 70% de los cuidadores mantienen una cita con el mismo pediatra después del diagnóstico de DA. Como resultado de la DA, el 86% de los cuidadores temen que sus hijos desarrollen "baja inmunidad" y se enfermen. Objetivo: apresentar características relacionadas às dificuldades alimentares (DF) em crianças brasileiras. Metodologia: estudo transversal, observacional, descritivo com abordagem quantitativa que utilizou questionário eletrônico estruturado sobre DF, gestão e reação dos cuidadores a essas dificuldades, repercussões familiares, fonte de conhecimento sobre o assunto e abordagem profissional. Resultados: 1.000 cuidadores de crianças entre 6 meses e 10 anos responderam integralmente ao questionário. A FD inicialmente se manifestou entre 1 e 4 anos de idade em 62% das crianças. A rejeição da experimentação de novos alimentos foi a principal FD (61%); 65% das crianças consumiam cinco ou menos tipos de alimentos/dia, sendo os alimentos cozidos preferidos por 79%; 33% dos cuidadores atribuíram a causa da FD a exemplos inadequados de alimentação familiar e 32% admitiram dificuldades em manter a criança focada durante a alimentação. A maioria dos cuidadores relatou que a FD não afeta ou tem pouco efeito na dinâmica familiar ou na vida escolar da criança. Os cuidadores relataram oferecer outro alimento para substituir o recusado (42%), insistindo em oferecer um novo alimento (30%) e buscando orientação de um pediatra (50%) ou nutricionista (28%), que aconselham repetidamente oferecer novos alimentos de diferentes formas/preparações (41%); 70% dos cuidadores mantêm consulta com o mesmo pediatra após o diagnóstico de DF. Como resultado da FD, 86% dos cuidadores temem que seus filhos desenvolvam "baixa imunidade" e adoeçam. Conclusões: A DF nos primeiros anos de vida é predominante no Brasil, causando preocupações para os cuidadores dessas crianças.

Fatty acids play a significant role in maintaining cellular and DNA protection and we previously found an inverse relationship between blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and DNA damage. The aim of this study was to explore differences in proteomic profiles, for 117 pro-inflammatory proteins, in two previously defined groups of individuals with different DNA damage and EPA and DHA levels. Healthy children and adolescents (n = 140) aged 9 to 13 years old in an urban area of Brazil were divided by k-means cluster test into two clusters of DNA damage (tail intensity) using the comet assay (cluster 1 = 5.9% ± 1.2 and cluster 2 = 13.8% ± 3.1) in our previous study. The cluster with higher DNA damage and lower levels of DHA (6.2 ± 1.6 mg/dL, 5.4 ± 1.3 mg/dL, p = 0.003) and EPA (0.6 ± 0.2 mg/dL, 0.5 ± 0.1 mg/dL, p &lt, 0.001) presented increased expression of the proteins CDK8–CCNC, PIK3CA–PIK3R1, KYNU, and PRKCB, which are involved in pro-inflammatory pathways. Our findings support the hypothesis that low levels of n-3 long-chain PUFA may have a less protective role against DNA damage through expression of pro-inflammatory proteins, such as CDK8–CCNC, PIK3CA–PIK3R1, KYNU, and PRKCB.

Objective To determine the prevalence of vitamin A deficiency (VAD) and serum concentrations of retinol, correlating them with IGF-1 concentrations in preschoolers with DS. Methods Cross-sectional study was conducted on 47 children with DS aged 24 to 72 months, in Ribeirao Preto, Brazil. VAD was determined by the relative dose-response (RDR) test. Retinol serum concentration ≤ 0.70 µmol/L and IGF-1 serum concentration below the 3rd percentile for sex and age were considered to represent deficiency. C-reactive protein (CRP) was determined at the beginning of the study. Weight, height, and information about fever and/or diarrhea were obtained at the beginning of the study. Results VAD prevalence was 25.5% (12/47), and 74.5% (35/47) of the children had deficient retinol before the intervention. CRP was not associated with VAD. Mean IGF-1 were 103.5 ng/mL (SD = 913) for the group with VAD and 116.3 ng/mL (SD = 54.9) for the group with no VAD (p-value = 0.85); 8.5% (4/47) of the children showed deficient IGF-1, but without VAD. No association was observed between VAD and IGF-1 deficiency. A moderate positive correlation was observed between pre-intervention retinol and IGF-1 (ρ = 0.37; p-value = 0.01). Conclusion a high prevalence of VAD and deficient retinol was observed and there was a positive correlation between serum retinol and IGF-1.

Background Systemic lupus erythematosus (SLE) is an independent risk factor for cardiovascular events. The present study determined the prevalence of subclinical atherosclerosis in childhood-onset SLE using the carotid intima-media thickness (CIMT) measurement and investigated associations between traditional and nontraditional risk factors for atherosclerosis, such as medications, SLE Disease Activity Index - SLEDAI-2 K and SLICC-ACR damage index and CIMT. Methods Cross-sectional prospective study between 2017 and 2018. CIMT was assessed by ultrasonography. Data were collected by chart review, nutritional evaluation and laboratory tests and analyzed by Fisher, Wilcoxon-Mann-Whitney tests, multiple linear and log binomial regression. Results Twenty-eight patients (mean age 13.9 years, SD 3) were enrolled. The prevalence of subclinical atherosclerosis was 32% (95% CI 14.8, 49.4). The mean CIMT was 0.43 ± 0.035 mm. The most common traditional risk factors observed were dyslipidemia (82.1%), uncontrolled hypertension (14.2%), obesity (14.3%), and poor diet (78.6%). Uncontrolled hypertension (p = 0.04), proteinuria (p = 0.02), estimated glomerular filtration rate 2 (p = 0.02) and SLEDAI-2 K > 5 (P = 0.04) were associated with subclinical atherosclerosis. SLEDAI-2 K > 5 maintained association with CIMT after adjusting for control variables. Conclusion Subclinical atherosclerosis is frequently observed in cSLE, mainly in patients with moderate to severe disease activity.

Certain B-vitamins and vitamin A may be involved in inflammatory pathways associated with homocysteine and omega-3 fatty acids. The aims of this study were (i) to determine whether different metabolic profiles of B-vitamins and vitamin A in Brazilian children and adolescents were positively or negatively related to homocysteine and omega-3 fatty acids using k-means clustering analysis, (ii) compare nutrient intakes and metabolites between the different metabolic profiles, (iii) evaluate if the statistically significant metabolites found between the metabolic groups, can predict the variation of leukotriene A4 hydrolase (LTA4H) levels, a biomarker of low-grade inflammation, in the total studied population. This cross-sectional study included 124 children and adolescents, aged 9-13 y old. Dietary intake was assessed by the food frequency questionnaire and 24-hour recall. Biomarkers for vitamins B2, B6, B12, folate and vitamin A were measured in plasma. Omega-3 fatty acids and homocysteine were measured in red blood cells (RBC). Two different metabolic profiles were found. Thirty of these individuals had overall average higher riboflavin, pyridoxal, and vitamin B12 plasma levels (metabolic group 1) compared to 94 individuals (group 2). Group 2 had lower dietary intake of vitamin B2, vitamin A, and vitamin B12 and higher RBC levels of homocysteine. EPA and DHA erythrocyte levels were not different between metabolic groups. Multiple linear regression analyses showed that blood cobalamin, riboflavin, pyridoxal and homocysteine combined, explained 9.0% of LTA4H levels variation in the total studied population. The metabolic group that had low plasma levels of riboflavin, pyridoxal, and cobalamin also had a lower dietary intake of B-vitamin and higher RBC homocysteine. The combined levels of the riboflavin, pyridoxal, cobalamin and homocysteine biomarkers can predict the variation of LTA4H in the total population studied, but it is not clear how this regulation occurs.

SUMMARY OBJECTIVE: To identify epidemiological and clinical characteristics of multisystemic inflammatory syndrome associated with coronavirus infection as one of the severe forms of COVID-19 involvement in children and adolescents. METHODS: review was based on articles published in 2020 in the PubMed, Medline, Scopus, SciELO and Cochrane databases. SUMMARY: Multisystemic inflammatory syndrome is a serious clinical disorder that affects children and adolescents and is associated with the detection of previous exposure to SARS-CoV-2. It is characterized by the installation of a shock picture, with a significant increase in inflammatory markers such as presentations of Kawasaki Disease or shock syndrome related to Kawasaki Disease, or even toxic shock syndrome, with the clinical picture being characterized by fever of difficult control, rash, conjunctivitis, peripheral edema, generalized pain in the extremities and gastrointestinal symptoms. CONCLUSIONS: Although the vast majority of children with COVID-19 have mild symptoms, it is necessary to consider that some have a hyperinflammatory response. It is essential that health professionals receive information that can assist in the recognition of this clinical condition, differentiating it from other diagnoses, so that early and appropriate treatment is instituted.

This study evaluated the validity of nutrient and food group intakes estimated by an FFQ against biomarkers. A 71-item semiquantitative FFQ was administered to 210 Brazilian children and adolescents aged 9–13 years. Intakes were correlated with biomarkers in plasma and red blood cells. Correlations between nutrients and their biomarkers were presented for animal protein, myristic acid (C14:0), EPA, DHA, β-carotene, folate, and vitamins B3, B5 and B6. Food groups and biomarkers were correlated as follows: fish products with EPA and DHA; milk and dairy with C14:0, pyridoxal 5'-phosphate and vitamin B12; total vegetables and dark green and orange vegetables with β-carotene; 5-methyltetrahydrofolate with green vegetables; and flour products with para-aminobenzoylglutamic acid. This FFQ is a valid tool for ranking Brazilian children and adolescents according to their intake of several nutrients and food groups.

Soy consumption is a millenary habit of populations of the eastern world and has recently increased in the western world. The risks and benefits of this practice have been extensively studied, with a current fundamental need of integration of available information. The aim of this study was to carry out an integrative review on this topic, in order to consolidate the available information. Based on the main question: “What is the impact of soy consumption on human health?”, were reviewed publications classified as original articles and reviews published from 1998 to 2020 in the databases Scopus, PubMed, SciELO, Web of Science, and Cochrane Library. A total of 97 studies were selected. In the present review were described the general impact of soy on human health and its protein quality, the effects of early exposure using soy formulas, and the effects of soy consumption on breast cancer, endometrial and ovarian cancer, prostate cancer, gastrointestinal cancer, cardiovascular disease, glucose metabolism and type 2 diabetes, obesity, reproductive health, menopause, female and male osteoporosis, microbiota, immunity and immunomodulation, thyroid function, attention-deficit hyperactivity disorder, and renal function. Resumo O consumo de soja é um hábito milenar de populações do mundo oriental e aumentou recentemente no mundo ocidental. Os riscos e benefícios dessa prática têm sido extensivamente estudados, com uma necessidade fundamental atual de integração das informações disponíveis. O objetivo deste estudo foi realizar uma revisão integrativa sobre este tema, a fim de consolidar as informações disponíveis. Com base na principal questão: “Qual o impacto do consumo de soja na saúde humana?”, foram revistas publicações classificadas como artigos originais e revisões publicadas de 1998 a 2020 nas bases de dados Scopus, PubMed, SciELO, Web of Science e Cochrane Library. Foram selecionados 97 estudos. Na presente revisão, foram descritos o impacto geral da soja sobre a saúde humana e sua qualidade proteica, os efeitos da exposição precoce com fórmulas de soja e os efeitos do consumo de soja no câncer de mama, endometrial e ovariano, câncer de próstata, câncer gastrointestinal, doença cardiovascular, doenças do metabolismo da glicose e diabetes do tipo 2, obesidade, saúde reprodutiva, menopausa, osteoporose feminina e masculina, microbiota, imunidade e imunomodulação, função da tireoide, distúrbio de déficit de atenção e hiperatividade, e função renal.

Introdução: Fatores de risco para doenças cardiovasculares (DCV) tornaram-se prevalentes em crianças e adolescentes. Ácidos graxos (AGs) ?3 auxiliam na prevenção de DCV, porém seu consumo alimentar na infância é reduzido. Há a hipótese de que as vitaminas B2, B6, B12 e folato possam contribuir para o aumento da concentração de ácidos graxos poli-insaturados (PUFAs) no plasma e nos eritrócitos, além de reduzir os níveis de homocisteína total (tHcy), e auxiliar na prevenção de DCV. Por essa razão, o presente estudo teve como objetivo verificar a associação entre perfil lipídico, perfil de ácidos graxos, homocisteína e biomarcadores para vitaminas do complexo B em crianças e adolescentes. Métodos: Este estudo transversal incluiu 249 crianças e adolescentes entre 9 e 13 anos de idade. O consumo alimentar foi avaliado por meio do questionário de frequência alimentar, recordatório de 24 horas e índice de qualidade da dieta (IQD). O perfil lipídico e os biomarcadores para vitaminas B2, B6, B12 e ácido fólico foram dosados no plasma. O perfil de AGs e os metabólitos do ciclo da homocisteína (metionina, SAM, SAH, tHcy, cistationina e cisteína) foram dosados nas células vermelhas do sangue. As associações foram testadas com modelos de regressão linear múltiplos, ajustados para sexo, estadiamento puberal, índice de massa corporal e IQD. Resultados: Não houve associação entre as vitaminas do complexo B e baixos níveis de colesterol total, triglicérides e LDL-c. Porém, houve associação positiva entre os níveis séricos de vitamina B2 e folato plasmático com PUFAs ?3 e ?6. O aumento de 1 nmol/L de vitamina B2 esteve associado ao aumento de 0,19 mg/dL de EPA e 0,21 mg/dL de ARA e DHA (p0,05). As vitaminas B6 e B12 estiveram associadas à redução dos níveis de tHcy (p0,05). Houve associação negativa entre os níveis séricos de vitamina B6 com PUFAs ?3 e ?6. O aumento de 1 nmol/L de vitamina B6 esteve associado à redução de 0,15 mg/dL de ARA e 0,14 mg/dL de DHA (p0.05). Vitamins B6 and B12 were associated with reduced tHcy levels (p 0.05). There was a negative association between serum levels of vitamin B6 with PUFAs ?3 and ?6. The increase of 1 nmol/L in vitamin B6 was associated with a reduction of 0.15 mg/dL of ARA and 0.14 mg/dL of DHA (p

Vitamins B2, B6, B12, and folate are essential for methylation reactions and possibly influence the transport of polyunsaturated fatty acids in plasma and red blood cells (RBC). Associations between B-vitamin biomarkers and fatty acid (FA) profile were analyzed in Brazilian children and adolescents. This cross-sectional study included 249 children and adolescents, aged 9&ndash, 13 years old. Dietary intake was assessed by the food frequency questionnaire and the healthy eating index (HEI). Biomarkers for vitamins B2, B6, B12, and folate were measured in plasma. The FA profile and the metabolites of one-carbon metabolism were measured in RBC. Associations were tested with multiple linear regression models. An increase of 1 nmol/L in vitamin B2 was associated with an increase of 0.19 mg/dL of EPA, 0.20 mg/dL of ARA, and 0.25 mg/dL of DHA in RBC. An increase of 1 ng/mL in plasma folate was associated with an increase of 0.14 mg/dL of EPA, 0.22 mg/dL of ARA, and 0.21 mg/dL of DHA in RBC. These findings highlight the importance of an adequate intake of vitamin B2 and folate in childhood, since they may improve the FA profile in RBCs and may help prevent cardiovascular disease.

Introdução: A impossibilidade da prática do aleitamento materno por mães HIV positivas contribui para alterações no padrão alimentar de seus filhos nos primeiros meses de vida. Objetivo: Analisar as práticas alimentares de lactentes expostos ao HIV, verificando-se o tipo de aleitamento praticado pelas mães, a diluição e o preparo do leite oferecido, o período e a forma de introdução da alimentação complementar, bem como os grupos alimentares oferecidos aos lactentes. Materiais e métodos: Estudo transversal, descritivo, realizado com crianças de 6 a 24 meses de idade. Os dados foram obtidos através de entrevista semiestruturada e consulta ao prontuário. Resultados: Todos os lactentes (n=32) iniciaram o uso da fórmula infantil após o nascimento, entretanto, 18,8% das mães diluíam a fórmula incorretamente. Não houve relato de aleitamento materno, porém 59,4% das crianças receberam leite de vaca antes dos doze meses. Em 31,2% dos casos a alimentação complementar foi introduzida antes do sexto mês, e alimentos como ovos, peixes, legumes e verduras ainda não foram oferecidos a todas as crianças. Além disso, alimentos industrializados fontes de carboidratos simples, sódio e gordura foram introduzidos a partir do quinto mês. Conclusões: A substituição do leite materno por fórmulas infantis foi adequada. Contudo, evidenciou-se inadequação na diluição das fórmulas, introdução inoportuna do leite de vaca e da alimentação complementar, oferta reduzida de leguminosas, carnes, ovos, legumes e verduras, e consumo inapropriado de alimentos industrializados e/ou ultraprocessados nos primeiros meses de vida. Tais práticas contribuem para alterações do estado nutricional e desenvolvimento de doenças crônicas não transmissíveis. Introduction: The impossibility of breastfeeding by HIV positive mothers contributes to changes in the dietary pattern of their children in the first months of life. Objective: To analyze the feeding practices of infants exposed to HIV, checking the type of feeding practiced by the mothers, the dilution and preparation of the milk offered, the period and the way of introduction of complementary feeding, as well as the food groups offered to infants. Materials and methods: A cross-sectional, descriptive study performed with children aged 6 to 24 months. The data were obtained through semi-structured interview and medical records. Results: All infants (n=32) started infant formula after birth, however, 18.8% of mothers diluted the formula incorrectly. There was no report of breastfeeding, but 59.4% of the children received cow milk before 12 months of life. In 31.2% of cases complementary feeding was introduced before the sixth month, and foods such as eggs, fish, and vegetables were not offered to all children. In addition, industrialized foods sources of simple carbohydrates, sodium, and fat were introduced since the fifth month. Conclusions: The replacement of breast milk for infant formulas was adequate. However, there was inadequacy in the dilution of the formulas, inopportune introduction of cow milk and complementary food, reduced supply of legumes, meat, eggs, vegetables, and inappropriate consumption of processed and/or ultraprocessed foods in the first months of life. Such practices contribute to changes in nutritional status and the development of noncommunicable chronic diseases.

Introduction: the non-alcoholic fatty liver disease (DHGNA) is a comorbidity associated with common obesity in the pediatric age group, whose impact on the nutritional status has been investigated. Objective: to verify that obese children and adolescents with DHGNA have more anthropometric, biochemical, and related to tests alterations that determine the diagnosis of metabolic syndrome (SM) compared to those obese without DHGNA. Methods: this was a cross-sectional study conducted in the pediatric outpatient service. The groups with and without DHGNA were compared regarding anthropometric, biochemical, and metabolic syndrome components of SM. SM or test alterations that are diagnostic criteria for SM were evaluated for association with DHGNA. Results: 59 obese subjects were evaluated; 25.4% presented DHGNA. The groups presented significant differences in alterations in weight, BMI, total cholesterol, vitamin D, folic acid, uric acid, C-reactive protein, GGT, total bilirubin, and alkaline phosphatase (p

O estudo de padrões alimentares oferece uma perspectiva diferente da tradicional análise com foco em nutrientes ou alimentos isolados, favorecendo a compreensão dos processos de prevenção e tratamento de doenças e se constitui numa ferramenta fundamental para os programas de intervenção nutricional. A avaliação do consumo alimentar é uma etapa fundamental na compreensão do desenvolvimento do acúmulo de gordura corporal. Objetivo: Investigar a associação dos padrões alimentares com obesidade e gordura corporal excessiva em adultos jovens. Método: Estudo transversal pertencente ao terceiro estágio de acompanhamento de uma coorte de nascidos vivos no ano de 1994 em Ribeirão Preto, SP. Foram avaliados 1041 adultos jovens, com idade entre 22 e 23 anos. Os participantes responderam a diversos questionários, entre esses um questionário geral abordando dados socioeconômicos, demográficos e de estilo de vida e um questionário de frequência alimentar (QFA). Os participantes realizaram exames clínicos, entre eles exames da composição corporal. Os padrões alimentares foram identificados usando análise fatorial por componentes principais (ACP). O índice de massa corporal (IMC) foi calculado dividindo-se o peso (kg) pela altura (m) ao quadrado (kg/m2), sendo considerados obesos aqueles indivíduos com IMC≥30,0 kg/m². A porcentagem de gordura corporal (%GC) foi obtida através da pletismografia por deslocamento de ar usando o equipamento denominado BodPod®, sendo que indivíduos com \"excesso de gordura\" e \"gordura elevada\" foram considerados com GC excessiva. Foi construído um gráfico acíclico direcionado (DAG) para realização do ajuste das análises de associação pelas variáveis confundidoras. Para avaliar a associação entre a adesão aos padrões alimentares e obesidade e GC excessiva foi utilizada regressão de Poisson com estimativa robusta da variância, ajustada para variáveis socioeconômicas e de estilo de vida. Resultados: Obesidade esteve presente em 1/5 dos adultos jovens (20,3%), sem diferença entre os sexos, e mais da metade (54,9%) tinha gordura corporal excessiva, com predomínio entre as mulheres. Foram identificados quatro principais padrões alimentares denominados Prudente, Denso em energia, Bar e Tradicional. Alta adesão aos padrões Prudente e Denso em energia foi associada com maior prevalência de obesidade (RP 1,71; IC95% 1,29-2,27 e RP 1,60; IC95% 1,16-2,20, respectivamente). Já em relação à GC excessiva, somente a alta adesão ao padrão alimentar Tradicional entre os homens foi associada com menor prevalência de GC excessiva (RP: 0,68; IC 95%: 0,48 - 0,97). Ter companheiro e sub-relatar a ingestão energética mostraram-se como risco para obesidade e GC excessiva. Conclusão: Nesta amostra, a prevalência de obesidade não diferiu entre os sexos, enquanto a GC excessiva foi maior entre as mulheres. O padrão alimentar Prudente foi associado com obesidade, sendo também o padrão Denso em energia associado com maior prevalência de obesidade. Alta adesão ao padrão alimentar Tradicional foi associada com menor prevalência de GC excessiva entre os homens. O reconhecimento dos padrões alimentares pode representar um ponto de partida para o desenvolvimento de estratégias de saúde pública direcionadas a grupos específicos com o objetivo de melhorar o estado nutricional e prevenir o desenvolvimento futuro da obesidade e suas complicações. The study of dietary patterns offers a different perspective from the traditional analysis focused on nutrients or isolated foods, favoring the understanding of disease prevention and treatment processes and constituting a fundamental tool for nutritional intervention programs. The assessment of food consumption is a fundamental step in understanding the development of body fat accumulation. Objective: To investigate the association of dietary patterns with obesity and excessive body fat in young adults. Method: Cross-sectional study belonging to the third stage of the follow-up of a cohort of live births in 1994 in Ribeirão Preto, SP. The sample consisted of 1,041 young adults aged between 22 and 23 years old. Participants completed several questionnaires, including a general questionnaire covering socioeconomic, demographic and lifestyle data and a food frequency questionnaire (FFQ). Participants underwent clinical examinations, including body composition examinations. Dietary patterns were identified using principal component factor analysis (PCA). The body mass index (BMI) was calculated by dividing weight (kg) by height (m) squared (kg/m2), with those individuals with BMI≥30.0 kg/m² being considered obese. The %BF was obtained through air displacement plethysmography using the equipment called BodPod®, and individuals with \"excess fat\" and \"high fat\" were considered to have excessive BF. A directed acyclic graph (DAG) was constructed to adjust the association analyzes for confounding variables. To assess the association between adherence to dietary patterns and obesity and excessive BF, Poisson regression with robust variance estimate, adjusted for socioeconomic and lifestyle variables, was used. Results: Obesity was present in 1/5 of young adults (20.3%), with no difference between genders, and more than half (54.9%) had excessive body fat, with predominance among women. Four main dietary patterns were identified, called Prudent, Energy dense, Bar and Traditional. High adherence to Prudent and Energy dense patterns was associated with a higher prevalence of obesity (PR 1.71; 95%CI 1.29-2.27 and PR 1.60; 95%CI 1.16-2.20, respectively). Regarding the excessive body fat, only the high adherence to the Traditional dietary pattern among men was associated with a lower prevalence of excessive BF (PR: 0.68; 95% CI: 0.48 - 0.97). Having a partner and underreporting energy intake showed to be a risk for obesity and excessive BF. Conclusion: In this sample, the prevalence of obesity did not differ between genders, while the excessive BF was higher among women. The Prudent dietary pattern was associated with obesity, and the Energy dense pattern was also associated with a higher prevalence of obesity. High adherence to the Traditional dietary pattern was associated with a lower prevalence of excessive BF among men. The recognition of dietary patterns can represent a starting point for the development of public health strategies aimed at specific groups with the objective of improving nutritional status and preventing the future development of obesity and its complications.