Carolina Abreu de Carvalho
@portalpadrao.ufma.br
Adjunct Professor, Department of Public Health
UNIVERSIDADE FEDERAL DO MARANHAO
RESEARCH, TEACHING, or OTHER INTERESTS
Epidemiology, Nutrition and Dietetics
Scopus Publications
Scopus Publications
Aline Carare Candido, Francilene Maria Azevedo, Sarah Aparecida Vieira Ribeiro, Anderson Marliere Navarro, Mariana de Souza Macedo, Edimar Aparecida Filomeno Fontes, Sandra Patricia Crispim, Carolina Abreu de Carvalho, Nathalia Pizato, Danielle Góes da Silva,et al.
MDPI AG
Background/Objectives: Iodine is an important nutrient for the human body, used in the production of thyroid hormones. During pregnancy, a deficiency can cause miscarriage and hypothyroidism, while an excess can cause thyroid dysfunction. Therefore, the objective of this study was to evaluate the factors associated with the iodine nutritional status of pregnant Brazilian women. Methods: This was a cross-sectional, multicenter study conducted with pregnant women over 18 years of age, users of the Unified Health System (SUS). A semi-structured questionnaire was used to obtain sociodemographic information. Iodine status was assessed by urinary iodine concentration (UIC). The iodine content of salt and homemade and industrial seasonings was determined by the titrimetric method. Dietary intake was estimated through a 24-hour dietary recall. The chi-square test and hierarchical multinomial logistic regression were used for statistical analysis. The significance level was set at p ≤ 0.05. Results: Among Brazilian pregnant women, the median UIC was 186.7 µg/L (P25: 118.05 µg/L-P75: 280.93 µg/L). Regarding iodine nutritional status, the prevalence of deficiency was 36.7% (n = 694), above the requirement was 28.7% (n = 543), and excess iodine intake was 3.6% (n = 68). We observed that non-white pregnant women were more likely (OR = 1.83; 95% CI: 1.27–2.64) to have iodine deficiency, and those who did not work were less likely (OR = 0.71; 95% CI: 0.52–0.98). Pregnant women in the last trimester of pregnancy were less likely to have iodine intake above the requirements (OR = 0.52; 95% CI: 0.31–0.88). Conclusions: A substantial proportion of pregnant women had iodine deficiency or intake above the required level. Iodine deficiency is more chance among non-white pregnant women and less chance among those not employed during pregnancy. On the other hand, pregnant women who were in their third trimester of pregnancy were less likely to have iodine intake above the required level.
Gabriele B. Silva, Débora L. F. Silva, Sylvia C. C. Franceschini, Mariana S. Macedo, Claudia C. B. Almeida, Carolina A. Carvalho, Renata J. Pereira, Danielle G. da Silva, Nathalia Pizato, Franciane R. Faria,et al.
Wiley
The objective of the study was to describe the dietary intake of Brazilian pregnant women assisted by primary healthcare, focusing on the degree of food processing. Data from the cross‐sectional multicenter study of iodine deficiency were analyzed. Participants were selected from basic health units in 11 research centers and completed questionnaires regarding socioeconomic status, demographics, and health. Dietary intake information was collected through 24 h recall and analyzed using GloboDiet software. Descriptive analyses estimated the average energy contribution and confidence interval (%) of NOVA food groups in total energy intake, considering the research center, sociodemographic factors, health status, and pregnancy characteristics. The analysis included 2247 pregnant women without history of thyroid disease or surgery, hypothyroidism, or hypertension. Unprocessed or minimally processed foods accounted for 62.1% of total energy intake, while ultraprocessed foods accounted for 23.8%. Food consumption predominantly occurred at home across all NOVA food groups. Ultraprocessed food consumption was lower during lunch and dinner but higher after dinner and when consumed outside the home, particularly in street settings, markets, parks, and/or beaches, compared with other food groups. This pattern was more prevalent among younger pregnant women (p < 0.001), those of white or yellow race (p = 0.007), residing in urban areas (p = 0.03), and with higher monthly household income (p = 0.001). These findings indicate a significant impact on the overall nutritional quality of the diet among pregnant women, with variations based on factors such as age, place of residence, race, income, place of consumption, and occasion of consumption.
Roberta Rejane Santos de Carvalho, Poliana Cristina de Almeida Fonseca Viola, Sandra Patrícia Crispim, Ana Karina Teixeira da Cunha França, Anderson Marliere Navarro, Bruno Feres de Souza, Franciane Rocha de Faria, Naiara Sperandio, Nathalia Pizato, Mariana de Souza Macedo,et al.
FapUNIFESP (SciELO)
ABSTRACT Objective: To investigate the sociodemographic, maternal, and gestational factors associated with the dietary total antioxidant capacity in pregnant Brazilian women. Methods: A cross-sectional study with 2,232 pregnant women aged 18 years old or older, in the first, second, and third trimesters of pregnancy, from eleven cities in the five Brazilian regions. A semi-structured questionnaire was applied to assess socioeconomic, demographic, and health data, and a 24-hour dietary recall (R24h) was used to assess food consumption and analyze the dietary total antioxidant capacity (DTAC), estimated using the ferric reducing antioxidant power (FRAP) method. Results: The median of DTAC was 5.32 mmol/day. Aracaju, Sergipe (SE) had the highest median of DTAC (6.44 mmol/day) and Palmas, Tocantins (TO) had the lowest (4.71 mmol/day). Pregnant women aged 20 to 34 years (OR 1.86; 95%CI 1.26-2.76), 35 years old or older (OR 3.68; 95%CI 2.21-6.14) and who were in the second trimester of pregnancy (OR 1.50; 95%CI 1.11-2.01) were more likely to be above the median DTAC. While pregnant women with higher education had a 67% lower chance of being above the median DTAC (OR 0.67; 95%CI 0.48-0.92). Conclusion: The study demonstrated that there are differences in antioxidant consumption in different cities in Brazil and that associated factors such as age, education, and gestational trimester can impact the intake of foods rich in antioxidants. The profile found draws attention to the importance of an adequate diet rich in antioxidants during prenatal care.
Thais Rangel Bousquet Carrilho, Michael E. Reichenheim, José Guilherme Cecatti, Renato T. Souza, Marco F. Mastroeni, Silmara S. B. S. Mastroeni, Gilberto Kac, and
Wiley
AbstractObjectivesTo construct prescriptive symphysis fundal height (SFH) curves based on data from the Brazilian Maternal and Child Nutrition Consortium (BMCNC).MethodsIndividual patient data from seven cohorts from the BMCNC were used. Adult women with singleton pregnancies, free of infectious and chronic diseases, gestational diabetes, and hypertensive disorders, who did not smoke or consume alcohol during pregnancy and delivered a live birth at term, adequate for gestational age, and with birth weight between 2500 and 4000 g were selected. SFH was obtained from medical records. The data were harmonized and cleaned and then split into training (n = 3969 individuals; 21 760 SFH measurements) and validation (n = 1700 individuals; 9284 SFH measurements). Fractional polynomial models were used to construct SFH curves between 14 and 40 gestational weeks.ResultsThe predicted median for SFH at 40 weeks was 36.1 cm (interquartile range, 34.5–37.7 cm). The internal and cross‐validation results showed that the percentages of SFH measurements below the selected percentiles were close to those expected.ConclusionThe new SFH charts will allow healthcare professionals to monitor SFH and identify individuals at risk for delivering neonates with adverse outcomes, improving the prenatal care routine in Brazil.
Débora Letícia Frizzi Silva, Sandra Patricia Crispim, Gabriele Beraldi Silva, Francilene Maria Azevedo, Juliana Farias de Novaes, Carolina Abreu de Carvalho, Danielle Góes da Silva, Edimar Aparecida Filomeno Fontes, Mariana de Souza Macedo, and Sylvia do Carmo Castro Franceschini
Springer Science and Business Media LLC
Carolina Abreu de Carvalho, Poliana Cristina de Almeida Fonseca Viola, Elma Izze da Silva Magalhães, Soraia Pinheiro Machado, Alicia Matijasevich, Ana Maria Baptista Menezes, Luciana Tovo-Rodrigues, Ina S Santos, Helen Goncalves, Fernando C Wehrmeister,et al.
BMJ
BackgroundThe benefits of breast feeding may be associated with better formation of eating habits beyond childhood. This study was designed to verify the association between breast feeding and food consumption according to the degree of processing in four Brazilian birth cohorts.MethodsThe duration of exclusive, predominant and total breast feeding was evaluated. The analysis of the energy contribution of fresh or minimally processed foods (FMPF) and ultra-processed foods (UPF) in the diet was evaluated during childhood (13–36 months), adolescence (11–18 years) and adulthood (22, 23 and 30 years).ResultsThose who were predominantly breastfed for less than 4 months had a higher UPF consumption (β 3.14, 95% CI 0.82 to 5.47) and a lower FMPF consumption (β −3.47, 95% CI −5.91 to −1.02) at age 22 years in the 1993 cohort. Exclusive breast feeding (EBF) for less than 6 months was associated with increased UPF consumption (β 1.75, 95% CI 0.25 to 3.24) and reduced FMPF consumption (β −1.49, 95% CI −2.93 to −0.04) at age 11 years in the 2004 cohort. In this same cohort, total breast feeding for less than 12 months was associated with increased UPF consumption (β 1.12, 95% CI 0.24 to 2.19) and decreased FMPF consumption (β −1.13, 95% CI −2 .07 to −0.19). Children who did not receive EBF for 6 months showed an increase in the energy contribution of UPF (β 2.36, 95% CI 0.53 to 4.18) and a decrease in FMPF (β −2.33, 95% CI −4 .19 to −0.48) in the diet at 13–36 months in the 2010 cohort. In this cohort, children who were breastfed for less than 12 months in total had higher UPF consumption (β 2.16, 95% CI 0.81 to 3.51) and lower FMPF consumption (β −1.79, 95% CI −3.09 to −0.48).ConclusionExposure to breast feeding is associated with lower UPF consumption and higher FMPF consumption in childhood, adolescence and adulthood.
Renata de Sousa Gomes, Poliana Cristina de Almeida Fonseca Viola, Roberta Rejane Santos de Carvalho, Nitin Shivappa, James R. Hebert, Ana Karina Teixeira da Cunha França, and Carolina Abreu de Carvalho
Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais
OBJECTIVE: To evaluate the association between t he inflammatory potential of the diet measured by the energy-adjusted diet inflammatory index (E-DII) and inflammatory markers in adolescents. METHODS: This cross-sectional study was conducted among 518 adolescents aged 18 and 19 years from São Luís, Maranhão, Brazil in 2016. A semiquantitative food frequency questionnaire (FFQ) was used to assess dietary intake from which E-DII scores were calculated to determine the inflammatory potential of the diet. The associations between E-DII and inflammatory markers (hs-CRP, IL-6, IL-4, TNF-α, and IFNγ) were analyzed using multivariable linear regression. The variables included in the adjusted model were identified using the directed acyclic graph. RESULTS: The diet of these adolescents was mostly pro-inflammatory; mean E-DII score was 1.71 and ranged from -2.44 to 5.58. Higher E-DII scores were positively associated with higher levels of IFNγ in the adjusted analysis (Adjusted Coef.: 1.19; 95%CI: 0.36–12.04). We observed no associations between E-DII and other inflammatory markers (hs-CRP, IL-6, IL-4, TNF-α). Study results indicate that E-DII is useful in evaluating the inflammatory potential of the diet of Brazilian adolescents. CONCLUSIONS: Cross-sectionally E-DII scores were positively associated with IFNγ concentrations. Future research should examine the association between changes in E-DII scores and levels of inflammatory markers longitudinally.
Ana Paula de Melo Simplício, Poliana Cristina de Almeida Fonseca Viola, Layanne Cristina de Carvalho Lavôr, Paulo Víctor de Lima Sousa, Carolina Abreu de Carvalho, Lays Arnaud Rosal Lopes Rodrigues, Larissa Carvalho Ribeiro de Sá Lustosa, Michelly da Silva Pinheiro, Jaine Magalhães Paz de Lima, Cyntia Regina Lucio de Sousa Ibiapina,et al.
Bentham Science Publishers Ltd.
Background:: Mental and behavioral disorders are influenced by biological, psychological and social factors, especially income, gender, age and family environment, indicating that physical health is directly associated with mental health. In this perspective, food consumption is highlighted as a risk factor for mental health, as healthy behaviors, along with a good quality diet, can reduce symptoms of anxiety and depression. Objective:: The objective of this a study is to investigate the association between CMD and dietary patterns, among other lifestyle and socioeconomic factors. Method:: Cross-sectional population-based and household study conducted with 1574 individuals aged over 20 years, of both sexes, residing in Teresina and Picos, Piaui, Brazil. Sociodemographic, lifestyle and food consumption data were collected. The instrument used to identify the presence of CMDs was the Self Reporting Questionnaire 20 (SRQ-20). Dietary patterns were obtained using the Principal Component Analysis method. Results:: Individuals of female sex, separated, with low education, smokers and lower level of physical activity had a higher prevalence of common mental disorders. As for the eating pattern, after adjustments, individuals who adhered to the unhealthy eating pattern had a 9% higher prevalence of CMD. Furthermore, adherence to the white meat standard represented 12% higher prevalence of CMD. Conclusion:: The results showed that, regardless of other socioeconomic and lifestyle factors, adherence to a more monotonous eating pattern in foods, characterized by the mainly consumption of animal protein and the lack consumption of foods like fruits and vegetables, as well as a less healthy one, characterized by the consumption of ultra-processed foods, increases the risk of developing CMD.
Carolina Abreu de Carvalho
Frontiers Media SA
Victor Nogueira da Cruz Silveira, Jéssica Bianca Machado do Nascimento, Nayra Anielly Cabral Cantanhede, Maria Tereza Borges Araújo Frota, Deysianne Costa das Chagas, Carolina Abreu de Carvalho, and Poliana Cristina de Almeida Fonseca Viola
FapUNIFESP (SciELO)
RESUMO Objetivo: Analisar a ocorrência de desigualdade racial e regional na tendência temporal das prevalências de déficit de estatura e excesso de peso de crianças brasileiras menores de cinco anos ao longo dos anos de 2008–2018. Métodos: Estudo ecológico de série temporal com dados do Sistema de Vigilância Alimentar e Nutricional das prevalências de déficit de estatura e excesso de peso em crianças menores de 5 anos de acordo com raça/cor, região e ano. Para avaliar diferenças entre prevalências medianas por ano dos desfechos, realizou-se teste de Kruskal-Wallis. Análises de regressão linear foram propostas para avaliar tendências das prevalências dos desfechos ao longo dos anos. Resultados: No Brasil, as crianças pretas apresentaram tendência de crescimento do excesso de peso (β=4,611; p=0,042). Entre as crianças pretas, houve aumento ao longo dos anos do déficit de estatura no Sudeste (β=3,960; p=0,014) e queda no Sul (β=-4,654; p=0,022). No Brasil e na maioria das regiões, a prevalência mediana do déficit de estatura foi maior nas crianças pretas do que nas brancas (12,86 vs. 11,54%, p<0,001). No Sudeste e Sul, as crianças pretas também apresentaram as maiores prevalências de excesso de peso (15,48 e 15,99%, respectivamente). Conclusão: Crianças de regiões menos desenvolvidas do Brasil e pretas apresentaram maior vulnerabilidade para dupla carga de má nutrição.
Allanne Pereira Araújo, Janaina Maiana Abreu Barbosa, Carolina Abreu de Carvalho, Poliana Cristina de Almeida Fonseca Viola, Cecilia Claudia Costa Ribeiro, Rosangela Fernandes Lucena Batista, and Vanda Maria Ferreira Simões
Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais
OBJETIVO: Analisar a associação entre o peso ao nascer e a densidade mineral óssea (DMO) na adolescência. MÉTODOS: Estudo de coorte de nascimentos em São Luís, Maranhão, utilizando dados de dois momentos: ao nascimento e aos 18–19 anos. A exposição foi o peso ao nascer em gramas, analisado de forma contínua. O desfecho foi a DMO, utilizando o índice Z-escore (corpo inteiro) medido pela densitometria por dupla emissão de raios X (DEXA). Foi construído modelo teórico em gráficos acíclicos direcionados para identificar o conjunto mínimo de variáveis de ajuste – renda familiar, a mãe saber ler e escrever à época do nascimento, realização de pré-natal, tabagismo durante a gestação e paridade – para avaliar a associação entre o peso ao nascer e a densidade mineral óssea na adolescência. Utilizou-se regressão linear múltipla no software Stata 14.0. O nível de significância adotado foi de 5%. RESULTADOS: Dos 2.112 adolescentes, 8,2% apresentaram baixo peso ao nascer e 2,8% apresentaram DMO considerada baixa para a idade. O Z-escore médio de corpo inteiro foi de 0,19 (± 1,00). O maior peso ao nascer foi associado de forma linear e direta aos valores de DMO na adolescência (Coef.: 0,10; IC95% 0,02–0,18), mesmo após ajuste para as variáveis renda familiar (Coef.: -0,33; IC95% 0,66–0,03) e a mãe saber ler e escrever (Coef.: 0,23; IC95% 0,03–0,43). CONCLUSÕES: Apesar de a associação ter sido atenuada após ajuste das variáveis, o peso ao nascer está associado de forma positiva e linear à DMO na adolescência.
Victor Nogueira da Cruz Silveira, Jéssica Bianca Machado do Nascimento, Nayra Anielly Cabral Cantanhede, Maria Tereza Borges Araújo Frota, Deysianne Costa das Chagas, Carolina Abreu de Carvalho, and Poliana Cristina de Almeida Fonseca Viola
FapUNIFESP (SciELO)
ABSTRACT Objective: To analyze the occurrence of racial and regional inequality in the temporal trend of the prevalence of stunting and overweight in Brazilian children under five years of age over the years 2008–2018. Methods: An ecological time-series study with data from the Food and Nutrition Surveillance System on the prevalence of stunting and overweight in children under five years old according to race/skin color, region, and year. To assess differences between median prevalence per year of outcomes, the Kruskal-Wallis test was performed. Linear regression analyses were proposed to assess trends in the prevalence of outcomes over the years. Results: In Brazil, black children tended to be overweight (β=4.611; p=0.042). Among black children, there was an increase over the years in stunting in the Southeast (β=3.960; p=0.014) and a decrease in the South (β=-4.654; p=0.022). In Brazil and in most regions, the median prevalence of stunting was higher in black children than in white ones (12.86 vs. 11.54%, p<0.001). In the Southeast and South, black children also had the highest prevalence of overweight (15.48 and 15.99%, respectively). Conclusion: Children from less developed regions of Brazil and of black skin color/race were more vulnerable to a double burden of malnutrition.
Poliana Cristina de Almeida Fonseca Viola, Sarah Aparecida Vieira Ribeiro, Roberta Rejane Santos de Carvalho, Cristiana Santos Andreoli, Juliana Farias de Novaes, Silvia Eloiza Priore, Carolina Abreu de Carvalho, and Sylvia do Carmo Castro Franceschini
FapUNIFESP (SciELO)
Abstract The present study aimed to evaluate the association of sociodemographic factors and lifestyle with the consumption of in natura or minimally processed (INMP) foods, ultra-processed foods (UPFs), and fruits and vegetables. This was a cross-sectional study conducted with 403 children, aged 4 to 7 years, from a retrospective cohort. Sociodemographic and lifestyle variables were investigated using a sociodemographic questionnaire. Food consumption was assessed by three food records. Bivariate and multivariate linear regression analyses were used to analyze associations. Children with lower income had a higher consumption of INMP foods and a lower consumption of UPFs. A shorter time spent at school was associated with a lower consumption of INMP foods and a higher consumption of UPFs. Children with more screen time and less educated parents consumed less fruits and vegetables. Unfavorable sociodemographic factors were associated with a better profile of food consumption according to the level of processing, except for fruits and vegetables. The longer time spent at school and a shorter screen time contributed to a healthier diet.
Ana Paula de Melo Simplício, Poliana Cristina de Almeida Fonseca Viola, Layanne Cristina de Carvalho-Lavôr, Carolina Abreu de Carvalho, Larissa Carvalho Ribeiro de Sá-Lustosa, Paulo Víctor de Lima-Sousa, Jany de Moura-Crisóstomo, Larisse Monteles-Nascimento, Lays Arnaud Rosal Lopes-Rodrigues, Amanda Ferreira Mesquita de-Oliveira,et al.
SciELO Agencia Nacional de Investigacion y Desarrollo (ANID)
Elma Izze da Silva Magalhães, Bianca Rodrigues de Oliveira, Lívia Carolina Sobrinho Rudakoff, Vitória Abreu de Carvalho, Poliana Cristina de Almeida Fonseca Viola, Soraia Pinheiro Machado Arruda, Carolina Abreu de Carvalho, Carla Cristine Nascimento da Silva Coelho, Maylla Luanna Barbosa Martins Bragança, Heloisa Bettiol,et al.
Nutrients MDPI AG
Longitudinal studies evaluating the relationship between UPF consumption and the incidence of Metabolic Syndrome (MetS) and its components are still scarce. This study aimed to evaluate the effect of UPF consumption on the incidence of MetS and its components in adults. A prospective study was conducted with 896 participants from the 1978/79 Ribeirão Preto cohort, São Paulo, Brazil. UPF consumption was evaluated in %kcal and %g at ages 23–25 years. Incidence of MetS and its components were estimated at ages 37–39 years, according to the Joint Interim Statement criteria. Poisson regression was used to assess associations, and interactions with sex were investigated. UPF consumption had no association with MetS (%kcal Adjusted PR: 1.00; 95% CI: 0.99–1.01; %g Adjusted PR: 1.00; 95% CI: 0.99–1.01). However, women with higher UPF consumption, in %kcal and %g, had a higher risk of abdominal obesity (%kcal: p = 0.030; %g: p = 0.003); and women with higher UPF consumption, in %g, had a higher risk of low HDL-cholesterol (p = 0.041). For the other components of MetS, no significant associations were observed in either sex. These findings suggest evidence of no association between UPF consumption and MetS; however, consumption of UPF was associated with increased WC and low HDL-c, but only in women.
Glauciane Márcia dos Santos Martins, Ana Karina Teixeira da Cunha França, Poliana Cristina de Almeida Fonseca Viola, Carolina Abreu de Carvalho, Karla Danielle Silva Marques, Alcione Miranda dos Santos, Mônica Araújo Batalha, Janete Daniel de Alencar Alves, and Cecilia Claudia Costa Ribeiro
Cambridge University Press (CUP)
AbstractObjective:To evaluate the association of the consumption of foods of the ultra-processed group (UPF) with inflammatory markers in the adolescent population in Northeastern Brazil.Design:A cross-sectional population-based study. Food consumption was evaluated using two 24-h dietary recalls using the NOVA classification for food processing levels. The following inflammatory markers were evaluated: adiponectin, IL-6, IL-8, C-reactive protein (CRP) and TNF-α. Multivariate linear regression was used to investigate the association between the percentage of UPF energy contribution and inflammatory markers.Setting:São Luís, Maranhão, Brazil.Participants:The sample consisted of 391 male and female adolescents, aged from 17 to 18 years.Results:The average daily energy consumption by adolescents was 8032·9 kJ/d, of which 26·1 % originated from UPF. The upper tertile (T3) of UPF consumption presented higher intake of simple carbohydrates, lipids, saturated fat, and Na and lower protein intake. Individuals in T3 presented higher serum leptin and CRP levels (P < 0·05). Adolescents with UPF energy consumption ≥30·0 % (tertile 3 of UPF) had a 79 % (exp (0·58) = 1·79) increase in IL-8 levels when compared with adolescents in tertile 1 of UPF (P = 0·013).Conclusions:The association between the consumption of UPF, poor quality diet and pro-inflammatory markers have important harmful effects that can be observed as early as in adolescence.
Allanne Pereira Araújo, Carolina Abreu de Carvalho, Cecilia Claudia Costa Ribeiro, Janaina Maiana Abreu Barbosa, Poliana Cristina de Almeida Fonseca Viola, and Vanda Maria Ferreira Simões
FapUNIFESP (SciELO)
Abstract Objectives: to investigate the association between prepregnancy body mass index (BMI) and newborns’ (NB) BMI. Methods: cohort study with 1,365 pregnant women and their newborns from the BRISA survey (Brazilian Ribeirão Preto and São Luís Birth Cohort Studies) in São Luís-MA. Prepregnancy BMI was self-reported, and newborns’ BMI was estimated using the weight and length measured at birth. A directed acyclic graph (DAG) was developed to identify the adjustment variables. The association between the prepregnancy BMI and newborns’ BMI were analyzed using multiple linear and Poisson regression with robust variance estimation. Results: NBs had 13.4±1.7kg/m2 average BMI at birth. In the linear analysis, we observed that as the prepregnancy BMI increases, the NBs BMI also increases (ß=0.07; CI95%=0.05–0.09;p<0.001). Newborns of mothers with prepregnancy overweight were 3.58 times more likely to be overweight. Conclusion: prepregnancy BMI can affect newborn’s BMI early. Thus, women planning to become pregnant should consider conducting nutritional planning to maintain or obtain a healthy weight to minimize the risk of overweight for the newborn.
Lilian Fernanda Pereira Cavalcante, Carolina Abreu de Carvalho, Luana Lopes Padilha, Poliana Cristina de Almeida Fonseca Viola, Antônio Augusto Moura da Silva, and Vanda Maria Ferreira Simões
FapUNIFESP (SciELO)
Obesity is considered a global public health problem. Cesarean section has been associated with high body mass index (BMI) and increased obesity throughout life. However, this association has been challenged by some studies. This study aims to assess the causal effect of cesarean section on the BMI of children aged 1-3 years. This is a cohort study of 2,181 children aged 1-3 years, born in 2010, obtained from the BRISA Birth Cohort, in São Luís, state of Maranhão, Brazil. Sociodemographic variables, maternal characteristics, type of childbirth, morbidity, anthropometric measurements, and BMI were assessed. Marginal structural models with a counterfactual approach were used to check the causal effect of the type of childbirth on obesity, weighted by the inverse probability of selection and exposure. Out of the 2,181 children assessed (52% female), 50.6% were born by cesarean section, 5.9% of the newborn infants were large for gestational age, and 10.7% of them had excess weight. No causal effect of cesarean section on BMI was observed (coefficient = -0.004; 95%CI: -0.136; 0.127; p = 0.948). Cesarean section did not have a causal effect on the BMI of children aged 1-3 years.
Thalita Costa da Silva, Carlos Martins Neto, Carolina Abreu de Carvalho, Poliana Cristina de Almeida Fonseca Viola, Lívia dos Santos Rodrigues, and Bruno Luciano Carneiro Alves de Oliveira
Ciencia & saude coletiva FapUNIFESP (SciELO)
Resumo O objetivo deste artigo é avaliar o risco nutricional e cardiovascular segundo medidas antropométricas em idosos quilombolas do estado do Maranhão. Trata-se de estudo transversal realizado em 11 comunidades remanescentes de quilombolas do município de Bequimão, Maranhão, Brasil. Realizou-se censo da população idosa que representou 205 pessoas. Foram estimados os riscos nutricional e cardiovascular por meio dos indicadores antropométricos segundo sexo e idade. Realizou-se Testes de Qui-quadrado de Pearson ou Exacto de Fisher e análises de variância. Diferenças foram consideradas estatisticamente significantes quando p<0,05. Idosos quilombolas vivem em precárias condições de moradia e de infraestrutura sanitária, com elevado risco nutricional e cardiovascular, mas com diferenças entre sexo e idade. O excesso de peso foi mais prevalente em mulheres e idosos mais jovens, enquanto os homens e idosos com 80 ou mais anos apresentaram-se mais desnutridos e com maior perda de massa corporal. O risco cardiovascular foi maior entre as mulheres e em todas as faixas etárias. Idosos quilombolas vivem em vulnerabilidade socioeconômica e apresentaram alta prevalência de baixo peso, perda de massa muscular e alto risco cardiovascular, sendo maior risco entre mulheres e idosos do grupo de maior idade.
Sara Costa Serra, Carolina Abreu de Carvalho, Rosangela Fernandes Lucena Batista, Erika Bárbara Abreu Fonseca Thomaz, Poliana Cristina de Almeida Fonseca Viola, Antônio Augusto Moura da Silva, and Vanda Maria Ferreira Simões
FapUNIFESP (SciELO)
Resumo O objetivo do estudo foi avaliar os fatores sociodemográficos, maternos e do recém-nascido associados à mortalidade perinatal em São Luís, Maranhão. Os óbitos perinatais foram identificados na coorte e pelo Sistema de Informações sobre Mortalidade. Foram incluídos 5.236 nascimentos, sendo 70 óbitos fetais e 36 neonatais precoces. Para investigar os fatores associados utilizou-se análise de regressão logística com modelo hierarquizado. O coeficiente de mortalidade perinatal foi 20,2 por mil nascimentos. A baixa escolaridade materna e a ausência de companheiro foram associadas a maior chance de óbito perinatal. A família ser chefiada por outros familiares foi fator de proteção. Tiveram maior chance de óbito perinatal filhos de mães que não realizaram pelo menos seis consultas de pré-natal (OR=4,61; IC95%:2,43-8,74) e com gravidez múltipla (OR=9,15; IC95%:4,08-20,53). Presença de malformações congênitas (OR=4,13; IC95%:1,23-13,82), nascimento pré-termo (OR= 3,36; IC95%: 1,56-7,22) e baixo peso ao nascer (BPN) (OR=11,87; IC95%:5,46-25,82) se associaram ao óbito perinatal. A mortalidade perinatal foi associada à vulnerabilidade social, não realização do número de consultas pré-natal recomendado, malformações congênitas, nascimento pré-termo e BPN.
Victor N. C. Silveira, Carolina A. Carvalho, Poliana C. A. F. Viola, Elma I. S. Magalhães, Luana L. Padilha, Sueli I. O. Conceição, Maria Tereza B. A. Frota, Isabela L. Calado, Nayra A. C. Cantanhede, Sylvia C. C. Franceschini,et al.
Cambridge University Press (CUP)
AbstractFe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.
Natália Oliveira Pereira, Carolina Abreu de Carvalho, Naiara Sperandio, Karla Danielle Silva Marques, Poliana Cristina de Almeida Fonseca Viola, Nitin Shivappa, James R. Hébert, and Ana Karina Teixeira da Cunha França
Cambridge University Press (CUP)
AbstractThe aim of the study was to assess the inflammatory potential of the Brazilian population’s diet and its association with demographic, socio-economic and anthropometric characteristics. A cross-sectional study was performed with 34 003 individuals aged 10 years and older, evaluated by the National Diet and Nutrition Survey from the Consumer Expenditure Survey (POF 2008–2009). The Energy-adjusted Dietary Inflammatory Index (E-DII™) was determined using thirty-four dietary parameters calculated through non-consecutive 2-d dietary records. Positive scores indicate a pro-inflammatory diet, while negative scores indicate an anti-inflammatory diet. A bivariate and multivariate linear regression analysis based on a hierarchical theoretical model was performed to verify the factors associated with the E-DII. The mean of the E-DII was 1·04 (range of −4·77 to +5·98). The highest values of the pro-inflammatory E-DII were found among adolescents (1·42; P < 0·001) and individuals with higher income (1·10; P < 0·001) and level of education (1·18; P < 0·001). In the final model, the E-DII was associated with higher income quartiles and was higher in the Northeast and South regions, in white people, individuals with ≥9 years of education and adults and adolescents age group. The Brazilian population consumes a diet with high inflammatory potential, especially adolescents, white people and those with higher income and level of education. Thus, the index presented uneven distribution among the population, emphasising groups with higher dietary inflammatory potential. The socio-economic risk profile of a diet with higher inflammatory potential in medium-income countries is different from what is observed in high-income nations.
Carolina Abreu de Carvalho, Poliana Cristina de Almeida Fonseca Viola, and Naiara Sperandio
Cambridge University Press (CUP)
AbstractThe goal of this commentary is to expose the situation of Food and Nutrition Security (FNS) in Brazil in the context of the COVID-19 pandemic by providing a critical analysis of this scenario and suggesting ways to move forward. When COVID-19 arrived in Brazil, a crisis scenario that incorporated economic, social and political aspects became highly visible. This scenario fostered unemployment, poverty and hunger. Besides that, it exposed multiple vulnerabilities that were getting worse over the past few years prior to the pandemic. In this context, COVID-19 found in Brazil a fertile ground for its dissemination and community transmission. The impacts of the suspension of many commercial activities and other economic sectors due to the pandemic were quickly felt socially and economically in Brazil. Some of the actions carried out by the Brazilian government included the emergency aid payment and exemption from payment of energy bills for vulnerable individuals, release of funds for programmes for the direct purchase of food from family farmers, delivery of school food kits directly to students despite the closure of schools and publication of sanitary rules for the operation of restaurants. However, these actions are still insufficient, slow and not sufficiently coordinated to contain the progress of the food and nutritional insecurity crisis in Brazil. The COVID-19 pandemic highlights the urgency for the Brazilian government to again prioritise the FNS agenda. This includes implementing mechanisms to ensure the Human Right to Adequate Food and expanding existing FNS programmes.