Terapia interdisciplinar de mudança do estilo de vida melhora sintomas de compulsão alimentar e insatisfação com a imagem corporal em adultos obesos brasileiros

INTRODUCTION: Obesity is related to numerous negative consequences for physical and mental health. It is often associated with the presence of binge eating disorder, body image dissatisfaction, and general psychopathology. OBJECTIVE: To assess the effects of an interdisciplinary lifestyle therapy on binge eating symptoms, depression, anxiety, body dissatisfaction, and quality of life in obese adults. METHODS: A total of 49 obese adults (body mass index = 37.35±5.82 kg/m²; age = 44.14±10.00 years) participated in a weight-loss program for 6 months. Symptoms suggestive of binge eating, body dissatisfaction, depression, anxiety, and quality of life were measured using self-reported questionnaires. Food intake was assessed using a 3-day dietary record. Data were analyzed using analysis of variance (ANOVA). RESULTS: ANOVA results showed a reduction in binge eating symptoms and in body dissatisfaction results. Depression and anxiety symptoms also decreased, and an increase was observed in quality of life scores. After therapy, a significant improvement was observed in dietary patterns, as well as significant weight loss. A positive correlation was found between variation of anxiety symptoms and lipid intake. Binge eating symptoms were associated with anxiety symptoms and body image dissatisfaction, and body image dissatisfaction correlated positively with anxiety symptoms in males only. In females, a positive correlation was observed between depression and binge eating symptoms. CONCLUSION: The interdisciplinary therapy was effective in promoting positive physical and psychological changes and in improving the quality of life of obese adults.INTRODUÇÃO: A obesidade se relaciona com inúmeras consequências negativas para a saúde física e mental. Está frequentemente associada com transtorno da compulsão alimentar periódica, insatisfação com a imagem corporal e psicopatologia geral. OBJETIVO: Avaliar os efeitos de uma terapia interdisciplinar de mudança do estilo de vida sobre sintomas de compulsão alimentar, depressão, ansiedade, insatisfação com a imagem corporal e qualidade de vida em adultos obesos. MÉTODOS: Um total de 49 adultos obesos (índice de massa corporal = 37.35±5.82 kg/m²; idade = 44.14±10.00 anos) participaram de um programa de redução de peso por 6 meses. Sintomas de compulsão alimentar, insatisfação com a imagem corporal, depressão, ansiedade e qualidade de vida foram avaliados por meio de questionários autoaplicáveis. O consumo alimentar foi avaliado utilizando-se um registro alimentar de 3 dias. Os dados foram analisados utilizando análise de variância (ANOVA). RESULTADOS: Os resultados da ANOVA mostraram uma redução nos sintomas de compulsão alimentar e na insatisfação com a imagem corporal. Os sintomas de depressão e ansiedade também diminuíram, e foi observado um aumento nos escores de qualidade de vida. Após a terapia, foi verificada melhora significativa no perfil nutricional, assim como significativa redução de peso. Foi observada uma correlação positiva entre a variação dos sintomas de ansiedade e o consumo de lipídios. Sintomas de compulsão alimentar apresentaram associação com sintomas de ansiedade e insatisfação com a imagem corporal, e a insatisfação com a imagem corporal se correlacionou positivamente com os sintomas de ansiedade nos homens. Nas mulheres, foi observada uma correlação positiva entre sintomas de depressão e de compulsão alimentar. CONCLUSÃO: A terapia interdisciplinar foi eficaz na promoção de mudanças físicas e psicológicas e proporcionou uma melhor qualidade de vida em adultos obesos.Universidade Federal de São Paulo (UNIFESP) Graduate Program in Interdisciplinary Health Sciences Obesity Study GroupUniversidade Federal de São Paulo (UNIFESP) Department of Health, Education, and Society Obesity Study GroupUniversidade Federal de São Paulo (UNIFESP) Department of Biosciences Obesity Study GroupUNIFESP, Graduate Program in Interdisciplinary Health Sciences Obesity Study GroupUNIFESP, Department of Health, Education, and Society Obesity Study GroupUNIFESP, Department of Biosciences Obesity Study GroupSciEL

O uso de cigarro, narguilé, cigarro eletrônico e outros indicadores do tabaco entre escolares brasileiros: dados da Pesquisa Nacional de Saúde do Escolar 2019

Objective: To describe the prevalence of smoking indicators among Brazilian students according to sociodemographic characteristics in 2019, and compare the prevalence between 2015 and 2019. Methods: Data from the National Survey of School Health 2015 and 2019 were used. Indicators related to tobacco use were analyzed. Indicators were compared between the 2015 and 2019 editions. Prevalence and respective 95% Confidence Interval (95%IC) were calculated for the total population and according to sex, age group and type of school. Results: 22.6% (95%CI 21.7–23.4) of the students had tried any cigarette and it was higher between 16 and 17 years of age (32.6%; 95% CI 31.4–33, 8) and in males (35.0%; 95%CI 33.6–36.4). The experimentation of hookah, electronic cigarette and other tobacco products are also high, with 26.9% (95%CI 26.0–27.8), 16.8% (95%CI 16.2–17.4) and 9.3% (95%CI 8.8–9.8), respectively, being higher among boys aged 16 to 17 years. It is noteworthy that there were no changes in the indicators of cigarette experimentation, smoking for the first time before the age of 13, smoking in the 30 days prior to the survey, and at least one of the smoking parents. Conclusion: Although smoked tobacco indicators are stable between 2015 and 2019, the high prevalence of experimentation with products such as hookah and electronic cigarettes is highlighted, drawing attention to the need for new regulatory measures.Objetivo: Descrever a prevalência de indicadores do tabagismo entre escolares brasileiros segundo características sociodemográficas em 2019 e comparar as prevalências entre 2015 e 2019. Métodos: Utilizaram-se dados da Pesquisa Nacional de Saúde do Escolar de 2015 e 2019. Foram analisados os indicadores referentes ao uso do tabaco, que foram comparados entre as edições de 2015 e 2019. Foram calculadas as prevalências e os respectivos intervalos de confiança de 95% (IC95%) para a população total e segundo sexo, faixa etária e tipo de escola. Resultados: Dos escolares, 22,6% (IC95% 21,7–23,4) já experimentaram cigarro alguma vez, porcentagem mais elevada entre os de 16 a 17 anos de idade (32,6%; IC95% 31,4–33,8) e no sexo masculino (35,0%; IC95% 33,6–36,4). A experimentação de narguilé, cigarro eletrônico e outros produtos do tabaco também se mostra elevada, com 26,9% (IC95% 26,0–27,8), 16,8% (IC95% 16,2–17,4) e 9,3% (IC95% 8,8–9,8), respectivamente, sendo mais alta entre os escolares do sexo masculino de 16 a 17 anos. Destaca-se que não houve mudanças nos indicadores “experimentação do cigarro”, “fumar pela primeira vez antes dos 13 anos”, “fumar nos 30 dias anteriores à pesquisa” e “ter ao menos um dos pais fumantes” entre os anos indicados. Conclusão: Embora os indicadores de tabaco fumado estejam estáveis entre 2015 e 2019, destacam-se as elevadas prevalências de experimentação de produtos como narguilé e cigarro eletrônico, que chamam a atenção para a necessidade de novas medidas regulatórias

Exposure to and burden of major non-communicable disease risk factors in Brazil and its states, 1990-2019 : the Global Burden of Disease Study

Introduction: Non-Communicable Diseases (NCDs) have become the main cause of disease burden in Brazil. Our objective was to describe trends (1990 to 2019) in prevalence and attributable burden of five modifiable risk factors and related metabolic risk factors in Brazil and its states. Methods: In Global Burden of Disease 2019 analyses, we described trends in prevalence of modifiable risk factors and their metabolic mediators as percentage change in Summary Exposure Value (SEV). We estimated deaths and disabilityadjusted life years (DALYs) attributable to the risk factors. Results: Age-adjusted exposures to alcohol [41.0%, Uncertainty Interval (UI): 24.2 – 63.4], red meat (61.2%, UI: 42.4–92.3), low physical activity (3.9%, UI: -5–17.5) and ambient particulate matter pollution (3.3%, UI: -48.9–128.0) have worsened. Those for smoking (-51.4%, UI: -54.7– - 47.8), diet low in fruits (-28.1%, UI: -39.1– -18.7) and vegetables (-19.6%, UI: -32.7 – -8.7), and household air pollution (-85.3%, UI: -92.9– -74.3) have improved. All mediating metabolic risk factors, except high blood pressure (0.7%, UI: -6.9–8.3), have worsened: BMI (110.2%, UI: 78.6–161.7), hyperglycemia (15.1%, UI: 9.3–21.2), kidney dysfunction (12.0%, UI: 8.4–17.2), and high LDL-c (11.8%, UI: 6.9–17.2). Conclusions: A variable pattern of progress and failure in controlling modifiable risk factors has been accompanied by major worsening in most metabolic risk factors. The mixed success in public health measures to control modifiable risk factors for NCDs, when gauged by the related trends in metabolic risk factors, alert to the need for stronger actions to control NCDs in the future

Prevalence of risk health behavior among members of private health insurance plans: results from the 2008 national telephone survey Vigitel, Brazil

O objetivo deste artigo é descrever a distribuição dos principais fatores de risco (FR) e proteção para doenças crônicas não transmissíveis (DCNT) entre os beneficiários de planos de saúde. Foi utilizada amostra aleatória de adultos com 18 ou mais anos de idade nas capitais brasileiras, analisando-se frequências de FR em 28.640 indivíduos em 2008. Homens mostraram alta prevalência dos seguintes fatores de risco: tabaco, sobrepeso, baixo consumo de frutas e legumes, maior consumo de carnes gordurosas e álcool, enquanto mulheres mostraram maior prevalência de pressão arterial, diabetes, dislipidemia e osteoporose. Homens praticam mais atividade física e mulheres consomem mais frutas e vegetais. Homens com maior escolaridade apresentam maior frequência de sobrepeso, consumo de carnes com gorduras e dislipidemia. Entre mulheres, tabaco, sobrepeso, obesidade e doenças autorreferidas decrescem com aumento da escolaridade, enquanto o consumo de frutas e legumes, atividade física, mamografia e exame de papanicolau aumentam com a escolaridade. CONCLUSÃO: a população usuária de planos de saúde constitui cerca de 26% da população brasileira, e o estudo atual visa acumular evidências para atuação em ações de promoção da saúde para esse público.This article aims at estimating the prevalence of adults engaging in protective and risk health behaviors among members of private health insurance plans. It was used a random sample of individuals over the age of 18 living in the Brazilian state capitals collected on 28,640 telephone interviews in 2008. The results showed that among males there was a high prevalence of the following risk factors: tobacco, overweight, low fruit and vegetable consumption, high meat with fat consumption and alcohol drinking. Among females we found a high prevalence of high blood pressure, diabetes, dyslipidemia and osteoporosis. Men were generally more physically active and women consumed more fruit and vegetables. As more educated males were lower was the prevalence of tobacco, high blood pressure, but also a higher prevalence of overweight, consumption of meat with fat, dyslipidemia and lower number of yearly check-ups done. For females, tobacco smoking, overweight, obesity, decreasing with schooling, and consumption of fruit and vegetables, physical activity, mammography and PAP test, increased with schooling. The health insurance user population constitutes about 26% of Brazilian people and the current study aims to accumulate evidence for health promotion actions by this public

Effect of diets with different levels of guanidinoacetic acid on newly weaned piglets

Ninety barrow piglets weaned at 21 days old were used to evaluate the effects of guanidinoacetic acid (GAA) supplementation on their performance and blood creatinine and creatine kinase (CK) levels during the nursery phase (21 to 63 days old). The piglets were distributed in a randomized block design with five treatments (0, 0.05, 0.10, 0.15, and 0.20% GAA inclusion), six repetitions, and three animals per repetition. The experimental rations were formulated to meet the nutritional requirements for the phases of 21 to 32, 33 to 42 and 43 to 63 days of age. The experimental diets and water were offered ad libitum throughout the experimental period. At 42 and 63 days old, blood was collected from one animal in each experimental unit for creatinine and creatine kinase analysis. The analysed variables were daily weight gain (DFG), daily feed intake (DFI), and feed conversion (FC) in the 21 to 42 days old and 21 to 63 days old of the nursery phase. All variables were subjected to analysis of variance and regression analysis. We adopted ? = 0.05, and considered a trend to be present when ? was between 0.05 and 0.10. In the pre-initial period (21 to 42 days old), there was an increasing trend in daily weight (P = 0.069), which increased to the level of 0.97% of GAA inclusion. The DFI and FC were not significantly affected by the addition of different GAA levels in the diet. Creatinine levels in the blood at 42 and 63 days old were not significantly influenced by the treatments. The level of CK at 42 days old showed an increasing trend (P = 0.077) that occurred quadratically to the level of 0.085% of GAA inclusion, with no significant difference for this variable at 63 days old. The use of GAA did not promote improvements in performance or blood creatinine and CK levels in piglets in the nursery phase

Proposta metodológica para redistribuição de óbitos por causas garbage nas estimativas de mortalidade para Doenças Crônicas Não Transmissíveis

Objective: to propose a method for improving mortality estimates from non-communicable chronic diseases (NCD), including the redistribution of garbage causes in the municipalities of Brazil. Methods: Information Mortality System (SIM) data was used in the three-year periods from 2010 to 2012 and 2015 to 2017, with comparison of age standardized rates before and after correction of NCDs (cardiovascular, chronic respiratory, diabetes and neoplasms). The treatment for data correction included missing data, under-registration and causes of garbage redistribution (CG). The trienniums and Bayesian method were used to estimate mortality rates by improving the fluctuation caused by small numbers at the municipal level. Results: The CG redistribution stage showed greater weight in the corrections, about 40% in 2000 and about 20% from 2007, with stabilization from this year.. Throughout the historical series, the quality of information on causes of death has improved in Brazil, with heterogeneous results being observed among the municipalities. Conclusions: methodological studies that propose the correction and improvement of the SIM are essential for monitoring the mortality rates due to NCDs at regional levels. The methodological proposal applied, for the first time in real data from Brazilian municipalities, is challenging and deserves further improvements. Despite the improvement in the data, the use of rates with raw data is not recommended, as the treatment in the data, the method used in this study for the treatment of raw data showed a great impact on the final estimates.Objetivo: propor método para melhoria das estimativas de mortalidade por doenças crônicas não transmissíveis (DCNT), incluindo a redistribuição de causas garbage nos municípios Brasileiros. Métodos: foram utilizados os dados do Sistema de Informações sobre Mortalidade (SIM) nos triênios de 2010-2012 e 2015-2017, comparadas com as taxas padronizadas por idade, antes e após correção das DCNT (cardiovasculares, respiratória crônicas, diabetes e neoplasias). O tratamento para correção dos dados abordou dados faltantes, sub-registro e redistribuição de causas garbage (CG). Foram utilizados triênios e método bayesiano para estimar as taxas de mortalidade diminuindo o efeito da flutuação provocada pelos pequenos números no nível municipal. Resultados: a etapa de redistribuição CG mostrou maior peso nas correções, cerca de 40% em 2000 e cerca de 20% a  partir de 2007, com estabilização a partir deste ano. Ao longo da série histórica a qualidade da informação sobre causas de morte melhorou no Brasil, sendo observados resultados heterogêneos nos municípios. Observou-se clusters com as maiores proporções de correção nas regiões Nordeste e Norte. O diabetes foi a causa com maior proporção de acréscimo (mais de 40% em 2000). Conclusões: estudos metodológicos que propõem correção e melhoria do SIM são essenciais para o monitoramento das taxas de mortalidade por DCNT em níveis regionais. A proposta metodológica aplicada, pela primeira vez em dados reais de municípios brasileiros, é desafiadora e merece maiores aprimoramentos. Apesar da melhora nos dados, o método utilizado neste estudo para o tratamento dos dados brutos mostrou um grande impacto nas estimativas finais

Effects of a monocomponent protease from Bacillus licheniformis on broiler performance, digestibility, and carcass yield

Two experiments were carried out to evaluate the effects of protease addition to the diet of broilers at a higher level (1× or 2×) than the nutritional value proposed for the enzyme. The first experiment, 1280 day-old chicks (Cobb500®) were randomly allocated (randomized block design, 2×2+1 factorial arrangement), five treatments, eight replicates containing 32 birds/replicate. Treatments consisted: control diet without protease (CD); CD + 1× nutritional value of the enzyme (CDM1); CD + 2× nutritional value of the enzyme (CDM2); CDM1 + protease; and CDM2 + protease. The experimental period was 42 days. The mean weight (AFW), feed intake (FI), weight gain (WG), feed conversion, and carcass yield were evaluated. Significant differences were observed for AFW, WG, FI, abdominal fat yield, and feet percentage in the carcass. In the second experiment, 120 Cobb500® chicks at 14 days of age were allotted in a completely randomized design, 2×2+1 factorial arrangement, five treatments, six replicates with four birds/replicate. The treatments were consistent with the first experiment. Significant improvements in the nitrogen balance were observed for the broilers that received protease. The use of the enzyme tested is recommended with the recommended nutritional matrix, improving the zootechnical indices of broilers

The Schistosoma mansoni cyclophilin A epitope 107-121 induces a protective immune response against schistosomiasis

Great efforts have been made to identify promising antigens and vaccine formulations against schistosomiasis. Among the previously described Schistosoma vaccine candidates, cyclophilins comprise an interesting antigen that could be used for vaccine formulations. Cyclophilin A is the target for the cyclosporine A, a drug with schistosomicide activity, and its orthologue from Schistosoma japonicum induces a protective immune response in mice. Although Schistosoma mansoni cyclophilin A also represents a promising target for anti-schistosome vaccines, its potential to induce protection has not been evaluated. In this study, we characterized the cyclophilin A (SmCyp), initially described as Smp17.7, analyzed its allergenic potential using in vitro functional assays, and evaluated its ability to induce protection in mice when administered as an antigen using different vaccine formulations and strategies. Results indicated that SmCyp could be successfully expressed by mammalian cells and bacteria. The recombinant protein did not promote IgE-reporter system activation in vitro, demonstrating its probable safety for use in vaccine formulations. T and B-cell epitopes were predicted in the SmCyp sequence, with two of them located within the active isomerase site. The most immunogenic antigen, SmCyp (107–121), was then used for immunization protocols. Immunization with the SmCyp gene or protein failed to reduce parasite burden but induced an immune response that modulated the granuloma area. In contrast, immunization with the synthetic peptide SmCyp (107–121) significantly reduced worm burden (48–50%) in comparison to control group, but did not regulate liver pathology. Moreover, the protection observed in mice immunized with the synthetic peptide was associated with the significant production of antibodies against the SmCyp (107–121) epitope. Therefore, in this study, we identified an epitope within the SmCyp sequence that induces a protective immune response against the parasite, thus representing a promising antigen that could be used for vaccine formulation against schistosomiasis

Uso, cessação, fumo passivo e exposição a mídia do tabaco no Brasil: resultados da Pesquisa Nacional de Saúde 2013 e 2019

Objective: To compare indicators of tobacco use, secondhand smoke, cessation and exposure to pro and anti-tobacco media in 2013 and 2019, and describe these indicators according to sociodemographic variables in 2019. Methods: Cross-sectional study with data from the National Health Survey. The indicators of use, secondhand smoke, cessation and exposure to tobacco-related media were evaluated. Prevalence and confidence intervals (95%CI) were estimated for the total population in 2013 and 2019 and according to sociodemographic variables for 2019. Poisson regression with robust variance was used to assess differences in prevalence.  Results: There was an improvement in most of the indicators studied; an increase in ex-smokers and a reduction in secondhand smoke and the attempt to quit smoking. All pro- and anti-tobacco media exposure indicators declined. When considering the prevalence according to sociodemographic characteristics in 2019, 43.8% (95%CI: 41.6;46.0) of men tried to quit smoking, and 50.8% (95%CI: 48.5;53.2) of women. Secondhand smoke at home was higher among women (10.2%; 95%CI: 9.7;10.8). Among those who thought about quitting smoking due to warnings, the proportion was higher among women (48.0%; 95%CI: 45.3;50.6). Tobacco use was higher among men (43.8% (95%CI: 41.6;46.0), in the population aged 40 to 59 years (14.9%; 95%CI: 14.2; 15.6), with a lower level of education (17.6%; 95%CI: 16.8;18.4). Conclusion: The study showed improvement in tobacco-related indicators between the years studied. It is noteworthy that this advance was smaller in relation to the other periods previously analyzed, and, therefore, greater investments in public policies to combat and control smoking in Brazil are necessary.Objetivo: Comparar indicadores de uso do tabaco, fumo passivo, cessação e exposição a mídia pró e antitabaco, em 2013 e 2019, e descrever esses indicadores segundo variáveis sociodemográficas em 2019. Métodos: Estudo transversal com dados da Pesquisa Nacional de Saúde. Avaliou-se os indicadores de uso, fumo passivo, cessação e exposição a mídia relacionada ao tabaco. Estimou-se as prevalências e intervalos de confiança (IC95%) para população total em 2013 e 2019, e segundo variáveis sociodemográficas para 2019. Para avaliar diferenças nas prevalências usou-se a Regressão de Poisson com variância robusta. Resultados: Houve melhoria dos indicadores de uso do tabaco; aumento de ex-fumantes e redução do fumo passivo e da tentativa de parar de fumar. Todos os indicadores de exposição a mídia pró e contra o tabaco diminuíram.  Ao considerar as prevalências segundo características sociodemográficas em 2019, 43,8% (IC95%: 41,6;46,0) dos homens tentaram parar de fumar e 50,8% (IC95%: 48,5;53,2) das mulheres. O fumo passivo no domicilio foi maior nas mulheres (10,2%; IC95%: 9,7;10,8). Entre os que pensaram em parar de fumar devido as advertências, a proporção foi maior nas mulheres (48,0%; IC95%: 45,3;50,6). O uso do tabaco foi mais elevado nos homens (43,8%; IC95%: 41,6;46,0), na população de 40 a 59 anos (14,9%; IC95%: 14,2;15,6) e com menor nível de instrução (17,6%; IC95%: 16,8;18,4). Conclusão: O estudo mostrou melhoria dos indicadores relacionados ao tabaco entre os anos estudados. Ressalta-se, que esse avanço foi menor em relação a outros períodos analisados previamente, e, portanto, torna-se necessário maiores investimentos em políticas públicas de enfrentamento e controle do tabagismo no Brasil