Nutrition in menopausal women : a narrative review

Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women, such as body composition, bone mass, and risk markers for cardiovascular disease. Current evidence suggests that low-fat, plant-based diets are associated with beneficial effects on body composition, but further studies are needed to confirm these results in postmenopausal women. The Mediterranean diet pattern along with other healthy habits may help the primary prevention of bone, metabolic, and cardiovascular diseases in the postmenopausal period. It consists on the use of healthy foods that have anti-inflammatory and antioxidant properties, and is associated with a small but significant decrease in blood pressure, reduction of fat mass, and improvement in cholesterol levels. These effects remain to be evaluated over a longer period of time, with the assessment of hard outcomes such as bone fractures, diabetes, and coronary ischemia

Associations between body composition and lifestyle factors with bone mineral density according to time since menopause in women from Southern Brazil : a cross-sectional study

Background: The aim of this study was to investigate whether body composition, dietary pattern and habitual physical activity are associated with BMD according to time since menopause in women from Southern Brazil with no clinical evidence of disease. Methods: 99 participants were enrolled and anthropometry, body composition and BMD by dual energy x-ray absorptiometry, rest metabolic rate by indirect calorimetry, dietary pattern by semi quantitative food frequency questionnaire and habitual physical activity by pedometer were performed. Results: Mean age was 55.2 ± 4.9 years and mean time since menopause was 6.8 ± 1.0 years. Weight, BMI, lean and fat mass and RMR were higher in women with less than 5 years since menopause with normal versus low bone mass. No differences were found in the studied variables between participants with normal or low bone mass and more than 5 years of menopause. Women with > 5 years since menopause had higher prevalence of osteoporosis, as well as lower BMD in all sites when compared to those with less time since menopause. Calories, carbohydrate, protein, fat and micronutrients intake were similar between groups. When the sample was adjusted for time since menopause, the odds ratio (OR) for low bone mass was 5.21 (95 % CI 1.57–17.25, P = 0.004) for BMI <25 kg/m², for lean mass <37.5 Kg an OR of 4.4 (95 % CI 1.64–11.80, P = 0.004, for fat mass <26.0 Kg an OR of 3.39 (95 % CI 1.29–8.85, P = 0.010) and for the intake of vitamin A < 700 mcg/day an OR of 3.00 (95 % CI 1.13–7.94, P = 0.012). Low meat and eggs intake or low protein intake did not influence the odds ratio for low bone mass. Conclusion: In this cross-sectional study with postmenopausal women with no clinical evidence of disease, time since menopause, low lean and fat mass were associated with low bone mass. Calories and macronutrients intake as well as habitual physical activity did not interfere with BMD, but participants were mostly sedentary. Further studies are needed in order to determine whether the adequate intake of specific food groups and the type of physical activity could attenuate the time since menopause impact on BMD

AS DINÂMICAS RURAIS NO CONTEXTO DO DESENVOLVIMENTO:ESTUDO DE CASO DO ASSENTAMENTO CÍCERO ROMANA I - PARAÍBA

Os assentamentos rurais surgem como um espaço territorialmente definido por apresentar objetivos vinculados a sujeitos socialmente excluídos do processo de produção capitalista. Logo, esta pesquisa teve como objetivo realizar um estudo de caso acerca das condições inibidoras percebidas pela população do assentamento Cícero Romana I localizado no município de Esperança- PB. Para tanto, realizou-se os seguintes procedimentos qualitativos: a) Levantamento fotográfico; b) Observação participante; c) Entrevistas individuais. Como recurso metodológico foi utilizada técnicas de Diagnóstico Rural Participativo- DRP. A partir desta pesquisa foram identificadas diversas sugestões para melhorias no assentamento, como saneamento básico e abastecimento de água encanada.Quanto ao problema identificou-se a insatisfação revela a pretensão de abandonar o local no futuro

AS DINÂMICAS RURAIS NO CONTEXTO DO DESENVOLVIMENTO:ESTUDO DE CASO DO ASSENTAMENTO CÍCERO ROMANA I - PARAÍBA

Os assentamentos rurais surgem como um espaço territorialmente definido por apresentar objetivos vinculados a sujeitos socialmente excluídos do processo de produção capitalista. Logo, esta pesquisa teve como objetivo realizar um estudo de caso acerca das condições inibidoras percebidas pela população do assentamento Cícero Romana I localizado no município de Esperança- PB. Para tanto, realizou-se os seguintes procedimentos qualitativos: a) Levantamento fotográfico; b) Observação participante; c) Entrevistas individuais. Como recurso metodológico foi utilizada técnicas de Diagnóstico Rural Participativo- DRP. A partir desta pesquisa foram identificadas diversas sugestões para melhorias no assentamento, como saneamento básico e abastecimento de água encanada.Quanto ao problema identificou-se a insatisfação revela a pretensão de abandonar o local no futuro

Percepção ambiental de estudantes do ensino fundamental sobre o Parque Natural Municipal dos Morros (Santa Maria, RS, Brasil)

Este estudio está dedicado a las Unidades de Conservación de Protección Integral, aquí, específicamente, a la categoría Parque Natural Municipal, llamada "Parque Natural Municipal dos Morros" (PNMM), situado en Santa Maria (Rio Grande do Sul, Brasil). &nbsp;El Parque está ubicado en una zona de transición geomorfológica y fitoecológica, entre los biomas Mata Atlántica y Pampa, con flora y fauna características y dotado de una privilegiada belleza escénica. El objetivo de este estudio fue investigar la percepción ambiental de los estudiantes de la Escuela Municipal de Enseñanza Primaria Profa. Hylda Vasconcellos sobre el PNMM, con vistas a la elaboración de acciones para motivar el conocimiento sobre el espacio, fomentar la pertenencia y su conservación, considerando que la escuela está situada en la zona de amortiguamiento del Parque. La recolección de datos fue realizada por medio de dibujos, con el uso de la dinámica llamada "Tela de Pintura". En cuanto a la percepción de los estudiantes, a pesar de vivir en el entorno del PNMM, la mayoría no conocía la Unidad de Conservación o tenía una visión parcial al respecto. Con el desarrollo de las acciones de Educación Ambiental, los estudiantes tendrán la oportunidad de conocer el PNMM - historia, biodiversidad, presiones ambientales, y serán invitados a convertirse en "Guardianes del PNMM".Este estudo é dedicado às Unidades de Conservação de Proteção Integral, aqui, especificamente, à categoria Parque Natural Municipal, chamada “Parque Natural Municipal dos Morros” (PNMM), situado em Santa Maria (Rio Grande do Sul, Brasil).&nbsp; O Parque está localizado em uma zona de transição geomorfológica e fitoecológica, entre os biomas Mata Atlântica e Pampa, com flora e fauna características e dotado de uma privilegiada beleza cênica. O objetivo deste estudo foi o de investigar a percepção ambiental de estudantes da Escola Municipal de Ensino Fundamental Profa. Hylda Vasconcellos sobre o PNMM, tendo em vista a elaboração de ações para motivar o conhecimento sobre o espaço, fomentar o pertencimento e a sua conservação, considerando que a escola está situada na zona de amortecimento do Parque. A coleta de dados foi realizada por meio de desenhos, com o uso da dinâmica chamada “Tela de Pintura”. Quanto à percepção dos estudantes, apesar de morarem no entorno do PNMM, a maioria não conhecia a Unidade de Conservação ou tinha uma visão parcial a seu respeito. Com o desenvolvimento das ações de Educação Ambiental, os estudantes terão a oportunidade de conhecer o PNMM - história, biodiversidade, pressões ambientais, e serão convidados a se tornar “Guardiães do PNMM”.This study is dedicated to the Conservation Units of Integral Protection, here, specifically, to the category Municipal Natural Park, called "Parque Natural Municipal dos Morros" (PNMM), located in Santa Maria (Rio Grande do Sul, Brazil).&nbsp; The Park is located in an area of geomorphological and phytoecological transition, between the Atlantic Forest and Pampa biomes, with characteristic flora and fauna and endowed with a privileged scenic beauty. The objective of this study was to investigate the environmental perception of students of the Municipal Elementary School Profa. Hylda Vasconcellos on the PNMM, with a view to developing actions to motivate knowledge about space, foster belonging and its conservation, considering that the school is located in the buffer zone of the Park. Data collection was performed through drawings, using the dynamics called "Canvas Painting". As for the perception of students, despite living in the surroundings of the PNMM, most did not know the Conservation Unit or had a partial view about it. With the development of Environmental Education actions, students will have the opportunity to know the PNMM - history, biodiversity, environmental pressures, and will be invited to become "PNMM Guardians"

Insulin resistance and associated factors in female adolescents from two capital cities in the north and south of Brazil

Background: It has been described that physiological changes in glucose metabolism, represented by insulin resistance (IR), are predicted during pubertal evolution, and obesity may be associated with its persistence even at the end of puberty. The aim of this study was to investigate the prevalence of IR in female adolescents with possible associated factors and evaluate the relationship of time since menarche (< 2 vs. ≥ 2 years) in the occurrence of IR in two Brazilian capital cities: Porto Velho (RO) and Porto Alegre (RS). Methods: This is a cross-sectional school-based study, using information from the Study of Cardiovascular Risks (ERICA) database for adolescents aged 12–17 years, enrolled in public and private schools, in municipalities with more than 100,000 inhabitants in Brazil, between 2013 and 2014. The present study included 889 adolescents, 382 in Porto Velho (PVh) and 507 in Porto Alegre (PoA). The homeostasis model assessment for insulin resistance (HOMA-IR) ≥ 3.16 and fasting insulin ≥ 15 mU/L was used to determine the outcome variable of IR. Estimates of crude and adjusted prevalence ratios with confidence intervals of 95% were calculated using Poisson regression with robust variance. Sociodemographic, behavioral, reproductive and nutritional characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of IR determination. Results: In the total sample, the prevalence of IR was 22.03% (95% CI 17.84–26.89). After adjusting the models, age 15–17 years and time since menarche ≥ 2 years were found to act as protective factors for IR; in contrast, the highest probability of IR was observed in black adolescents, with increased waist circumference (WC) and overweight/obesity (Ow/Ob). The protective effect of two or more years since menarche (post-menarche) was observed for both higher HOMA-IR and fasting insulin in PVh; in PoA, such protection was maintained only for fasting insulin ≥ 15 mU/L after adjustments in the multivariate models

Percepção ambiental de estudantes do ensino fundamental sobre o Parque Natural Municipal dos Morros (Santa Maria, RS, Brasil)

Este estudo é dedicado às Unidades de Conservação de Proteção Integral, aqui, especificamente, à categoria Parque Natural Municipal, chamada “Parque Natural Municipal dos Morros” (PNMM), situado em Santa Maria (Rio Grande do Sul, Brasil).  O Parque está localizado em uma zona de transição geomorfológica e fitoecológica, entre os biomas Mata Atlântica e Pampa, com flora e fauna características e dotado de uma privilegiada beleza cênica. O objetivo deste estudo foi o de investigar a percepção ambiental de estudantes da Escola Municipal de Ensino Fundamental Profa. Hylda Vasconcellos sobre o PNMM, tendo em vista a elaboração de ações para motivar o conhecimento sobre o espaço, fomentar o pertencimento e a sua conservação, considerando que a escola está situada na zona de amortecimento do Parque. A coleta de dados foi realizada por meio de desenhos, com o uso da dinâmica chamada “Tela de Pintura”. Quanto à percepção dos estudantes, apesar de morarem no entorno do PNMM, a maioria não conhecia a Unidade de Conservação ou tinha uma visão parcial a seu respeito. Com o desenvolvimento das ações de Educação Ambiental, os estudantes terão a oportunidade de conhecer o PNMM - história, biodiversidade, pressões ambientais, e serão convidados a se tornar “Guardiães do PNMM”

Prevalence of vitamin D deficiency in women from southern Brazil and association with vitamin D-binding protein levels and GCDBP gene polymorphisms

Vitamin D deficiency is highly prevalent worldwide, and vitamin D-binding protein (DBP) a major regulator of serum vitamin D levels. The rs4588 and rs7041 polymorphisms of the GC gene constitute the genetic basis of the three major isoforms of circulating DBP (GC1s, GC1f, and GC2), while the rs2282679 variant is located in an important regulatory region of the GC gene. The aim of this study was to assess the prevalence of 25-hydroxyvitamin D [25(OH)D] deficiency and to ascertain whether it is associated with DBP levels and with GC gene variants. Biorepository samples of 443 women aged 20 to 72 years, with no evidence of clinical disease, were analyzed. Circulating levels of 25(OH)D were considered sufficient if ≥20 ng/mL and deficient if <20 ng/mL. Genotype analysis was performed by RT-PCR. Mean age was 53.4±9.4 years; mean BMI was 27.8±5.8 kg/m2. The overall sample had mean 25(OH)D levels of 22.8±8.3 ng/mL; 39.7% of participants had deficient circulating 25 (OH)D levels. Higher prevalence ratios (PR) of 25(OH)D deficiency were found for the CC genotype of rs2282679 (PR 1.74; 95%CI 1.30 to 2.24; p<0.001), GC2 isoform (PR 1.66; 95%CI 1.17 to 2.38; p = 0.005), time since menopause (PR 1.02; 95%CI 1.003 to 1.03, p = 0.016), and HOMA-IR (PR 1.02; 95%CI 1.01 to 1.03, p = 0.004). DBP levels (per 30 μg/mL increase in DBP) were associated with lower PR for 25(OH)D deficiency (PR 0.89; 95%CI 0.80;0.99; p = 0.027). Except for HOMA-IR, these prevalence ratios remained significant after adjustment for age and BMI. In conclusion, the rs2282679 polymorphism and the GC2 isoform of DBP were associated with lower serum DBP levels and with susceptibility to 25 (OH)D deficiency in Brazilian women with no evidence of clinical disease