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Background: Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy. Aim: Systematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy. Methods: A search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic interventions on clinical, nutritional or neurodevelopmental outcomes. Risk of bias was investigated using the RoB-2 tool. The study was registered on PROSPERO (CRD42020181284). Results: Fifteen studies were selected. Positive results included the use of whey-based or pectin-enriched enteral formulas for gastroesophageal reflux (n = 6); 25-hydroxy-vitamin D supplementation for hypovitaminosis D (n = 2); supplementation with lipid mixture or diet with high-density energy for improvements in anthropometric measures (n = 2); supplementation with probiotics, prebiotics, symbiotics or magnesium for constipation (n = 2); nutritional support system for gross motor function (n = 1); lactoferrin and iron hydroxide polymaltose for iron deficiency anemia (n = 1); and educational intervention to improve feeding skills (n = 1). The overall risk of bias was high for 60% of the studies, and some concerns were raised for the remaining 40%. Conclusion: Some promising dietary and nutritional interventions may promote important clinical improvements for patients with cerebral palsy. However, evidence is weak, as few clinical trials have been published with many methodological errors, leading to a high risk of bias. [ABSTRACT FROM AUTHOR]

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Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: to consolidate secondary data and provide some as yet unpublished information on changes in the nutritional status of Brazilian children, and, principally, adults, from an anthropometrical point of view as evaluated in the course of the most recent surveys, laying emphasis on geographical and socio-economic features. Methods: tables and graphs were used to consolidate data published by the Brazilian Institute of Geography and Statistics and from other sources, along with estimates for results not included in these original documents. Preliminary data from two as yet unpublished studies were also included. Results: it was shown that, alongside the decline in malnutrition in children there are signs of an epidemic increase in obesity and overweight in adults. This is characteristic of the change in epidemiological profile associated with the nutritional transition. There is an apparent paradox that the highest frequencies for normal anthropometric measurements in adults were found in the poorer North and Northeast regions of Brazil. These results were even found in localities with very low indices for human development in the Northeast region. The best anthropometric situation for adult populations in Brazil was found in families with a low income (less than 1/4 of one minimum wage per household per capita, with a prevalence rate twice as high among adult males in comparison with the higher household income group). Conclusions: the results for nutritional anthropometry among adults, showing more normal measurements among the low-income population, reflect a peculiar phase in epidemiological terms in the process of the nutritional transition in the country, which constitutes a paradox arising in these specific circumstances, which is probably temporary. [ABSTRACT FROM AUTHOR]

Objective: To verify the association of obesity and infertility related to anovulatory issues. Methods: This case-control study was carried out with 52 women, aged 20 to 38 years, divided into two groups (infertile - cases - and fertile - control), seen at outpatient clinics, in the period from April to December, 2017. Results: We found significant evidence that obesity negatively affects women's fertility (p=0.017). The group of infertile women was 7.5-fold more likely to be obese than fertile women. Conclusion: Strategies that encourage weight control are indicated for women with chronic anovulation, due to hight metabolic activity of adipose tissue. [ABSTRACT FROM AUTHOR]

OBJECTIVE To analyze if the nutritional status of children aged less than five years is related to the biological conditions of their mothers, environmental and socioeconomic factors, and access to health services and social programs.METHODS This cross-sectional population-based study analyzed 664 mothers and 790 children using canonical correlation analysis. Dependent variables were characteristics of the children (weight/age, height/age, BMI/age, hemoglobin, and retinol serum levels). Independent variables were those related to the mothers' nutritional status (BMI, hemoglobin, and retinol serum levels), age, environmental and socioeconomic factors and access to health service and social programs. A < 0.05 significance level was adopted to select the interpreted canonical functions (CF) and ± 0.40 as canonical load value of the analyzed variables.RESULTS Three canonical functions were selected, concentrating 89.9% of the variability of the relationship among the groups. In the first canonical function, weight/age (-0.73) and height/age (-0.99) of the children were directly related to the mother's height (-0.82), prenatal appointments (-0.43), geographical area of the residence (-0.41), and household incomeper capita (-0.42). Inverse relationship between the variables related to the children and people/room (0.44) showed that the larger the number of people/room, the poorer their nutritional status. Rural residents were found to have the worse nutritional conditions. In the second canonical function, the BMI of the mother (-0.48) was related to BMI/age and retinol of the children, indicating that as women gained weight so did their children. Underweight women tended to have children with vitamin A deficiency. In the third canonical function, hemoglobin (-0.72) and retinol serum levels (-0.40) of the children were directly related to the mother's hemoglobin levels (-0.43).CONCLUSIONS Mothers and children were associated concerning anemia, vitamin A deficiency and anthropometric markers. Living in rural areas is a determining factor for the families health status.

The prevalence and risk factors associated with vitamin A deficiency (VAD) were analyzed in 664 mothers and their 790 children under the age of five in Pernambuco in 2006. A population-based cross-sectional study, with a representative sample in urban and rural areas was conducted. VAD was defined as serum retinol levels < 20 mg/dL for both groups (mothers and children). Bi and multivariate analysis were performed using the complementary log-log model as a link function adopting a model of explanatory hierarchical order of VAD to children and a logistic model for mothers. The prevalence of VAD was 6.9% in mothers and 16.1% in their children, with similar statistics for urban and. rural groups. In the urban area, the housing occupation regime had a significant association with VAD in mothers. After the final adjustment of the model for urban children, the mother's age, the number of pre-natal consultations and birth weight were featured as predictive variables. In rural areas, VAD in mothers is associated with VAD in children; PR= 3.99 (95% CI:1.73-9.19), with their birth weight and the incidence of diarrhea in the previous 15 days. VAD continues to be a public health issue in the state of Pernambuco, with marked variations in prevalence and associated factors in mothers and children.

The scope of this study was to evaluate trends in the temporal evolution of anemia in students ranging from the ages of 7 to 11 in Várzea district (Recife-PE) based on three reports concluded in 1982, 2001 and 2005. An evaluation was achieved in ten public schools in the first study and nine in the last two (one was shut down), in a sample of 305 students (1982), 684 students (2001) and 756 students (2005). Hemoglobin was determined in blood samples taken by venopunction, having two criteria to describe anemia: cut points < 12 g/dL and < 11.5 g/dL. By the first criteria, the prevalence of anemia increased from 8.8% in 1982 to 18.9% in 2001, decreasing to 13.4% in 2005. In the last evaluation, the problem of anemia practically disappeared starting from the age of 9. The evolution of anemia revealed two very different trends: marked elevation in the first phase (1982 to 2001) and a rapid decrease in the second stage (2001 to 2005).

Prevalence of anemia and associated factors were analyzed in mothers (n = 1,022) and their children under 5 years of age (n = 1,242) in Pernambuco State, Brazil, 2006. This was a cross-sectional population-based study with a probabilistic sample in an urban and rural area. Anemia was diagnosed by hemoglobin level (children < 11.0 g/dL, women < 12.0 g/dL) using HemoCue. Univariate and multivariate analyses used Poisson regression with robust adjustment of standard error, adopting a hierarchical model for determination in children with anemia as the outcome. This same procedure was not applied to mothers because of the small number of associated factors in the univariate analyses. Anemia prevalence was 16.4% in mothers and 34.4% in children. Anemic as compared to non-anemic mothers showed a prevalence ratio of 1.44 (95%CI: 1.21-1.72) for anemia in their children, maintaining similar values in the adjusted model (PR = 1.39: 95%CI: 1.16-1.66). Anemia prevalence in children was double that of mothers, with the final model showing only one common factor: per capita family income.

The aim of this study was to analyze the growing prevalence of anemia and overweight/obesity as contrasting trends in Brazil's nutritional transition. Twenty-eight studies published on anemia in children and childbearing-age women were selected, based on statistical representativeness, standardization of laboratory methods, and World Health Organization criteria. Overweight/obesity in adults was assessed by body mass index: 25 to 29.9 kg/m(2) (overweight) and > or =30 kg/m(2) (obesity). Three surveys were compared for analysis of tendencies: 1974/1975 (36.4%), 1989 (53.5%), and 2002/2003 (51.9%) for overweight/obesity prevalence. In the most representative study on anemia among children (< 11 g/dL), the prevalence increased from 22.0% (1974) to 46.9% (1995/1996). For pregnant woman (< 11 g/dL), results ranged from 14.7 to 40.4%. Prevalence of anemia among children and overweight/obesity among adults showed similar tendencies over time. Recent evidence of reduction in anemia can be attributed to flour supplementation with iron and folic acid. Anemia and overweight/obesity are associated with significant changes in food intake as a substratum of the nutritional transition.