Cardiovascular Risk In Adolescents Research Articles

Reduced rank regression dietary patterns and dyslipidemia in Brazilian adolescents: results from the Study of Cardiovascular Risk in Adolescents (ERICA).

Evidence on the harmful effects of diet on serum lipids in adolescence has not been consistent. The present study sought to establish which dietary patterns are associated with biomarkers of dyslipidemia. Data from 36,217 Brazilian adolescents participating in the Study of Cardiovascular Risk in Adolescents were evaluated. Dietary patterns were identified using the reduced rank regression analysis. Linear regression models were applied to verify the association between dietary pattern scores and the biomarkers of dyslipidemia. The two first dietary patterns identified by reduced rank regression (RRR-DP1 and RRR-DP2) were kept for further analysis. The RRR-DP1 was highly and positively loaded for sweets and red meat and negatively loaded for beans, fruits, vegetables, and rice. The RRR-DP2 was positively loaded for beans and rice and negatively loaded for sugar-sweetened beverages, fruit juices, and sweets. Linear regression models estimated that one standard deviation (SD) increase in the RRR-DP1 score was only associated with a mean increase of 0.29 mg/dL in HDL-cholesterol (95% CI 0.06;0.53), while one SD increase in the RRR-DP2 score was associated with the lower mean of triglycerides (β = -2.24, 95% CI -3.57;-0.91), LDL-c (β = -0.82 95% CI -1.53;-0.12), and total cholesterol (β = -1.30 95% CI -1.94;-0.65). Higher adherence to the dietary patterns positively loaded for red meat and sweets was associated with increased HDL-c levels, while adherence to a more Brazilian traditional dietary pattern (RRR-DP2) was associated with a better lipids profile.

Prevalence of social jetlag and associated factors in Brazilian adolescents: Results from a country-wide cross-sectional study

ObjectivesSocial jetlag is a disturbance in the circadian rhythm caused by a desynchronization between an individual's biological rhythm and social commitments and responsibilities. It leads to sleep debt during the week and compensation on weekends. Social jetlag is associated with an increased risk of chronic diseases and cognitive dysfunction in adolescents. This study aims to assess the prevalence of social jetlag and associated factors in Brazilian adolescents. MethodsAdolescents of both sexes, aged between 12 and 17years, participating in the Study of Cardiovascular Risks in Adolescents (ERICA), were included. The sleep duration on a typical weekday and weekend day was collected through a self-reported questionnaire. The occurrence of social jetlag was defined as the difference between the midpoint of sleep on weekends and weekdays, with differences equal to or higher than 1hour considered as an indicator of positive social jetlag. Factors associated with the prevalence of social jetlag were investigated using Poisson regression models. ResultsThe sample included a total of 64,029 adolescents. Social jetlag affects more than 80% of Brazilian adolescents, with higher prevalence among girls in the age group of 16-17years, with white skin color, attending private schools, and those having morning classes. Additionally, unhealthy risk behaviors such as skipping breakfast, alcohol consumption, and increased screen time are associated with a higher prevalence of social jetlag. ConclusionThe prevalence of social jetlag was high in Brazilian adolescents, and, among its associated factors, studying in the morning shift and engaging in unhealthy risk behaviors stand out.

Association of childhood mental health and cardiovascular risk in adolescence and young adulthood

Abstract Introduction Mental health (MH), and in particular depression, is linked bi-directionally to cardiovascular disease through biological as well as behavioral pathways. Low MH has been associated with behaviors associated closely with cardiovascular risk (CVR) factors, such as reduced physical activity and sleep disturbances. It is not clear at what age the relation between MH and CVR begins to manifest and if MH in the young is also associated with vascular remodeling, operationalized as carotid-intima media thickness (CIMT). Methods We investigated the longitudinal association between childhood MH problems (age 3 to 17) and CVR factors as well as CIMT from carotid sonography in 4,361 14 to 28-year-olds of the KiGGS cohort. Using linear regression analyses adjusted for socioeconomic status, we analyzed the association of the Strength and Difficulties Questionnaire (SDQ) score with systolic blood pressure (SBP), body mass index (BMI), total cholesterol (TC), and CIMT in z-scores by sex and age. Additional cross-sectional analyses included scores of the Mental Health Inventory (MHI-5) and Patient Health Questionnaire (PHQ-9) in young adulthood. Results Childhood SDQ scores were significantly associated with SBP, BMI and TC one decade later (-0.03 ≤ ß ≥ 0.02). Cross-sectionally, no association of MHI-5 scores in young adults with CVR factors was found. PHQ-9 scores in young adults were associated significantly with SBP and BMI (-0.26≤ ß≥ 0.01). The investigated MH problems from childhood to young adulthood were not linked to CIMT. Conclusions Our results confirm an early association of MH with the examined CVR factors. However, we could not find evidence for an association between MH and vascular remodeling in this population-based sample of adolescents and young adults. Our results emphasize the importance of prevention strategies focusing on both, physical and MH of the young, in order to prevent vascular damage later in life. Key messages • Our results show an early association of childhood mental health with the examined cardiovascular risk factors systolic blood pressure, body mass index and total cholesterol one decade later. • Our results confirm the importance of prevention strategies focusing on both, physical and mental health of the young.

7669 Higher Serum Uric Acid Levels Are Associated With a Deleterious Metabolic and Inflammatory Profile in Brazilian Adolescents: An Exploratory Cross-Sectional Analysis

Abstract Disclosure: F.Q. Iorra: None. M.P. Guahnon: None. P.G. Rodrigues: None. A.T. Barcelos: None. F.V. Cureau: None. M. Drehmer: None. B.D. Schaan: None. Introduction: The association of high serum uric acid (sUA) with metabolic syndrome (MetS) and its components have been widely studied, but there are still gaps in how this breakdown product of purine metabolism might refine cardiovascular risk assessment and correlate with other cardiovascular disease biomarkers, especially in children and adolescents. Objective: To evaluate if sUA is associated with metabolic syndrome components and inflammatory markers in Brazilian adolescents. Methods: For this cross-sectional study, 786 individuals aged 12 to 17 years old, previously enrolled in the Study of Cardiovascular Risk in Adolescents (ERICA) - a Brazilian nationwide school based study, and who were from the city of Porto Alegre, had their sUA measured from blood samples that were stored in a biorepository. Anthropometric, biochemical and blood pressure data were collected. MetS diagnosis was based on the International Diabetes Federation age-specific criteria (2005), and insulin resistance was assessed by the HOMA-IR. In accordance with a non-parametric distribution, sUA was divided into quartiles (3.7 mg/dL, 4.4 mg/dL, 5.3 mg/dL for the 25th, 50th, and 75th percentiles, respectively) for the analysis. A linear regression model and a Poisson regression model with robust error variance were used, both adjusted for age, sex and skin color. Results: Participants were 14.8 ± 1.5 years-old, predominantly women (61.7%), self-identified as white skin color (72%) and eutrophic (66.9%). Through the linear regression model, significant positive associations were found between high sUA levels and body mass index Z-score, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, HOMA-IR and C-reactive protein, and significant negative associations were observed for HDL cholesterol and adiponectin. No association was found between sUA and glucose or HbA1c. We also computed a metabolic risk score as the mean Z score of waist circumference, systolic blood pressure, HDL cholesterol (negative Z score), triglycerides and glucose, which was positive related to sUA (β ± SE = 0.13 ± 0.02; p < 0.001). Finally, the Poisson regression model was applied to estimate the prevalence ratios (PR) for MetS and its components, between adolescents with sUA in the 4th quartile to those in the 1st quartile. An association was observed for MetS (PR 6.37, 95% CI 1.39 - 29.21, p 0.017), high waist circumference (PR 4.61, 95% CI 2.55 - 8.36, p < 0.001) and increased triglycerides (PR 4.76, 95% CI 1.47 - 15.44, p 0.009). Conclusion: High sUA levels were associated with a worse metabolic and inflammatory profile, as well as a greater prevalence of MetS and some of its components in adolescents. Therefore, uric acid should be considered as a potential additional marker of cardiovascular risk in this population. Support: CNPq, CAPES, FIPE, FAPERGS. Presentation: 6/1/2024

9193 Higher Serum Uric Acid Levels Are Associated With a Deleterious Metabolic and Inflammatory Profile in Brazilian Adolescents: An Exploratory Cross-Sectional Analysis

Abstract Disclosure: F.Q. Iorra: None. M.P. Guahnon: None. P.G. Rodrigues: None. A.T. Barcelos: None. F.V. Cureau: None. M. Drehmer: None. B.D. Schaan: None. Introduction: The association of high serum uric acid (sUA) with metabolic syndrome (MetS) and its components have been widely studied, but there are still gaps in how this breakdown product of purine metabolism might refine cardiovascular risk assessment and correlate with other cardiovascular disease biomarkers, especially in children and adolescents. Objective: To evaluate if sUA is associated with metabolic syndrome components and inflammatory markers in Brazilian adolescents. Methods: For this cross-sectional study, 786 individuals aged 12 to 17 years old, previously enrolled in the Study of Cardiovascular Risk in Adolescents (ERICA) - a Brazilian nationwide school based study, and who were from the city of Porto Alegre, had their sUA measured from blood samples that were stored in a biorepository. Anthropometric, biochemical and blood pressure data were collected. MetS diagnosis was based on the International Diabetes Federation age-specific criteria (2005), and insulin resistance was assessed by the HOMA-IR. In accordance with a non-parametric distribution, sUA was divided into quartiles (3.7 mg/dL, 4.4 mg/dL, 5.3 mg/dL for the 25th, 50th, and 75th percentiles, respectively) for the analysis. A linear regression model and a Poisson regression model with robust error variance were used, both adjusted for age, sex and skin color. Results: Participants were 14.8 ± 1.5 years-old, predominantly women (61.7%), self-identified as white skin color (72%) and eutrophic (66.9%). Through the linear regression model, significant positive associations were found between high sUA levels and body mass index Z-score, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, HOMA-IR and C-reactive protein, and significant negative associations were observed for HDL cholesterol and adiponectin. No association was found between sUA and glucose or HbA1c. We also computed a metabolic risk score as the mean Z score of waist circumference, systolic blood pressure, HDL cholesterol (negative Z score), triglycerides and glucose, which was positive related to sUA (β ± SE = 0.13 ± 0.02; p < 0.001). Finally, the Poisson regression model was applied to estimate the prevalence ratios (PR) for MetS and its components, between adolescents with sUA in the 4th quartile to those in the 1st quartile. An association was observed for MetS (PR 6.37, 95% CI 1.39 - 29.21, p 0.017), high waist circumference (PR 4.61, 95% CI 2.55 - 8.36, p < 0.001) and increased triglycerides (PR 4.76, 95% CI 1.47 - 15.44, p 0.009). Conclusion: High sUA levels were associated with a worse metabolic and inflammatory profile, as well as a greater prevalence of MetS and some of its components in adolescents. Therefore, uric acid should be considered as a potential additional marker of cardiovascular risk in this population. Support: CNPq, CAPES, FIPE, FAPERGS. Presentation: 6/1/2024

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity.

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity.

Carotid Intima-Media Thickness and Cardiovascular Risk in Adolescents with Overweight or Obesity: Are There Gender-Related Differences?

Carotid Intima-Media Thickness and Cardiovascular Risk in Adolescents with Overweight or Obesity: Are There Gender-Related Differences?

Cardiovascular health of Brazilian adolescents within the framework of Life's Essential 8: Findings from the ERICA study

The Life's Essential 8 (LE8) is an official cardiovascular health (CVH) assessment tool, however, its use remains limited within the adolescent population. We aim to describe the prevalence of CVH in Brazilian adolescents using the LE8 framework and to analyze its distribution considering sociodemographic factors. The sample comprised 36,956 adolescents aged 12 to 17years, who participated in the Study of Cardiovascular Risks in Adolescents, a nationwide, cross-sectional, school-based study. CVH was assessed by the LE8 score (0-100 points), comprising eight metrics categorized into two domains: health behaviors (diet, physical activity, nicotine exposure, and sleep) and health factors (body mass index, non-HDL cholesterol, blood glucose, and blood pressure). Sociodemographic factors were sex, age, type of school, skin color, and region of residence. The results were expressed as means with 95% confidence intervals (95% CI). The overall average score was 75.8 points (95% CI: 75.3-76.3), classified as moderate CVH. The general score was higher among males (76.8; 95% CI: 76.6-77.7) and younger adolescents (12-14years old) (78.5; 95% CI: 77.7-79.4). The health factors had a higher mean than behavioral factors (87.6, 95% CI: 87.3-87.9 vs. 64.0, 95% CI: 63.3-64.7). The best score was blood glucose (94.7; 95% CI: 94.2-95.2), while the diet score was the lowest (48.5; 95% CI: 46.3-50.6). The CVH of Brazilian adolescents is classified as moderate and varied according to sociodemographic characteristics. Intervention actions should prioritize behavioral factors to improve the LE8 score and consequently prevent cardiovascular events in adulthood.

Cut-off points of adiposity indices associated with insulin resistance in Brazilian postpubertal adolescents

ObjectivesThis study aims to establish cut-off points for lipid accumulation product and tri-ponderal mass index to identify insulin resistance (IR) in Brazilian postpubertal adolescents. MethodsWe conducted an analysis of postpubertal adolescents enrolled in the national school-based cross-sectional study of cardiovascular risks in adolescents (ERICA-BRAZIL) from February 2013 to November 2014. IR was defined by homeostatic model assessment index for IR values ≥2.32 for girls and ≥2.87 for boys. The analysis involved calculating the area under receiver operating characteristic curves, sensitivity values, specificity, positive and negative predictive values, and positive and negative likelihood ratios to determine reference values of indices with optimal performance. ResultsThe sample was comprised of 14 026 adolescents, with 25.3% (95% confidence intervals: 24.6%–26.1%) exhibiting IR, more prevalent among girls and overweight individuals. The ideal lipid accumulation product cut-off points associated with IR were 13.5 for the total population, 13.8 for male adolescents, and 13.5 for girls. Regarding tri-ponderal mass index, the optimal cut-off values for identifying IR were 14.1, 13.9, and 14.5 kg/m³ in the general sample, boys, and girls, respectively. ConclusionsThis study establishes cut-off points for adiposity indices, demonstrating their effectiveness in screening for IR in postpubertal Brazilian adolescents.

Dietary exposure from food colours by Brazilian adolescents using the ERICA 2013–2014 food consumption database

Colouring food additives are added for the purpose of restoring, intensifying or imparting colour. Although food colours exposure estimates are available in Brazil, no comprehensive assessments were found covering all food colours allowed in the country and no study considered consumption data from ERICA (Study of Cardiovascular Risks in Adolescents), which covers data from more than 70,000 Brazilian students from 12 to 17 years old. This study estimated dietary exposure to 33 food colours authorized in Brazil and for which numerical safety values have been established, followed by risk characterization. Consumption data were obtained from two days dietary recalls applied to students in public and private schools from Brazilian cities with more than 100,000 residents. Exposure estimates were performed in two scenarios: mean and high exposures levels, undertaking conservative assumptions. Estimates were compared with the Acceptable Daily Intake (ADI) values established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). Prioritization for future risk assessment was made based on ADI exceedance, with 14 colours as a low priority, 10 as a medium and 9 as a high priority. For high priority food colours, refined estimates are encouraged to evaluate more precisely real exposures and the need of implementation of management actions to reduce exposure.

Sleep duration and consumption of ultra-processed foods among Brazilian adolescents

BackgroundSleep duration influences the dietary pattern and quality of life of adolescents and is associated with increased ultra-processed food (UPF) consumption among those with inadequate sleep duration, which may be related to the increased prevalence of obesity, insulin resistance, and high blood pressure in this age group. Thus, the study objective was to verify the association between sleep duration and UPF intake among Brazilian adolescents participating in the Study of Cardiovascular Risks in Adolescents (ERICA). MethodsCross-sectional study using ERICA data, conducted between March 2013 and December 2014 with adolescents aged 12 to 17 years from public and private schools in Brazilian cities with more than 100,000 inhabitants. UPF consumption was obtained by recording a 24-hour food diary and was used as the outcome variable (in grams). The sleep duration was obtained through a questionnaire, stratified into recommended sleep duration (eight to 10 h) and inadequate sleep duration (less than 8 h and more than 10 h). Linear regression was performed to verify the association between sleep duration and UPF consumption. The analyses were carried out using Stata. Results66,791 adolescents were included in the study, 55.94 % of whom had inadequate sleep duration. Regardless of sleep duration, male adolescents had a higher average UPF consumption, as did adolescents in the 14–15 age group, who belong to the high socioeconomic score. Adolescents who slept less than 8 or more than 10 h a night (inadequate sleep duration) showed an increase in UPF consumption compared to adolescents who complied with the recommended hours of sleep (37.20 (22.64 – 51.76). ConclusionThe results show the importance of healthy lifestyle habits, such as adequate sleep duration and healthy eating, for health promotion. Food and Nutrition Education actions in schools are recommended to warn about the harm of inadequate sleep time and excessive UPF consumption.

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity.

Pediatric obesity is closely associated with cardiometabolic comorbidities, but the role of sex in this relationship is less investigated. We aimed to evaluate sex-related differences on cardiometabolic risk factors and preclinical signs of target organ damage in adolescents with overweight/obesity (OW/OB). The main cross-sectional study included 988 adolescents (510 boys and 478 girls) with OW/OB aged 10-18 years. In all youths clinical and biochemical variables were evaluated and an abdominal echography was performed. Echocardiographic data for the assessment of left ventricular mass (LVM) and relative wall thickness (RWT) were available in an independent sample of 142 youths (67 boys and 75 girls), while echographic data of carotid intima media thickness (cIMT) were available in 107 youths (59 boys and 48 girls). The three samples did not differ for age, body mass index, and sex distribution. In the main sample, boys showed higher waist-to-height ratio (WHtR) values (p 0.0001) and fasting glucose levels (p = 0.002) than girls. Lower levels of estimates glomerular filtration rate (eGFR) were found in girls vs boys (p 0.0001). No sex-related differences for prediabetes and hyperlipidemia were observed. A higher prevalence of WHtR 0.60 (57.3% vs 49.6%, p = 0.016) and fatty liver disease (FLD) (54.5% vs 38.3%, p 0.0001) as well as a trend for high prevalence of hypertension (40.4 vs 34.7%, p = 0.06) were observed in boys vs girls. More, a higher prevalence of mild reduced eGFR (MReGFR) ( 90 mL/min/1.73 ) was observed in girls vs boys (14.6% vs 9.6 %, p 0.0001). In the sample with echocardiographic evaluation, boys showed higher levels of LVM (p = 0.046), and RWT (p = 0.003) than girls. Again, in the sample with carotid echography, boys showed higher levels of cIMT as compared to girls (p = 0.011). Adolescent boys with OW/OB showed higher risk of abdominal adiposity, FLD, and increased cardiac and vascular impairment than girls, whereas the latter had a higher risk of MReGFR. Risk stratification by sex for cardiometabolic risk factors or preclinical signs of target organ damage should be considered in youths with OW/OB.

Cardiometabolic risk assessment: A school-based study in Brazilian adolescent

Background and aimsRecently, new indices combining routine and low-cost anthropometric and biochemical measurements have emerged. Among them, the visceral adiposity index (VAI) and lipid accumulation product (LAP) are being investigated for the prediction of altered blood pressure (BP) and insulin resistance (IR). Therefore, this study aimed to evaluate whether visceral adiposity index (VAI) and height-corrected lipid accumulation product (HLAP) are predictors of cardiometabolic risk in Brazilian adolescents. Methods and resultsData were obtained from the Cardiovascular Risk in Adolescents (ERICA) study, a cross-sectional, national, multicenter, school-based survey conducted between 2013 and 2014 in Brazil. The sample consisted of 37,815 adolescents aged 12–17 years of both genders attending the last 3 years of elementary or secondary school from public and private schools located in 273 municipalities with more than 100,000 inhabitants. A Poisson regression was performed to verify associations between VAI and HLAP indices and the presence of altered BP and IR according to sex. In addition, receiver operating characteristic curve (ROC) analysis was applied to compare the predictive ability and determine the cut-off points of the VAI and HLAP indices in identifying cardiometabolic risk obtained by altered BP and IR. The prevalences of altered BP and IR were 24.49 % (95 % confidence interval [CI]: 23.14–25.87) and 24.22 % (95 % CI: 22.70–25.80), respectively. ConclusionsThe VAI and HLAP indices are good predictors of cardiometabolic risk in Brazilian adolescents. HLAP showed better performance in identifying insulin resistance in males.

Genetic and Environmental Factors and Cardiovascular Disease Risk in Adolescents

Cardiovascular risk factors in youth have been associated with future cardiovascular disease (CVD), but conventional observational studies are vulnerable to genetic and environmental confounding. To examine the role of genetic and environmental factors shared by full siblings in the association of adolescent cardiovascular risk factors with future CVD. This is a nationwide cohort study with full sibling comparisons. All men who underwent mandatory military conscription examinations in Sweden between 1972 and 1995 were followed up until December 31, 2016. Data analysis was performed from May 1 to November 10, 2022. Body mass index (BMI), cardiorespiratory fitness, blood pressure, handgrip strength, and a combined risk z score in late adolescence. The primary outcome was fatal or nonfatal CVD, as recorded in the National Inpatient Register or the Cause of Death Register before 2017. A total of 1 138 833 men (mean [SD] age, 18.3 [0.8] years), of whom 463 995 were full brothers, were followed up for a median (IQR) of 32.1 (26.7-37.7) years, during which 48 606 experienced a CVD outcome (18 598 among full brothers). All risk factors were associated with CVD, but the effect of controlling for unobserved genetic and environmental factors shared by full siblings varied. In the sibling analysis, hazard ratios for CVD (top vs bottom decile) were 2.10 (95% CI, 1.90-2.32) for BMI, 0.77 (95% CI, 0.68-0.88) for cardiorespiratory fitness, 1.45 (95% CI, 1.32-1.60) for systolic blood pressure, 0.90 (95% CI, 0.82-0.99) for handgrip strength, and 2.19 (95% CI, 1.96-2.46) for the combined z score. The percentage attenuation in these hazard ratios in the sibling vs total cohort analysis ranged from 1.1% for handgrip strength to 40.0% for cardiorespiratory fitness. Consequently, in the sibling analysis, the difference in cumulative CVD incidence at age 60 years (top vs bottom decile) was 7.2% (95% CI, 5.9%-8.6%) for BMI and 1.8% (95% CI, 1.0%-2.5%) for cardiorespiratory fitness. Similarly, in the sibling analysis, hypothetically shifting everyone in the worst deciles of BMI to the middle decile would prevent 14.9% of CVD at age 60 years, whereas the corresponding number for cardiorespiratory fitness was 5.3%. In this Swedish national cohort study, cardiovascular risk factors in late adolescence, especially a high BMI, were important targets for CVD prevention, independently of unobserved genetic and environmental factors shared by full siblings. However, the role of adolescent cardiorespiratory fitness in CVD may have been overstated by conventional observational studies.

Depressive symptoms and cardiovascular risk in adolescents: The neighborhood context

Depressive symptoms and cardiovascular risk in adolescents: The neighborhood context

Depressive symptoms and cardiovascular risk in adolescents: The neighborhood context

Depressive symptoms and cardiovascular risk in adolescents: The neighborhood context

Dietary patterns and biochemical markers related to diabetes mellitus: an association analysis based on data from the Study of Cardiovascular Risk in Adolescents (ERICA)

ObjectiveThe aim of this study was to investigate the association between dietary patterns and biochemical markers related to diabetes mellitus (DM): glucose, insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance index from 35 454 Brazilian adolescents 12 to 17 y of age. MethodsDietary patterns were derived using factor analysis by the principal components method. The data originated from the school-based study ERICA (Study of Cardiovascular Risk in Adolescents) carried out between 2013 and 2014. Linear regression models analyzed the associations. ResultsThree dietary patterns were found: traditional Brazilian, bread and coffee, and Western. An inverse association was found in young girls between the traditional Brazilian pattern and fasting glucose (β = –0.76; P = 0.005) and HbA1c in the second and third tertiles (β = –0.04; P = 0.002; β = –0 .06; P < 0.001), and the Western pattern with HbA1c (β = –0.02; P = 0.035). In boys, a positive association was found between the second tertile of the dietary pattern and insulin (β = 0.48; P = 0.009) and homeostasis model assessment of insulin resistance index (β = 0.11; P = 0.012). ConclusionsThis study showed that the traditional Brazilian pattern was inversely associated with blood glucose and HbA1c values in girls. Furthermore, the data suggest that there is an important difference between boys and girls in the association of dietary patterns and the markers used.

Omega-3 and omega-6 fatty acids food intake and metabolic syndrome in adolescents 12 to 17 years old: A school-based cross-sectional study

Fatty acids (FAs) of the omega-3 and omega-6 family are considered essential, and adequate intake seems to be associated with lower risk of developing chronic non-communicable diseases. The objective was to evaluate the association of omega-3 and omega-6 FAs dietary intake with the prevalence of MS and its components waist circumference (WC), blood pressure (BP), fasting blood glucose, triglycerides and High Density Lipoprotein - cholesterol (HDL-c) in Brazilian adolescents aged 12-17 years. This is a school-based cross-sectional investigation, using data from the Study of Cardiovascular Risks in Adolescents (ERICA), carried out between 2013 and 2014. The following variables were collected and assessed: 1) sociodemographic (sex, age, type of school, school location whether urban or rural and region of the country); 2) food consumption was measured through a 24-h Food Recall (24hR), and a second 24hR was applied to 7% of the total sample; 3) anthropometrics (weight, height, WC), BP and biochemical (glycemia, triglycerides and HDL-c) were also assessed. Logistic regression analysis was performed according to gender and age group. A total of 36,751 adolescents participated in the study. The intake of omega-3 FAs in the total population was 1.71g/day and of omega-6 FAs, 13.56g/day, with an omega-6/omega-3 ratio of 7.93:1. It was found that higher intake of omega-3 FAs was associated with an 53% lower chance of low HDL-c. For omega-6 FAs, no significant results were found. The findings indicated an association between omega-3 FAs and HDL-c. More studies are needed to elucidate the effects of omega-6 FAs.

Caffeine consumption and association with sleep duration and screen time in Brazilian adolescents (ERICA Study)

ObjectivesSome studies have demonstrated that caffeine consumption is a risk factor for insufficient sleep or poor sleep quality in adolescents. The aim of this study was to estimate the average daily caffeine consumption and to investigate the association between caffeine, sleep duration, and screen time in a large sample of Brazilian adolescents. MethodsWe evaluated data from 71 533 adolescents aged 12 to 17 y, who participated in the ERICA study (Study of Cardiovascular Risk in Adolescents). Caffeine intake was extracted from 24-h dietary recalls of caffeine-containing products. The mean daily intake of caffeine/mg and caffeine/mg/kg, the prevalence of caffeine intake, and their respective 95% confidence intervals (CIs) were estimated according to the general characteristics. Associations between caffeine consumption, sleep duration, and screen time were analyzed by a multinomial logistic regression model, considering P < 0.05. ResultsThe overall average daily caffeine intake was 99.45 mg (95% CI, 91.43–107.47) and 1.88 mg/kg (95% CI, 1.71–2.04). Daily caffeine intake >3 mg/kg was significantly associated with screen time ≤2 h/d (odds ratio [OR], 1.16; 95% CI, 1.06–1.26) and sleep duration ≥8 h (OR, 1.31; 95% CI, 1.17–1.46), which remained significant after adjustment. The time of day of the highest caffeine consumption was in the morning (05:00–12:59). The most consumed caffeine-containing product was coffee (35%), followed by soda (27%). ConclusionsThis study demonstrated that caffeine consumption does not interfere with sleep duration or screen time. Moreover, the study provided important information about the source of caffeine most consumed by Brazilian adolescents, which could help professionals plan appropriate caffeine consumption.

Food consumption frequency in schoolaged adolescents and its cardiovascular risk association

Childhood and adolescence are the life stages where eating habits related to the development of cardiovascular risk factors are usually established. To classify cardiovascular risk in school adolescents from Villavicencio (Colombia) and, additionally, to estimate its association with food intake frequency according to food kind. This is an analytical cross-sectional study developed in 1,504 adolescents of 13 to 17 years of age schooling in Villavicencio. We evaluated the cardiovascular risk according to the model proposed by Rodríguez-Soriano and Sanjurjo, and the food intake frequency with a structured survey. We used a binomial regression model to estimate the relationship between cardiovascular risk and food intake frequency. The mean age of the participants was 14.9 ± 0,07 years; 61.9% were women, and 80.6% came from schools located in urban areas. According to the cardiovascular risk classification, 34.5% of adolescents had a high cardiovascular risk, while 25.4% had intermediate risk. Men and those who consume more than two sugary drinks per day are those who presented a higher percentage of high cardiovascular risk (48.6% and 36.9%, respectively). Regression models showed that consumption of more than one sugary drink per day was associated with high levels of cardiovascular risk in adolescents (OR 1.27 95%CI 1.04-1.55). A high proportion of adolescents have medium and high cardiovascular risk; additionally, the consumption ofsugary drinks showed its association with cardiovascular risk.