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In evergreen tropical forests, the extent, magnitude, and controls on photosynthetic seasonality are poorly resolved and inadequately represented in Earth system models. Combining camera observations with ecosystem carbon dioxide fluxes at forests across rainfall gradients in Amazônia, we show that aggregate canopy phenology, not seasonality of climate drivers, is the primary cause of photosynthetic seasonality in these forests. Specifically, synchronization of new leaf growth with dry season litterfall shifts canopy composition toward younger, more light-use efficient leaves, explaining large seasonal increases (~27%) in ecosystem photosynthesis. Coordinated leaf development and demography thus reconcile seemingly disparate observations at different scales and indicate that accounting for leaf-level phenology is critical for accurately simulating ecosystem-scale responses to climate change.

Describing the consumption of ultra-processed foods (UPF) and their association with the nutritional profiles among users of a health promotion service in a Brazilian city. Cross-sectional study. Public health promotion service of Primary Health Care in Belo Horizonte, Minas Gerais, Brazil. Totally, 3372 participants. UPF were found to contribute to 27·7 % of the diet's total energy. The highest consumption was associated with higher values for energy intake (1561·8 v. 1331·8 kcal/d; P < 0·01), energy density (1·7 v. 1·4 kcal/g; P < 0·01), total (32·5 v. 27·3 %; P < 0·01) and trans-fats (2·1 v. 1·2 %; P < 0·01) and Na (1001·6 v. 758·9 mg/1000 kcal; P < 0·01) and with lower values for proteins (14·9 v. 19·6 %; P < 0·01), mono-unsaturated fats (16·1 v. 20·1 %; P = 0·02), n-3 (0·9 v. 1·1 %; P < 0·01) and some vitamins and minerals when comparing individuals in the last quintile of energy contribution from UPF in relation to the first one. The prevalence rate of nutrient inadequacy aimed at preventing non-communicable diseases increased between 30 % and 100 % when compared with the values of the fifth to the first quintile of UPF consumption (P < 0·001). However, the participants had lower energy intake, energy density and Na and higher fibre consumption when compared to Brazilian population. Participants showed a high consumption of UPF, but also positive diet characteristics when compared with the national data. The results suggest the importance of health promotion services to promote healthy food and the need to include approaches to reduce UPF consumption.

This study aimed to compare fruits and vegetables (FV), and carbonated soft drink (CSD) consumption among adolescents from seventy-four countries, according to macroeconomic indicators. This is an ecological study, developed with countries evaluated through the Global School-based Student Health Survey (2003–2014) and the National School Health Survey (PeNSE-Brazil, 2015). The percentages of students in each country who consumed CSD and FV daily and their association with the Human Development Index (HDI) and the Gross National Income per capita (GNIpc) were assessed. Scatter plots were constructed for each marker, and a multilevel model was tested to consider the effects of region in the associations. The overall prevalence of daily CSD consumption was 54·1 %. CSD consumption was positively associated with HDI and GNIpc through multilevel models, and Central and South America showed a considerable higher consumption compared with other regions. Overall, FV daily consumption was 67·9 % and 74·6 %, respectively, and no associations with macroeconomic indicators were found. The study shows concerning rates of CSD consumption among adolescents, and a trend of increased consumption with the improvement of the country’s development and GNIpc. This points for the importance of public policies that regulate food and beverage industries to reduce CSD consumption and related co-morbidities among adolescents.

Background Given the current worldwide epidemic of obesity , there is a demand for interventions with higher impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of intervention performed according to the stages of change of the transtheoretical model (TTM) for weight management. Methods This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education. The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The intervention group (IG, n  = 51) received the same orientation as the comparison group (CG, n  = 35) plus individual health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance (ANCOVA) used to assess intervention effectiveness. Results There was a difference between groups of − 1.4 kg (CI95%: − 2.5; − 0.3) in body weight after the intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood glucose results compared to the CG during follow-up. Conclusion The individualized TTM-based intervention, combined with usual care, was an effective strategy in PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify additional strategies is needed to address barriers to weight maintenance among obese low-income women. Trial registration The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv , Registration date: 12/12/2017 (retrospectively registered).

•Food insecurity negatively affected the fruit and vegetable consumption.•Food insecurity did not change the intake of ultra-processed foods.•It is important to develop actions to reduce social inequities to promote healthy food.•There is an intrinsic relation between alimentary systems and food consumption. We aim to identify the prevalence of food insecurity and to ascertain the association between food insecurity and food intake. A cross-sectional survey. The study included users of a primary healthcare service in Belo Horizonte, Brazil, from 2013 to 2014. Socioeconomic, health, and food intake data were gathered using a questionnaire and the Brazilian Food Insecurity Scale. Individuals 20 years old or older (n = 2817). The prevalence of food insecurity among families with individuals under 18 years was 41.0%, and 26.4% in other households. After adjusting for potential confounders, the households in food insecurity with members under 18 years old, the consumption of fruits and vegetables (RP = 0.70, 95%IC: 0.58–0.84), and fruits (RP = 0.74, 95%IC: 0.59–0.93) was lower; and consumption of beans was higher (RP = 1.49, 95%IC: 1.06–2.09) compared to those with food security. In households without members under 18 years old, the consumption of fruits and vegetables (RP = 0.68, 95%IC: 0.58–0.79), fruits (RP = 0.61, 95%IC: 0.50–0.74), and beans (RP = 0.78, 95%IC: 0.63–0.97) was lower; and the consumption of tubers (RP = 1.36, 95%IC: 1.03–1.79) was higher. However, the state of food insecurity did not affect the consumption of ultra-processed foods, independently of age, sex, marital status, educational level, and employed status. Food insecurity negatively affected the fruit and vegetable consumption in both types of families tested. The consumption of beans was higher in households with children and adolescents, and the consumption of tubers was higher in households without children and adolescents. However, food insecurity did not change the intake of ultraprocessed foods.

Obesity has been identified as an important risk factor for cardiovascular disease and other chronic diseases. However, dietary treatment of obesity is far from being a closed issue. Therefore, it is critical to identify the most appropriate obesity management approaches. The aim of this review was to summarize the effects, potentialities, and limitations of nutritional interventions aimed at managing obesity in primary and secondary health care settings, highlighting the most effective strategies and theories. This systematic review of randomized controlled trials evaluated nutritional interventions aimed at achieving weight loss in primary and secondary health care patients. All screening and extraction processes were conducted according to PRISMA. From an initial 7816 studies that were identified, 28 met the criteria and were included in the review. Most studies were conducted in a developed country in primary care, with a higher proportion of women. Most of the nutrition interventions maintained continuous contacts during follow-up, and telephone calls were the most commonly used technology. A physical activity component was included in most studies, and the most common dietary approaches used were energy restrictions, changes in macronutrient distribution, and diet self-monitoring. Regarding theories, interventions mainly incorporated Social Cognitive Theory and Motivational Interviewing. Most trials presented significant and moderate weight loss (~5%), in which the key contributors were behavioral theories, the dietary approach of calorie restriction, and interventions delivered by dietitians and psychologists. Most trials presented better weight loss results with the association of calorie restrictions and theory-based interventions delivered by dietitians or psychologists. We identified the need to develop interventions in other contexts, such as low- and middle-income countries; further trials comparing a theory- versus not-theory–driven intervention; group-based versus individually based intervention; and intervention using or not using technology. •Most trials were effective in producing significant and moderate weight loss (≅5.0%).•Better weight loss results when nutritional interventions have caloric restrictions.•Theory-based interventions delivered by dietitians or psychologist were also better.•It is needed to develop interventions in other contexts (low and middle-income countries).

Pericytes are multipotent perivascular cells whose involvement in vasculature development is well established. Evidences in the literature also suggest that pericytes display immune properties and that these cells may serve as an in vivo reservoir of stem cells, contributing to the regeneration of diverse tissues. Pericytes are also capable of tumor homing and are important cellular components of the tumor microenvironment (TME). In this review, we highlight the contribution of pericytes to some classical hallmarks of cancer, namely, tumor angiogenesis, growth, metastasis, and evasion of immune destruction, and discuss how collectively these hallmarks could be tackled by therapies targeting pericytes, providing a rationale for cancer drugs aiming at the TME.

Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde - PAS). A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis. Belo Horizonte - Brazil. 3372 adults (≥20 years). Users in the third tertile of PAS (24·4-61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1-24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0-10 months). Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.

Evaluate the 5-year changes in the consumers' food environment in the area of a health promotion service in Brazilian primary health care. Our hypothesis is that the consumers' food environment in the areas with primary healthcare services has changes that may favour healthy eating habits over time. Longitudinal study. The territory around the primary healthcare services in Belo Horizonte, Minas Gerais, Brazil. All food stores and open-air food markets that sell fruits and vegetables around the primary healthcare services in 2013 ( 272) and in 2018 ( 265). Fruit diversity increased by 13·4 % ( < 0·001) and vegetables variety and quality by 16·1 % ( = 0·003) and 12·5 % ( < 0·001), respectively. Corn snacks showed an increase in availability (13·5 %; = 0·002). The increase in advertising was observed for fruits and vegetables (34·6 %; < 0·001) and ultra-processed foods (47·6 %; < 0·001). Supermarkets showed an increase in the Healthy Food Store Index (three points; < 0·001), while fruits and vegetables stores showed a decrease of one point in the index ( < 0·001). The unequal changes in the consumers' food environment according to the food stores types demonstrate the importance of food supply policies that promote a healthy environment and favour the maintenance of traditional healthy food retailers.

•The present study found a high prevalence of overweight in a health promotion service of primary health care.•Although there was adequate diversity and variety of fruit and vegetables sold in food stores, the quality of these items was low.•There was a high presence of ultraprocessed foods in stores selling fruit and vegetables.•The variety of vegetables was the only food environment measure that explained overweight. The aim of this study was to investigate the association between aspects of the consumer food environment in food stores selling fruit and vegetables (FVs) and the incidence of overweight among users of a Brazilian primary health care service. This cross-sectional study assessed individual-level and food environment variables, within the context of a representative sample of a primary health care service in a Brazilian city (the Health Academy Program [HAP]) in 2013. Users of HAP units and multiple aspects of the consumer food environment (availability, diversity, variety, quality, advertising, and price) related to FVs and ultraprocessed foods (UPFs) were examined. Multilevel logistic models were used to examine the relationships among overweight and consumer environment characteristics. We analyzed 2810 participants and audited 336 food stores. More than 70% of stores had adequate diversity and variety of FVs; Regarding quality, only 24.5% of stores presented inadequate quality of fruits and 39.6% inadequate quality of vegetables. UPFs were present in 60.6% of FV stores. The results indicated a high prevalence of overweight (62.6%) in participants of the health promotion service and the multilevel models revealed an association with variety of vegetables in stores (0.99; 95% confidence interval, 0.97–0.99; P < 0.05). Given the importance of food environment in food choice at the time of purchase, it is important to consider consumer food environment in determining consumption. The results suggest that increased exposure to healthy foods should be included as guidelines for weight management.