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To analyse the association between food consumption according to the degree of processing and incidence of hypertension in CUME project participants. Longitudinal study in which food consumption was evaluated according to the percentage contribution of daily energetic intake (%/d) of each NOVA classification group (unprocessed/minimally processed foods and culinary preparations (U/MPF&CP); processed foods and ultra-processed foods (UPF)). Hypertension was defined according to American College of Cardiology/American Heart Association (ACC/AHA) criteria. Adjusted relative risks (RR) and their 95% confidence intervals (95 % CI) were estimated by Poisson regression models with robust variances. Brazil. 1221 graduates classified as non-hypertensive at baseline and monitored for 2 years. Daily energetic percentage from each group according to degree of processing was 64·3 (sd 12) % for U/MPF 9·9 (sd 5·8) % for processed foods and 25·8 (sd 11) % for UPF. Incidence of hypertension was high (152/1000 person-years; n 113, 193/1000 person-years in males and n 257, 138/1000 person-years in females). After adjusting for potential confounders, participants in the upper quintile of daily energetic intake of U/MPF&CP presented a reduced risk of hypertension (RR: 0·72; 95 % CI 0·52, 0·98), while those in the upper quintile of daily energetic intake of UPF presented an increased risk of the outcome (RR: 1·35; 95 % CI 1·01, 1·81). In this prospective cohort of Brazilian middle-aged adult university graduates, the highest consumptions of U/MPF&CP and UPF were associated with, respectively, reduced and increased risk of hypertension. Additional longitudinal studies are needed to confirm our results.

Studies demonstrate that consuming plant-based diets has beneficial effects on several health outcomes. However, the evaluation of the healthiness of plant-based diets and the incidence of hypertension has still been little explored in the literature. Objectives: Thus, this study aimed to evaluate the association between plant-based diet indices and the incidence of hypertension in Brazilian adults and test whether the interaction between hPDI, sociodemographic, and lifestyle variables modifies this association. Methods: This longitudinal study included 3192 (F = 2125, average age 34 years) participants from the Cohort of Universities of Minas Gerais (CUME Study, Brazil, 2016-2022). Dietary intakes were assessed using a validated food frequency questionnaire. We measured three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Participants were classified as new cases of hypertension if they were free of this disease at baseline, had a systolic blood pressure ≥ 140 mmHg, a diastolic blood pressure ≥90 mmHg, were using antihypertensive medications, or had a diagnosis of hypertension by a physician in at least one of the follow-ups. Crude and adjusted Cox regression models were used to evaluate the relationship between plant-based diet indices and hypertension incidence and a multiplicative interaction was tested. Results: The incidence of hypertension was 19,8/1000 person-years total. The mean follow-up time was 3.36 years. There was an inverse association between the highest quintiles of hPDI (HR = 0.56, 95% CI = 0.37–0.86; HR = 0.55, 95% CI = 0.35–0.88) and hypertension. In subgroup analysis, inverse associations between hPDI and hypertension risk were stronger in participants who were insufficiently active and overweight (p-interaction < 0.05). Conclusion: Greater consumption of healthful plant foods, reduced consumption of animal-source foods, and less consumption of unhealthful plant foods are important for hypertension prevention in the Brazilian population. •Adherence to a healthy plant-based diet is associated with a lower risk of hypertension.•It involves greater consumption of whole grains, fruits, vegetables, nuts and legumes.•Implies lower consumption of fruit juices, refined grains, potatoes, sugary drinks, and sweets.•It implies less consumption of all foods of animal origin.•Insufficiently active or overweight individuals may be more likely to benefit from its consumption.

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).

Background: Few studies have evaluated the impact of branched-chain amino acid (BCAA) intake on the risk of obesity in adults. The results are contradictory, and the causality has not been explored. This study assessed the association between BCAA intake and obesity incidence among Brazilian adults and investigated the potential moderating role of the plant-based index (PDI) in this relationship. Methods: A longitudinal study was conducted between 2016 and 2022, with 3090 participants (2043 women, 1047 men; mean age 34 years) from the Cohort of Universities of Minas Gerais (CUME) Study. Data were collected through an online questionnaire. The relationship between BCAA intake and obesity incidence was assessed using crude and adjusted Cox regression models. Restricted cubic spline analysis (RCS) was used to estimate the nonlinearity. The multiplicative interaction with PDI was tested. Results: The overall incidence of obesity was 192 cases (6.21%). The incidence was 16.4/1000 person-years in females; 21.8/1000 person-years in males; and 18.3/1000 person-years total, with a mean follow-up period of 3.4 years. Compared to the first tertile, the highest intake tertiles for BCAA (HR = 1.50, 95% CI = 1.03–2.18), isoleucine (HR = 1.52, 95% CI = 1.04–2.22), and leucine (HR = 1.51, 95% CI = 1.03–2.20) were independently associated with obesity risk. BCAA intake above 16 g/day increases the risk of obesity. Conclusions: There was a positive association between the intake of BCAA, isoleucine, and leucine with the risk of obesity. The PDI accentuated the association between BCAA intake and obesity in both the lowest and highest quintiles.

Background: Quantifying urinary catecholamines and metanephrines is essential for the clinical screening and diagnosis of neuroendocrine tumours. HPLC with electrochemical detection (HPLC-ECD) is commonly used for this type of analysis but requires extensive sample cleanup. Simple and rapid dilute-and-shoot LC–multiple-reaction monitoring (MRM)-MS assays have been developed for quantitating these analytes in urine but have not yet been validated according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Methods: A simple dilute-and-shoot sample preparation without derivatization was used. C18 RP-UPLC-MRM-MS and positive-ion ESI were used, usually with two transitions per analyte being monitored. Certified deuterated internal standards were used for each analyte. Results: This assay was validated according to the CLSI C62-A guidelines, including accuracy/trueness, imprecision, sensitivity, specificity, carryover, stability, and linearity. The final MRM-MS method was compared to the established HPLC-ECD clinical chemistry reference method. The run time was reduced from 25 min to 5 min. Conclusions: A simple, robust, rapid, and cost-effective LC-MRM-MS assay for measuring urinary catecholamines and metanephrines was developed and validated according to the CLSI guidelines. This validated method requires minimal sample manipulation before analysis and provides sensitivity, specificity, and improved precision. The implementation of this assay in clinical laboratories will facilitate early and accurate diagnosis.

Evidence confirms that the satisfaction perceived by the nursing staff is associated with indicators of the professionals' well-being and quality of the provided services. The aim of this cross-sectional study was to investigate factors associated with reports of job satisfaction. Job satisfaction was assessed based on the validated question: \"Are you satisfied with your work?\". Stratified and proportional random sampling included nurses, nursing aides and technicians from the municipal health network. The multivariate model was based on the Poisson regression technique with robust variances to estimate factors independently associated with job satisfaction. A total of 290 subjects participated: 73.8% of them reported job satisfaction. Age, having strong social support and better working conditions were positively associated with satisfaction. Positive screening for common mental disorders was negatively associated with satisfaction. The emphasis on the work environment and type of management indicates the relevance of these factors for the strengthening of human resources in health.

This study aims to evaluate the association between Dietary Total Antioxidant Capacity (dTAC) and Total Antioxidant Capacity of food groups (fgTAC) with the incidence of depression in Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). The sample consisted of 2572 participants without a medical diagnosis of depression at baseline who responded to at least one follow-up questionnaire from the CUME Project. The Ferric Reducing Antioxidant Power assay was used to determine dTAC. Incidence of depression was estimated by self-reported medical diagnosis of depression during the years of cohort follow-up. Cox regression models were used to relate dTAC and fgTAC to the incidence of depression. The mean follow-up time was 2·96 (1·00) years, and 246 cases of depression were observed (32·3/1000 person-years). The mean dTAC was 11·03 (4·84) mmol/d. We found no associations between higher dTAC and lower risk of developing depression after adjusting for possible confounders. The incidence of depression was inversely associated with fgTAC of the beans and lentils group (hazard ratio (HR): 0·61; 95 % CI 0·41, 0·90). The fgTAC of the junk food group was positively associated with higher incidence of depression after all adjustments (HR: 1·57; 95 % CI 1·08, 2·26). Our findings do not support an association between dTAC and the incidence of depression in a highly educated Brazilian population. However, associations of fgTAC show the importance of analysing the food matrix in which these antioxidants are inserted. We highlight the need for more prospective studies with different nationalities to confirm these results.

To explore the relationship between ultra-processed foods (UPF) consumption and dietary, lifestyle and social determinants using pathway analysis in the baseline of the Cohort of Universities of Minas Gerais (CUME project). Cross-sectional study, in which path analysis was used to estimate direct and indirect effects of dietary practices, sleep, time on the computer and professional status on UPF consumption. Data were collected in 2016, through an online questionnaire composed of sociodemographic, anthropometric, lifestyle and dietary practices questions, and a FFQ. Baseline participants from the CUME Project ( 2826), adults who graduated from Universidade Federal de Viçosa or Universidade Federal de Minas Gerais, Brazil. Being employed ( = 0·024), the time spent on the computer ( = 0·031) and the frequency of fried food intake ( < 0·001) were positively and directly associated with UPF consumption, whereas the sleep duration ( = 0·007) and the number of meals per d ( < 0·001) were negatively and directly associated with UPF consumption. Indirect effects were observed between being employed, mediated by the sleep duration ( = 0·032) and fried food intake ( = 0·005), whereas being a student is mediated by the time on the computer ( = 0·048). The time spent on the computer, sleep duration and fried food consumption showed direct effects on UPF consumption. They also acted as mediators on the relationship between professional status and UPF consumption. Besides, the number of meals eaten each day also was directly associated with UPF consumption.

The aim of this study was to evaluate the independent association of the dietary inflammatory index (DII®) score with overweight and obesity in Brazilian participants of the Cohort of Universities of Minas Gerais (CUME project). This was a cross-sectional study consisting of 3,151 graduates and postgraduates (2197 women) with a mean (SD) age of 36.3 y (±9.4 y). Sociodemographic characteristics, lifestyle, and anthropometric data were assessed via online self-reported questionnaire. Additionally, a validated food frequency questionnaire with 144 food items was used to generate energy-adjusted DII (E-DIITM) scores, which evaluated the inflammatory potential of the diet. The prevalence of overweight and obesity were 28.2% and 11%, respectively. Participants in the highest E-DII quartile (most proinflammatory diet) were more likely to be smokers/former smokers; sedentary; and consumers of red and ultra-processed meats, fats and oils (excluding olive oil), bottled fruit juices and soft drinks, sugars, sweets, and higher overall caloric intake, compared with the first quartile of E-DII. Both men and women in the fourth E-DII quartile had the highest prevalence of overweight and obesity (prevalence ratio [PR], 1.35; 95% confidence interval [CI], 1.14–1.59 and PR, 1.97; 95% CI, 1.20–3.22, respectively, in men; PR, 1.38; 95% CI, 1.17 to 1.65 and PR, 1.95; 95% CI, 1.31–2.90, respectively, in women). The most proinflammatory dietary pattern was associated with a higher prevalence of overweight and obesity and other unhealthy lifestyles including being sedentary, smoking, and consuming a obesogenic diet. •The most proinflammatory diet was independently associated with a higher prevalence of overweight and obesity in individuals with high scholarity.•A proinflammatory dietary pattern is accompanied by other unhealthy lifestyles that are risk factors for obesity and chronic diseases.•The study of the dietary pattern index can be useful in establishing risk association as well as in prevention strategies for obesity and related chronic diseases.

Global food systems are contributing to a shift toward unhealthy diets, which is linked to the three components of the global syndemic. This cross-sectional study evaluates how dietary patterns in Brazil are associated with the components of the global syndemic. Anthropometric and food intake data were obtained from the CUME Study—a prospective cohort conducted with a sample of Brazilian university graduates. BMI was used to assess obesity. Insufficient intake of micronutrients was considered undernutrition. Carbon, water, and ecological footprints were used to assess the environmental impact of dietary patterns. Dietary patterns were identified through principal components analysis. Linear regression models were used to evaluate associations between dietary patterns and the components of the global syndemic. The Unhealthy Dietary Pattern was positively associated with BMI and had the highest environmental impact. The Brazilian Dietary Pattern was also positively associated with BMI but had the lowest environmental impact. The Healthy Dietary Pattern was the most protective against micronutrient inadequacy. Diet affected the environment and people’s health in this sample. The dietary patterns identified here as contributing to poor health and environmental damage can help the government develop policies that incorporate the costs of these effects into the prices of food.