Background: Multimorbidity is defined as the presence of multiple chronic conditions in the same individual. Multimorbidity is more prevalent in older adults and can lead to several adverse health outcomes. Methods: We systematically reviewed evidence from observational studies to verify the association between multimorbidity and hospitalization in older adults. Furthermore, we also aimed to identify whether it changes according to gender, advanced age, institutionalization, and wealth of the country of residence. We searched the PubMed, Embase and Scopus databases from December 2020 to April 2021. The analysed outcomes were as follows: hospitalization, length of stay and hospital readmission. Results: Of the 6,948 studies identified in the databases, 33 were included in this review. From the meta-analysis results, it was found that multimorbidity, regardless of the country’s wealth, was linked to hospitalization in older adults (OR = 2.52, CI 95% = 1.87–3.38). Both definitions of multimorbidity, ≥2 (OR = 2.35, 95% CI = 1.34–4.12) and ≥3 morbidities (OR = 2.52, 95% CI = 1.87–3.38), were associated with hospitalization. Regardless of gender, multimorbidity was associated with hospitalization (OR = 1.98, 95% CI = 1.67–2.34) and with readmission (OR = 1.07, 95% CI = 1.04–1.09). However, it was not possible to verify the association between multimorbidity and length of stay. Conclusions: Multimorbidity was linked to a higher hospitalization risk, and this risk was not affected by the country’s wealth and patient’s gender. Multimorbidity was also linked to a higher hospital readmission rate in older adults. PROSPERO Registration (Registration number: CRD42021229328).

Summary: Evidence shows a strong relationship between obesity, cancer and cardiovascular disease (CVD) risk. However, there is not enough evidence of the role of visceral obesity on both CVD and cancer. Visceral obesity may be more pro‐oncogenic than total body fat. Therefore, it is important to know whether abdominal obesity can lead to both CVD and cancer. The present integrative review aimed at evaluating epidemiological evidence on the potential connection of visceral obesity in the occurrence of cancer and CVD. The following databases were searched: SCOPUS, PubMed, Science Direct, Lilacs, SciELO, Google Scholar, Web of Science, Scopus and ProQuest. The presence of visceral obesity can increase the risk of some specific cancer types, but there is controversial evidence about CVD risk based on sex‐specific and ageing analyses. There is enough evidence that visceral obesity increases the risk of colorectal, pancreatic and gastro‐oesophageal cancer. However, for some types of cancer such as breast, endometrial and renal, visceral obesity is a risk only in post‐menopausal women. Regarding prostate cancer, the evidence is controversial. Despite the risk of visceral obesity being consistently associated with CVD in adults, this association disappears in sex‐specific and older adults analyses. Moreover, in older adults, the results are controversial due to the use of different measures such as waist circumference and visceral adipose tissue. However, the evidence showing visceral obesity as a risk factor to CVD remains controversial. Sex differences, ageing and body mass index (BMI) category can potentially modify this association. Therefore, further epidemiological studies with analyses stratified by sex and samples including older adults aged 65 and older are needed.

Objective: To validate calf circumference as a technology for assessing muscle mass in the elderly. Method: Cross-sectional study with 132 elderly people from Goiânia, Goiás, Brazil. Decreased muscle mass was determined by the skeletal muscle mass index (IME) using Dual Energy X-Ray Absortometry (DEXA). The cutoff circumferences (CC) cutoff points to indicate muscle mass decrease were estimated by ROC curve, sensitivity, specificity and accuracy. Results: The most accurate cut-off points for detecting decreased muscle mass in the elderly were 34 cm for men (sensitivity: 71.5%, specificity: 77.4%) and 33 cm for women (sensitivity: 80.0%; specificity: 84.6%). Conclusion: CC can be used as a measure for early identification of muscle mass decrease in routine evaluations of the elderly in primary care.

The association between obesity, cancer and cardiovascular disease (CVD) has been demonstrated in animal and epidemiological studies. However, the specific role of visceral obesity on cancer and CVD remains unclear. Visceral adipose tissue (VAT) is a complex and metabolically active tissue, that can produce different adipokines and hormones, responsible for endocrine-metabolic comorbidities. This review explores the potential mechanisms related to VAT that may also be involved in cancer and CVD. In addition, we discuss the shared pharmacological treatments which may reduce the risk of both diseases. This review highlights that chronic inflammation, molecular aspects, metabolic syndrome, secretion of hormones and adiponectin associated to VAT may have synergistic effects and should be further studied in relation to cancer and CVD. Reductions in abdominal and visceral adiposity improve insulin sensitivity, lipid profile and cytokines, which consequently reduce the risk of CVD and some cancers. Several medications have shown to reduce visceral and/or subcutaneous fat. Further research is needed to investigate the pathophysiological mechanisms by which visceral obesity may cause both cancer and CVD. The role of visceral fat in cancer and CVD is an important area to advance. Public health policies to increase public awareness about VAT’s role and ways to manage or prevent it are needed.

Aim. To identify methods, index, diagnostic criteria, and corresponding cutoff points used to estimate the prevalence of sarcopenia in older people in different countries.Methods. A systematic review was carried out in accordance with PRISMA Statement. The search encompassed the MEDLINE and LILACS databases and was executed during March 2012 using the keyword sarcopenia.Results. A total of 671 studies were identified by the search strategy, and 30 meet all inclusion criteria. Specifically for dual-X-ray absorptiometry, prevalence ranged from 2.2% to 95% in men and from 0.1% to 33.9% in women. For bioelectrical impedance analysis, the range was from 6.2% to 85.4% in men and 2.8% to 23.6% in women. Regarding anthropometric and computed tomography, prevalence rates were, respectively, 14.1% and 55.9%.Conclusions. Heterogeneity in prevalence of sarcopenia was identified, due to diagnostic method choice, cutoff points, and, characteristics of the population as well as reference population. These factors should be considered in research designs to enable comparison and validation of results. Despite the limitations of most studies that indicated high prevalence rates, the results indicate the need for early detection of this syndrome.

This cross-sectional study utilized the National School Health Survey 2015 database to assess the association between school cafeterias; the meals offered by the Brazilian School Food Program (PNAE); and the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks among Brazilian adolescents. A sample of 102,072 adolescents, aged 11–19 years, who were enrolled in the 9th grade completed the survey. The evaluated outcome was the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks. A Poisson regression model-based multivariate analysis was performed. The effect measure was the prevalence ratio (PR) with its respective 95% confidence intervals (CIs). The results indicated that Brazilian adolescents who attended schools without meals offered through the PNAE had a higher probability of regularly (≥5 times/week) consuming ultra-processed salty foods [PR = 1.06, CI = 1.01–1.11] and soft drinks [PR = 1.08, CI = 1.03–1.14] compared to those who attended schools that offered PNAE meals. Moreover, the presence of a school cafeteria was associated with a higher probability to consume industrialized/ultra-processed salty foods [PR = 1.05, CI = 1.02–1.08], sweets [PR = 1.09, CI = 1.07–1.11], and soft drinks [PR = 1.10, CI = 1.07–1.13]. School meals appear to be associated with the consumption of ultra-processed foods by Brazilian adolescents, indicating areas for health promotion programs.