Globally, vitamin A deficiency (VAD) affects about 19.1 million pregnant women. Its occurrence is classically associated with inadequate food intake and may also be associated with socioeconomic factors and the presence of infection. The aim of this study was to determine the factors related to serum retinol levels among pregnant teenagers. The sample consisted of 89 pregnant adolescents, from whom socioeconomic, obstetric, anthropometric, and food consumption data were collected. Serum concentrations of retinol and the supposed presence of infection were determined by high-performance liquid chromatography and C-reactive protein quantification, respectively. The serum retinol concentrations were classified according to the criteria of the World Health Organization. We adopted a 5% significance level for all statistical tests. Serum retinol levels were significantly and positively associated with sanitation (p = 0.008) and pre-gestational nutritional status (p = 0.002), and negatively with the trimester (p = 0.001). The appropriate sanitation conditions and pre-pregnancy body mass index (BMI) were shown to have a protective effect against VAD. Conversely, serum retinol levels were reduced with trimester progression, favoring VAD occurrence.

Early clinical prognosis and mortality reduction remains a challenge in chronic liver disease (CLD). The full potential of the Nutritional Prognostic Index (NPI) for nutritional assessment and management in CLD patients remains unexplored. The aim of this study was to establish an NPI cutoff point for the identification of nutritional risk in advanced CLD (ACLD) patients, as well as to assess the NPI's ability to predict ACLD-associated mortality. This ethically approved prospective cohort study investigated malnutrition risk using both the NPI and the Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) in patients hospitalized for ACLD. NPI reference values were determined using a receiver operating characteristic curve. Associations between nutritional risk identified by the RFH-NPT and the NPI were assessed using Fisher's exact test, and agreement between tools was assessed using the Kappa index. The association between NPI-defined nutritional risk and 12-mo mortality was examined using Pearson Chi-square test. The sample population consisted of 120 adults, comprising 84 (70%) male and 57 (50.9%) of alcoholic etiology and presenting as Child-Pugh A, B, or C at admission. The identified cutoff point for NPI was <41, identifying nutritional risk in 82.5% of patients. The NPI presented a statistically significant association with the RFH-NPT, with a substantial agreement coefficient of 0.34. An association between NPI <41 cutoff and mortality were observed, with 82.1% of the sample below cutoff experiencing mortality within 12 mo. The NPI is a valuable nutritional marker for the identification of nutritional risk in ACLD and is a simple and effective assessment tool that can aid in early CLD prognosis assessment. Validation, however, remains necessary in other CLD populations of different etiologies.

Objetivo: avaliar o consumo alimentar habitual de pacientes com Doença Hepática Gordurosa não Alcoólica (DHGNA) de acordo com o grau de esteatose hepática, verificar a associação com variáveis antropométricas e desenvolver um Questionário de Frequência Alimentar (QFA) direcionado para essa população. Métodos: Estudo observacional de corte transversal desenvolvido com 60 pacientes adultos, diagnosticados com DHGNA leve ou moderada. Realizou-se avaliação antropométrica e aplicação de recordatórios de 24 horas. Para a análise da composição da dieta e classificação dos alimentos considerou-se a proposta NOVA. Para o desenvolvimento do QFA foram selecionados os alimentos que contribuíram com até 95% de energia, macronutrientes e micronutrientes de interesse. Utilizou-se o teste de Mann Whithey para verificar a diferença entre as medianas das variáveis com o grau de esteatose hepática e o coeficiente de correlação de Spearman para o cálculo das correlações. O nível de significância adotado na decisão dos testes foi de 5%. Resultados: observou-se ingestão alimentar semelhante entre os pacientes com DHGNA, com predomínio dos alimentos in natura ou minimamente processados. O grau de processamento dos alimentos não apresentou correlação significativa com as medidas antropométricas e grau de esteatose. O QFA foi elaborado a partir da seleção de 96 alimentos. Conclusões: o consumo alimentar apresenta-se semelhante ao padrão básico da população brasileira. O consumo total de macro e micronutrientes destes pacientes não se correlacionou com a gravidade da esteatose, nem com os dados antropométricos. Espera-se que o QFA proposto torne-se uma ferramenta útil no monitoramento das práticas alimentares de indivíduos com DHGNA.

Objective To estimate the prevalence of vitamin A deficiency and determine the socioeconomic and demographic factors associated with serum retinol levels in public school students. Methods This cross-sectional study included 245 students from the urban and rural areas of the city of Teresina, Piauí, Brazil. Socioeconomic data were collected using a form. Serum retinol level was determined by high-performance liquid chromatography and classified according to the cut-off points provided by the World Health Organization. All statistical tests had a significance level of 5%. Results The prevalence of vitamin A deficiency (retinol level 0.05). Water well or other untreated water sources were the factors most strongly associated with low retinol levels (OR=3.28; 95%CI=1.48-7.28; p=0.003). Conclusion Vitamin A deficiency was characterized as a mild public health problem in the students, indicating the need of actions that address this issue in schools and of studies with larger samples to investigate the problem at the municipal and state levels. Untreated water intake, a possible source of waterborne illnesses, contributed to lower retinol levels.

Background: Sarcopenia is a highly prevalent and clinically impactful complication of cirrhosis, affecting 30-70% of patients depending on diagnostic criteria and disease stage. It is strongly associated with increased mortality, hepatic decompensation, infections, waitlist dropout, and inferior posttransplant outcomes. Despite growing recognition, the field remains limited by heterogeneous definitions, lack of standardized cutoffs, and inconsistent integration of functional and structural assessments. Objective and Methods: This narrative review synthesizes mechanistic pathways linking cirrhosis to muscle wasting, including hyperammonemia, anabolic resistance, systemic inflammation, hormonal dysregulation, and mitochondrial dysfunction, and critically evaluates current diagnostic tools such as CT morphometry, DEXA, BIA, and functional performance tests. Emerging biomarkers (myostatin, irisin, metabolomic signatures) and artificial intelligence-based imaging approaches are discussed as promising but still immature tools requiring validation. Conclusion: Therapeutic strategies remain constrained by low-quality evidence, with nutritional optimization, resistance training, and management of hepatic complications forming the cornerstone of care. Novel anabolic and anticatabolic therapies show potential but lack robust clinical trial data. Standardization of diagnostic criteria, integration of multimodal assessments, and development of targeted interventions represent urgent priorities to improve outcomes in cirrhosis-associated sarcopenia.

This study longitudinal investigated food consumption and factors related to weight variation in 81 adult patients with Non-Alcoholic Fatty Liver Disease (NAFLD) during the COVID-19 pandemic. Sociodemographic, anthropometric, physical activity and food intake data were collected during two periods: before and during the pandemic. For analysis, variations in weight were divided into two categories: weight gain less than or equal to two kilos and weight gain greater than two kilos. Mann Whitey test was used to verify the difference between the medians, while Spearman's correlation coefficient to calculate correlations, Fisher's exact test to assess associations. The significance level adopted in the decision of the tests was 5%. Results showed increases in the consumption of processed and ultra-processed foods among NAFLD patients alongside a reduction in the consumption of natural or minimally processed foods. Both findings were more frequent among patients demonstrating weight gain greater than two kilograms. However, analysis of the nutritional composition of patients’ diets revealed increases in carbohydrate consumption to be the only factor significantly correlated with weight gain. There was a high percentage of individuals who did not practice physical exercise before the pandemic, and this number was exacerbated during home isolation. Thus, it is observed that NAFLD patients have difficulty maintaining a healthy lifestyle and these difficulties have worsened during the pandemic, as reflected by weight gain. Therefore, it is suggested that specialized nutritional assistance be aimed at NAFLD patients seeing as they are at an increased risk for progression to more severe forms of COVID-19.