Hyperlipidemia caused by a diet high in saturated fat can lead to visceral fat weight gain, obesity, and metabolic syndrome. Being over-weight from visceral fat has been linked to increased risk of developing most age-related diseases and disability, along with a lower income potential and quality of life. However, researchers are just beginning to understand the biological mechanisms that regulate the conversion of excess calories into visceral fat storage rather than glycogen or muscle. Epidemiological studies have repeatedly shown a comorbid association between age-related diseases involving hyperlipemia and circulating levels of uric acid, but not a direct association. This study utilized archival data from 31 healthy, middle-aged adults, who participated in a randomized, double-blind, crossover clinical trial on blood markers of lipidemia and inflammation following a high saturated fat (HSF) verses a "healthy" polyunsaturated fat (PUFA) meal. This primary study was conducted and funded by the National Institute on Aging. A secondary analysis of this data using Pearson's correlation with least squares (2-tailed) regression modeling found that when stratified by gender, baseline uric acid level was an independent and significant predictor of the lipemic response from the HSF, but not the PUFA meal. The linear regression plots indicated that males with uric acid levels above 4.5, and females above 3.0 mg/dL, had a progressively increased lipemic response to the HSF meal. The public health utility of this finding may include the clinical use of the gender-specific linear regression plots of uric acid values to identify and advise individuals at risk for hyperlipidemia from a diet high in saturated fats.

No description available.

No description available.

Adult exposure to high fat diet (HFD) has been linked to increased risk of musculoskeletal, cardiovascular, and metabolic diseases; however, the contribution of gestational HFD to elevated oxidative stress (OS), perinatal cardiovascular, skeletal, and metabolic dysfunction as well as long-term effects on adult offspring are incompletely understood. Pathophysiologic mechanisms linking gestational HFD, OS, and insulin resistance to perinatal development and adult-onset chronic diseases are explored in the present study, and maternal antioxidant (quercetin) is offered as a potential preventive dietary supplement to reduce fetal and maternal sequelae of HFD. Female C57BL/6 mice were fed "cafeteria-style" HFD (including 32.1% saturated fat to mimic a typical fast food menu) with or without quercetin for one month prior to conception, and throughout gestation. HFD dams developed gestational diabetes with significantly increased placental OS and vasculopathy. Neonates were smaller at birth than age-matched controls, and surviving offspring developed type 2 diabetes, hypertension and osteoporosis during adulthood, despite having been fed healthy diet throughout their postnatal life. Additional measures of bone using three-dimensionally reconstructed computed tomographic image analysis (microCT) revealed microarchitectural changes of bone at birth, and at 6 and 12 months postnatally. Fetuses from HFD dams displayed diminished bone mineral density (BMD) and disrupted endochondral and intramembranous ossification with significantly shortened distal limb lengths, as compared to offspring of standard rodent chow dams. Skeletal malformation persisted into adulthood despite the fact that both control and HFD offspring were fed conventional rodent chow throughout postnatal life. The offspring gestationally exposed to HFD showed significant decreased femoral BMD at 6 months of age and dysregulation of distal femoral trabecular architecture at 12 months of age, indicating development of osteoporosis. We were able to reduce incidence of placental vasculopathy, fetal maldevelopment and adult-onset type 2 diabetes, hypertension and osteoporosis with concurrent maternal quercetin supplementation during pregnancy. Collectively, these data suggested that maternal HFD increases placental OS and vascular damage during pregnancy, which are associated with fetal malformation and elevated adult-onset multisystemic chronic diseases. Maternal quercetin supplementation must be further explored as a potential dietary intervention for improved placental integrity, fetal development and lifelong health. / Ph. D.

Objetivo: Nesta dissertação de mestrado, investigamos a associação entre o consumo de gordura saturada (GS), seus alimentos-fontes e os ácidos graxos saturados (AGS) de diferentes tamanhos de cadeia com a incidência de diabetes mellitus tipo 2 (DM2). Método: O Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) é uma coorte multicêntrica que tem por objetivo investigar fatores de risco e de progressão de diabetes, doenças cardiovasculares e outras doenças crônicas relacionadas. Um total de 15.105 servidores ativos e aposentados de instituições públicas de educação superior e pesquisa, localizadas em seis capitais (Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Vitória e Porto Alegre), foram recrutados entre agosto de 2008 e dezembro de 2010 para realizarem exames laboratoriais e clínicos e responderem uma série de questionários e entrevistas. Anualmente, todos os participantes são contatados por telefone para entrevista de seguimento, sendo questionados sobre novos diagnósticos médicos, incluindo diabetes. Adicionalmente, entre os anos de 2011 e 2015, os participantes do estudo foram convidados a retornar aos centros de pesquisa para realização de novos exames clínicos e laboratoriais. Todos os participantes assinaram termo de consentimento livre e esclarecido, concordando em participar do estudo, e o protocolo de pesquisa foi aprovado pelo comitê de ética de todas as instituições envolvidas. Para o presente estudo, foram analisados dados de participantes entre 35 e 74 anos, que relataram não possuir diabetes e outras doenças crônicas que pudessem influenciar no consumo alimentar que responderam a um questionário de frequência alimentar (QFA) com 114 itens e os demais questionários com variáveis confundidoras na linha de base (2008-2010), e que não apresentaram ingestão do valor energético total diário pouco plausível (<600 ou >6.000 Kcal/dia) resultando, assim, em uma amostra final de 8.187 participantes. Para a análise do consumo alimentar alguns dos alimentos considerados fontes de GS foram agrupados: laticínios integrais, laticínios desnatados, laticínios fermentados, carnes processadas, carnes não processadas, carne vermelha e peixes. Os diferentes AGS foram organizados conforme o tamanho de sua cadeia: de cadeia curta e média (≤ 12 carbonos) e de cadeia longa (>13 carbonos). Para estimar a composição nutricional dos alimentos incluídos no QFA, foi utilizado o software Nutrition Data System for Research (NDSR). As medidas antropométricas (peso e altura) foram obtidas através de protocolos internacionalmente padronizados. A incidência de DM2 foi identificada de forma autorreferida em entrevistas anuais de seguimento e através do resultado de exames de sangue (glicemia de jejum, hemoglobina glicada e/ou glicemia 2h após teste de tolerância 75g de glicose) realizados em nova visita aos centros de pesquisa (2013-2015). Na análise descritiva, as características dos participantes de acordo com categorias de consumo de GS são comparadas por proporções através do teste quiquadrado, médias por ANOVA e medianas por teste de Wilcoxon. Modelos de Riscos Proporcionais de Cox foram usados para estimar razões de risco e IC95% na relação entre o consumo dos diferentes ácidos graxos saturados, gordura saturada total e seus alimentos-fontes com a incidência de diabetes. Para minimizar a influência de potenciais fatores de confusão, foram utilizados três modelos multivariaveis. As análises estatísticas foram conduzidas com o software SAS versão 9.4. Resultados: Foram identificados 300 novos casos de DM2. Após ajuste para confundidores sociodemográficos, de estilo de vida e dietéticos, encontrou-se efeito protetor da DM2 para o consumo de gordura saturada proveniente de manteiga de 0,1 a 0,8 g/dia (HR=0,69, IC95%: 0,49-0,96, vs. nenhum consumo), proveniente de laticínios integrais ≥10,5 g/dia (HR=0,63; IC95%: 0,53-0,92, vs. ≤2,0g/dia) e proveniente de peixes acima de 1,2 g/dia (HR= 0,63; IC95%: 0,43-0,92, vs. ≤0,2 g/dia) e, para ingestão de alimentos, de 0,1 a 1,6 g/dia de manteiga (HR=0,69; IC95%: 0,49-0,96, vs. nenhum consumo) e de peixes acima de 56,8 g/dia (HR=0,63; IC95%: 0,44-0,91, vs. ≤16,8 g/dia). O consumo 0,5 a 1,3 g/dia de gordura saturada de carnes processadas apresentoumaior risco (HR = 1,46, IC95%: 1,06-2,01, vs. ≤0,4 g/dia). A ingestão de ácidos graxos saturados de cadeia média e curta, presentes em maior quantidade em lácteos e peixes, acima de 4,1 g/dia, mostrou-se protetora (HR=0,70; IC95%: 0,45-0,96), quando ajustada para fatores sociodemográficos, de estilo de vida e de consumo de alguns alimentos. Gordura saturadas totais, ácidos graxos saturados de cadeia longa, demais alimentos e fontes de gordura saturada não apresentaram associação significativa com incidência de DM2. Conclusão: As associações entre gordura saturada e incidência de DM2 dependem das diferentes fontes e dos ácidos graxos saturados que as compõem. / Objective: In these masters dissertation, we investigated the association between the intake of Saturated Fat (SF), its food sources, saturated fatty acids (SFA) of different chain sizes and the incidence of diabetes mellitus type 2 (DM2). Method: The Longitudinal Study of Adult Health (ELSA-Brazil) is a multicenter cohort whose objective is to investigate risk factors and progression of diabetes, cardiovascular diseases and other related chronic diseases. A total of 15,105 active and retired employees from public institutions of higher education and research, located in six capitals (Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Vitória and Porto Alegre) were recruited between August 2008 and December 2010 to perform laboratory and clinical exams and to answer a series of questionnaires and interviews. Each year, all participants are contacted by phone for follow-up interview, being questioned about new medical diagnoses, including diabetes. In addition, between the years 2011 and 2015, the study participants were invited to return to the research centers for further clinical and laboratory tests. All participants signed a free and informed consent form, agreeing to participate in the study, and the research protocol was approved by the ethics committee of all the institutions involved. For the present study, data of participants between 35 and 74 years of age, who reported not having diabetes and other chronic diseases that could influence food consumption, who answered a food frequency questionnaire(FFQ) with 114 items and the other questionnaires with confounding variables in the study at baseline (2008-2010) and did not present daily intakes of total daily energy value (<600 or> 6,000 Kcal / day) were analized, resulting in a final sample of 8,187 participants. For the analysis of food consumption, some of the foods considered GS sources were grouped: whole dairy products, skimmed milk products, fermented dairy products, processed meats, unprocessed meats, red meat and fish. The different AGS were organized according to the size of their chain: short and medium chain (≤ 12 carbons) and long chain (> 13 carbons). The Nutrition Data System for Research (NDSR) software was used to estimate the nutritional composition of the foods included in the F. Anthropometric measures (weight and height) were obtained through internationally standardized protocols. The incidence of DM2 was self-reported in follow-up annual interviews and through the results of blood tests (fasting glycemia, glycated hemoglobin and / or glucose 2h after 75g glucose tolerance test) performed on a new visit to the research centers (2013-2015). In the descriptive analysis, the characteristics of the participants according to categories of GS consumption are compared by proportions through the chi-square test, means by ANOVA and medians by Wilcoxon test. Cox proportional hazards models were used to estimate risk ratios and 95% CI in the relationship between intake of different saturated fatty acids, total saturated fat and their source foods with the incidence of diabetes. To minimize the influence of potential confounders, three multivariate models were used. Statistical analyzes were conducted with SAS software version 9.4. Results: Were identified 300 new cases of T2DM. After adjustment for sociodemographic confounders, lifestyle and diet, It wasfound a protective effect ofT2DM for the intake of saturated fat from butter 0,1 to 0,8 g/day (HR = 0.69, 95% CI: 0.49 to 0.96, vs. No consumption), from dairy integrals ≥10,5 g/day (HR = 0.63; 95% CI: .53-.92, vs. ≤2,0 g/day) andfrom fish intake above 1.2 g/day (HR = 0.63, 95% CI: 0.43 to 0.92, vs. ≤0,2 g/day), and for food intake of 0.1 to 1.6 g/day butter (HR = 0.69, 95% CI: 0.49 to 0.96, vs. No consumption) andfor fish above 56.8 g/day (RH = 0.63; 95% CI: 0.44-0.91, vs. ≤16,8 g/day). Consumption of0.5 to 1.3 g/processed meats saturated fat showed increased risk (HR: 1.46, 95% CI: 1.06 to 2.01, vs. ≤0,4 g/day) . The intake of Medium and Short chain saturated fatty acids, presented in greater quantities in dairy and fish, above 4.1 g/day, seems to be protective (HR = 0.70; 95% CI: 0.45 to 0, 96) When adjusted for sociodemographic, lifestyle factors and consumption of some foods. Total saturated fat, long chain saturated fatty acids, other foods and saturated fat sources were not significantly associated with incidence of type 2 diabetes. Conclusion: Associations between saturated fat and DM2 incidence depend on its different sources and saturated fatty acids.

Recently published scientific articles have led to mixed nutritional advice on dietary saturated fatty acids. Lesser et. al (2007) identified that mixed conclusions in scientific articles on sweetened beverages might be attributed industry funding, as articles funded by the beverage industry are four to eight times more likely to report conclusions in favor of the sponsor’s products. This thesis applies Lesser’s methods to determine whether industry funding influences the inconsistent conclusions on saturated fatty acids. This thesis analyzes 100 articles on foods high in dietary saturated fatty acids. While studies with food industry funding are more likely to produce favorable conclusions, this trend is not significant (p= 0.205). On the other hand, the odds ratio of a favorable versus an unfavorable conclusion in articles where investigators disclosed a food industry related conflict of interest is 2.67 (95% CI, 1.03 to 6.88). The prevalence of both industry funding and conflict of interest have increased over time, yet the percent of articles reporting favorable conclusions has not changed over time. This suggests that while industry funding and conflict of interest might skew nutrition research, the mixed conclusions in articles on saturated fatty acids are largely influenced by other factors. Therefore, all nutrition-related scientific articles on saturated fatty acids should be critically evaluated before informing dietary recommendations.

Objetivo: Nesta dissertação de mestrado, investigamos a associação entre o consumo de gordura saturada (GS), seus alimentos-fontes e os ácidos graxos saturados (AGS) de diferentes tamanhos de cadeia com a incidência de diabetes mellitus tipo 2 (DM2). Método: O Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) é uma coorte multicêntrica que tem por objetivo investigar fatores de risco e de progressão de diabetes, doenças cardiovasculares e outras doenças crônicas relacionadas. Um total de 15.105 servidores ativos e aposentados de instituições públicas de educação superior e pesquisa, localizadas em seis capitais (Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Vitória e Porto Alegre), foram recrutados entre agosto de 2008 e dezembro de 2010 para realizarem exames laboratoriais e clínicos e responderem uma série de questionários e entrevistas. Anualmente, todos os participantes são contatados por telefone para entrevista de seguimento, sendo questionados sobre novos diagnósticos médicos, incluindo diabetes. Adicionalmente, entre os anos de 2011 e 2015, os participantes do estudo foram convidados a retornar aos centros de pesquisa para realização de novos exames clínicos e laboratoriais. Todos os participantes assinaram termo de consentimento livre e esclarecido, concordando em participar do estudo, e o protocolo de pesquisa foi aprovado pelo comitê de ética de todas as instituições envolvidas. Para o presente estudo, foram analisados dados de participantes entre 35 e 74 anos, que relataram não possuir diabetes e outras doenças crônicas que pudessem influenciar no consumo alimentar que responderam a um questionário de frequência alimentar (QFA) com 114 itens e os demais questionários com variáveis confundidoras na linha de base (2008-2010), e que não apresentaram ingestão do valor energético total diário pouco plausível (<600 ou >6.000 Kcal/dia) resultando, assim, em uma amostra final de 8.187 participantes. Para a análise do consumo alimentar alguns dos alimentos considerados fontes de GS foram agrupados: laticínios integrais, laticínios desnatados, laticínios fermentados, carnes processadas, carnes não processadas, carne vermelha e peixes. Os diferentes AGS foram organizados conforme o tamanho de sua cadeia: de cadeia curta e média (≤ 12 carbonos) e de cadeia longa (>13 carbonos). Para estimar a composição nutricional dos alimentos incluídos no QFA, foi utilizado o software Nutrition Data System for Research (NDSR). As medidas antropométricas (peso e altura) foram obtidas através de protocolos internacionalmente padronizados. A incidência de DM2 foi identificada de forma autorreferida em entrevistas anuais de seguimento e através do resultado de exames de sangue (glicemia de jejum, hemoglobina glicada e/ou glicemia 2h após teste de tolerância 75g de glicose) realizados em nova visita aos centros de pesquisa (2013-2015). Na análise descritiva, as características dos participantes de acordo com categorias de consumo de GS são comparadas por proporções através do teste quiquadrado, médias por ANOVA e medianas por teste de Wilcoxon. Modelos de Riscos Proporcionais de Cox foram usados para estimar razões de risco e IC95% na relação entre o consumo dos diferentes ácidos graxos saturados, gordura saturada total e seus alimentos-fontes com a incidência de diabetes. Para minimizar a influência de potenciais fatores de confusão, foram utilizados três modelos multivariaveis. As análises estatísticas foram conduzidas com o software SAS versão 9.4. Resultados: Foram identificados 300 novos casos de DM2. Após ajuste para confundidores sociodemográficos, de estilo de vida e dietéticos, encontrou-se efeito protetor da DM2 para o consumo de gordura saturada proveniente de manteiga de 0,1 a 0,8 g/dia (HR=0,69, IC95%: 0,49-0,96, vs. nenhum consumo), proveniente de laticínios integrais ≥10,5 g/dia (HR=0,63; IC95%: 0,53-0,92, vs. ≤2,0g/dia) e proveniente de peixes acima de 1,2 g/dia (HR= 0,63; IC95%: 0,43-0,92, vs. ≤0,2 g/dia) e, para ingestão de alimentos, de 0,1 a 1,6 g/dia de manteiga (HR=0,69; IC95%: 0,49-0,96, vs. nenhum consumo) e de peixes acima de 56,8 g/dia (HR=0,63; IC95%: 0,44-0,91, vs. ≤16,8 g/dia). O consumo 0,5 a 1,3 g/dia de gordura saturada de carnes processadas apresentoumaior risco (HR = 1,46, IC95%: 1,06-2,01, vs. ≤0,4 g/dia). A ingestão de ácidos graxos saturados de cadeia média e curta, presentes em maior quantidade em lácteos e peixes, acima de 4,1 g/dia, mostrou-se protetora (HR=0,70; IC95%: 0,45-0,96), quando ajustada para fatores sociodemográficos, de estilo de vida e de consumo de alguns alimentos. Gordura saturadas totais, ácidos graxos saturados de cadeia longa, demais alimentos e fontes de gordura saturada não apresentaram associação significativa com incidência de DM2. Conclusão: As associações entre gordura saturada e incidência de DM2 dependem das diferentes fontes e dos ácidos graxos saturados que as compõem. / Objective: In these masters dissertation, we investigated the association between the intake of Saturated Fat (SF), its food sources, saturated fatty acids (SFA) of different chain sizes and the incidence of diabetes mellitus type 2 (DM2). Method: The Longitudinal Study of Adult Health (ELSA-Brazil) is a multicenter cohort whose objective is to investigate risk factors and progression of diabetes, cardiovascular diseases and other related chronic diseases. A total of 15,105 active and retired employees from public institutions of higher education and research, located in six capitals (Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Vitória and Porto Alegre) were recruited between August 2008 and December 2010 to perform laboratory and clinical exams and to answer a series of questionnaires and interviews. Each year, all participants are contacted by phone for follow-up interview, being questioned about new medical diagnoses, including diabetes. In addition, between the years 2011 and 2015, the study participants were invited to return to the research centers for further clinical and laboratory tests. All participants signed a free and informed consent form, agreeing to participate in the study, and the research protocol was approved by the ethics committee of all the institutions involved. For the present study, data of participants between 35 and 74 years of age, who reported not having diabetes and other chronic diseases that could influence food consumption, who answered a food frequency questionnaire(FFQ) with 114 items and the other questionnaires with confounding variables in the study at baseline (2008-2010) and did not present daily intakes of total daily energy value (<600 or> 6,000 Kcal / day) were analized, resulting in a final sample of 8,187 participants. For the analysis of food consumption, some of the foods considered GS sources were grouped: whole dairy products, skimmed milk products, fermented dairy products, processed meats, unprocessed meats, red meat and fish. The different AGS were organized according to the size of their chain: short and medium chain (≤ 12 carbons) and long chain (> 13 carbons). The Nutrition Data System for Research (NDSR) software was used to estimate the nutritional composition of the foods included in the F. Anthropometric measures (weight and height) were obtained through internationally standardized protocols. The incidence of DM2 was self-reported in follow-up annual interviews and through the results of blood tests (fasting glycemia, glycated hemoglobin and / or glucose 2h after 75g glucose tolerance test) performed on a new visit to the research centers (2013-2015). In the descriptive analysis, the characteristics of the participants according to categories of GS consumption are compared by proportions through the chi-square test, means by ANOVA and medians by Wilcoxon test. Cox proportional hazards models were used to estimate risk ratios and 95% CI in the relationship between intake of different saturated fatty acids, total saturated fat and their source foods with the incidence of diabetes. To minimize the influence of potential confounders, three multivariate models were used. Statistical analyzes were conducted with SAS software version 9.4. Results: Were identified 300 new cases of T2DM. After adjustment for sociodemographic confounders, lifestyle and diet, It wasfound a protective effect ofT2DM for the intake of saturated fat from butter 0,1 to 0,8 g/day (HR = 0.69, 95% CI: 0.49 to 0.96, vs. No consumption), from dairy integrals ≥10,5 g/day (HR = 0.63; 95% CI: .53-.92, vs. ≤2,0 g/day) andfrom fish intake above 1.2 g/day (HR = 0.63, 95% CI: 0.43 to 0.92, vs. ≤0,2 g/day), and for food intake of 0.1 to 1.6 g/day butter (HR = 0.69, 95% CI: 0.49 to 0.96, vs. No consumption) andfor fish above 56.8 g/day (RH = 0.63; 95% CI: 0.44-0.91, vs. ≤16,8 g/day). Consumption of0.5 to 1.3 g/processed meats saturated fat showed increased risk (HR: 1.46, 95% CI: 1.06 to 2.01, vs. ≤0,4 g/day) . The intake of Medium and Short chain saturated fatty acids, presented in greater quantities in dairy and fish, above 4.1 g/day, seems to be protective (HR = 0.70; 95% CI: 0.45 to 0, 96) When adjusted for sociodemographic, lifestyle factors and consumption of some foods. Total saturated fat, long chain saturated fatty acids, other foods and saturated fat sources were not significantly associated with incidence of type 2 diabetes. Conclusion: Associations between saturated fat and DM2 incidence depend on its different sources and saturated fatty acids.

Objetivo: Nesta dissertação de mestrado, investigamos a associação entre o consumo de gordura saturada (GS), seus alimentos-fontes e os ácidos graxos saturados (AGS) de diferentes tamanhos de cadeia com a incidência de diabetes mellitus tipo 2 (DM2). Método: O Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) é uma coorte multicêntrica que tem por objetivo investigar fatores de risco e de progressão de diabetes, doenças cardiovasculares e outras doenças crônicas relacionadas. Um total de 15.105 servidores ativos e aposentados de instituições públicas de educação superior e pesquisa, localizadas em seis capitais (Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Vitória e Porto Alegre), foram recrutados entre agosto de 2008 e dezembro de 2010 para realizarem exames laboratoriais e clínicos e responderem uma série de questionários e entrevistas. Anualmente, todos os participantes são contatados por telefone para entrevista de seguimento, sendo questionados sobre novos diagnósticos médicos, incluindo diabetes. Adicionalmente, entre os anos de 2011 e 2015, os participantes do estudo foram convidados a retornar aos centros de pesquisa para realização de novos exames clínicos e laboratoriais. Todos os participantes assinaram termo de consentimento livre e esclarecido, concordando em participar do estudo, e o protocolo de pesquisa foi aprovado pelo comitê de ética de todas as instituições envolvidas. Para o presente estudo, foram analisados dados de participantes entre 35 e 74 anos, que relataram não possuir diabetes e outras doenças crônicas que pudessem influenciar no consumo alimentar que responderam a um questionário de frequência alimentar (QFA) com 114 itens e os demais questionários com variáveis confundidoras na linha de base (2008-2010), e que não apresentaram ingestão do valor energético total diário pouco plausível (<600 ou >6.000 Kcal/dia) resultando, assim, em uma amostra final de 8.187 participantes. Para a análise do consumo alimentar alguns dos alimentos considerados fontes de GS foram agrupados: laticínios integrais, laticínios desnatados, laticínios fermentados, carnes processadas, carnes não processadas, carne vermelha e peixes. Os diferentes AGS foram organizados conforme o tamanho de sua cadeia: de cadeia curta e média (≤ 12 carbonos) e de cadeia longa (>13 carbonos). Para estimar a composição nutricional dos alimentos incluídos no QFA, foi utilizado o software Nutrition Data System for Research (NDSR). As medidas antropométricas (peso e altura) foram obtidas através de protocolos internacionalmente padronizados. A incidência de DM2 foi identificada de forma autorreferida em entrevistas anuais de seguimento e através do resultado de exames de sangue (glicemia de jejum, hemoglobina glicada e/ou glicemia 2h após teste de tolerância 75g de glicose) realizados em nova visita aos centros de pesquisa (2013-2015). Na análise descritiva, as características dos participantes de acordo com categorias de consumo de GS são comparadas por proporções através do teste quiquadrado, médias por ANOVA e medianas por teste de Wilcoxon. Modelos de Riscos Proporcionais de Cox foram usados para estimar razões de risco e IC95% na relação entre o consumo dos diferentes ácidos graxos saturados, gordura saturada total e seus alimentos-fontes com a incidência de diabetes. Para minimizar a influência de potenciais fatores de confusão, foram utilizados três modelos multivariaveis. As análises estatísticas foram conduzidas com o software SAS versão 9.4. Resultados: Foram identificados 300 novos casos de DM2. Após ajuste para confundidores sociodemográficos, de estilo de vida e dietéticos, encontrou-se efeito protetor da DM2 para o consumo de gordura saturada proveniente de manteiga de 0,1 a 0,8 g/dia (HR=0,69, IC95%: 0,49-0,96, vs. nenhum consumo), proveniente de laticínios integrais ≥10,5 g/dia (HR=0,63; IC95%: 0,53-0,92, vs. ≤2,0g/dia) e proveniente de peixes acima de 1,2 g/dia (HR= 0,63; IC95%: 0,43-0,92, vs. ≤0,2 g/dia) e, para ingestão de alimentos, de 0,1 a 1,6 g/dia de manteiga (HR=0,69; IC95%: 0,49-0,96, vs. nenhum consumo) e de peixes acima de 56,8 g/dia (HR=0,63; IC95%: 0,44-0,91, vs. ≤16,8 g/dia). O consumo 0,5 a 1,3 g/dia de gordura saturada de carnes processadas apresentoumaior risco (HR = 1,46, IC95%: 1,06-2,01, vs. ≤0,4 g/dia). A ingestão de ácidos graxos saturados de cadeia média e curta, presentes em maior quantidade em lácteos e peixes, acima de 4,1 g/dia, mostrou-se protetora (HR=0,70; IC95%: 0,45-0,96), quando ajustada para fatores sociodemográficos, de estilo de vida e de consumo de alguns alimentos. Gordura saturadas totais, ácidos graxos saturados de cadeia longa, demais alimentos e fontes de gordura saturada não apresentaram associação significativa com incidência de DM2. Conclusão: As associações entre gordura saturada e incidência de DM2 dependem das diferentes fontes e dos ácidos graxos saturados que as compõem. / Objective: In these masters dissertation, we investigated the association between the intake of Saturated Fat (SF), its food sources, saturated fatty acids (SFA) of different chain sizes and the incidence of diabetes mellitus type 2 (DM2). Method: The Longitudinal Study of Adult Health (ELSA-Brazil) is a multicenter cohort whose objective is to investigate risk factors and progression of diabetes, cardiovascular diseases and other related chronic diseases. A total of 15,105 active and retired employees from public institutions of higher education and research, located in six capitals (Salvador, Belo Horizonte, Rio de Janeiro, São Paulo, Vitória and Porto Alegre) were recruited between August 2008 and December 2010 to perform laboratory and clinical exams and to answer a series of questionnaires and interviews. Each year, all participants are contacted by phone for follow-up interview, being questioned about new medical diagnoses, including diabetes. In addition, between the years 2011 and 2015, the study participants were invited to return to the research centers for further clinical and laboratory tests. All participants signed a free and informed consent form, agreeing to participate in the study, and the research protocol was approved by the ethics committee of all the institutions involved. For the present study, data of participants between 35 and 74 years of age, who reported not having diabetes and other chronic diseases that could influence food consumption, who answered a food frequency questionnaire(FFQ) with 114 items and the other questionnaires with confounding variables in the study at baseline (2008-2010) and did not present daily intakes of total daily energy value (<600 or> 6,000 Kcal / day) were analized, resulting in a final sample of 8,187 participants. For the analysis of food consumption, some of the foods considered GS sources were grouped: whole dairy products, skimmed milk products, fermented dairy products, processed meats, unprocessed meats, red meat and fish. The different AGS were organized according to the size of their chain: short and medium chain (≤ 12 carbons) and long chain (> 13 carbons). The Nutrition Data System for Research (NDSR) software was used to estimate the nutritional composition of the foods included in the F. Anthropometric measures (weight and height) were obtained through internationally standardized protocols. The incidence of DM2 was self-reported in follow-up annual interviews and through the results of blood tests (fasting glycemia, glycated hemoglobin and / or glucose 2h after 75g glucose tolerance test) performed on a new visit to the research centers (2013-2015). In the descriptive analysis, the characteristics of the participants according to categories of GS consumption are compared by proportions through the chi-square test, means by ANOVA and medians by Wilcoxon test. Cox proportional hazards models were used to estimate risk ratios and 95% CI in the relationship between intake of different saturated fatty acids, total saturated fat and their source foods with the incidence of diabetes. To minimize the influence of potential confounders, three multivariate models were used. Statistical analyzes were conducted with SAS software version 9.4. Results: Were identified 300 new cases of T2DM. After adjustment for sociodemographic confounders, lifestyle and diet, It wasfound a protective effect ofT2DM for the intake of saturated fat from butter 0,1 to 0,8 g/day (HR = 0.69, 95% CI: 0.49 to 0.96, vs. No consumption), from dairy integrals ≥10,5 g/day (HR = 0.63; 95% CI: .53-.92, vs. ≤2,0 g/day) andfrom fish intake above 1.2 g/day (HR = 0.63, 95% CI: 0.43 to 0.92, vs. ≤0,2 g/day), and for food intake of 0.1 to 1.6 g/day butter (HR = 0.69, 95% CI: 0.49 to 0.96, vs. No consumption) andfor fish above 56.8 g/day (RH = 0.63; 95% CI: 0.44-0.91, vs. ≤16,8 g/day). Consumption of0.5 to 1.3 g/processed meats saturated fat showed increased risk (HR: 1.46, 95% CI: 1.06 to 2.01, vs. ≤0,4 g/day) . The intake of Medium and Short chain saturated fatty acids, presented in greater quantities in dairy and fish, above 4.1 g/day, seems to be protective (HR = 0.70; 95% CI: 0.45 to 0, 96) When adjusted for sociodemographic, lifestyle factors and consumption of some foods. Total saturated fat, long chain saturated fatty acids, other foods and saturated fat sources were not significantly associated with incidence of type 2 diabetes. Conclusion: Associations between saturated fat and DM2 incidence depend on its different sources and saturated fatty acids.

Objectives. Evaluate C-reactive protein (CRP) levels according to weight and physical activity. The study explored how changes in CRP were associated with baseline CRP, weight, and physical activity and changes in these variables. Methods. A randomized controlled study design assigned 348 individuals to the intervention or control group with measurements taken at baseline, 6 weeks, and 6 months of body weight, physical activity, and serum CRP levels. Participants attended an intensive 40-hour educational course delivered over a four-week period. Results. At baseline, CRP was negatively associated with total steps/week, and positively associated with weight, BMI, percent fat, and saturated fat at baseline. CRP significantly decreased through 6 weeks and also through 6 months for only those with high CRP at baseline. For those with high CRP at baseline, the decrease was significant for normal, overweight, and obese groups of people. Changes in weight or physical activity were not significantly associated with changes in CRP. Conclusions. Over 6 week and 6 month follow-up periods, the intervention failed to discriminate changes in CRP. Changes in CRP were only associated with baseline levels of CRP and BMI and were not associated with changes in any of the selected variables considered.

<p>The development of the metabolic syndrome (MetS) and cardiovascular diseases have been suggested to be influenced more by the quality than the amount of dietary fat. The FA composition of serum lipids may be used as biomarkers of dietary fat quality. FAs can, however, also be endogenously synthesized by lipogenic enzymes such as elongases and desaturases. Three desaturases are important in humans: Stearoyl-CoA-desaturase (SCD), ∆6-desaturase (D6D) and ∆5-desaturase (D5D) and surrogate measures of desaturase activities can be estimated as product-to-precursor FA ratios.</p><p>In this thesis, we demonstrated that high SCD, D6D and low D5D estimated activities predicted MetS 20 years later, as well as cardiovascular and total mortality during a maximum of 33.7 years. The relation between D5D and MetS was independent of lifestyle and BMI, while the relation between SCD, D6D and MetS was confounded by BMI. Serum proportions of palmitic (16:0), palmitoleic (16:1) and dihomo-γ-linoleic acids were higher and the serum proportion of linoleic acid (LA) lower at baseline in those individuals who developed MetS. Further, LA was inversely related to mortality, while palmitic, palmitoleic and dihomo-γ-linoleic acids were directly associated with mortality. We also demonstrated that a diet rich in saturated fat “induced” a similar serum FA pattern (including estimated desaturase activities) that was associated with MetS, cardiovascular disease and mortality. We also propose that the SCD ratio [16:1/16:0] might be a novel and useful marker of dietary saturated fat, at least in Western high-fat diets. Finally, genetic variations in the human SCD1 gene were linked to obesity and insulin sensitivity, results that agree with data in SCD1 deficient mice.</p><p>This thesis suggests that dietary fat quality and endogenous desaturation may play a role in the development of metabolic and cardiovascular diseases and the results support current dietary guidelines.</p>