Sociodemographic, clinical, and dietary characteristics of overweight adults: a secondary analysis of a population study / Caracterização sociodemográfica, clínica e da alimentação de adultos com excesso de peso: análise secundária de um estudo populacional

ABSTRACT Objective: To estimate the prevalence of overweight among Brazilian adults aged 20 to 59, according to sociodemographic characteristics, health-related behaviors, and food consumption. Methods: A cross-sectional study based on data from a population-based survey in a major metropolitan city in the state of São Paulo, Brazil, conducted between 2015-2016. Prevalences and prevalence ratios were estimated using Poisson regression; food consumption means were estimated using linear regression. Results: We analyzed data from 855 adults, 61% of whom were overweight. The prevalence of overweight was significantly higher among males, those aged 30 or older, with 8 to 11 years of education, and those who reported eating more than they should. The body mass index was significantly associated with hypertension, diabetes, high cholesterol, waist-to-height ratio, taking weight-loss medications, overeating, and the habit of checking labels. Overweight adults reported eating meat with visible fat and drinking soda more frequently than those not overweight. Overweight adults reported eating significantly more grams of food daily and had a higher intake of energy, total fat, saturated fats, trans fats, carbohydrates, protein, insoluble dietary fiber, sodium, and potassium. Their diets had a higher glycemic load when compared to participants who were not overweight. Conclusion: Adults with and without overweight differed in their sociodemographic, dietary, and clinical characteristics. Diet quality was similar between both groups, suggesting a need for improving dietary habits in this population regardless of body weight.

RESUMO Objetivo: Estimar a prevalência de excesso de peso entre adultos brasileiros, de 20 a 59 anos, segundo características sociodemográficas, de comportamentos relacionados à saúde e quanto ao consumo alimentar. Métodos: Estudo transversal, de pesquisa de base populacional, em uma cidade metropolitana de São Paulo - Brasil, conduzida entre os anos de 2015 e 2016. Foram estimadas as prevalências e as razões de prevalência por meio da regressão de Poisson, e as médias de consumo alimentar pelo uso da regressão linear. Resultados: Foram analisados dados referentes à 855 adultos, 61% destes apresentavam sobrepeso. A prevalência de excesso de peso foi significativamente maior entre: homens, com 30 anos ou mais, pessoas que possuíam entre 8 e 11 anos de estudo e entre aqueles que acreditavam comer mais do que deveriam. O índice de massa corporal foi significativamente associado à hipertensão, diabetes, colesterol alto, razão cintura-estatura, uso de medicamentos, comer mais do que deveria e o hábito de checar rótulos. Adultos com excesso de peso ingeriam carnes com gordura e refrigerantes em maior frequência quando comparados à adultos com peso saudável. Adultos com excesso de peso consumiam, significativamente, mais gramas de alimentos por dia e apresentaram maior ingestão de calorias, gorduras totais, saturadas e trans, carboidratos, proteína, fibras insolúveis, sódio e potássio. A dieta deles continha uma maior carga glicêmica quando comparada àqueles com peso saudável. Conclusão: Adultos com e sem excesso de peso, diferiram quanto às características sociodemográficas, dietéticas e clínicas. A qualidade da dieta foi similar em ambos os grupos, o que sugere a necessidade de melhora dos hábitos alimentares da população, independentemente do peso corporal.

Índice glicemico y carga glicémica de Galletas de Chuño / Glycemic index and glucemic load of Chuño biscuits

INTRODUCCION. El índice glicémico (IG) es la forma numérica que representa la rapidez de la absorción de los carbohidratos de un alimento, este índice multiplicado por la cantidad de carbohidratos en gramos dividido entre 100 es la carga glicémica (CG), ambos indicadores permiten la selección y uso de alimentos en dietas para controlar los niveles de glucosa sanguínea repercutiendo sobre el estado y restitución de la salud. La Galleta de Chuño es un alimento de repostería a base de fécula de papa que ha ampliado su mercado de consumo a las ciudades bolivianas, es fuente de carbohidratos y es consumido como sustituto del pan y galletas. OBJETIVOS. Determinar el índice glicémico y la carga glicémica de Galletas de Chuño en estudiantes del CETAL La Paz. MATERIALES Y MÉTODOS. Se realizó un estudio observacional, prospectivo, transversal y descriptivo seleccionando 10 estudiantes que cumplieron con criterios de selección. Se evaluó la respuesta glucémica a los 0, 15, 30, 45, 60, 90 y 120 min tras la ingesta de una solución con 50 g de glucosa y tras el consumo de 72,14 g de Galletas de Chuño, siguiendo procedimientos recomendados por la FAO/WHO para posteriormente calcular el índice glucémico y la carga glucémica. RESULTADOS. El valor promedio del IG de las Galletas de Chuño fue de 65,5 ± 4,8. La CG fue 13,6 para una ración de 30 g de las Galletas de Chuño. CONCLUSIONES. La Galleta de Chuño es un alimento de índice glucémico medio y de carga glicémica media, por lo que es recomendado para el consumo de la población en general, pero con moderación en su ingesta frecuente.

INTRODUCTION. The glycemic index (GI) is the numerical form that represents the rate of the carbohydrate absorption after a meal. This index multiplied by the amount of carbohydrates in grams divided by 100 is the glycemic load (CG). Both indicators allow selection and use of food in diets to control blood glucose levels, affecting the state and restitution of health. Chuño biscuits is a pastry food based on potato starch that has expanded its consumer market to Bolivian cities, it is a source of carbohydrates, and it is consumed as a substitute for bread and cookies. OBJECTIVES. To determine the glycemic index and the glycemic load of Chuño biscuits in students of Centro de Estudios Técnicos Acelerados Loreto (CETAL) in La Paz city. MATERIALS AND METHODS. This observational, prospective, cross-sectional and descriptive study included ten students who met the selection criteria. The glycemic response was evaluated at 0, 15, 30, 45, 60, 90, and 120 min after ingesting a solution with 50 g of glucose and after consuming 72.14 g of Chuño biscuits, following procedures recommended by FAO / WHO to calculate the glycemic index and glycemic load subsequently. RESULTS. The average GI value of Chuño biscuits was 65.5 ± 4.8. The CG was 13.6 for a serving of 30 g of the Galletas de Chuño. CONCLUSIONS. Chuño biscuits are a food with a medium glycemic index and a medium glycemic load, so it is recommended for consumption by the general population, however, when its intake is frequent, it should be consumed in moderation.

Association between dietary glycemic index and excess weight in pregnant women in the first trimester of pregnancy / Associação entre o índice glicêmico dietético e o excesso de peso em gestantes no primeiro trimestre de gestação

Abstract Objective To assess the association between dietary glycemic index (GI) and excess weight in pregnant women in the first trimester of pregnancy. Methods A cross-sectional study in a sample of 217 pregnant women was conducted at the maternal-fetal outpatient clinic of the Hospital Geral de Fortaleza, Fortaleza, state of Ceará, Brazil, for routine ultrasound examinations in the period between 11 and 13 weeks + 6 days of gestation.Weight and height were measured and the gestational body mass index (BMI) was calculated. The women were questioned about their usual body weight prior to the gestation, considering the prepregnancy weight. The dietary GI and the glycemic load (GL) of their diets were calculated and split into tertiles. Analysis of variance (ANOVA) or Kruskal-Walls and chi-squared (χ2) statistical tests were employed. A crude logistic regression model and a model adjusted for confounding variables known to influence biological outcomes were constructed. A p-value < 0.05 was considered significant for all tests employed. Results The sample group presented a high percentage of prepregnancy and gestational overweight (39.7% and 40.1%, respectively). InthetertilewiththehigherGIvalue, therewasa lower dietary intake of total fibers (p = 0.005) and of soluble fibers (p = 0.008). In the third tertile, the dietary GI was associated with overweight in pregnant women in the first trimester of gestation, both in the crude model and in the model adjusted for age, total energy intake, and saturated fatty acids. However, this association was not observed in relation to the GL. Conclusion A high dietary GI was associated with excess weight in women in the first trimester of pregnancy.

Resumo Objetivo Avaliar a associação entre índice glicêmico (IG) dietético e presença de excesso de peso em gestantes no primeiro trimestre de gestação. Métodos Estudo transversal realizado com 217 gestantes atendidas no Ambulatório de Medicina Materno-Fetal do Hospital Geral de Fortaleza, Fortaleza, CE, para realização de exames ultrassonográficos de rotina no período entre 11 e 13 semanas e 6 dias de gestação. Peso e altura foram obtidos para o cálculo do índice de massa corporal (IMC) gestacional. As mulheres foram questionadas quanto ao peso corporal habitual anterior à gestação, considerado o peso pré-gestacional. O IG e a carga glicêmica (CG) das suas dietas foram calculados e divididos em tercis. As associações foram investigadas por análise de variância (ANOVA, na sigla em inglês) ou pelos testes Kruskal-Walls e qui-quadrado (χ2). Resultados O grupo tinha alto percentual de excesso de peso pré-gestacional (39,7%) e gestacional (40,1%). Houve menor consumo de fibras totais (p = 0,005) e fibras insolúveis (p = 0,008) no tercil de maior valor de IG. No terceiro tercil, o IG da dieta foi associado ao excesso de peso dasmulheres no primeiro trimestre de gestação, tanto no modelo bruto como no modelo ajustado para idade, consumo total de energia e de ácidos graxos saturados. No entanto, não se observou esta associação emrelação à CG. Conclusão O alto IG da dieta consumida foi associado ao excesso de peso das mulheres no primeiro trimestre da gestação.

Asociación entre la carga glicémica de la ingesta alimentaria y el síndrome metabólico en niños y adolescentes obesos / Association between dietary glycemic load and metabolic syndrome in obese children and adolescents

Objetivo. Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Población y método. Estudio transversal en niños y adolescentes obesos (índice de masa corporal ≥ percentil 95) de 10 a 15 años. Se clasificó como SM según los criterios de la International Diabetes Federation. Se aplicó un recordatorio de 24 horas y se calculó la CG total y por comida. Se evaluó la asociación entre los terciles de CG (comparación con el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, antecedentes familiares, de actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados. De 273 niños y adolescentes obesos, 52,4% fueron varones y 94,9% fueron físicamente inactivos. La mediana de CG fue de 213 (164,8287,4) y la de ingesta calórica diaria fue 2275 (1851-3024) kcal, dada principalmente por carbohidratos (62%). La prevalencia de SM fue de 22,3%; los componentes con mayor prevalencia fueron la obesidad abdominal (81,7%) y los valores de lipoproteínas de alta densidad (HDL, del inglés high density lipoprotein) bajos (63,7%). Por último, se encontró una asociación entre el consumo elevado de CG y el riesgo de presentar SM (RPa 4,5; IC 95%: 1,3-15,3). Conclusiones. Existe una asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad.

Objective. To study the association between the metabolic syndrome (MS) and the glycemic load (GL) of food intake among obese children and adolescents seen in consultation by the endocrinology team in a pediatric referral hospital in Lima, Peru. Population and Method. Cross-sectional study among obese children and adolescents (body mass index ≥ 95 percentile), 10-15 years old. The MS was classified according to criteria of the International Diabetes Federation. A 24 hour reminder was used, and the overall and per meal GL was calculated. The association between the GL tertiles (comparison with the lower tertile) and the MS was assessed using prevalence ratios adjusted by demographic outcome measures, family history, physical activity and total carbohydrate consumption in Poisson regression models with a robust variance. Results. Out of 273 obese children and adolescents, 52.4% were male and 94.9% did not engage in any physical activity. Glycemic load median value was 213 (164.8-287.4) and the daily calorie intake value was 2275 (1851-3024) kcal, consisting mainly of carbohydrates (62%). MS prevalence was 22.3%; the most prevalent components were abdominal obesity (81.7%) and low values of high density lipoprotein (HDL) (63.7%). Lastly, an association was observed between a high consumption of GL and the risk of developing MS (aRP 4.5; 95% CI: 1.3-15.3). Conclusions. There is an association between a high consumption of GL and the presence of MS among obese children and adolescents.

Evaluation of the impact of orally administered carbohydrates on postprandial blood glucose levels in different pre-clinical models

ABSTRACT We developed a pre-clinical model in which to evaluate the impact of orally administered carbohydrates on postprandial blood glucose levels. For this purpose, we compared the effects of different carbohydrates with well-established glycemic indexes. We orally administered (gavage) increasing amounts (0.2, 0.4, 0.6, 0.8, and 1.0 g/kg) of sucrose and lactose to rats which had been fasted for 6 h or 15 h, respectively. In part of the experiments we administered frutose (gavagem). Three different models were compared for measuring postprandial blood glucose levels: a) evaluation of interstitial glucose concentrations by using a real time continuous glucose monitoring system; b) evaluation of glucose levels in blood obtained from the rat tail; c) evaluation of serum glucose levels in blood collected after decapitation. Our results showed that blood obtained from the tails of 15-h fasted rats was the best model in which to evaluate the effect of carbohydrates on postprandial blood glucose levels.

Índice, carga glicémica y fibra dietética de los alimentos y su asociación con resistencia a la insulina en adultos chilenos / Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults

El Índice y Carga Glicémica (IG y CG) categorizan los alimentos según su capacidad de incrementar la glicemia, considerando cantidad y calidad de hidratos de carbono consumidos. Diferentes estudios han postulado que una dieta con IG y CG altos y bajo consumo de fibra incrementan la glicemia e insulinemia, aunque con resultados heterogéneos.El objetivo de este estudio fue analizar la asociación entre IG, CG e ingesta de fibra y valores HOMA-IR en adultos jóvenes. En una muestra representativa de 738 personas que tenían entre 32 y 38 años, nacidos en el Hospital de Limache, Región de Valparaíso, Chile, se recogió información socioeconómica, de salud, se determinó estado nutricional, glicemia, insulina basal y HOMA, y con la encuesta de frecuencia de consumo se estimó IG, CG e ingesta de fibra. Se construyeron modelos de regresión múltiple, controlando efectos de confusión e interacción. En modelos ajustados, se observó que por cada 10 unidades que aumenta el IG y CG de la dieta en individuos con exceso de peso, aumenta el HOMA-IR en 0,31 (p=0,042) y 0,03 (p=0,012), respectivamente y por cada 10 gramos que aumenta la fibra total y soluble, disminuye el HOMA-IR en 0,10 (p=0,04) y 0,62 (p=0,034) respectivamente. En personas sin exceso de peso no hubo estos efectos. Existe una asociación directa entre el aumento de IG y CG de los alimentos y el incremento de HOMA-IR sólo en individuos con exceso de peso y una asociación inversa entre ingesta de fibra dietética total y soluble y HOMA-IR(AU)

Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults. Glycemic index and glycemic load (GI and GL) categorize foods according to their ability to increase blood sugar levels, considering quantity and quality of carbohydrates consumed. Different studies have postulated that a high GI and GL diet and low fiber intake increased glycemia and insulinemia, although with heterogeneous results. The aim of this study was to analyze the association between GI, GL and fiber intake and HOMA-IR values in young adults. In a representative sample of 738 people aged between 32 and 38 years old, born in the Limache’s Hospital, Valparaiso, Chile, socioeconomic and health information, nutritional status, basal glycemia, insulin and HOMA were collected. With a food frequency questionnaire, GI, GL and fiber intake were estimated. Multiple regression models were constructed, controlling confounding and interaction effects. In adjusted models, it was found that for every 10 units that increases diet GI and GL in overweight individuals, HOMA- IR increases in 0.31 (p = 0.042) and 0.03 (p = 0.012) respectively, and for every 10 grams that increases total and soluble fiber intake, HOMA-IR reduces in 0.10 (p = 0.04) and 0.62 (p = 0.034) respectively. In people without overweight such effects were not observed. There was a direct association bet- ween increased GI and GL foods and increased HOMA-IR only in individuals with overweight and an inverse association between total and soluble fiber intake and HOMA-IR(AU)

Associação entre o índice glicêmico e a carga glicêmica da dieta de frequentadores de clínicas estéticas privadas de Porto Alegre - RS e indicadoresde adiposidade corporal / Association between glycemic index and glycemic load in the diet of clients of private esthetics clinics in Porto Alegre and body fat indicators

Objective: To evaluate the possible association between dietary glycemic index (GI) and glycemic load (GL) and anthropometric indicators of adiposity in clients of private esthetics clinics of Porto Alegre, Rio Grande do Sul state, Brazil. Methods:Observational, cross-section study in which all participants underwent anthropometric (measurement of weight, height, BMI, and waist circumference) and dietary (24-hour recall) assessments. The dietary GI and GL were calculated as proposed by the Food and Agriculture Organization ? FAO, considering the values of the International Table of GlycemicIndex (2008). Dietary analysis was performed using DietWin® software and statistical analysis using SPPS 16.0 Package®. Results: One hundred nineteen clients of three private cosmetic clinics of Porto Alegre were Included in the current study. The following data were collected from the study subjects: 39.12 ± 13.55 years old, BMI equals to 26.21 ± 5.10kg/m², and waist circumference equal to 80.5 ± 11.3 cm for women and 99.7 ± 13.7 cm for men. The daily GL was equal to 89.9 ± 38.7 grams and the GI was equal to 54.4 ± 7.5%. The daily GL differed between participants categorized byBMI, considering the cutoff of the World Health Organization (WHO): higher GL was observed among overweight and obese participants in comparison to participants with underweight and normal weight (89.9 ± 38.7 g vs 89.9 ± 38.7 grams, p = 0.02). The GL explained approximately 26% of the variability in waist circumference values (p <0.001). Conclusion: Clients of private cosmetic clinics of Porto Alegre included in the current study presented overweight in a high proportion; it could be related to a high dietary GL. This aspect should be considered in the nutrition counseling ofthis group of patients regarding carbohydrate intake

Objetivo: Avaliar a possível associação entre o índice glicêmico (IG) e a carga glicêmica (CG) da dieta de frequentadores de clínicas estéticas privadas de Porto Alegre/RS e indicadores antropométricos de adiposidade corporal. Métodos: Estudo observacional transversal em que os participantes foram submetidos à avaliação antropométrica [peso, estatura, índice de massa corporal (IMC) e circunferência da cintura (CC)] e do consumo alimentar (recordatório de 24 horas). O IG e a CG das dietas foram calculados conforme padrão proposto pela FAO, a partir dos valores de IG da Tabela internacional (2008). A análise dietética dos dados foi realizada no software DietWin® e as análises estatísticas no Pacote SPPS 16.0®. Resultados: Foram avaliados 119 frequentadores de três clínicas estéticas privadas de Porto Alegre com idade média de 39,12 ± 13,55 anos, IMC de 26,21 ± 5,10Kg/m² e CC de 80,5 ± 11,3cm (para mulheres) e de 99,7 ± 13,7cm (para homens). A CG diária foi igual a 89,9 ± 38,7g e o IG igual a 54,4 ± 7,5%. A CG diária diferiu entre os grupos quando categorizados pelo IMC, considerando-se os pontos de corte da Organização Mundial de Saúde (OMS): maior CG diária entre os participantes com sobrepeso e obesidade em comparação àqueles com baixo peso e eutrofia (89,9 ± 38,7g vs. 89,9 ± 38,7g, P=0,02). A CG da dieta explicou cerca de 26% da variabilidade nos valores de CC dos participantes (P<0.001). Conclusão: Elevada prevalência de excesso de peso corporal foi observada na amostra de frequentadoresde clínicas estéticas privadas avaliada, o que foi relacionado ao consumo de dieta com elevada CG. A orientação nutricional desse grupo específico de indivíduos deve ponderar para esse aspecto quando da escolha de alimentos-fonte de carboidrato.

Glycemic index and glycemic load of tropical fruits andthe potential risk for chronic diseases

The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases.Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”), guava,tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined accordingto the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluatedare healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruitscausing early glycemic peak and the fruits with moderated GI (coconut water and custard apple).

Índice glicémico y carga glucémica de las dietas de adultos diabéticos y no diabéticos / Glycemic index and glycemic load of diets of diabetic and nondiabetic adults

El Índice Glicémico (IG) y la Carga Glucémica (CG) son indicadores válidos del efecto de los alimentos en la respuesta de la glucosa plasmática. El objetivo de la investigación fue evaluar el IG y CG de las dietas consumidas por adultos diabéticos y no diabéticos, como indicadores de la calidad de la dieta y su relación con el estado nutricional. El estudio se llevó a cabo en la consulta de Endocrinología del Hospital Militar "Dr. Carlos Arvelo" durante el período julio 2010 - enero 2011. Se trata de una investigación descriptiva, con un grupo de estudio de 43 sujetos adultos, 23 diabéticos (D) y 20 no diabéticos (ND). Se aplicó una evaluación nutricional antropométrica y se determinó el IG y CG de la dieta. Para la comparación entre las medias de los grupos se realizó la prueba de "t" de Student y para las distribuciones entre los grupo se utilizó Chi2. Se encontró un predominio de IG medio y alto (70% en ND y 88% en D), CG moderada y alta (75% en ND y 78% en D) y malnutrición por exceso (55% en ND y 70% en D) en ambos grupos. Se concluye que IG y CG son indicadores alternativos y válidos de la calidad de la dieta y puede considerarse su utilidad en la evaluación y manejo dietoterapéutico de los diabéticos y en programas de prevención de enfermedades crónicas, dirigidos a la población en general, sin hacer uso aislado ni desconocer sus limitaciones(AU)

The Glycemic Index (GI) and Glycemic Load (GL) are valid indicators of effect of foods on blood glucose response. This study aimed to assess the GI and GL of diets consumed by diabetics and nondiabetics adults, as indicators of diet quality and its relation to nutritional status. The study was carried out in the consultation of Endocrinology of the Military Hospital "Dr. Carlos Arvelo" during the period July 2010 - January 2011. This is a descriptive research, with a study group of 43 adult subjects, 23 diabetics (D) and 20 nondiabetics (ND). Nutritional anthropometric evaluation was applied and determined the GI and GL of diet. For comparison between means groups the test "t" of Student was conducted and for distributions between groups Chi2 was used. Was found a predominance of medium and high IG (70% ND and 88% in D), medium and high CG (75% in ND and 78.3% in D) and excess malnutrition (55% in ND and 70% D) in both groups. We conclude that GI and GL are alternative and valid indicators of quality of diet and may be considered useful in the assessment and dietary management of diabetics and in prevention of chronic diseases programs, aimed at the general population, without using isolated and unaware of their limitations(AU)