HIGH-FIBER DIET PROMOTES METABOLIC, HORMONAL, AND SATIETY EFFECTS IN OBESE WOMEN ON A SHORT-TERM CALORIC RESTRICTION.

•Body weight and BMI decrease in both the EG and CG groups during the period of caloric restriction. •For both the EG and CG groups, fat-free mass decreases during food restriction. •Subjects on a high-fiber diet have reduced fasting glucose and basal insulin as well as improved insulin resistance, as attested by the lower HOMA-IR index. •Obese women on a high-fiber diet have suppressed postprandial (after 60 min) acylated ghrelin, confirming that the diet composition influences ghrelin levels from the first day. •In the present study, it was possible to verify that fasting leptin concentration diminishes in obese women on a high-fiber diet. Background - Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective - To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Results - Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion - A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.

Dieta rica em fibra promove efeitos metabólicos, hormonais e de saciedade em mulheres obesas com restrição calórica de curto prazo / High-fiber diet promotes metabolic, hormonal, and satiety effects in obese women on a short-term caloric restriction

ABSTRACT Background: Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective: To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. Methds: In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Results: Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion: A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.

RESUMO Contexto: Vários mecanismos, incluindo a fome excessiva, são responsáveis pelas dificuldades dos pacientes em manter a perda de peso e mudanças na dieta após a restrição calórica. Objetivo: Avaliar o efeito da dieta de curta duração rica em fibras e com restrição calórica nos hormônios reguladores do apetite e nas sensações de fome e saciedade em mulheres com obesidade. Métodos: Em um estudo randomizado controlado, 30 mulheres com índice de massa corporal (IMC) superior a 30 kg/m2 e com idade entre 20 e 50 anos foram hospitalizadas seguindo dieta com restrição calórica (1000 kcal/dia) por 3 dias. O grupo experimental (n=15) recebeu dieta rica em fibras e o grupo controle (n=15), dieta convencional. Foram avaliados peso corporal, IMC, gasto energético de repouso (GER), grelina acilada e total, leptina, insulina e glicose e sensações de fome e saciedade. Modelos de regressão linear com efeitos mistos (efeitos fixos e aleatórios) ajudaram a avaliar as variáveis entre os dois grupos e dentro dos grupos. Resultados: O peso corporal e o IMC diminuíram tanto no grupo experimental quanto no controle (P<0,001). Após a dieta rica em fibras, os níveis de grelina acilada pós-prandial (P=0,04), glicose (P<0,001), insulina (P=0,04) e leptina (P=0,03), bem como o índice HOMA-IR (P=0,01) diminuiu, enquanto a saciedade melhorou (P=0,02). Mulheres obesas que seguiram a dieta convencional apresentaram aumento do percentual de gordura corporal (P=0,04) e menor GER (P=0,02). As duas dietas não diferiram em termos de sensação de fome. Conclusão: Uma dieta rica em fibras de curto prazo melhora as sensações de saciedade e os parâmetros metabólicos, suprimindo a grelina acilada pós-prandial (60 minutos) e mantendo o gasto energético de repouso.

Effectiveness of a minimally processed food-based nutritional counselling intervention on weight gain in overweight pregnant women: a randomized controlled trial.

PURPOSE: This study aimed at evaluating the effectiveness of a nutritional counselling intervention based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed products, and the practice of physical activities to prevent excessive gestational weight gain in overweight pregnant women. METHODS: This was a two-armed, parallel, randomized controlled trial conducted in primary health units of a Brazilian municipality from 2018 to 2021. Overweight, adult pregnant women (n = 350) were randomly assigned to control (CG) or intervention groups (IG). The intervention consisted of three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods rather than ultra-processed products, following the NOVA food classification system, and the practice of physical activities. The primary outcome was the proportion of women whose weekly gestational weight gain (GWG) exceeded the Institute of Medicine guidelines. Adjusted logistic regression models were employed. RESULTS: Complete data on weight gain were available for 121 women of the IG and 139 of the CG. In modified intention-to-treat analysis, there was a lower chance of the IG women having excessive GWG [OR 0.56 (95% CI 0.32, 0.98), p = .04], when compared to the CG. No between-group differences were observed for the other maternal outcomes investigated. CONCLUSION: The present study was unprecedented in demonstrating that nutritional counselling based on the NOVA food classification system, together with encouraging the practice of physical activity, is effective in preventing excessive weight gain in overweight pregnant women. TRIAL REGISTRATION: Registered on July 30th 2018 at Brazilian Registry of Clinical Trials (RBR-2w9bhc).

Does feeling what you eat change how you eat? Implications of an intervention to promote consciousness of eating experiences.

Introduction: This work aims to understand the experience of participating in the Food and Nutrition Education Program workshops with Sensory and Cognitive Exercises (PESC) and measure its impact on eating behavior. Methods: The PESC consists of four workshops with exercises stimulating perception and reflection on bodily sensations triggered in eating situations. It was developed to promote consciousness of eating experiences in women who reported difficulty in controlling their body weight and who increased over 5% of their body weight in the previous year. This is a mixed-methods study designed as a controlled trial. The intervention group (n = 19) was evaluated before the first workshop (T0) and after the last workshop (T1) and the control group (n = 18), which did not participate in the workshops, was evaluated twice (T0 and T1), with an interval of 3 to 4 weeks. At T0 and T1, it was applied the Intuitive Eating Scale (IES-2) and the Three Factor Eating Questionnaire (TFEQ-R21). In T1, the intervention group also participated in a qualitative interview. Results: After participating in the PESC, the intervention group showed an increase in the IES-2 total score (95% Confidence Interval = (0.10, 0.39)) and a decrease in the emotional eating scale score (95% Confidence Interval = (-16.03; -3.85)). The interviews' analysis revealed the participants' self-observation process, which led to the perception of their practices, priorities, intentions, eating difficulties, and the connection between these aspects and environmental issues. The following themes were considered: Food management/control, Body dissatisfaction, Reflection/re-signification, and Different ways of being in familiar contexts. Discussion: The results allow us to infer that, after participating in the PESC, the intention to manage food intake became more effective, less susceptible to oscillations imposed by the external environment, and more supported by internal resources.

Educational instrument for intervention in the lifestyle of overweight pregnant women / Instrumento educativo de intervenção no estilo de vida para gestantes com sobrepeso

Abstract Objectives: to conduct the semantic validation of the images and text in educational material about eating and lifestyle for overweight women in different stages of pregnancy. Methods: qualitative, descriptive, analytical, cross-sectional study with focus groups for adapting and semantically validating the messages and images of educational material for women in three moments of the pre-natal period, as well as the support scripts for healthcare providers. The Consolidated Criteria for Reporting Qualitative Research (COREQ - Portuguese acronym) were considered. Results: participants of this study were seven pregnant women aged 21 to 40 who were in pre-natal care and 17 nutritionists aged 25 to 51. The folder was validated over seven meetings with the focus group, with one-week intervals between the groups. For each folder there were at least two meetings with focus groups, and one meeting for each script. The language was adjusted for the messages, and two images were changed to improve the self-identification of pregnant women. Technical and didactic adaptations were suggested for the scripts. Conclusion: images and text were semantically adapted; the instrument is easy to use in primary and secondary healthcare, providing support for pregnant women and healthcare providers on the subject of eating habits and lifestyle for overweight women in different stages of pregnancy.

Resumo Objetivos: realizar validação semântica de imagem e texto de material educativo sobre alimentação e estilo de vida para diferentes etapas da gestação de mulheres com sobrepeso. Métodos:. estudo qualitativo, descritivo e analítico, transversal, para adaptação e validação semântica de mensagens e imagens, com grupos focais, de material educativo para gestantes em três períodos do pré-natal e de roteiros de apoio direcionados aos profissionais de saúde. Foram observados os Critérios Consolidados para Relatos de Pesquisa Qualitativa (COREQ) Resultados: participaram do estudo sete gestantes adultas entre 21 e 40 anos em atendimento de pré-natal e 17 nutricionistas entre 25 e 51 anos. A validação dos folders constituiu-se em sete sessões de grupo focal com intervalo de uma semana entre os grupos. Para cada folder, aconteceram pelo menos dois encontros com grupos focais e para a construção de cada roteiro foi realizado um encontro. Foram realizados ajustes da linguagem paras as mensagens e mudança de duas imagens para melhorar a autoidentificação das gestantes. Foram propostas adaptações textuais nos roteiros de conteúdo técnico e didático. Conclusão: o material educativo foi adaptado semântica e imageticamente, sendo um instrumento didático de fácil acesso para ser empregado na atenção primária e secundária à saúde, apoiando gestantes e profissionais da saúde sobre alimentação e estilo de vida.

Food Consciousness Intervention Improves Interoceptive Sensitivity and Expression of Exteroception in Women.

The perception of the body's internal state (interoception) and the perception and processing of environmental sensory stimuli (exteroception) act together to modulate adaptive behaviour, including eating behaviour, and are related to bodyweight control. This study evaluated the impact of the Food and Nutrition Education Program with Sensory and Cognitive Exercises on interoceptive sensitivity and on the expression of exteroceptive perception in women who experienced difficulty in controlling their body weight. Thirty-seven women were randomized into two groups and evaluated at two moments: before and after the intervention or before and after a 3- to 4-week waiting period. A heartbeat tracking task was used for interoception evaluation. Participants were asked to write a text describing three foods after tasting them for exteroception evaluation. After the intervention, the participants showed an increase in interoceptive sensitivity, and an increase in the expression of exteroceptive stimuli perception through a semantic assessment of their writing related to the tasting experience. In addition, the results point to a possible connection between the mechanisms governing interoception and exteroception. This work brings important contributions to the search for strategies capable of promoting the perception and integration of physiological and environmental stimuli in food consumption.

Educational intervention for food consciousness: A randomized study protocol.

BACKGROUND: Contemporary living conditions present opportunities that promote obesity. In addition, traditional nutritional intervention have been considered inefficient, and there is a demand for the development and evaluation of strategies not based on the traditional paradigm of diets. AIM: The aim of this study is to describe the Food and Nutrition Education Program with Sensory and Cognitive Exercises (PESC), which seeks to promote consciousness of eating experience and body signals appreciation to adult women and thus to make them less vulnerable to food consumption stimuli. METHOD: This protocol outlines a randomized study that will include 60 adult women. PESC is based on the sensory influence for eating behavior and on the Triple-Aspect Monism theory of consciousness. It is composed of exercises that explore sensory, cognitive and emotional aspects of food experience in order to promote it into a conscious process. The program consists of four weekly workshops that explore themes related to the current obesogenic environment problematic. The intervention group (n=30) will be evaluated at the beginning of the first workshop and after the last one. The control group (n=30) will not participate on the workshops and will be evaluated twice, with a one-month interval. CONCLUSIONS: This study will contribute substantially to the development of nutritional interventions based on sensory aspects and consciousness of food experience. Therefore, PESC is considered an innovative approach with regard to improving individuals' eating behavior. TRIAL REGISTRY: This clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC), http://www.ensaiosclinicos.gov.br/rg/RBR-4qgpg5/,numberRBR-4qgpg5.

Food and Nutrition Education integrated in a holistic educational model / Educação Alimentar e Nutricional integrada a um modelo educacional holístico

ABSTRACT: Objective: To propose elements for the development of Food and Nutrition Education practices integrated to pedagogical activities for children. Methods: This is a qualitative case study, with participant observation and semi-structured interviews, carried out in a non-formal learning space, that is inspired in anthroposophy, Slow Food movement and Pikler approach. Participants were 13 children aged one to four years and three educators, and the data were interpreted by reflexive thematic analysis, using the Complex Thought as a theoretical framework. Results: The Food and Nutrition Education was consolidated in different pedagogical activities, such as cultivation practices, reverence in dealing with food, rituals and sharing, in an environmental and transdisciplinary approach. Conclusion: Nutrition education activities as part of a relationship with the environment and the planet, seen from a transdisciplinary perspective, is a differential in the formation of principles and values in early childhood education.

RESUMO: Objetivo: O artigo busca propor elementos para o desenvolvimento de práticas de Educação Alimentar e Nutricional integradas a atividades pedagógicas para crianças. Métodos: Trata-se de um estudo de caso qualitativo, com observação participante e entrevistas semiestruturadas realizadas em um espaço de educação não formal, inspirado na antroposofia no movimento slow food e na abordagem Pikler. Os participantes foram 13 crianças de 1 a 4 anos e três educadores e os dados foram interpretados por meio de análise temática reflexiva, tendo como referencial teórico o Pensamento Complexo. Resultados: A Educação Alimentar e Nutricional foi consolidada em diferentes atividades pedagógicas, como práticas de cultivo, reverência aos alimentos, rituais e partilha, em uma abordagem ambiental e transdisciplinar. Conclusão: As atividades de educação nutricional como parte da relação com o meio ambiente e o planeta, vistas de uma perspectiva transdisciplinar, são um diferencial na formação de princípios e valores na Educação Infantil.

Relationship of negative emotion with leptin and food intake amongoverweight women.

Negative emotions can influence food intake. Leptin (an anorectic hormone) levels may change in response to psychological stressors. This study aimed to explore the relationship between leptin and food intake triggered by negative emotions in overweight women. Two groupswere studied: normal weight women (n = 21) and overweight women (n = 23). Both groups were exposed to videos to stimulate negative and neutral emotions followed by application ofthe Subjetive Analog Scale. Plasma leptin levels were evaluated before and after exposure to the videos. Subsequently, a brunch containing sweet and salty foods was offered to simulatea high food availability environment. Results show that when exposed to negative emotions there was an increase in food intake (normal weight: p=.010 / overweight: p=.005). There was no change in plasma leptin levels in normal weightand overweight women. Negative emotions promotedan increase in energy intake in both groups. The results reinforce the integration of biopsychosocial aspects involving emotions and food intake.

Conjunctural hunger and structural obesity in the global scenario: reflections on what Covid-19 masks reveal / Fome conjuntural e obesidade estrutural no cenário global: reflexões sobre o que revelam as máscaras da Covid-19

ABSTRACT This essay is a reflection on the interconnection of the Covid-19 pandemic, social inequality, food insecurity and obesity in the global scenario. The pandemic health crisis is bound to an economic and social crisis marked by an increase in unemployment and a decrease in income with a consequent growth of food and nutritional insecurity. The impacts are felt worldwide, although the situation in each country, with regard to the conditions of social inequality and access to food, influences the magnitude of the pandemic consequences. At the same time, we are aware that food and nutritional insecurity is associated with low food quality and higher rates of obesity, which impairs the immune response and predisposes to worse prognosis. Thus, more economically vulnerable populations must face poorer disease outcome, besides the worsening of the economic situation and food and nutritional insecurity and the increase in obesity rates.

RESUMO Este ensaio traz uma reflexão sobre a inter-relação da pandemia da doença causada pelo novo coronavírus com a desigualdade social, a insegurança alimentar e a obesidade no cenário global. A crise sanitária oriunda da pandemia está atrelada a uma crise econômica e social, marcada pelo aumento do desemprego e pela diminuição da renda, com consequente acréscimo da insegurança alimentar e nutricional. Os impactos devem ser sentidos em todo o mundo, embora a situação de cada país, no que diz respeito às condições de desigualdade social e acesso à alimentação, influencie na magnitude dos efeitos da pandemia. Paralelamente, sabe-se que a insegurança alimentar e nutricional está associada à baixa qualidade alimentar e a maiores índices de obesidade, o que prejudica a resposta imunológica e predispõe a piores prognósticos. Dessa forma, populações mais economicamente vulneráveis devem encarar piores desfechos da doença, além do agravamento da situação econômica, da piora da IAN e do aumento dos índices de obesidade.

Desafios atuais da prática em pesquisa qualitativa: reflexões e posicionamento do pesquisador / Desafíos actuales de la práctica de la investigación cualitativa: reflexiones y posicionamiento del investigador / Challenges on current practice of qualitative research: reflections and researcher positioning

Este artigo parte do discurso provocativo feito pelo pesquisador Svend Brinkmann na 17ª Conferência sobre Pesquisa Qualitativa em Saúde para refletir criticamente sobre três desafios enfrentados na prática atual da pesquisa qualitativa e sobre o papel do pesquisador nesse contexto. São abordadas questões éticas, de reconhecimento e validade da pesquisa e relacionadas ao rigor metodológico que destacam o papel do posicionamento do pesquisador para o reconhecimento e a valorização da pesquisa qualitativa, em especial na área de pesquisa em saúde. (AU)

Este artículo se basa en el provocador discurso pronunciado por el investigador Svend Brinkmann en la 17ª Conferencia de Investigación Cualitativa en Salud para reflexionar críticamente sobre tres desafíos enfrentados en la práctica actual de la investigación cualitativa y el papel del investigador en ese contexto. Se abordan cuestiones éticas, de reconocimiento y vigencia de la investigación y relacionadas con el rigor metodológico, destacando el papel del puesto de investigador para el reconocimiento y valorización de la investigación cualitativa, especialmente en el área de la investigación en salud. (AU)

Building on the provocative speech given by researcher Svend Brinkmann at the 17th Qualitative Health Research Conference, this paperwork aims to critically think over three challenges faced during the current practice of qualitative research, and also the role of the researcher in this context. We have taken into consideration ethical issues and issues of recognition and validation of the research, as well as issues related to methodological rigor, which highlight the role of the researcher in the recognition and valuation of qualitative research, particularly in the health research field. (AU)

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults.

The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.

Study Protocol effectiveness of a nutritional intervention based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities for appropriate weight gain in overweight, adult, pregnant women: a randomized controlled trial.

BACKGROUND: Evidence from observational studies suggests that a greater intake of ultra-processed foods during pregnancy is associated with a higher chance of obesity, increased gestational weight gain, and neonatal adiposity. The aim of the present study is to evaluate the effectiveness of a nutritional intervention based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities for appropriate weight gain in overweight, adult, pregnant women. Additionally, the effect of the intervention on pregnancy outcomes, neonatal adiposity, and the child's weight and height will be investigated. METHODS: This is a two-armed parallel randomized controlled trial that will be conducted at primary health units in Ribeirão Preto, SP, Brazil. Adult pregnant women who are overweight and receiving prenatal care in the public health system will be included. The women will be randomly allocated into control (standard care) or intervention groups. Those enrolled in the intervention group will participate in three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities. The recruitment of the participants will be carried out at seven health facilities over 12 months, with a sample of 300 women expected. Maternal anthropometric, sociodemographic, blood pressure, biochemical, and lifestyle data will be obtained at baseline (up to the 16th week of gestation), and during a second assessment (34th to 36th gestational week). The neonate body composition will be estimated after birth, and data on pregnancy outcomes, weight and height of children at 6, 12 and 24 months of age will be further obtained from medical records. DISCUSSION: This will be the first randomized controlled trial to test the effectiveness of a nutritional intervention based on encouraging the consumption of unprocessed and minimally processed foods and the practice of physical activities for appropriate weight gain in adult, overweight, pregnant women. Furthermore, the effect of the intervention on pregnancy outcomes, neonatal adiposity and the child's weight and height will be evaluated. TRIAL REGISTRATION: Registro Brasileiro de Ensaios Clínicos (Rebec) RBR-2w9bhc July 30th 2018 (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-2w9bhc+), and RBR-7yx36h June 4th 2019 (http://www.ensaiosclinicos.gov.br/rg/?q=RBR-7yx36h+0.

Dietary quality differences between women with and without weight loss in nutritional treatment.

BACKGROUND & AIMS: The obesity nutritional treatment is structured to weight loss and diet is considered an important indicator of treatment effectiveness. The purpose of this study is to compare the diet quality among women who lost weight to women who maintained or gained weight during the nutritional treatment. METHODS: This is a retrospective study that included 66 obese women in nutritional treatment for weight loss, over six months, divided in tercile according to their weight loss. The diet quality was evaluated by score, which was obtained with a food frequency questionnaire. RESULTS: The diet quality comparison was made among the group with weight loss (GL; n = 22) and the group that maintained or gained weight during the nutritional treatment (GG; n = 22) showed that both groups had improvement in their diet quality scores from pre-treatment to post-treatment. Nevertheless, the GG had higher sugar consumption than the GL in the pre-treatment (p = 0.02) and in the post-treatment (p 0.01) periods. In the post-treatment, GL increased their scores for leafy vegetables (0.013), fruit (0.004), sweets (p 0.03), and soft drinks (p 0.02). GL improved their scores for fried food (p 0.01) and sweets (p 0.008). CONCLUSION: This indicates that in the weight loss treatment special attention should be given to the incentive to the fruit and leafy vegetables consumption and, to reduce the consumption of sweets.

ADDITIONAL ABDOMINAL MEASUREMENTS ARE A USEFUL TOOL TO EVALUATE BODY COMPOSITION IN OBESE WOMEN.

BACKGROUND: During weight gain, most of the excess adipose tissue accumulates in the trunk. This alters the body shape and makes collection of anthropometric measurements, especially waist circumference (WC), difficult. OBJECTIVE: To evaluate the sensitivity and applicability of additional abdominal measurements in order to assess body composition of obese women. METHODS: A total of 30 women between 20 and 50 years of age and BMI above 30 kg/m² were assessed. Three WC measurements, were performed: at the umbilical scar designated as WC1 and at 8 and 16 cm above the umbilical scar, designated as WC2, and WC3 respectively. The correlation (r) between these anthropometric measurements and their sum was assessed against the parameters fat mass (FM), free fat mass (FFM), body fat percentage (%BF), and trunk fat percentage (%TF), obtained by total and trunk segmental bioelectric impedance analysis (BIA) as well as by the golden standard total and trunk dual energy X-ray absorptiometry (DXA). RESULTS: The measurements WC1, WC2, WC3, and their sum correlated strongly and moderately with the parameters FM, FFM, and %BF in total BIA and in both total DXA and trunk DXA. CONCLUSION: The results demonstrated a robust correlation between the sum of the three WC measurements and total and trunk DXA in obese women suggesting that such measurements may be a good indicator of body and trunk fat in women, actually superior to BIA results. The use of these three measurements may be an alternative for the assessment of body and trunk fat, in those cases in which the body shape due to adipose tissue trunk accumulation makes accurate classical measurement (WC1) difficult.

Medidas abdominais adicionais são uma ferramenta útil para avaliar a composição corporal em mulheres obesas / Additional abdominal measurements are a useful tool to evaluate body composition in obese women

ABSTRACT BACKGROUND: During weight gain, most of the excess adipose tissue accumulates in the trunk. This alters the body shape and makes collection of anthropometric measurements, especially waist circumference (WC), difficult. OBJECTIVE: To evaluate the sensitivity and applicability of additional abdominal measurements in order to assess body composition of obese women. METHODS: A total of 30 women between 20 and 50 years of age and BMI above 30 kg/m² were assessed. Three WC measurements, were performed: at the umbilical scar designated as WC1 and at 8 and 16 cm above the umbilical scar, designated as WC2, and WC3 respectively. The correlation (r) between these anthropometric measurements and their sum was assessed against the parameters fat mass (FM), free fat mass (FFM), body fat percentage (%BF), and trunk fat percentage (%TF), obtained by total and trunk segmental bioelectric impedance analysis (BIA) as well as by the golden standard total and trunk dual energy X-ray absorptiometry (DXA). RESULTS: The measurements WC1, WC2, WC3, and their sum correlated strongly and moderately with the parameters FM, FFM, and %BF in total BIA and in both total DXA and trunk DXA. CONCLUSION: The results demonstrated a robust correlation between the sum of the three WC measurements and total and trunk DXA in obese women suggesting that such measurements may be a good indicator of body and trunk fat in women, actually superior to BIA results. The use of these three measurements may be an alternative for the assessment of body and trunk fat, in those cases in which the body shape due to adipose tissue trunk accumulation makes accurate classical measurement (WC1) difficult.

RESUMO CONTEXTO: O acúmulo de tecido adiposo excessivo no ganho de peso se dá em maior proporção no segmento do tronco, leva à alteração dos formatos corporais dificultando a tomada de medidas antropométricas, em especial a circunferência abdominal (CA). OBJETIVO: Avaliar a sensibilidade de medidas adicionais na região abdominal, considerando cada medida individualmente e sua somatória, e a aplicabilidade dessas medidas na avaliação da composição corporal de mulheres obesas. MÉTODOS: Foram avaliadas 30 mulheres com idade entre 20 e 50 anos e IMC acima de 30 kg/m² com a realização de três medidas de CA denominadas: CA1 padronizada na cicatriz umbilical, CA2 a 8 cm acima da cicatriz umbilical e CA3 a 16 cm acima da cicatriz umbilical. Foi avaliada a correlação (r) destas medidas antropométricas e de sua somatória com os parâmetros massa gorda (MG), massa livre de gordura (MLG), porcentagem de gordura corporal (%GC) e do tronco (%GT) obtidos por impedância bioelétrica (BIA) total e segmentar do tronco e por absorciometria de raios-X de dupla energia (DXA) total e do tronco, como padrão ouro. RESULTADOS: As medidas CA1, CA2, CA3 e a somatória das três tiveram correlação forte e moderada com os parâmetros MG, MLG e %GC tanto para BIA total como para DXA total e DXA do tronco. CONCLUSÃO: Os resultados deste estudo mostram forte correlação entre a soma das medidas de três pontos no abdome com DXA de tronco e total, em mulheres obesas, sugerindo serem estas medidas, um bom indicador de gordura corporal e de gordura da região do tronco, superior aos resultados obtidos por BIA. O uso dessas três medidas pode ser um indicador alternativo de avaliação da gordura corporal e de tronco, nos casos em que o formato corporal de acúmulo de gordura na região do tronco, dificultar a acurácia da medida clássica (CA1).