Dietary Inflammatory Index of Obese Individuals with Obstructive Sleep Apnea: A Descriptive Study.

The objective of the present study was to describe the dietary inflammatory profile and its correlations with sleep parameters of obese individuals with obstructive sleep apnea (OSA). Forty individuals underwent nocturnal polysomnography, anthropometric measurements, body composition by plethysmography, assessment of food consumption by three-day food records, and blood collection for the lipid, glycemic and hormonal profile. Food consumption data were evaluated semiquantitatively, quantitalively assessment, and calculation of the dietary inflammatory index (DII) was perfomed. The results demonstrated a predominantly proinflammatory dietary profile. The participants showed a low intake of fruit and vegetables. Additionally, a low consumption of fiber, magnesium, vitamin D, and vitamin E was observed, although there was an adequate distribution of macronutrients. In conclusion, although the inflammatory profile did not correlate with OSA, the study showed a directly proportional relationship between adequate dietary patterns and better sleep quality.

Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus.

Genital infection by human papillomavirus (HPV) tends to occur more frequently in patients with conditions associated with immune suppression. Systemic lupus erythematosus (SLE) is an immunological disorder characterized by generalized inflammation and a number of clinical manifestations and circulating autoantibodies. The aim of the present study was to determine the prevalence of genital HPV infection among female SLE patients. Women diagnosed with SLE based on American College of Rheumatology classification criteria followed at rheumatology outpatient clinic of the Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil, were included in the study. As a comparison group, clinically healthy women who were attending the gynecology outpatient clinic for routine examination at the same institution were recruited. Testing for cervical HPV infection was performed using the nested polymerase chain reaction technique. Eighty-eight female SLE patients (mean age, 41.4 ± 11.6 years) and seventy healthy female subjects (control group) were studied. The prevalence of HPV infection was 80.7 % (71/88) in the SLE group and 35.7 % (25/70) in the control group (p < 0.0001). After adjustment of the variables (early sexual activity, number of partners and obstetric history), the odds ratio (OR) for genital HPV infection in women with SLE was 7.2 (95 % CI, 2.9 to 17.8; p = 0.0001). The use of immunosuppressive drugs was not associated with a higher prevalence of HPV infection. This study demonstrated that SLE patients have a higher prevalence of genital HPV infection, even when exposed to less potential risk factors for the virus.

Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods.

Introduction: The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. Methods: This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). Results: The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Conclusion: Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.

Effects of physical distancing by COVID-19 pandemic on diet quality, neurological and immunological markers, and fecal microbiota of Brazilian older women.

Physical distancing was used to prevent transmission of COVID-19, however there are concerns that this may promote harmful impacts on health, such as reduced levels of physical practice and changes in food intake and gut microbiota composition. This study evaluated the impacts of 6 months physical distancing on Brazilian older women upon body mass index (BMI), strength, physical activity level (IPAQ), eating habits, neurological markers (brain-derived neurotrophic factor-BDNF and cortisol), cytokines (IL-2, IL-5, IL-6, IL-10, interferon-IFN-γ, tumor necrosis factor-TNF-α), aging-associated markers (vascular endothelial growth factor-VEGF, insulin-like growth factor-IGF-1, klotho and thymic stromal lymphopoietin-TSLP), besides specific groups of fecal microbiota. Fifteen women, over 60 years old, residents of São Paulo state (Brazil), were evaluated in March and in September 2020. The older adult women, with a mean age 66 ± 6.2 years presented significantly increased BMI and high effect size for non-protective foods consumption, reduced light physical activity and strength 6 months following the physical distancing. Furthermore, the serum concentration of IFN-γ, IGF-1, and IFN-γ/IL-5 were significantly higher, while lower concentration of IL-2 and IL-5 were observed 6 months after the physical distancing. Significant increase was noted only to Blautia spp. abundance after 6 months of physical distancing. Several correlations were observed at both before and after physical distancing, however, interestingly, many of them were lost or inverted 6 months following, while new ones emerged. Taken together, these results showed that lifestyle changes and stress conditions addressed by physical distancing from the COVID-19 pandemic impacted the health of older women included in the present study. Therefore, future follow-up studies are essential to propose interventions in order to restore the health conditions observed before the pandemic period, and thus to maintain the quality of life of older adults in different socioeconomic contexts.

Micronutrient intake in elderly living in nursing homes.

OBJECTIVE: The aim of this study was to evaluate the ingestion of micronutrients in elderly living in nursing homes. METHODS: This is a cross-sectional study, conducted with 216 individuals of both sexes, age equal or greater than 60 years, living in nursing homes for elderly in Salvador, Bahia, Brazil. Direct weighing of the food was used to get food intake, and prevalence of inadequacy was obtained using the software Multiple Source Method (MSM) and evaluated by estimated average requirement (EAR). RESULTS: A high prevalence of inadequate intake of micronutrients was observed, being over 90% for vitamins E, folate, pyridoxine and calcium, in both sexes and between 50 and 70% for selenium, retinol, riboflavin, cyanocobalamin and vitamin C. CONCLUSION: The high prevalence of inadequate intake of micronutrients in elderly living on nursing homes observed in this study may be used for planning public health strategies aiming to improve the nutritional context of this population and their quality of life, reducing the costs of health care.

Balance of macronutrient intake among Brazilian elderly: analysis of the National Dietary Survey 2008-2009. / Balanço de macronutrientes na dieta de idosos brasileiros: análises da Pesquisa Nacional de Alimentação 2008-2009.

OBJECTIVE:: This study aimed at evaluating the balance in the intake of protein, carbohydrate, and fat among the Brazilian elderly population. METHODS:: The data analyzed were taken from the National Dietary Survey 2008-2009, from a total of 4,286 Brazilian elders (60-104 years old). Based on the dietary intake obtained from two food records, the Multiple Source Method (MSM) was used to evaluate the macronutrients and saturated fat. The AMDR (Acceptable Macronutrient Distribution Range), by the Institute of Medicine (IOM), was used to evaluate the macronutrient energy percentage (%E). Linear regression models identified differences between macronutrients %E and household location (urban or rural), Brazilian macro-regions and gender. RESULTS:: Protein intake showed higher agreement with the AMDR reference value (99.86%). It was observed that in 9.2% of the population, fat intake was higher than the reference value, almost twice as high as the carbohydrate-energy percentage (4.9%) and nine times higher than protein (1.0%). Among those with low carbohydrate-energy percentage, 14.5% had higher fat-energy percentage (ß = 8.19; p < 0.001), which means that 50% of the elderly whose carbohydrate intake was above the recommendation presented an overconsumption of fat. According to the macro-regions, the Midwest region was the only one to show differences for carbohydrate-energy percentage, which was lower than the others regions (51.6%; p < 0.05). The South region presented the lowest protein-energy percentage (17.9%; p < 0.01) and the highest fat-energy percentage (28.7%; p < 0.01). CONCLUSION:: Higher prevalence of inadequate fat intake among the Brazilian elderly may indicate an important public health problem that is associated with an increased risk of chronic diseases.

Sintomas de depressão, risco nutricional e capacidade funcional em idosos longevos / Depression symptoms, nutritional risk and functional capacity in longlived ederly / Sintomas de depression, riesgo nutritional y capacidad funcional en personas mayores a largo plazo

Objetivou-se avaliar a relação entre sintomas de depressão, risco nutricional e capacidade funcional com características sociais, econômicas, demográficas e de saúde, em idosos longevos. Trata-se de uma pesquisa transversal, realizada em quatro municípios do estado de São Paulo. A relação entre as variáveis foi obtida por meio da técnica de Análise de Correspondência Múltipla. Foram avaliados 103 idosos, a maioria do sexo feminino, com idade entre 80 e 90 anos e com até quatro anos de estudo. Os resultados evidenciam a correspondência entre a presença de sintomas de depressão, risco nutricional, comprometimento funcional, baixa escolaridade e inadequada autoavaliação de saúde. Nota-se, portanto, a necessidade de uma abordagem interdisciplinar, e o desenvolvimento de políticas públicas direcionadas aos muito idosos, oferecendo atenção necessária para a redução do risco de depressão, de desnutrição e na melhoria da funcionalidade dos idosos longevos, que levem a um impacto positivo em sua qualidade de vida (AU).

This is study aimed to evaluate the relationship between depression symptoms, nutritional risk, and functional capacity, with social, economic, demographic and health characteristics in in long-lived elderly. It is a cross-sectional survey carried out in four municipalities in the state of São Paulo. The relationships among the studied variables were investigated through the technique of Multiple Correspondence Analysis. A total of 103 elderly were evaluated, most of whom were female, aged between 80 and 90 years and up to four years of schooling. The results evidence the correspondence between depression symptoms, nutritional risk, functional impairment, low schooling, and inadequate health self-assessment. Therefore, there is need a broad and interdisciplinary approach and the development of public policies directed at the very elderly are necessary, to reduce the risk of depression, malnutrition and improve the functioning of the long-lived elderly, that have a positive impact on their quality of life (AU).

Objetivo evaluar la relación entre síntomas de depresión, riesgo nutricional y capacidad funcional, con recursos sociales, económicos, demográficos y de salud, en ancianos de larga vida. Esta es un estudio transversal realizada en cuatro municipios del estado de São Paulo. Las relaciones entre las variables se investigaron utilizando la técnica de Análisis de Correspondencia Múltiple. 103 personas mayores fueron grabadas, la mayoría mujeres, con edades comprendidas entre 80 y 90 años y hasta cuatro años de estudio. Los resultados muestran una correspondencia entre la presencia de síntomas de depresión, riesgo nutricional, deterioro funcional, baja educación y salud inadecuada. Nota la necesidad de un enfoque interdisciplinario y el desarrollo de políticas públicas dirigidas a las personas mayores, ayuda a prestar atención para reducir los riesgos de depresión, desnutrición y mejorar la funcionalidad de las personas mayores de edad, lo que tiene un impacto positivo en su calidad de vida (AU).

The Role of Nutrition and Physical Activity in Cholesterol and Aging.

Cholesterol is a precursor of several substances with important biologic activities; however, it is common to associate this molecule only with bad outcomes. This article reviews the cholesterol metabolism, its functions in the human body, its pathogenicity, and its elimination. The modifications in biochemical paths of cholesterol in aging are highlighted. Finally, the role of diet, physical activity, and exercise in cholesterol management is discussed.

O uso da bioimpedância elétrica e do ângulo de fase na avaliação do estado nutricional de pacientes com câncer: uma revisão integrativa / The use of electrical bioimpedance and the phase angle in the evaluation the nutritional status of patients with cancer: an integrative review

Contexto: Pacientes com câncer podem apresentar involução do estado nutricional devido a alterações metabólicas determinadas pela doença e ao tratamento, e a avaliação nutricional pode identificar precocemente a desnutrição e permitir intervenção adequada. O uso da bioimpedância elétrica tem crescido nos últimos anos, uma vez que a obtenção do ângulo de fase tem demonstrado ser bom indicador do estado nutricional. Objetivo: Apresentar e discutir os resultados de estudos que utilizaram o ângulo de fase na avaliação do estado nutricional de pacientes com câncer. Métodos: Estudo de revisão integrativa da literatura, no qual foi realizado o levantamento de artigos científicos nas bases de dados Cochrane, PubMed, LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde) e Korea Med. Resultados: A busca resultou em 86 artigos, sendo selecionadas 21 publicações. Destes, 38,1% estudaram mais de um tipo de câncer, sendo cabeça e pescoço (19,1%) o tipo mais avaliado, e 61,9% avaliaram a sobrevida em relação aos valores do ângulo de fase. A observação da redução nos valores do ângulo de fase foi relacionada à sobrevida, ao estado nutricional e ao estadiamento. Conclusão: A bioimpedância elétrica para a avaliação do ângulo de fase é um procedimento rápido, de baixo custo e não invasivo. É importante considerar que outros estudos com a utilização da bioimpedância sejam conduzidos, a fim de confirmar sua confiabilidade como marcador de estado nutricional na prática clínica.

[Association of children's consumption of processed foods and family income in the city of São Paulo, Brazil]. / Consumo infantil de alimentos industrializados e renda familiar na cidade de São Paulo.

OBJECTIVE: To describe children's consumption of processed foods and its relationship with per capita family income based on a household survey. METHODS: Food consumption was studied in a statistical sample of 718 children living in the city of São Paulo in the period 1995-1996. A 24-hour dietary recall was used. Data regarding the association of children's consumption of 24 processed foods and per capita family income (arranged in quartiles) was analyzed. RESULTS: Consumption of sugar was higher among children of low income families whereas the consumption of chocolate powder, chocolate, yogurt, infant formula and soft drinks was higher among children of high income families (p< 0.05). CONCLUSIONS: It seems that per capita family income affects the consumption of some processed foods.

Assessment guidance of carbohydrate counting method in patients with type 2 diabetes mellitus.

AIMS: We evaluated the application of the method of carbohydrate counting performed by 21 patients with type 2 diabetes, 1 year later attending a guidance course. METHODS: Participants answered a questionnaire to assess patients' adhesion to carbohydrate counting as well as to identify habit changes and the method's applicability, and values of glycated hemoglobin were also analyzed. RESULTS: Most participants (76%) were females, and 25% of them had obesity degree III. There was a statistically significant decrease in glycated hemoglobin from 8.42±0.02% to 7.66±0.01% comparing values before and after counseling. We observed that although patients stated that the method was difficult they understood that carbohydrate counting could allow them make choices and have more freedom in their meals; we also verified if they understood accurately how to replace some foods used regularly in their diets and most patients correctly chose replacements for the groups of bread (76%), beans (67%) and noodles (67%). CONCLUSIONS: We concluded that participation in the course led to improved blood glucose control with a significant reduction of glycated hemoglobin, better understanding of food groups and the adoption of healthier eating habits.

Evaluation of dynapenia in the elderly in São Caetano do Sul, São Paulo, Brazil / Avaliação da dinapenia em idosos de São Caetano do Sul, São Paulo, Brasil / Evaluación de la dinapenia em adultos mayores de São Caetano do Sul, São Paulo, Brasil

Abstract Introduction: Aging is characterized by psychological, social, nutritional and biological changes, among which dynapenia stands out. Objective: To analyze the presence of dynapenia and associated factors in elderly people living in the city of São Caetano do Sul. Method: A cross-sectional study was carried out with 295 elderly individuals aged 60 years or older, who were users of public health units in the city of São Caetano do Sul. Dynapenia was assessed by handgrip strength, and its associations were investigated using multivariate logistic regression, according to sociodemographic variables, nutritional status, protein consumption, presence of diseases, and physical activity. Statistical analysis was performed using the IBM-SPSS (Statistical Package for Social Science) software. The adopted level of significance was p < 0.05. Results: Most of the participants were female (n = 251), with mean age of 70.6 years (± 7.0). The presence of dynapenia was observed in 24.07% (n = 71), among which 47 were women (18.73%) and 24 were men (54.55%). Observed associations concerned older age, male sex, lower circumference of the arm and calf, and lower triceps skinfold (p < 0.05). Conclusion: Approximately one-fourth of the elderly studied presented dynapenia, which represents a higher risk of morbidity and mortality. The inclusion of PPF alongside other anthropometric measures for assessing nutritional status is recommended. It is important for public policies to be directed towards health promotion and risk prevention in this age group.

Resumo Introdução: O envelhecimento é marcado por alterações psicológicas, sociais, nutricionais e biológicas, entre as quais destaca-se a dinapenia. Objetivo: Avaliar a presença de dinapenia em idosos residentes no município de São Caetano do Sul e os fatores a ela associados. Método: Estudo transversal, realizado com 295 idosos com idade igual ou maior a 60 anos, de ambos os gêneros, usuários de unidades de saúde no município de São Caetano do Sul. A dinapenia foi avaliada pela força de preensão palmar (FPP) e foi investigada sua associação com variáveis sociodemográficas, estado nutricional, consumo protéico, presença de doenças e prática de atividade física, através de regressão logística multivariada. Para análise estatística foi utilizado o software IBM - SPSS (Statistical Package for Social Science), o nível de significância adotado p < 0,05. Resultados: A maioria dos idosos estudados era do sexo feminino (n = 251), idade média 70,6 anos (± 7,0). A presença de dinapenia foi observada em 24,07% (n = 71), sendo 47 mulheres (18,73%) e 24 homens (54,55%), sendo observada associação com maior idade, sexo masculino, menor circunferência do braço, circunferência de panturrilha e dobra cutânea triciptal (p < 0,05). Conclusão: Aproximadamente um quarto dos idosos estudados apresentaram dinapenia, o que representa maior risco de morbimortalidade. Entre as medidas antropométricas para avaliação do estado nutricional recomenda-se a inclusão da FPP. É importante que políticas públicas sejam direcionadas para promoção de saúde e prevenção de riscos neste grupo etário.

Resumen Introducción: El envejecimiento está marcado por alteraciones psicológicas, sociales, nutricionales y biológicas, entre las que destaca la dinapenia. Objetivo: Evaluar la presencia de dinapenia en adultos mayores (AM) residentes en el municipio de São Caetano do Sul (Brasil) y los factores asociados a esta alteración. Método: Estudio transversal, que evaluó un grupo de 295 AM, de ambos generos, usuarios de centros de salud de São Caetano do Sul. La dinapenia fué evaluada por la Fuerza de Prensión Manual (FPM) y se investigó su asociación con variables sociodemográficas, estado nutricional, consumo proteico, presencia de enfermedades y práctica de actividad física, a través de regresión lineal multiple. Para el análisis estadístico se utilizó el software IBM - SPSS (Statistical Package for Social Science), con un nivel de significancia menor a 0,05. Resultados: La mayoría de los AM estudiados era del sexo femenino (n = 251), edad media 70,6 años (± 7,0). La presencia de dinapenia se observó en el 24,07% (n = 71), de los cuales 47 eran mujeres (18,73%) y 24 eran hombres (54,55%), siendo observada asociación con edad mayor, sexo masculino, menor perímetro del brazo, perímetro de la pantorrilla y pliegue cutáneo tricipital (p < 0,05). Conclusión: Aproximadamente un cuarto de los AM estudiados presentaron dinapenia, lo que representa un mayor riesgo de morbimortalidad. Entre las medidas antropométricas para evaluación del estado nutricional se recomienda la inclusión de la prueba de FPM. Es importante que las políticas públicas se dirijan a la promoción de la salud y la prevención de riesgos en este grupo de edad.

Evaluation of food intake in patients with mucopolysaccharidosis

Background: Mucopoly saccharidosis (MPS) are inborn errors of metabolism (IEM) recognized by deficient enzymes enrolled in glycosaminoglycans catabolism. The resulting accumulation of glycosaminoglycans leads to clinical progressive and generalized manifestations. Considering the severity of MPS and the relevance of establishing dietetic strategies to these patients, the present study was tailored to evaluate the food intake in patients with MPS types I, II, and VI. Methods: Food intake in patients with MPS I, II, and VI was assessed. A descriptive cross-sectional study was conducted. Energetic demand based on estimated necessity of energy equations and reported food intake was analyzed. Total energetic value and nutrients (vitamins B1, B2, C, calcium, iron, and phosphate) were analyzed inaccordance with the standardized interval for macronutrient distribution and the method of apparent adequacy for nutrient intake. Results: Food intake of 17 patients (6- to 30-year-olds) was considered adequate regarding macronutrients. Children and adolescents failed in presenting this parameter. Macronutrients were satisfactory in both groups. Children and adolescents displayed increased intake of iron and vitamins B1 (p< 0.05), B2, B3, and C (p< 0.077)and probability of adequacy≥50%. Calcium and phosphorus intake was greater in adults. Conclusions: The results obtained demonstrated that patients with MPS have nutrition deficiency in their diet, which may directly or indirectly influence the course of the disease.

[Development and evaluation of nutritional screening tools]. / Desenvolvimento e avaliação de instrumentos de triagem nutricional.

This study aims to describe the development and evaluation of nutritional screening tools to identify risk of malnutrition in hospitalized patients. From the identification of predictive variables, the patient should be referred to the multidisciplinary team of nutrition therapy for intervention. Were studied 300 patients from a hospital in Sao Paulo, applied with a nutritional assessment survey of risk variables and conducted a multiple logistic regression for the selection of predictors. The variables associated with malnutrition were: unintentional weight loss, apparent bones, decreased appetite, diarrhea, inadequate energy intake and male sex. A nutritional screening tool was developed and showed good agreement with validated instruments.

Factors associated with protein consumption in elderly / Fatores associados ao consumo proteico de idosos

ABSTRACT Objective We evaluated factors associated with protein consumption by the elderly. Methods We performed a cross-sectional study in a sample of 295 elderly consumers of health facilities in São Caetano do Sul, São Paulo, Brazil. Protein consumption data (g and g/kg) were obtained through 24-hour dietary recalls, which was reapplied in a 30% sub-sample to estimate habitual consumption, with an interval of two weeks. The association between protein consumption and sociodemographic, economic, health, and dietary variables was tested using multiple linear regression. Results There was a positive association between protein consumption (g and g/kg) and better Brazilian Healthy Eating Index-Revised, between protein consumption (g) and male sex, and a negative association between protein consumption (g/kg) and greater calf circumference. Higher average protein consumption (g or g/kg) was observed among married elderly, individuals with higher income and schooling, who were economically active, eutrophic, without dyslipidemia and symptoms of dysphagia, who consumed three main meals and an intermediate snack. Conclusion The results showed that protein consumption was associated with diet quality, sex, and calf circumference. The identification of elderly groups prone to protein inadequacy may direct individual and collective interventions to prevent muscle mass reduction and its implications, such as sarcopenia and other adverse outcomes.

RESUMO Objetivo Avaliar os fatores associados ao consumo proteico de idosos. Métodos Estudo transversal descritivo realizado com 295 idosos usuários de centros para terceira idade e unidades de saúde do Município de São Caetano do Sul, São Paulo. O consumo proteico (g e g/kg) foi obtido na avaliação do recordatório de 24 horas, que foi reaplicado numa subamostra de 30% para estimar o consumo habitual, com intervalo máximo de duas semanas. A associação entre proteína e variáveis sociodemográficas, econômica, de saúde e dietéticas foram testadas por meio de regressão linear múltipla. Resultados Houve associação positiva entre o consumo de proteína (g e g/kg) e melhor Índice de Qualidade da Dieta Revisado, entre o consumo de proteína (g) com o sexo masculino, e associação negativa entre proteína (g/kg) e maior circunferência da panturrilha. Maior consumo médio de proteína (g e/ou g/kg) foi observado entre idosos casados, com maior renda e escolaridade, economicamente ativos, eutróficos, sem dislipidemia e sintomas de disfagia, que consumiram as três refeições principais e lanche intermediário. Conclusão Os resultados demonstraram que o consumo proteico foi associado à qualidade da dieta, sexo e circunferência da panturrilha. A identificação de grupos de idosos propensos à inadequação proteica pode direcionar intervenções individuais e coletivas com intuito de prevenir a redução de massa muscular e suas implicações, como sarcopenia e outros desfechos adversos.

Balanço de macronutrientes na dieta de idosos brasileiros: análises da Pesquisa Nacional de Alimentação 2008-2009 / Balance of macronutrient intake among Brazilian elderly: analysis of the National Dietary Survey 2008-2009

RESUMO: Objetivo: Analisar a contribuição de proteína, lipídio e carboidrato no total de energia da dieta de idosos das diferentes regiões brasileiras. Métodos: Foram analisados dados de 4.286 idosos (60 a 104 anos) provenientes da Pesquisa de Orçamentos Familiares 2008/2009. Baseado no consumo obtido por dois registros alimentares, o programa Multiple Source Method estimou o consumo habitual de macronutrientes e gordura saturada. As recomendações do Institute of Medicine (IOM), segundo os Acceptable Macronutrient Distribution Ranges (AMDR), foram utilizadas para avaliar a participação relativa dos macronutrientes de acordo com percentual energético (PE). Modelos de regressão linear identificaram diferenças entre PE dos macronutrientes, situação do domicílio, macrorregiões e gênero. Resultados: A proteína foi o macronutriente que apresentou maior concordância com o AMDR (99,8%). Com relação ao PE lipídico, observou-se que 9,2% da população ficaram acima da recomendação, sendo o dobro do encontrado para carboidrato (4,9%) e nove vezes o percentual de idosos, cujo PE-proteico (1,0%) foi acima do recomendado. Em 14,5% dos idosos a ingestão de carboidratos foi abaixo da AMDR, sendo que essas dietas apresentaram maior PE lipídico (β = 8,19; p < 0,001), revelando que 50% dos idosos que consumiam carboidratos abaixo do PE recomendado apresentou um consumo excessivo de lipídio. Segundo macrorregiões, o Centro-Oeste foi o único a apresentar diferença para carboidrato, sendo esta de menor percentual (51,6%; p < 0,05). A região Sul (17,9%; p < 0,01) apresentou o menor PE proteico e o maior de lipídios (28,7%; p < 0,01). Conclusões: A elevada frequência de inadequação da ingestão de lipídio pode significar uma pior qualidade da dieta, contribuindo com o aumento no risco de desenvolvimento de doenças crônicas.

ABSTRACT: Objective: This study aimed at evaluating the balance in the intake of protein, carbohydrate, and fat among the Brazilian elderly population. Methods: The data analyzed were taken from the National Dietary Survey 2008-2009, from a total of 4,286 Brazilian elders (60-104 years old). Based on the dietary intake obtained from two food records, the Multiple Source Method (MSM) was used to evaluate the macronutrients and saturated fat. The AMDR (Acceptable Macronutrient Distribution Range), by the Institute of Medicine (IOM), was used to evaluate the macronutrient energy percentage (%E). Linear regression models identified differences between macronutrients %E and household location (urban or rural), Brazilian macro-regions and gender. Results: Protein intake showed higher agreement with the AMDR reference value (99.86%). It was observed that in 9.2% of the population, fat intake was higher than the reference value, almost twice as high as the carbohydrate-energy percentage (4.9%) and nine times higher than protein (1.0%). Among those with low carbohydrate-energy percentage, 14.5% had higher fat-energy percentage (β = 8.19; p < 0.001), which means that 50% of the elderly whose carbohydrate intake was above the recommendation presented an overconsumption of fat. According to the macro-regions, the Midwest region was the only one to show differences for carbohydrate-energy percentage, which was lower than the others regions (51.6%; p < 0.05). The South region presented the lowest protein-energy percentage (17.9%; p < 0.01) and the highest fat-energy percentage (28.7%; p < 0.01). Conclusion: Higher prevalence of inadequate fat intake among the Brazilian elderly may indicate an important public health problem that is associated with an increased risk of chronic diseases.

Quality of life in the elderly in a stretching program / Qualidade de vida em idosos em um programa de alongamento / Calidad de vida en adultos mayores en un program de estiramiento

The aim was to evaluate the quality of life of the elderly before and after the intervention. Twenty-one elderly (mean 65.71 years, ± 5.08) participated in a stretching program and WHOQOL-Bref and WHOQOL-Old were used for evaluation. The four dimensions of WHOQOL-Bref showed improvement in indicators, as well as the dimensions of WHOQOL-Old: Past, Present and Future Activities, Social Participation, and Intimacy. It is concluded that there is evidence that stretching type physical activity seems to be beneficial for the studied population.

Objetivou-se avaliar a qualidade de vida de idosos pré- e pós-intervenção. Participaram 21 idosos (média 65,71anos, ±5,08), de um programa de alongamento e, para avaliação, foi utilizado o WHOQOL-Bref e WHOQOL-Old. As quatro dimensões do WHOQOL-Bref apresentaram melhoria dos indicadores, como também as dimensões do WHOQOL-Old: Atividades Passadas, Presentes e Futuras, Participação Social e Intimidade. Conclui-se que há evidência de que a atividade física do tipo alongamento parece ser benéfica para a população estudada.

El objetivo fue evaluar la calidad de vida de los ancianos antes y después de la intervención. Veintiún ancianos (media de 65,71 años, ± 5,08) participaron en un programa de estiramiento y WHOQOL-Bref y WHOQOL-Old se utilizaron para la evaluación. Las cuatro dimensiones de WHOQOL-Bref mostraron mejoras en los indicadores, así como las dimensiones de WHOQOL-Viejo: Actividades pasadas, presentes y futuras, Participación social e Intimidad. Se concluye que existe evidencia de que la actividad física de estiramiento parece ser beneficiosa para la población estudiada.

Dietary patterns and associated factors among the elderly / Padrões dietéticos e fatores associados em idosos

OBJECTIVE: The aim of the present study was to identify dietary patterns among the elderly, and associate the same with sociodemographic characteristics, health and lifestyle. METHODS: A cross-sectional study was carried out with a non-probabilistic sample of 295 elderly residents of both genders of the city of São Caetano do Sul, São Paulo, Brazil, who were users of public health units. Dietary patterns were identified considering 44 food items identified through 24-hour dietary recall. Factor analysis by the principal components method was used, adopting loads greater than 0.25 as the cut-off point, followed by Varimax orthogonal rotation. The associations were analyzed by the linear regression method, with variables with p<0.20 in univariate regression selected, and those with p<0.05 maintained in the multivariate model. There was a greater percentage of elderly females (85.1%) and those aged 60-69 years (46.4%). RESULTS: Three dietary patterns were identified: the "traditional" pattern was associated with the male gender (β=0.59, p<0.001) and physically active individuals (β=0.39, p=0.020); the "Pastas, pork and sweets" pattern was associated with the male gender (β=0.38, p=0.025) and retired individuals (β=0.55, p=0.017); and the "Coffee with milk and bread and butter" pattern was associated with an age of 80 years or older (β=0.55, p=0.004) and elderly persons who had difficulty chewing (β=0.38, p=0.013). CONCLUSION: The dietary patterns identified show that the elderly tend to maintain similar eating habits to the Brazilian population in general, and that diet changes to a similar degree as health and life style conditions. AU

OBJETIVO: Identificaram-se padrões dietéticos em idosos e associaram-se com características sociodemográficas de saúde e estilo de vida. Este foi um estudo transversal descritivo com amostra não probabilística de 295 idosos residentes no município de São Caetano do Sul, São Paulo, Brasil, usuários de unidades públicas de saúde, de ambos os sexos. METODOS: Os padrões dietéticos foram identificados, considerando-se 44 itens alimentares oriundos de Recordatório de 24 horas. Utilizou-se análise fatorial pelo método de componentes principais, adotando-se como ponto de corte cargas superiores a 0,25, seguida de rotação ortogonal Varimax. As associações foram realizadas pelo método de regressão linear, sendo selecionadas as variáveis que obtiveram p<0,20 na regressão univariada, e mantidas no modelo multivariado aquelas com p<0,05. RESULTADOS: Observou-se maior percentual de idosos do sexo feminino (85,1%) e na faixa etária de 60 a 69 anos (46,4%). Foram identificados três padrões dietéticos: o padrão Tradicional, associado com sexo masculino (β=0,59, p<0,001) e praticantes de atividade física (β=0,39, p=0,020); o padrão Massa, carne suína e doce, o qual se associou com o sexo masculino (β=0,38, p=0,025) e idosos aposentados (β=0,55, p=0,017); e o padrão Café com leite e pão com manteiga, que se associou a faixa etária de 80 anos ou mais (β=0,55, p=0,004) e idosos que apresentavam dificuldade de mastigação (β=0,38, p=0,013). CONCULSÃO: Os padrões dietéticos identificados demonstram que os idosos tendem a manter os hábitos alimentares similares aos da população brasileira em geral, e a dieta é alterada na medida em que as condições de saúde e de vida se modificam. AU

Factors associated with diet quality of older adults / Fatores associados à qualidade da dieta de idosos

ABSTRACT Objective Evaluate the factors associated with diet quality of older adults from the city of São Caetano do Sul, São Paulo, Brazil. Methods A cross-sectional study was carried out on a sample of 295 older adults receiving care in health care units in São Caetano do Sul. Diet quality was assessed using the Brazilian Healthy Eating Index. The associations between the diet quality mean score and the socio-demographic, economic, and anthropometric characteristics and lifestyle and health conditions were verified using multiple linear regression. Results Lower diet quality mean score were associated with the variables: marital status (widowed or separated) (β=-2.02; p=0.047), retired (β=-4.24; p=0.034), and smoking (β=-8.06; p=0.001); whereas higher diet quality mean score were associated with higher education level (9 years or more) (β=3.49; p=0.013). Conclusion Individuals with higher education level had better diet quality, and those who were widowed or separated, retired, and smokers had worse diet quality indicating that socio-demographic, economic, and lifestyle are factors that can influence food choice of older adults.

RESUMO Objetivo Avaliar os fatores associados à qualidade da dieta de idosos de São Caetano do Sul, São Paulo. Métodos Estudo transversal em uma amostra de 295 idosos usuários das unidades de saúde do município de São Caetano do Sul. A qualidade alimentar foi avaliada pelo Índice de Qualidade da Dieta Revisado. As associações entre as médias do Índice de Qualidade da Dieta Revisado e variáveis sociodemográficas, econômicas, antropométricas, estilo de vida e condições de saúde foram verificadas por meio de regressão linear múltipla. Resultados Ao relacionar as variáveis com o Índice de Qualidade da Dieta Revisado, o estado civil viúvo ou separado (β=-2,02; p=0,047), estar aposentado (β=-4,24; p=0,034) e o hábito de fumar (β=-8,06; p=0,001) determinaram índices menores, enquanto que em idosos com maior escolaridade (9 anos ou mais de estudo) as médias observadas foram maiores (β=3,49; p=0,013). Conclusão A qualidade da dieta apresentou-se melhor em indivíduos com maior escolaridade e pior em viúvos ou separados, aposentados e fumantes, indicando que fatores sociodemográficos, econômicos e de estilo de vida podem influenciar nas escolhas alimentares de idosos.

Identification of malnutrition risk factors in hospitalized patients.

OBJECTIVE: To identify factors associated with the risk of malnutrition in hospitalized patients. METHODS: Cross-sectional study, performed in a general hospital located in São Paulo, in a convenience sample of 300 adult individuals, aged 18 to 64 years. A structured questionnaire was applied consisting of anthropometric, clinical and dietary data, and the patients were evaluated and dichotomized into malnourished and non-malnourished. A multiple logistic regression was performed to identify the factors associated with malnutrition. The variables were organized according to the values of odds ratio (OR), confidence interval (95% CI), regression coefficient (ß) and descriptive level of significance (p). RESULTS: The malnutrition occurred in 60.7% and the variables associated with malnutrition were: recent and involuntary weight loss, apparent bony structure, decreased appetite, diarrhea, inadequate energy intake and male sex. CONCLUSION: The factors associated with malnutrition can be identified at hospital admission and lead to a nutritional evaluation that will allow adequate intervention and nutritional therapy.