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1.
Sci Rep ; 13(1): 16629, 2023 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-37789121

RESUMO

To investigate the prevalence of multimorbidity and complex multimorbidity and their association with sociodemographic and health variables in individuals with severe obesity. This is a baseline data analysis of 150 individuals with severe obesity (body mass index ≥ 35.0 kg/m2) aged 18-65 years. The outcomes were multimorbidity and complex multimorbidity. Sociodemographic, lifestyle, anthropometric and self-perceived health data were collected. Poisson multiple regression was conducted to identify multimorbidity risk factors. The frequency of two or more morbidities was 90.7%, three or more morbidities was 76.7%, and complex multimorbidity was 72.0%. Living with four or more household residents was associated with ≥ 3 morbidities and complex multimorbidity. Fair and very poor self-perceived health was associated with ≥ 2 morbidities, ≥ 3 morbidities and complex multimorbidity. A higher BMI range (45.0-65.0 kg/m2) was associated with ≥ 2 morbidities and ≥ 3 morbidities. Anxiety (82.7%), varicose veins of lower limbs (58.7%), hypertension (56.0%) were the most frequent morbidities, as well as the pairs and triads including them. The prevalence of multimorbidity and complex multimorbidity in individuals with severe obesity was higher and the risk for multimorbidity and complex multimorbidity increased in individuals living in households of four or more residents, with fair or poor/very poor self-perceived health and with a higher BMI.


Assuntos
Hipertensão , Obesidade Mórbida , Humanos , Multimorbidade , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/complicações , Brasil/epidemiologia , Obesidade/epidemiologia , Obesidade/complicações , Hipertensão/epidemiologia , Hipertensão/complicações , Prevalência
2.
Nutrients ; 13(11)2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34836393

RESUMO

We analyzed the effectiveness of two nutritional interventions alone and together, EVOO and the DieTBra, on the inflammatory profile of severely obese individuals. This study was an RCT with 149 individuals aged from 18 to 65 years, with a body mass index ≥ 35 kg/m2, randomized into three intervention groups: (1) 52 mL/day of EVOO (n = 50); (2) DieTBra (n = 49); and (3) DieTBra plus 52 mL/day of EVOO (DieTBra + EVOO, n = 50). The primary outcomes we measured were the-neutrophil-to-lymphocyte ratio (NLR) and the secondary outcomes we measured were the lymphocyte-to-monocyte ratio (LMR); leukocytes; and C reactive protein (CRP). After 12 weeks of intervention, DieTBra + EVOO significantly reduced the total leucocytes (p = 0.037) and LMR (p = 0.008). No statistically significant differences were found for the NLR in neither the intra-group and inter-group analyses, although a slight reduction was found in the DieTBra group (-0.22 ± 1.87). We observed reductions in the total leukocytes and LMR in the three groups, though without statistical difference between groups. In conclusion, nutritional intervention with DietBra + EVOO promotes a significant reduction in inflammatory biomarkers, namely leukocytes and LMR. CRP was reduced in EVOO and DieTBra groups and NLR reduced in the DieTBra group. This study was registered at ClinicalTrials.gov under NCT02463435.


Assuntos
Dieta Saudável/métodos , Mediadores da Inflamação/sangue , Obesidade Mórbida/sangue , Obesidade Mórbida/dietoterapia , Azeite de Oliva/administração & dosagem , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Brasil , Proteína C-Reativa/análise , Dieta Saudável/etnologia , Feminino , Humanos , Inflamação , Leucócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Monócitos , Neutrófilos , Resultado do Tratamento , Adulto Jovem
3.
BMC Gastroenterol ; 21(1): 217, 2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980157

RESUMO

BACKGROUND: Constipation and obesity have common risk factors. However, little is known about the occurrence of constipation in individuals with severe obesity and the associated factors. OBJECTIVE: To evaluate the prevalence of intestinal constipation and its associated factors in adults with obesity class II and III. METHOD: This study analyzed baseline data from a randomized clinical trial with adults aged 18-64 with a Body Mass Index (BMI) ≥ 35 kg/m2, living in the metropolitan region of Goiânia, Brazil. Data were collected using a questionnaire containing sociodemographic, lifestyle, level of obesity, presence of comorbidities, water intake and food consumption variables. The outcome variable was constipation assessed by the Rome III criteria and the Bristol Stool Form Scale. Multiple Poisson regression analysis was used to assess the association between explanatory variables and the outcome. RESULTS: Among the 150 participants, the prevalence of constipation was 24.67% (95% CI: 17.69-31.64). After multiple regression analyses constipation was associated with polypharmacy (adjusted PR: 2.99, 95% CI: 1.18-7.57, p = 0.021), younger age group i.e. 18-29 years (adjusted PR: 3.12, 95% CI: 1.21-8.06, p = 0.019) and former smoking (adjusted PR: 3.24, 95% CI: 1.28-9.14, p = 0.014). There was no statistically significant association between constipation and daily consumption of fiber-rich foods, however, the non-consumption of whole grains was borderline significant (adjusted PR: 2.92, 95% CI: 1.00 to 8.49, p = 0.050). CONCLUSION: A high prevalence of constipation was found in adults with obesity class II and III. Constipation was significantly associated with the simultaneous use of five or more medications, younger age group and being a former smoker.


Assuntos
Constipação Intestinal , Obesidade , Adolescente , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Constipação Intestinal/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Adulto Jovem
5.
Clin Nutr ; 40(2): 404-411, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32675019

RESUMO

RATIONAL & OBJECTIVE: Although the relationship between obesity, anxiety and depression is known, the clinical benefits of nutrition therapy in individuals with obesity have been scarcely studied. This study assessed the effectiveness of a traditional Brazilian diet (DieTBra) and extra virgin olive oil (EVOO) on the symptoms of anxiety and depression in severe obese participants. METHOD: This was a parallel randomized clinical trial in adults with severe obesity (Body Mass Index - BMI ≥ 35 kg/m2), DietBra Trial. Participants were randomized into three intervention groups in a ratio of 1: 1: 1 and followed up for 12 weeks. The three intervention groups were: 1) DieTBra, 2) 52 mL/day EVOO, and 3) DieTBra +52 mL/day EVOO. The symptoms of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. The outcome variables were: anxiety, depression and simultaneous anxiety and depression in the same individual. RESULTS: 149 severe obese individuals were randomized. The mean BMI was 46.3 ± 6.5 kg/m2 with a mean age of 38.9 ± 8.7 years. After randomization, individuals on medication for depression and anxiety were excluded, totaling 129 at baseline, with 44:43:42 per group. At the end of 12 weeks 113 individuals completed the study. There was a significant reduction of symptoms for the three groups: EVOO, DieTBra and DieTBra + EVOO, respectively: anxiety 38.23% (p = 0.019), 45.83% (p=<0.014), 33.33% (p < 0.013) depression 55.17% (p=<0.001), 50.00% (p=<0.007), 34.61% (p=<0.035), and anxiety/depression 57.69% (p=<0.001), 66.67% (p=<0.014), 27.78% (p=<0.013). CONCLUSIONS: Both DieTBra and olive oil interventions were effective in reducing symptoms of anxiety and depression in severe obese adults. These interventions can be integrated with clinical protocols for treatment of symptoms of anxiety and depression in severe obese individuals. TRIAL REGISTRATION: Clinicaltrials.gov NCT02463435.


Assuntos
Ansiedade/dietoterapia , Depressão/dietoterapia , Dieta/métodos , Obesidade Mórbida/psicologia , Azeite de Oliva/administração & dosagem , Adolescente , Adulto , Ansiedade/etiologia , Índice de Massa Corporal , Brasil , Depressão/etiologia , Dieta/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
6.
Nutrients ; 12(10)2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-32998416

RESUMO

Antiretroviral therapy (ART) increases the risk of cardiometabolic diseases in people living with HIV/AIDS (PLWHA). However, there is a lack of evidence regarding the effectiveness of a nutritional intervention on several cardiometabolic parameters in this population. Therefore, this study aimed to evaluate the effectiveness of two nutritional interventions on several cardiometabolic parameters in PLWHA treated with ART. A parallel randomized clinical trial was performed with PLWHA treated with ART. The participants (n = 88) were divided into two intervention groups: (1) nutritional counseling (n = 44) and (2) individualized dietary prescription (n = 44). The follow-up period was 30 weeks. A reduction in low-density lipoprotein (LDL) was the primary outcome. Secondary outcome variables were reductions in total cholesterol (TC), triglycerides (TG), fasting plasma glucose (FPG), systolic and diastolic blood pressures (SBP and DBP, respectively), waist circumference (WC), body mass index (BMI), and increases in high-density lipoproteins (HDL). A multiple linear regression was used to analyze the effectiveness of the interventions, adjusted for sociodemographic, lifestyle, and clinical characteristics. Sixty-two PLWHA completed the trial (nutritional counseling, n = 32; individualized dietary prescription, n = 30). At follow-up, we observed in the nutritional counseling group significant reductions in SBP (p = 0.036) and DBP (p = 0.001). Significant reductions in FPG (p = 0.008) and DBP (p = 0.023) were found in the individualized dietary prescription group. In the fully adjusted models, significant reductions in LDL, SBP, DBP, and BMI were found in the individualized dietary prescription group. In conclusion, the two investigated nutritional interventions were effective in reducing some cardiometabolic risk factors in PLWHA. However, after adjustments for covariates, the individualized dietary prescription showed significant reductions in the primary outcome and, also, in more cardiometabolic risk factors than the nutritional counseling.


Assuntos
Aconselhamento/métodos , Dislipidemias/terapia , Infecções por HIV/terapia , HIV , Terapia Nutricional/métodos , Adulto , Antirretrovirais/uso terapêutico , Glicemia/análise , Pressão Sanguínea , Índice de Massa Corporal , Fatores de Risco Cardiometabólico , Colesterol/sangue , Terapia Combinada , Dislipidemias/fisiopatologia , Dislipidemias/virologia , Jejum/sangue , Feminino , Infecções por HIV/complicações , Infecções por HIV/fisiopatologia , Humanos , Modelos Lineares , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Triglicerídeos/sangue , Circunferência da Cintura
7.
Arch Public Health ; 78: 71, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774854

RESUMO

BACKGROUND: Understanding the association between sarcopenia-related variables and several risk factors may help to implement interventions aimed at preventing its occurrence by reducing or controlling the identified risk factors. Although changes in body composition occur in both sexes, in women, muscle loss is accentuated due to decreased estrogen levels following menopause. This study aims to determine the factors associated with sarcopenia-related parameters in middle-aged women identified with class II/III obesity (body mass index [BMI] ≥ 35 kg/m2). METHODS: The study included 104 women with severe obesity (40.23 ± 8.49 years) with an average body fat percentage of 52.45 ± 4.14%. Sarcopenia was assessed using total appendicular skeletal muscle mass (ASMM), appendicular skeletal muscle mass index (ASMMI), and appendicular skeletal muscle mass adjusted by BMI (ASMM/BMI) as evaluated using dual energy X-ray absorptiometry (DXA). Hand grip strength (HGS) and HGS adjusted by BMI (HGS/BMI) were evaluated using dynamometry. Functional performance was assessed using the walking speed test (WS). The explanatory variables were age, lifestyle, comorbidities, food consumption, and metabolic parameters. A multivariate linear regression was performed. RESULTS: Factors associated with sarcopenia-related variables in 104 severely obese women with a mean BMI of 43.85 kg/m2 were as follows: ASMMI negatively correlated with serum levels of tetraiodothyronine (T4) and tobacco use; ASMM/BMI negatively correlated with age, serum T4 levels, and diabetes; ASMM negatively correlated with T4 serum levels and diabetes; HGS negatively correlated with age and hypercholesterolemia, and positively correlated with low-density lipoprotein cholesterol (LDL-c); HGS/BMI negatively correlated with age and hypercholesterolemia and positively correlated with LDL-c; and WS negatively correlated with hypothyroidism and diabetes. CONCLUSION: In severely obese women, muscle mass and function were inversely associated with age, smoking status, endocrine parameters, hypercholesterolemia, and comorbidities such as diabetes. Thus, the results of this investigation are relevant in supporting the development of clinical interventions to aid in the prevention of sarcopenia in adult women with severe obesity.

8.
Korean J Pain ; 33(3): 245-257, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32606269

RESUMO

BACKGROUND: Musculoskeletal pain is associated with obesity; however, information on factors associated with pain in adults with obesity and severe obesity is limited. The purpose of this study was to assess the prevalence of musculoskeletal pain by site and intensity of pain and associated factors in individuals with severe obesity (body mass index ≥ 35.0 kg/m2). METHODS: Baseline data from the DieTBra Trial study evaluating pain symptoms in nine body regions over the last seven days using the Nordic Questionnaire on Musculoskeletal Symptoms and Numerical Pain Scale. The variables analyzed using multiple Poisson regression with hierarchical analysis were: sociodemographic, lifestyle, food consumption, clinical, and anthropometric, and the outcome was moderate and intense pain. RESULTS: In 150 participants, there was a high prevalence of ankle and foot pain (68.7%), lower back pain (62.7%), pain in the knees (53.3%) and upper back pain (52.0%), with a predominance of intense pain. Factors associated with pain according to specific sites were: type 2 diabetes with hand/wrist pain; sedentary time with hip pain; insomnia with pain in the hip and knee; edema in the lower limbs with pain in the lower back and ankles/feet; degree of obesity with ankle/foot pain; and percentage of total fat with ankle/foot pain. CONCLUSIONS: There was a high prevalence of pain and intense pain in individuals with severe obesity and an association with clinical variables, the degree of obesity, and sedentary lifestyle.

9.
Artigo em Inglês | MEDLINE | ID: mdl-32498226

RESUMO

Despite the worldwide growth of class II and III obesity, the factors associated with type 2 diabetes mellitus (T2DM) in these obese individuals are not widely understood. Moreover, no study has investigated these associations in South America. Our study aimed to investigate the prevalence of T2DM and its associated factors, with an emphasis on biochemical parameters and eating habits, in class II and III obese individuals. We also aimed to analyze the correlation between glycemic parameters and body mass index (BMI). Baseline data from a randomized clinical trial (DieTBra Trial) of 150 class II and III obese individuals (BMI > 35 kg/m2) was used. An accelerometer, Food Frequency Questionnaire, and bioimpedance analysis were used to assess physical activity levels, eating habits, and body composition, respectively. Blood was collected after 12 h of fasting. Hierarchical multivariate Poisson regression was performed, and prevalence ratios (PRs) were calculated. Correlations between glycemic parameters (fasting blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin) and BMI were also analyzed. The prevalence of T2DM was 40.0% (95% CI, 32.1-48.3), high fasting blood glucose level was 19.33% (95% CI, 13.3-26.6), and high glycosylated hemoglobin was 32.67% (95% CI, 25.2-40.8). Age ≥ 50 years (PR = 3.17, 95% CI, 1.26-7.98) was significantly associated with T2DM; there was a positive linear trend between age and T2DM (p = 0.011). Multivariate analysis showed an association with educational level (PR = 1.49, 1.07-2.09, p = 0.018), nonconsumption of whole grains daily (PR = 1.67, 1.00-2.80, p = 0.049), and high HOMA-IR (PR = 1.54, 1.08-2.18, p = 0.016). We found a high prevalence of T2DM and no significant correlations between BMI and glycemic parameters.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Resistência à Insulina , Obesidade/epidemiologia , Glicemia , Índice de Massa Corporal , Feminino , Humanos , Insulina , Masculino , Prevalência , América do Sul/epidemiologia
10.
Nutrients ; 12(5)2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32422956

RESUMO

Cardioprotective effects associated with extra virgin olive oil (EVOO) have been studied within the Mediterranean diet. However, little is known about its consumption in the traditional Brazilian diet (DieTBra) or without any dietary prescription, particularly in severely obese individuals. This study aimed to assess the effectiveness of DieTBra and EVOO in cardiometabolic risk factor (CMRF) reduction in severely obese individuals. We conducted a parallel randomized clinical trial with 149 severely obese individuals (body mass index ≥ 35.0 kg/m2) aged 18-65 years, assigned to three groups: 52 mL/day of EVOO (n = 50), DieTBra (n = 49), and DieTBra + 52 mL/day of EVOO (n = 50). Participants were followed up for 12 weeks. Low-density lipoprotein cholesterol (LDL-c) was the primary endpoint and several cardiometabolic parameters were secondary endpoints. Endpoints were compared at baseline and at the end of the study using analysis of variance, the Kruskal-Wallis test, and Student's t-test. The TC/High-density lipoprotein (HDL) ratio (-0.33 ± 0.68, p = 0.002) and LDL/HDL ratio (-0.26 ± 0.59, p = 0.005) decreased in the EVOO group. Delta values for all variables showed no significant statistical difference between groups. However, we highlight the clinical significance of LDL-c reduction in the EVOO group by 5.11 ± 21.79 mg/dL and in the DieTBra group by 4.27 ± 23.84 mg/dL. We also found a mean reduction of around 10% for Castelli II (LDL/HDL) and homocysteine in the EVOO group and TG and the TG/HDL ratio in the DieTBra group. EVOO or DieTBra when administered alone lead to reduction in some cardiometabolic risk parameters in severely obese individuals.


Assuntos
Dieta/métodos , Ingestão de Alimentos/fisiologia , Obesidade Mórbida/dietoterapia , Azeite de Oliva/administração & dosagem , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil , Fatores de Risco Cardiometabólico , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Dieta/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/sangue , Resultado do Tratamento , Triglicerídeos/sangue , Adulto Jovem
11.
Nutrients ; 12(2)2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32032997

RESUMO

Dietary interventions can stabilize and/or reverse bone mass loss. However, there are no reports on its effects on bone mineral density (BMD) in severely obese people, despite the vulnerability of this group to bone loss. We examine the effect of extra virgin olive oil supplementation and the traditional Brazilian diet (DieTBra) on BMD and levels of calcium, vitamin D, and parathyroid hormone (PTH) in severely obese adults. A randomized controlled trial followed-up with severely obese adults (n = 111, with mean body mass index 43.6 kg/m2 ± 4.5 kg/m2) for 12 weeks. Study participants received either olive oil (52 mL/day), DieTBra, or olive oil + DieTBra (52 mL/day + DieTBra). BMD was assessed by total spine and hip dual-energy X-ray absorptiometry. After interventions, BMD means for total spine (p = 0.016) and total hip (p = 0.029) were higher in the DieTBra group than in the olive oil + DieTBra group. Final mean calcium levels were higher in the olive oil group compared to the olive oil + DieTBra group (p = 0.026). Findings suggest that DieTBra and extra virgin olive oil have positive effects on bone health in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).


Assuntos
Densidade Óssea , Dieta/métodos , Suplementos Nutricionais , Obesidade Mórbida/dietoterapia , Azeite de Oliva/administração & dosagem , Absorciometria de Fóton , Adolescente , Adulto , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/prevenção & controle , Brasil , Cálcio/sangue , Dieta/etnologia , Feminino , Humanos , Masculino , Obesidade Mórbida/complicações , Obesidade Mórbida/fisiopatologia , Hormônio Paratireóideo/sangue , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/fisiopatologia , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/fisiopatologia , Vitamina D/sangue , Adulto Jovem
12.
AIDS Care ; 30(8): 1004-1009, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29471672

RESUMO

The aim of this study was to determine the prevalence of physical inactivity and whether it is associated with sociodemographic, lifestyle, clinical, anthropometric, and body composition variables in people living with HIV/AIDS (PLWHA). This study makes use of data from a cohort of 288 adults aged ≥19 years, conducted between October 2009 and July 2011. The variables studied were sex, age, education, income, skin color, tobacco use, alcohol intake, body mass index, body fat percentage, waist circumference, and waist-hip ratio, length of HIV/AIDS diagnosis, use of antiretroviral therapy and length of its use, CD4, hypertension (HT) and diabetes mellitus. Physical inactivity was defined as a score below 600 metabolic equivalent minutes/week according to the International Physical Activity Questionnaire - Short Version. Poisson multiple regression was applied in the multivariate analysis with a significance level of 5%. The prevalence of physical inactivity was 44.1%. Education of ≤4 years of study (prevalence ratio [PR]: 1.71) and HT (PR: 1.49) were associated with physical inactivity. Physical inactivity was highly prevalent in PLWHA and associated with low educational level and HT. We highlight the simultaneous association between two cardiometabolic risk factors, HT and physical inactivity.


Assuntos
Escolaridade , Infecções por HIV/complicações , Infecções por HIV/fisiopatologia , Hipertensão/complicações , Comportamento Sedentário , Adulto , Idoso , Brasil , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
Am J Hum Biol ; 29(3)2017 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-28161905

RESUMO

OBJECTIVES: The purpose of this study was to investigate whether sitting height-to-stature ratio (SHSR) is associated with total and central obesity in the elderly. METHODS: This was a cross-sectional study with 133 noninstitutionalized elderly. High SHSR (≥ 1SD above the mean) was used as a marker of undernutrition (MU) in early life. Poisson's multiple regression was used to determine the association between variables. RESULTS: The prevalence of high SHSR was 21.0%, total obesity 43.6% and central obesity 50.4%. Elderly with high SHSR presented a statistically significant association with total obesity (PR 1.50; 95% CI 1.04-2.18) and central obesity (PR 1.42; 95% CI 1.03-1.95) after adjustment for sex, age, educational level and income in the multivariate analysis. CONCLUSION: The occurrence of total and central obesity in the elderly was associated with a MU in early life. This result indicates that nutritional deficiencies in childhood may increase the risk of obesity in the elderly, a nutritional paradox.


Assuntos
Estatura , Desnutrição/epidemiologia , Estado Nutricional , Obesidade/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/etiologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etiologia , Prevalência
14.
Clin Nutr ; 36(3): 680-685, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27395330

RESUMO

BACKGROUND & AIMS: Gastrointestinal symptoms are among the most frequent reported complaints by people living with HIV and AIDS (PLWHA). Treatments that aim to attenuate these symptoms are important to avoid low adherence to antiretroviral therapy and to improve the quality of life. This study aimed to evaluate the effectiveness of nutritional treatment and synbiotic use in PLWHA on reducing gastrointestinal symptoms. METHODS: A randomized clinical trial nested to an outpatient cohort was conducted to evaluate the effectiveness of two treatments for gastrointestinal symptoms reduction in adult patients with antiretroviral therapy presenting at least one gastrointestinal symptom: 1) nutritional treatment + placebo (6 g maltodextrin) and 2) nutritional treatment + synbiotic (Lactobacillus and Bifidobacterium strains + 6 g fructooligosaccharides). Placebo and synbiotic were consumed twice a day during six months. The primary outcome variable was percentage reduction in the incidence of diarrhea, and secondary outcomes the decrease in the incidence of nausea and/or vomiting, dyspepsia, heartburn, constipation, flatulence, and the presence of three or more gastrointestinal symptoms. RESULTS: Out of 283 patients evaluated for eligibility, 64 met inclusion criteria to enter in this study with 1:1 allocation ratio. Both analyzed groups were homogeneous regarding sociodemographic, clinical and lifestyle variables at baseline. In the intergroup analysis, no difference was found between groups except for heartburn, which had a higher reduction in the placebo group (0.01). Regarding the intragroup analysis, in the placebo group a significant decrease in diarrhea (p = 0.02) and heartburn (p < 0.01) were observed while there was a significant reduction for nausea e/or vomit (p = 0.01), dyspepsia (p = 0.10), diarrhea (p = 0.01) and constipation (p = 0.08) in the synbiotic group. CONCLUSIONS: Diarrhea decreased in both groups, but no statistical difference between treatments was observed. The use of synbiotic appeared to reduce a greater number of symptoms although there were no statistical differences in the intergroup analysis. This clinical trial was registered at ClinicalTrials.gov (NCT02180035).


Assuntos
Dieta , Gastroenteropatias/prevenção & controle , Infecções por HIV/terapia , Simbióticos/administração & dosagem , Adulto , Bifidobacterium , Método Duplo-Cego , Feminino , Humanos , Lactobacillus , Masculino , Pessoa de Meia-Idade , Oligossacarídeos/administração & dosagem , Qualidade de Vida , Fatores Socioeconômicos , Resultado do Tratamento , Adulto Jovem
15.
PLoS One ; 11(10): e0164774, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27749931

RESUMO

This study aimed to estimate the incidence of gastrointestinal symptoms (GIS) and associated factors in an outpatient cohort of people living with HIV/AIDS (PLWHA) followed between October 2009 and July 2011. We evaluated nausea and/or vomiting, dyspepsia, heartburn, diarrhea, constipation, and flatulence. The outcome variable was the presence of three or more GIS. Sociodemographic (sex, skin color, age, income, years of schooling), lifestyle (smoking status, alcohol consumption, physical activity level), clinical (antiretroviral therapy, time of HIV infection, CD4 lymphocyte count, viral load), and anthropometric (nutritional status and waist circumference) variables were investigated. Data on sociodemographic and lifestyle variables were collected through a pre-tested and standardized questionnaire. CD4 count was determined by flow cytometry and viral load by branched DNA (bDNA) assays for HIV-1. All variables were analyzed at a p<0.05 significance level. Among 290 patients, the incidence of three or more GIS was 28.8% (95% CI 23.17 to 33.84) and 74.48% presented at least one symptom. Female gender (IR 2.29, 95% CI 1.63 to 3.22) and smoking status (IR 1.93, 95% CI 1.30 to 2.88) were risk factors for the presence of three or more GIS after multivariate Poisson regression. A high incidence of gastrointestinal symptoms was found among PLWHA, and it was significantly associated with female sex and tobacco use. Those results reinforce the relevance of investigating the presence of GIS in PLWHA as it may affect treatment adherence.


Assuntos
Gastroenteropatias/epidemiologia , Infecções por HIV/patologia , Adulto , Consumo de Bebidas Alcoólicas , Fármacos Anti-HIV/uso terapêutico , Brasil/epidemiologia , Contagem de Linfócito CD4 , Demografia , Exercício Físico , Feminino , Gastroenteropatias/complicações , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Incidência , Estilo de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Pacientes Ambulatoriais , Fatores de Risco , Fumar , Carga Viral , Circunferência da Cintura , Adulto Jovem
16.
Cien Saude Colet ; 21(4): 1165-74, 2016 Apr.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27076015

RESUMO

This article aims to investigate the prevalence of cardiovascular risk factors and food intake inadequacies in cadets from the Brazilian Air Force Academy and the association with sex and year of graduation. Cross-sectional study with 166 adult cadets from the Air Force Academy, placed in Pirassununga - SP, from June to December 2013. Anthropometric measures, biochemical and clinical parameters, physical activity level, smoking habit and food intake were evaluated. Pearson's Chi-square and Fisher's exact tests were used. Overweight prevalence (BMI > 25.0 kg/m2) was 29.7% in men and 16.7% in women. Hypertension was observed in 15.2% of men. Hypercholesterolemia was detected in 50.7% of the cadets; 24.3% presented high levels of low-density lipoprotein and 11.2%, low levels of high-density lipoprotein. There was association between the time spent in the Academy and low levels of high-density lipoprotein. High intake of saturated fat (87.2%) and cholesterol (42.7%) were observed. Inadequate intake of fibers was verified in 92.7% of the sample. There was considerable prevalence of cardiovascular risk factors among the cadets, especially hypercholesterolemia and inadequate food intake.


Assuntos
Doenças Cardiovasculares/epidemiologia , Militares , Adulto , Brasil/epidemiologia , Colesterol , Estudos Transversais , Feminino , Humanos , Hipercolesterolemia , Hipertensão , Masculino , Sobrepeso , Fatores de Risco
17.
Ciênc. Saúde Colet. (Impr.) ; 21(4): 1165-1174, Abr. 2016. tab
Artigo em Português | LILACS | ID: lil-778596

RESUMO

Resumo O objetivo deste artigo é investigar a prevalência de fatores de risco cardiovascular e inadequações de consumo alimentar em cadetes da Academia da Força Aérea Brasileira e a associação com sexo e ano de formação. Estudo transversal com 166 cadetes da Academia da Força Aérea Brasileira, em Pirassununga – SP, entre junho e dezembro de 2013. Foram avaliadas medidas antropométricas, parâmetros bioquímicos e clínicos, nível de atividade física, tabagismo e consumo alimentar. Testes de Qui-Quadrado de Pearson ou Exato de Fisher foram utilizados. A prevalência de excesso de peso (IMC >25,0 kg/m2) foi de 29,7% nos homens e de 16,7% nas mulheres. Hipertensão arterial foi prevalente em 15,2% dos homens. Verificou-se hipercolesterolemia em 50,7% dos cadetes; 24,3% apresentaram valores elevados de lipoproteína de baixa densidade e, 11,2%, lipoproteína de alta densidade baixa. Houve associação entre tempo de permanência na Academia e lipoproteína de alta densidade baixa. Observou-se consumo elevado de gorduras saturadas (87,2%) e de colesterol (42,7%). A ingestão inadequada de fibras foi verificada em 92,7% da amostra. Observou-se considerável prevalência de fatores de risco cardiovascular entre os cadetes, principalmente hipercolesterolemia e consumo alimentar inadequado.


Abstract This article aims to investigate the prevalence of cardiovascular risk factors and food intake inadequacies in cadets from the Brazilian Air Force Academy and the association with sex and year of graduation. Cross-sectional study with 166 adult cadets from the Air Force Academy, placed in Pirassununga – SP, from June to December 2013. Anthropometric measures, biochemical and clinical parameters, physical activity level, smoking habit and food intake were evaluated. Pearson’s Chi-square and Fisher’s exact tests were used. Overweight prevalence (BMI > 25.0 kg/m2) was 29.7% in men and 16.7% in women. Hypertension was observed in 15.2% of men. Hypercholesterolemia was detected in 50.7% of the cadets; 24.3% presented high levels of low-density lipoprotein and 11.2%, low levels of high-density lipoprotein. There was association between the time spent in the Academy and low levels of high-density lipoprotein. High intake of saturated fat (87.2%) and cholesterol (42.7%) were observed. Inadequate intake of fibers was verified in 92.7% of the sample. There was considerable prevalence of cardiovascular risk factors among the cadets, especially hypercholesterolemia and inadequate food intake.


Assuntos
Humanos , Masculino , Feminino , Adulto , Doenças Cardiovasculares/epidemiologia , Militares , Brasil/epidemiologia , Colesterol , Estudos Transversais , Fatores de Risco , Sobrepeso , Hipercolesterolemia , Hipertensão
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