Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents.

OBJECTIVE: To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements. METHODS: This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05. RESULTS: A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls - who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL. CONCLUSIONS: The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents / Prevalência de dislipidemia, risco aterogênico e cardiovascular em adolescentes com sobrepeso e obesidade

Abstract Objective: To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements. Methods: This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05. Results: A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls — who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL. Conclusions: The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

RESUMO Objetivo: Analisar o perfil lipídico e os índices de risco cardiovascular de adolescentes com sobrepeso e obesidade e correlacionar os achados com medidas antropométricas. Métodos: Estudo transversal com adolescentes com sobrepeso ou obesidade de ambos os sexos (14 a 18 anos). Foram coletadas as variáveis: sexo, peso, altura, idade, colesterol total, triglicerídeos, lipoproteína de alta densidade (HDL-c) e lipoproteína de baixa densidade (LDL-c). Calcularam-se o índice aterogênico plasmático e os índices de Castelli I e II. Eles foram classificados em pontos de corte para estratificar o risco cardiovascular. O perfil antropométrico foi avaliado por meio do escore Z com base no índice de massa corporal para a idade. Considerou-se o nível de significância p≤0,05. Resultados: Foram incluídos 146 adolescentes, com média de idade de 16,4±1,1 anos, a maioria do sexo feminino (74,7%) e obesa (52,7%). As dislipidemias prevalentes foram: triglicerídeos (47,9%), LDL-c (26,7%), colesterol total (37,7%) elevado e HDL-c baixo (46,6%). A maioria apresentou risco aterogênico aumentado pelo índice aterôgenico plasmático (55,5%); 15,1% apresentaram alto risco cardiovascular segundo o índice de Castelli I e 13,7%, segundo o índice de Castelli II. Os meninos apresentaram valores superiores de medidas antropométricas e índices de Castelli I e II em relação às meninas, que, por outro lado, apresentaram valores superiores de HDL-c. Houve correlação positiva do escore Z com o índice aterôgenico plasmático e negativa com HDL-c. Conclusões: Os adolescentes do estudo apresentaram alta prevalência de risco cardiovascular e aterogênico conforme os índices avaliados. Além disso, o risco cardiovascular aumentado foi correlacionado com maior índice de massa corporal.

Intervenção interdisciplinar reduz o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade / Interdisciplinary intervention reduces the consumption of ultra-processed foods in adolescents with overweight or obesity

Este estudo objetivou avaliar o efeito da intervenção interdisciplinar com abordagem motivacional sobre o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade. O método utilizado foi um ensaio clínico randomizado no qual os participantes distribuíram-se em grupo controle (GC) e grupo intervenção (GI). A coleta de dados do consumo alimentar ocorreu mediante o recordatório de 24 horas, obtido no início e ao final das intervenções. Os alimentos consumidos foram categorizados nos quatro grupos da classificação alimentar NOVA conforme o grau de processamento a qual são submetidos. Participaram 42 adolescentes com média de idade de 16,5±1,3 anos, a maioria do gênero feminino (69%). No GI, a média de quilocalorias de alimentos ultraprocessados diminuiu 37,5% após a intervenção; em contrapartida, aumentou o consumo de alimentos processados em ambos os grupos. Concluiu-se que a intervenção interdisciplinar com abordagem motivacional foi eficaz na redução do consumo de alimentos ultraprocessados na população estudada.

The aim of this study was to evaluate the effect of interdisciplinary intervention with motivational approach on the consumption of ultra-processed foods in overweight or obese adolescents. The method used was a randomized clinical trial in which participants were allocated to control group (CG) and intervention group (IC). The data collection of food consumption occurred through the 24-hour food record, obtained at the beginning and end of interventions. The foods consumed were classified into the four NOVA groups according to the degree of processing which they are submitted. Forty-two adolescents with a mean age of 16.5±1.3 years, mostly female (69%), participated in the study. In IG, the average kcal of ultra-processed foods decreased by 37.5% after intervention. In contrast, there was an increase in the consumption of processed foods in both groups. It was concluded that the interdisciplinary intervention with a motivational approach was effective in reducing the consumption of ultra-processed foods in the studied population.

The Effect of Different Interventions for Lifestyle Modifications on the Number of Diagnostic Criteria and Clinical Aspects of Metabolic Syndrome.

Background: Lifestyle intervention programs comprise the first-choice therapy to reduce the cardiovascular risk factors in metabolic syndrome (MetS). Our aim was to compare the effects of three lifestyle modification programs on the number of diagnostic criteria and clinical parameters of MetS. Methods: Twelve-week clinical trial, including 125 adults who presented at least three of the criteria defined by the revised NCEP ATP III (National Cholesterol Education Program Adult Panel III) for MetS. Individuals were randomized into three multidisciplinary intervention groups: Standard Intervention (SI), Group Intervention (GI) and Individual Intervention (II). Results: Seventy-one individuals, aged 34-59 years, concluded the study: SI: 20, GI: 25, and II: 26. The GI and II groups presented a significant decrease of body mass index, abdominal circumference, diastolic and systolic arterial pressure after intervention. The number of diagnostic criteria for MetS decreased significantly. Within the GI and II groups, 16.0% and 15.4% of the individuals, respectively, did not meet the criteria for the clinical condition studied at the end of the interventions. In the II group, the percentage of individuals with five criteria reduced 83.5%. In the GI group, the percentage of individuals with five criteria remained the same, but the number of individuals with four criteria presented a 50.0% reduction. Conclusions: Results reinforce that nonpharmacological strategies for changing lifestyle affect the reduction of cardiovascular risk factors existing in MetS. They are also able to remove the population from this clinical condition by decreasing the diagnostic criteria. II or GI lead to a successful treatment of MetS, especially when conducted by multidisciplinary team. Brazilian Registry of Clinical Trials-ReBEC number: RBR-9wz5fc.

MnSOD Val16Ala gene polymorphism is associated with REDOX biomarkers in the elderly of primary health care in the city of Porto Alegre.

Studies suggest that redox imbalance may be closely associated with pathological aging, contributing effectively to the genesis of several chronic diseases. One of the major defence enzymes against oxidation is Manganese-dependent superoxide dismutase (MnSOD) that acts within the mitochondria. The gene encoding this enzyme is polymorphic and Val16Ala variant is one of its most investigated polymorphisms regarding aging and oxidative stress. This study aimed to verify the occurrence of the MnSOD Val16Ala gene polymorphism association with markers of REDOX metabolism in the elderly of primary health care. A cross-sectional study was performed. The sample consisted of 270 elderly individuals from Family Health Strategy in the city of Porto Alegre, Rio Grande do Sul, Brazil (EMISUS). The following variables were investigated in all subjects: sociodemographic: gender, age, marital status, schooling and income; Anthropometric: weight, height, body mass index (BMI); REDOX markers: advanced oxidation protein products (AOPP), ischemia-modified albumin (IMA), nitric oxide metabolites (NOx), ferric reducing ability of plasma (FRAP) and malondialdehyde (MDA), MnSOD Val16Ala gene polymorphism. Val16Ala gene polymorphism was evaluated by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Statistically significant associations were observed in the elderly with AA genotype compared to those with VV genotype, concerning AOPP (p = 0.023) and FRAP (p = 0.027) quartile frequencies, respectively. No statistically significant differences were observed between MnSOD genotypes with MDA, NOx and IMA oxidative markers. Val16Ala gene polymorphism is associated with AOPP and FRAP quartiles frequencies in the elderly of primary health care.

Associação do tabagismo com biomarcadores REDOX e fatores de risco cardiometabólicos em idosos / Association of smoking with redox biomarkers and cardiometabolic risk factors in elder individuals

Resumo Introdução O tabagismo constitui a principal causa de morte evitável no mundo e é considerado um importante fator de risco para as doenças cardiovasculares (DCV). Objetivo Verificar a associação do tabagismo com sexo, metabolismo redox e fatores de risco cardiometabólicos de 381 idosos da Estratégia Saúde da Família de Porto Alegre/RS. Método Para categorizar o tabagismo, seguiram-se as recomendações do Center of Diseases Control (CDC). Os marcadores de estresse oxidativo investigados foram: produtos avançados da oxidação proteica (AOPP), metabólitos do óxido nítrico (NOx), capacidade antioxidante medida por meio do ensaio ferric reducing ability of plasma (FRAP). Fatores de risco cardiometabólicos também foram avaliados. Resultados Em relação ao sexo/fumo, foram mais frequentes as mulheres não fumantes (P = 0,001). Os homens ex-tabagistas apresentaram maiores concentrações de FRAP (P = 0,001), e os tabagistas, maior concentração de NOx, (0,012), menores médias de circunferência de cintura-CC (P = 0,017) e de índice de massa corporal-IMC (P = 0,003) e maior HDL-c (P = 0,003). Não foram verificados resultados significativos entre as mulheres. Conclusão Os idosos do sexo masculino tabagistas apresentaram menores valores de CC, IMC e HDL-c, porém os tabagistas apresentaram aumento da concentração do NO x, o qual é um biomarcador de estresse oxidativo associado a doenças cardiovasculares. Portanto, é preciso destacar a importância na prevenção e adesão à cessação de tabagismo para evitar comorbidades cardiovasculares.

Abstract Background Smoking is the leading cause of preventable death worldwide, and is considered an important risk factor for cardiovascular disease (CVD). Objective To investigate the association of smoking with sex, redox metabolism and cardiometaboic risk factors of 381 elderly from the Family Health Strategy of Porto Alegre. Method To categorize smoking, followed by the recommendations of the Center for Disease Control (CDC). We studied the following oxidative stress markers investigated: advanced products of protein oxidation (AOPP), nitric oxide metabolites (NOx), the antioxidant capacity was measured by Ferric Reducing Ability of Plasma (FRAP). Cardiometabolic risk factors were also evaluated. Results Regarding sex/smoking, women are more often non-smokers (P = 0.001). Former male smokers had higher concentrations of FRAP (P = 0.001), and smokers had higher concentration of NOx (0.012), lower average waist circumference-WC (P = 0.017), body mass index-BMI (P = 0.003) and increased HDL-c levels (P = 0.003). There were found significant results among women. Conclusion The elderly male smokers presented lower values of WC, BMI and HDL-c, but smokers presented increased NOx concentration, which is a oxidative stress biomarker associated with cardiovascular diseases. Therefore, it is important to emphasize the importance in preventing and adhering to smoking cessation to avoid cardiovascular comorbidities..

Comparação do consumo alimentar calculado a partir de duas tabelas de composição de alimentos / Comparing food intake calculated by two lists of food composition

O objetivo do presente trabalho foi comparar o consumo de energia, macronutrientes e micronutrientes calculado a partir de duas tabelas de composição dos alimentos: Tabela Brasileira de Composição de Alimentos (TACO) mais informações de rótulos de alimentos e United States Department of Agriculture Food Composition Databases (USDA). Trata-se de estudo transversal, com dados do consumo alimentar de participantes do estudo principal "Modificação do Estilo de Vida e Risco Cardiovascular". Os dados foram analisados por meio dos Testes de Kruskal Wallis, Post Hoc de Dunn, e Correlação de Pearson. Foram avaliados 59 Recordatórios de 24 horas e as medianas de 21 entre 29 nutrientes (72,4%) apresentaram diferença estatisticamente significativa (p<0,05) na comparação entre os resultados obtidos das tabelas avaliadas. Foram encontradas divergências significativas entre os valores nutricionais apresentados nas tabelas. Este fato alerta para o uso destes instrumentos e a sua influência nos resultados do cálculo do consumo alimentar e impacto na prescrição nutricional

Energy, macronutrient and micronutrient intakes are compared by two food composition lists: Brazilian Food Composition List and nutrition facts and the United States Department of Agriculture Food Composition Databases (USDA). Current transversal study comprised data on food intake of participants within the main research theme 'Changes in Life Style and Cardiovascular Risks'. Data were analyzed by Kruskal Wallis and Post-Hoc Dunn tests and by Pearson´s Co-relation test. Fifty-nine 24-h records were evaluated. Medians of 21 out of 29 nutrients (72.4%) showed statistically significant difference (p<0.05) when compared to results from evaluated tables. There was significant divergence between the nutrition rates in the lists. The above is a warning on the use of these tools and their influence on results in calculating food intake and impact in nutritional prescriptions

Impact of human aging and modern lifestyle on gut microbiota.

Human evolution and lifestyle changes caused by the agricultural and industrial revolutions have led to great advances in medicine and increased life expectancy, whilst also profoundly altering the ecological relationships and disease patterns of populations. Studies involving populations that still enjoy a rural way of life and with traits similar to the Paleolithic period reveal them to present a more robust, resistant and diverse gut microbiota, in comparison to highly industrialized civilizations. The human diet has expanded and broadened to include the consumption of high-calorie foods, particularly from animal sources such as game meat and eggs. For some time, authors have been alert to the fact that a modern lifestyle leads to reduced intake of beneficial bacteria, suggesting that nonpathogenic bacteria are being eradicated. Furthermore, therapeutic procedures, including the use of probiotics and prebiotics, have been proposed to lead to recovery of this microbiota, which is altered due to both the ageing process and lifestyle related aspects. Accordingly, this article aims to review the impact of human aging and modern lifestyle on gut microbiota, within an evolutionary, ecological, epidemiological and therapeutic context.

Impact of roux-en-y gastric bypass surgery (rygb) on metabolic syndrome components and on the use of associated drugs in obese patients / Impacto do bypass gástrico em Y de Roux (RYGB) nos componentes da síndrome metabólica e sobre o uso de drogas associadas em pacientes obesos

ABSTRACT BACKGROUND The prevalence of obesity and metabolic syndrome is increasing worldwide and both behavior modification and drug therapy have low adherence. Gastric bypass has shown effective results in both reducing weight and improving comorbidities. OBJECTIVE To evaluate the impact of Roux-en-Y Gastric Bypass Surgery (RYGB) on both metabolic syndrome components and the use of associated drugs in obese patients. METHODS Historical cohort of patients subjected to Roux-en-Y Gastric Bypass Surgery (RYGB) between January 2007 and March 2014 in a private clinic. The sample consisted of 273 obese class II and III individuals, 86.4% of whom were female, with age ≥20 years, followed up for 2 months after surgery. Sociodemographic, anthropometric, biochemical, clinical, and drug-use data were collected from patients’ medical records. RESULTS Significant differences were found in weight, body mass index and waist circumference, after 60 postoperative days. Components for metabolic syndrome diagnosis (hypertension P=0.001; hyperglycemia P<0.001; hypertriglyceridemia P=0.006) were reduced after 60 days of postoperative, with the exception HDL-c (P=0.083). There was a significant reduction in the use of antihypertensive (P<0.001), hypoglycemic (P=0.013), lipid lowering (P<0.001), and antiobesity (P=0.010) drugs and increased use of gastroprotective drugs, vitamins, and minerals (P<0.001) after 60 postoperative days. CONCLUSION Patients subjected to Roux-en-Y Gastric Bypass Surgery exhibited both weight loss and significant improvement not only in metabolic syndrome components (except for HDL-c) but in the use of drugs associated with obesity and metabolic syndrome.

RESUMO CONTEXTO A prevalência de obesidade e síndrome metabólica é crescente no mundo e tanto a terapia de modificação de estilo de vida quanto a medicamentosa têm baixa adesão. O bypass gástrico tem apresentado resultados eficazes na redução de peso e comorbidades. OBJETIVO Avaliar o impacto do bypass gástrico em Y de Roux nos componentes da síndrome metabólica e sobre o uso de drogas associadas em pacientes obesos. MÉTODOS Coorte histórica de pacientes submetidos ao bypass gástrico em Y de Roux entre janeiro de 2007 e março de 2014, em clínica privada. A amostra foi composta por 273 indivíduos obesos classe II e III, 86,4% dos quais eram do sexo feminino, idade ≥20 anos, acompanhados por 2 meses após a cirurgia. Dados sociodemográficos, antropométricos, bioquímicos, clínicos e de uso de medicamentos foram coletados nos prontuários dos pacientes. RESULTADOS Foram encontradas diferenças significativas no peso, índice de massa corporal e circunferência da cintura, após 60 dias de pós-operatório. Os componentes para diagnóstico da síndrome metabólica (hipertensão P=0,001; hiperglicemia P<0,001; hipertrigliceridemia P=0,006) foram reduzidos no pós-operatório, com exceção do HDL-c (P=0,083). Houve uma redução significativa no uso de medicamentos anti-hipertensivos (P<0,001), hipoglicêmicos (P=0,013), hipolipemiantes (P<0,001), antiobesidade (P=0,010) e uma maior utilização de gastroprotectores, vitaminas e minerais (P<0,001) após 60 dias de pós-operatório. CONCLUSÃO Os pacientes submetidos ao bypass gástrico em Y de Roux exibiram perda de peso e uma melhora significativa, não só em componentes da síndrome metabólica (exceto para o HDL-c), mas também no uso de medicamentos associados à obesidade e à síndrome metabólica.

IMPACT OF ROUX-EN-Y GASTRIC BYPASS SURGERY (RYGB) ON METABOLIC SYNDROME COMPONENTS AND ON THE USE OF ASSOCIATED DRUGS IN OBESE PATIENTS.

BACKGROUND: The prevalence of obesity and metabolic syndrome is increasing worldwide and both behavior modification and drug therapy have low adherence. Gastric bypass has shown effective results in both reducing weight and improving comorbidities. OBJECTIVE: To evaluate the impact of Roux-en-Y Gastric Bypass Surgery (RYGB) on both metabolic syndrome components and the use of associated drugs in obese patients. METHODS: Historical cohort of patients subjected to Roux-en-Y Gastric Bypass Surgery (RYGB) between January 2007 and March 2014 in a private clinic. The sample consisted of 273 obese class II and III individuals, 86.4% of whom were female, with age ≥20 years, followed up for 2 months after surgery. Sociodemographic, anthropometric, biochemical, clinical, and drug-use data were collected from patients' medical records. RESULTS: Significant differences were found in weight, body mass index and waist circumference, after 60 postoperative days. Components for metabolic syndrome diagnosis (hypertension P=0.001; hyperglycemia P<0.001; hypertriglyceridemia P=0.006) were reduced after 60 days of postoperative, with the exception HDL-c (P=0.083). There was a significant reduction in the use of antihypertensive (P<0.001), hypoglycemic (P=0.013), lipid lowering (P<0.001), and antiobesity (P=0.010) drugs and increased use of gastroprotective drugs, vitamins, and minerals (P<0.001) after 60 postoperative days. CONCLUSION: Patients subjected to Roux-en-Y Gastric Bypass Surgery exhibited both weight loss and significant improvement not only in metabolic syndrome components (except for HDL-c) but in the use of drugs associated with obesity and metabolic syndrome.

Anthropometric Measures and Frailty Prediction in the Elderly: An Easy-to-Use Tool.

PURPOSE: Anthropometry is a useful tool for assessing some risk factors for frailty. Thus, the aim of this study was to verify the discriminatory performance of anthropometric measures in identifying frailty in the elderly and to create an easy-to-use tool. METHODS: Cross-sectional study: a subset from the Multidimensional Study of the Elderly in the Family Health Strategy (EMI-SUS) evaluating 538 older adults. Individuals were classified using the Fried Phenotype criteria, and 26 anthropometric measures were obtained. The predictive ability of anthropometric measures in identifying frailty was identified through logistic regression and an artificial neural network. The accuracy of the final models was assessed with an ROC curve. RESULTS: The final model comprised the following predictors: weight, waist circumference, bicipital skinfold, sagittal abdominal diameter, and age. The final neural network models presented a higher ROC curve of 0.78 (CI 95% 0.74-0.82) (P < 0.001) than the logistic regression model, with an ROC curve of 0.71 (CI 95% 0.66-0.77) (P < 0.001). CONCLUSION: The neural network model provides a reliable tool for identifying prefrailty/frailty in the elderly, with the advantage of being easy to apply in the primary health care. It may help to provide timely interventions to ameliorate the risk of adverse events.

Síndrome metabólica em idosos da atenção terciária em Porto Alegre, Rio Grande do Sul: associação com o Índice de Alimentação Saudável / Metabolic syndrome in elderly from tertiary health care in Porto Alegre, Rio Grande do Sul, Brazil: association with the Healthy Eating Index

Objetivos: Avaliar a associação entre síndrome metabólica e Índice de Alimentação Saudável em idosos em atendimento em um serviço de atenção terciária pelo Sistema Único de Saúde. Métodos: Estudo transversal, realizado no ambulatório do Serviço de Geriatria do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, em Porto Alegre, RS, entre novembro de 2009 e novembro de 2010. Foram convidados a participar do estudo todos os idosos atendidos no período, sendo excluídos aqueles com declínio cognitivo, transtornos psiquiátricos severos, grande restrição de mobilidade ou deficiência auditiva severa que comprometessem a avaliação nutricional. O diagnóstico de síndrome metabólica foi estabelecido pelo Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII) revisado e o padrão alimentar foi avaliado por meio do Índice de Alimentação Saudável adaptado para a população brasileira. Resultados: A amostra incluiu 186 idosos, a maioria mulheres (81,7%). A frequência de síndrome metabólica foi de 58,6%. Não houve diferença entre os escores do Índice de Alimentação Saudável de idosos com e sem síndrome metabólica. Na maioria dos idosos, a dieta necessitava de adequações. Idosos com síndrome metabólica tinham escore inferior somente para legumes e verduras (p=0,026). Na amostra total, o escore de cereais, pães, tubérculos e raízes foi diretamente associado com obesidade central (p=0,005); o de legumes e verduras inversamente com triglicerídeos (p=0,002) e diretamente com colesterol ligado a lipoproteínas de alta densidade (HDL-c) (p=0,004); o de frutas, diretamente com obesidade central (p=0,048), glicemia (p=0,024), triglicerídeos (p=0,001) e inversamente com HDL-c (p=0,015); o de leguminosas com glicemia (p=0,019); o de gordura total indiretamente com obesidade central (p=0,004) e glicemia (p=0,041); e variedade da dieta inversamente com glicemia (p=0,002) e pressão arterial diastólica (p=0,031). Conclusões: A dieta dessa amostra de idosos da atenção terciária necessitava de adequação. Não se observou associação entre o escore total do Índice de Alimentação Saudável e síndrome metabólica. Contudo, entre dez componentes do índice, seis mostraram-se associados com os critérios diagnósticos da síndrome metabólica. Assim, destaca-se a necessidade de intensificar o cuidado em relação à adequação nutricional em todos os níveis da atenção à saúde, uma vez que a nutrição é um fator importante na modulação da síndrome metabólica e de seus componentes.

Aims: To evaluate the association of metabolic syndrome with the Healthy Eating Index in elderly patients treated in a tertiary care facility affiliated with the Brazilian public health system. Methods: A cross-sectional study was performed at the geriatric outpatient clinic of Sao Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil, between November 2009 and November 2010. All elderly patients treated during this period were invited to participate in the study. Those with cognitive decline, severe psychiatric disorders, severe mobility restriction, or severe hearing impairment that could compromise nutritional assessment were excluded. The diagnosis of metabolic syndrome was established according to the revised "Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults" (NCEP-ATPIII), and the dietary pattern was evaluated using the Healthy Eating Index adapted to the Brazilian population. Results: The sample included 186 elderly patients, mostly women (81.7%). The frequency of metabolic syndrome was 58.6%. No difference was found between the Healthy Eating Index scores of elderly individuals with and without metabolic syndrome. The diet had to be adjusted in most of the patients. Elderly patients with metabolic syndrome presented lower scores only for the intake of legumes and vegetables (p=0.026). In the total sample, the score for cereals, breads, tubers, and roots was directly associated with central obesity (p=0.005); the score for legumes and vegetables was inversely associated with triglycerides (p=0.002) and directly with high-density lipoprotein cholesterol (HDL-c) (p=0.004); the score for fruits was directly associated with central obesity (p=0.048), blood glucose (p=0.024), and triglycerides (p=0.001), and inversely associated with HDL-c (p=0.015); the score for pulses was associated with blood glucose (p=0.019); total fat was indirectly associated with central obesity (p=0.004) and blood glucose (p=0.041); and dietary variety was inversely associated with blood glucose (p=0.005) and diastolic blood pressure (p=0.031). Conclusions: The diet of this sample of elderly from tertiary health care needed some adjustment. No association was observed between the total score of the Healthy Eating Index and metabolic syndrome. However, among 10 components of the index, six were associated with some diagnostic criteria of metabolic syndrome. Thus, it is important that nutritional adequacy be met at all levels of health care, since nutrition is an important factor in the modulation of metabolic syndrome and its components.

Perfil do paciente obeso e portador de síndrome metabólica candidato à cirurgia bariátrica em uma clínica particular de Porto Alegre, Rio Grande do Sul / Profile of obese patients with metabolic syndrome eligible for bariatric surgery at a private clinic in Porto Alegre, Rio Grande do Sul, Brazil

OBJETIVOS: Descrever o perfil sociodemográfico, de comorbidades, bioquímico, de estilo de vida e de uso de medicamentos de pacientes obesos, portadores de síndrome metabólica, candidatos à cirurgia bariátrica. MÉTODOS: Este estudo transversal retrospectivo incluiu indivíduos obesos grau I, II e III, portadores de síndrome metabólica e candidatos à cirurgia bariátrica, atendidos em uma clínica para tratamento da obesidade, em Porto Alegre, Rio Grande do Sul. Os pacientes foram atendidos entre janeiro de 2007 e março de 2014 e os dados para estudo foram coletados dos prontuários médicos. As variáveis investigadas foram: idade, sexo, escolaridade, estado civil, comorbidades, marcadores bioquímicos, uso de medicamentos, histórico de tabagismo, história de excesso de peso na infância e qualidade do sono. Os pacientes foram classificados com obesidade grau I (IMC=30-34,9), obesidade grau II (IMC=35-39,9) e obesidade grau III, ou grave (IMC≥40). O diagnóstico de síndrome metabólica foi realizado de acordo com a International Diabetes Federation. RESULTADOS: Foram avaliados 198 indivíduos, com média de idade de 40,5±11,1 anos (intervalo de 21 a 69 anos), dos quais 83,8% eram mulheres e 68,7% eram casados. A faixa etária mais frequente foi de 30 a 39 anos (37,4%). Com relação às condições de saúde, 77,3% dos pacientes tinham hipertensão arterial sistêmica, 75,8% eram dislipidêmicos e 75,3% eram portadores de gastrite, destacando-se que 67,2% dos pacientes utilizavam medicamentos anti-hipertensivos e 42,9% faziam uso de medicação psiquiátrica. Com relação aos níveis de proteína C reativa, verificou-se uma mediana de 0,81 (0,70-0,97mg/dL). Cento e treze pacientes (57%) referiam ter tido peso excessivo na infância. Má qualidade do sono foi mencionada por 61 (31%) dos indivíduos. CONCLUSÕES: A maior parte dos indivíduos com obesidade grau I, II e III e síndrome metabólica, que procurou atendimento na clínica de cirurgia bariátrica, era constituída de mulheres adultas jovens, casadas, com ensino de nível superior ou especializado e com a presença de várias comorbidades somadas ao excesso de peso e caráter inflamatório. Outros achados frequentes incluíram alterações do sono, relato de peso excessivo na infância e uso de mais de um tipo de medicamento.

AIMS: To describe the sociodemographic and biochemical profiles, presence of comorbidities, lifestyles, and drug utilization of obese patients with metabolic syndrome eligible for bariatric surgery METHODS: This retrospective cross-sectional study included metabolic syndrome patients with class I, II, and III obesity treated at a specialized clinic in Porto Alegre, Rio Grande do Sul, Brazil, who were candidates for bariatric surgery. The patients were seen between January 2007 and March 2014 and the data for the study were collected from medical records. The following variables were investigated: age, sex, education, marital status, comorbidities, biochemical markers, drug utilization, smoking history, history of childhood overweight, and sleep quality. Patients were classified as class I obesity (BMI=30 to 34.9), class II obesity (BMI=35 to 39.9), and class III, or severe, obesity (BMI≥40). The diagnosis of metabolic syndrome was established according to the International Diabetes Federation. RESULTS: A total of 198 subjects (83.8% of whom were women and 68.7% were married) with a mean age of 40.5±11.1 years (range of 21-69 years) were evaluated. Most of the patients (37.4%) were 30 to 39 years old. With regard to health, 77.3% of the patients had hypertension, 75.8% had dyslipidemia, and 75.3% had gastritis, and it should be noted that 67.2% of the patients were on antihypertensive medications and 42.9% on psychiatric drugs. A median of 0.81 (0.70-0.97mg/dL) was obtained for C-reactive protein levels. One hundred and thirteen patients (57%) reported having had excessive weight in childhood. Poor sleep quality was mentioned by 61 (31%) of individuals. CONCLUSIONS: Most individuals with class I, II, and III obesity and metabolic syndrome who sought care at the bariatric surgery clinic were young, adult, and married women with a college degree or higher education presenting with several comorbidities in addition to excess weight and inflammatory conditions. Other common findings included sleep disorders, excessive weight in childhood, and use of more than one type of medication.

Adesão à dieta por idosos com síndrome metabólica assistidos na Estratégia Saúde da Família: frequência e associação com depressão / Diet adherence in elderly patients with metabolic syndrome treated by the Family Health Strategy: frequency and association with depression

OBJETIVOS: Descrever a frequência de adesão à dieta e analisar sua associação com depressão em idosos com síndrome metabólica assistidos na atenção básica de saúde. MÉTODOS: Estudo transversal que incluiu idosos com síndrome metabólica diagnosticada pelos critérios do National Cholesterol Education Program Adult Treatment Panel III, participantes do Estudo Epidemiológico e Clínico dos Idosos Atendidos pela Estratégia de Saúde da Família do Município de Porto Alegre (EMI-SUS). A avaliação da adesão à dieta foi realizada através de um questionário, elaborado pelos pesquisadores com base nas recomendações da I Diretriz Brasileira de Síndrome Metabólica, sobre a adesão a oito possíveis orientações dietéticas recebidas de profissionais da saúde (em relação à ingestão de "alimentos integrais", "doces", "açúcar", "frutas/verduras/legumes", "sal", "alimentos gordurosos/frituras", "alimentos processados" e "peixes"). Considerou-se aderente à dieta o indivíduo que seguiu todas as orientações dietéticas recebidas, independentemente de quantas foram (entre uma e oito possíveis orientações). O diagnóstico de depressão foi baseado no instrumento Mini International Neuropsychiatric Interview, aplicado por psiquiatras. RESULTADOS: Foram incluídos 109 idosos, sendo que a maioria era do sexo feminino (67,9%). A média da idade foi 68,4±6,6 anos (61-90 anos). Trinta e sete idosos (33,9%) foram considerados aderentes à dieta. A orientação dietética com maior adesão foi a de diminuir a ingestão de sal (89,1%) e a com menor adesão foi a de consumir alimentos integrais (59,7%). Não se observou associação da adesão à dieta com variáveis sociodemográficas, clínicas e componentes da síndrome metabólica. A frequência de adesão à orientação de evitar o consumo de açúcar e de doces foi significativamente menor entre os indivíduos com depressão (43,9% vs 34,9%; p=0,001). CONCLUSÕES: A adesão à dieta foi observada em um terço dos idosos com síndrome metabólica atendidos na atenção básica de saúde. Nos indivíduos com diagnóstico de depressão, a adesão às orientações de evitar o consumo de doces e de açúcar foi menor.

AIMS: To describe diet adherence and to analyze its association with depression in elderly patients with metabolic syndrome treated by the Family Health Strategy. METHODS: Cross-sectional study including elderly patients with metabolic syndrome diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria who participated in the Epidemiological and Clinical Study of Elderly Individuals Treated by the Family Health Strategy in Porto Alegre, Brazil. A questionnaire developed by the researchers based on the recommendations of the I Brazilian Guideline for Metabolic Syndrome was used to evaluate compliance with eight possible dietary guidelines provided by health professionals (intake of "whole foods", "sweets", "sugar", "fruits/vegetables/legumes", "salt", "fatty foods/fried foods", "processed foods" and "fish"). Diet adherence was considered when an individual followed all dietary guidelines (regardless of their number, which ranged from one to eight). The diagnosis of depression was based on the Mini International Neuropsychiatric Interview instrument, used by psychiatrists. RESULTS: A total of 109 elderly patients were included in the study, most of whom were female (67.9%). The mean age was 68.4±6.6 years (61-90 years). Thirty-seven elderly patients (33.9%) were considered adherent to the diet. Lower salt intake was the dietary guidance with greater adherence (89.1%) while the consumption of whole foods exhibited less adherence (59.7%). There was no association of diet adherence with sociodemographic and clinical parameters and with metabolic syndrome components. The frequency of adherence to the recommendation against the consumption of sugar and sweets was significantly lower among individuals with depression (43.9% vs 34.9%; p = 0.001). CONCLUSIONS: Diet adherence occurred in one third of elderly patients with metabolic syndrome treated at the primary health care level. There was lower adherence to the recommendation against the consumption of sweets and sugar in individuals diagnosed with depression.

Idosos praticantes de treinamento resistido apresentam melhor mobilidade do que idosos fisicamente ativos não praticantes / Elderly resistance training practitioners have better mobility than physically active elderly non-practitioners

O processo de envelhecimento pode afetar negativamente a massa, a força muscular e a independência funcional. O declínio do tecido musculoesquelético interfere significativamente na capacidade funcional dos idosos. Porém, a prática regular de treinamento resistido (TR) pode postergar, minimizar ou até mesmo evitar estes declínios funcionais oriundos do processo de envelhecimento. O objetivo do presente estudo foi comparar variáveis de força muscular, mobilidade e independência entre idosos que praticam TR e idosos considerados fisicamente ativos pelo Questionário de Atividade Física Internacional (IPAQ), porém não praticantes do TR. Estudo transversal com grupo de comparação, observacional e não probabilístico. A amostra foi composta por 114 idosos, divididos em dois grupos: grupo TR (GTR), composto por 43 idosos praticantes de TR e grupo fisicamente ativos (GFA), composto por 71 idosos considerados fisicamente ativos, não praticantes de TR. As variáveis coletadas foram: sociodemográficas, de independência funcional, força e mobilidade. Os instrumentos utilizados para a coleta desses dados foram: questionário estruturado fechado, teste de sentar e levantar, teste de dinamometria de força de preensão manual, Escore de Lawton, Escala de Katz e TUG test, respectivamente. Aplicou-se o Test t de Student para amostras independentes para verificar diferenças estatisticamente significativas entre os grupos. Com relação às variáveis categóricas foi aplicado o teste do Qui-quadrado. O nível de significância mínimo para todos os testes estatísticos foi fixado em p<0,05. A amostra foi ajustada para sexo, idade, renda e escolaridade. Foram encontradas diferenças significativas entre os grupos em relação ao sexo, estado civil, renda e escolaridade (p<0,001). O grupo GTR apresentou média menor no tempo de deslocamento no TUG test (6,24±0,86 segundos) em relação ao GFA, que apresentou média de 11,24±4,26 segundos (p=0,035). Após serem realizados os ajustes estatísticos, não foram encontradas diferenças estatisticamente significativas entre os grupos em relação ao Escore de Lawton, à força de preensão manual e no teste de sentar e levantar. Concluiu-se que idosos praticantes do TR apresentaram desempenho significativamente melhor no TUG test, o que está diretamente relacionado com a prevenção de quedas e fraturas.(AU)

The aging process can adversely affect the mass, muscle strength and functional independence. The decline of musculoskeletal tissue interferes significantly with the functional capacity of the elderly. However, the regular practice of resistance training (RT) may postpone, minimize or even avoid these functional declines arising from the aging process. The aim of this study was to compare variables of muscle strength, mobility and independence among older adults who practice TR and those considered still physically active by the International Physical Activity Questionnaire (IPAQ), who don't practice the TR. The sample consisted of 114 elderly individuals divided into two groups: the resistance training group (RTG), composed of 43 elderly individuals practicing RT and the physically active group (GFA), composed of 71 elderly individuals considered physically active, but don't practice TR. The collected variables were: sociodemographic, functional independence, strength and mobility. The instruments used to collect such data were closed structured questionnaire, sitting and standing up test, handgrip strength dynamometry test, Lawton Score, Katz Scale and TUG test, respectively. We applied the Student's t test for independent samples to verify statistically significant differences between the groups. Regarding the categorical variables we used the chi-square test. The minimum level of significance for all statistical tests was set at p <0.05. The sample was adjusted for sex, age, income and education. Significant differences were found between the groups in relation to sex, marital status, age, income and education (p <0.001). The RTG group had lower average in commuting time in the TUG test (6.24 ± 0.86 seconds) in relation to the AFG, which had a mean of 11.24 ± 4.26 seconds (p = 0.035). After statistical adjustments, no statistically significant differences were found between the groups regarding the Lawton Score, the handgrip strength dynamometry test and the sitting and standing up test. It was concluded that RT elderly practitioners had significantly better performance in the TUG test, which is directly related to the prevention of falls and fractures.(AU)

Frailty and geriatric syndromes in elderly assisted in primary health care / Fragilidade e síndromes geriátricas em idosos assistidos na atenção primária à saúde

The aim of this study was to describe the association between frailty and geriatric syndromes (GS) [cognitive impairment (CI); postural instability (PI); urinary/fecal incontinence (UFI); polypharmacy (PP); and immobility (IM)] and the frequency of these conditions in elderly people assisted in primary health care. Five hundred twenty-one elderly participants of The Multidimensional Study of the Elderly in the Family Health Strategy (EMI-SUS) were evaluated. Sociodemographic data, identification of frailty (Fried phenotype) and GS were collected. Multinomial logistic regression analysis was performed. The frequency of frailty was 21.5%, prefrailty 51.1% and robustness 27.4%. The frequency of CI was 54.7%, PP 41.2%, PI 36.5%, UFI 14% and IM 5.8%. The odds of frailty when compared to robustness and adjusted for gender, age, depression, self-perception of health, nutritional status, falls, vision and hearing, was significantly higher in elderly with CI, PI and PP. The adjusted odds of prefrail when compared to robustness was significantly higher only in elderly with CI. The most frequently presented number of GS (0- 5) was two geriatric syndromes (26.87%). The frequency of frailty was high among elderly in primary health care and was associated with three of five GS (CI - PI - PP).

O objetivo deste estudo foi descrever a associação entre fragilidade e síndromes geriátricas (SG) [declínio cognitivo (DC); instabilidade postural (IP); incontinência urinária/fecal (IUF); polifarmácia (PF); e imobilidade (IM)] e a frequência destas condições em idosos assistidos na atenção básica. Foram avaliados 521 idosos, participantes do Estudo Multidimensional dos Idosos da Estratégia Saúde da Família (EMI-SUS). Foram coletados dados sociodemográficos, de identificação da fragilidade (fenótipo de Fried) e das SG. Realizou-se análise de regressão logística multinomial. A frequencia de fragilidade foi 21,5%, de pré-fragilidade 51,1% e de robustez 27,4%. A frequência de DC foi 54,7%, de PF 41,2%, de IP 36,5%, de IUF 14% e de IM 5,8%. A chance de fragilidade quando comparada à robustez, ajustada para sexo, idade, depressão, autopercepção de saúde, estado nutricional, quedas, visão e audição, foi significativamente maior em idosos com DC, IP e PF. A chance ajustada de pré -fragilidade, quando comparada à robustez foi significativamente maior somente nos idosos com DC. O número mais frequente de SG (0-5) presentes foram duas SG (26,8%). A frequência de fragilidade foi alta entre idosos da atenção básica e mostrou-se associada a três das cinco SG (DC-IP-PF).

Altura do joelho como medida alternativa confiável na avaliação nutricional de idosos / Knee-height as a reliable alternative measure for nutritional assessment in older adults

Objetivo:Avaliar o uso da altura do joelho como medida alternativa confiável na avaliação nutricional de idosos atendidos em um ambulatório de geriatria.Métodos:Estudo transversal com idosos atendidos em ambulatório de geriatria de um hospital universitário, entre novembro de 2009 e novembro de 2010. Variáveis investigadas: gênero, idade, peso, estatura, altura do joelho, estatura estimada através das equações de Chumlea, índice de massa corporal para as medidas de estatura aferida e estimada e classificado segundo Lipschitz, e dados sociodemográficos. Na análise descritiva dos dados foram usadas medidas de tendência central, dispersão e proporção; a homogeneidade entre as medidas foi verificada através do coeficiente de correlação intraclasse e do gráfico de Bland e Altman e a concordância entre a avaliação nutricional baseada no índice de massa corporal calculado a partir da estatura aferida e a avaliação nutricional baseada no índice de massa corporal calculado a partir da estatura estimada foi avaliada através do coeficiente Kappa ponderado com pesos quadráticos.Resultados:Foram avaliados 186 idosos com média de idade de 74,3±7,1 anos. A média do índice de massa corporal aferido e estimado foi 28,96±5,86 kg/m2e 27,95±5,47 kg/m2, respectivamente, e a prevalência de sobrepeso foi de 59,7% para o índice de massa corporal aferido e 53,2% para o estimado. Foi observada uma boa concordância (Kappa=0,79; p<0,001) entre as duas avaliações.Conclusão:Os resultados mostraram ser possível utilizar a altura do joelho na estimativa da estatura para cálculo do índice de massa corporal em idosos atendidos em ambulatório, alternativa útil para aqueles que apresentam limitações na aferição das medidas, sendo esta uma medida alternativa importante na avaliação nutricional de idosos.

Objective:To evaluate the use of knee-height as a reliable alternative measure for nutritional evaluation in older adults in a geriatrics outpatient clinic.Methods:Cross-sectional study with elderly patients being treated in a geriatrics outpatient clinic of a University Hospital between November 2009 and November 2010. Variables investigated: gender, age, weight, stature, kneeheight, estimated stature using Chumlea equations, body mass index based on measured and estimated stature and classified according to Lipschitz, and socio-demographic characteristics. Measures of central tendency, dispersion, and proportion were used in the descriptive data analysis. Homogeneity between these measures was verified using intraclass correlation coefficient and Bland and Altman plot, and the correlation between the nutritional assessment concerning the body mass index calculated based on the measured stature and the nutritional assessment calculated based on the estimated stature was established using the quadratic weighted Kappa coefficient.Results:One hundred eight-six elderly patients with average age of 74.3±7.1 years were evaluated. The average body mass index calculated and estimated were, respectively, 28.96±5.86 kgm2, 27.95±5.47 kgm2, and the prevalence of overweight was 59.7% for body mass index calculated and 53.2% for body mass index estimated. A good agreement between the evaluations was observed (Kappa=0.79; p<0.001).Conclusion:Results showed that it is possible to use the knee-height for the estimation of stature to determine the body mass index in elderly patients in a geriatric outpatient clinic. It proved a useful alternative especially when it is difficult to obtain accurate measures in older adults, suggesting that knee-height is an important alternative measure for the nutritional status evaluation in elderly patients.

Medidas antropométricas em idosos assistidos na atenção básica e sua associação com gênero, idade e síndrome da fragilidade: dados do EMI-SUS / Anthropometric measurements in elderly assisted in primary health care and their association with gender, age and frailty syndrome: EMI-SUS data

Objetivos: Descrever medidas antropométricas em idosos assistidos na atenção básica e analisar sua associação com gênero, idade e síndrome da fragilidade. Métodos: Este estudo transversal é parte do Estudo Epidemiológico e Clínico dos Idosos Atendidos pela Estratégia Saúde da Família de Porto Alegre-RS-Brasil (EMI-SUS). Foram obtidas dos idosos 27 medidas antropométricas (analisadas de forma isolada ou em equações, totalizando 41 dados de medidas antropométricas) e dados para determinação da síndrome de fragilidade (Fenótipo de Fried). Foram utilizados o teste de Kolmogorov-Smirnov, o teste t de Student e o teste de análise de variância (ANOVA). Considerou-se o nível de confiança de 95%. Resultados: A amostra incluiu 583 idosos, sendo 371 (63,6%) mulheres. Homens apresentaram médias significativamente superiores de peso, estatura, altura do joelho, circunferências (antebraço, muscular do braço, pescoço, punho), área muscular do braço, relações (cintura/quadril, cintura/coxa, dobras tronco/extremidades) e índices (sagital, de conicidade). Mulheres apresentaram médias superiores do índice de massa corporal, circunferências (braço, cintura, coxa, quadril), dobras cutâneas (bicipital, tricipital, subescapular, suprailíaca, peitoral, coxa, panturrilha, média seis dobras), área de gordura do braço, relação cintura/estatura e relação diâmetro abdominal sagital/estatura. Idosos mais jovens apresentaram medidas superiores das circunferências do antebraço, braço, músculo do braço, coxa e área muscular do braço em relação aos mais velhos. Idosos robustos tinham estatura, altura do joelho, circunferência muscular do braço e área muscular do braço superiores e área de gordura do braço, dobras cutâneas da coxa, peitoral, bicipital, tricipital, panturrilha e relação diâmetro abdominal sagital/estatura inferiores aos frágeis e pré-frágeis. Idosos frágeis tinham circunferências da panturrilha e antebraço menores e relações cintura/estatura, cintura/coxa, cintura/panturrilha e índices de conicidade e sagital, maiores que os robustos. Conclusões: As medidas antropométricas mostraram-se associadas com gênero, idade e fragilidade. Nos homens, as médias das medidas de tamanho, compleição e de reserva de massa muscular foram maiores. Nas mulheres, as médias das medidas de reserva adiposa foram maiores e a associação das medidas com a faixa etária foi mais frequente. Fragilidade mostrou-se associada com perda de massa muscular. Idosos frágeis apresentaram medidas inferiores de tamanho e compleição.

Aims: To describe anthropometric measurements and analyze their association with gender, age, and frailty syndrome in elderly assisted in primary health care. Methods: This cross-sectional study is part of the Multidimensional Study of the Elderly in the Family Health Strategy in Porto Alegre, RS, Brazil (EMI-SUS). Twenty-seven anthropometric measurements (analyzed in isolation or in equations, totaling 41 measurements) and data for determining the frailty (Fried Phenotype) were collected from elderly individuals. Kolmogorov-Smirnov test, Student t test and analysis of variance (ANOVA) were used for statistical analysis, considering a confidence level of 95%. Results: The sample included 583 elderly, of whom 371 (63.6%) were women. Men presented significantly higher means for weight, height, knee-height; forearm, muscle arm, neck and wrist circumferences; muscle arm area; ratios for waist-to-hip, waist-to-thigh, and trunk-to-skinfolds-extremities; and sagittal and conicity indexes. Women showed higher means for body mass index; arm, waist, thigh and hip circumferences; biceps, triceps, subscapular, suprailiac, pectoral, thigh, calf, and mean of six skinfolds; fat arm area, waist-to-height ratio and sagittal abdominal diameter-to-height ratio. The younger elderly presented higher measures of forearm, arm, muscle arm and thigh circumferences; and muscle arm area, in relation to the older. The robust elderly had higher measures of height, knee-height, muscle arm circumference and muscle arm area; and lower fat arm area, thigh, pectoral, biceps, triceps and calf skinfolds; and sagittal abdominal diameterto-height ratio, than the pre-frail and frail seniors. The frail elderly had lower calf and forearm circumferences than the robust elderly, and higher waist-to-height, waist-to-thigh and waist-to-calf ratios, and conicity and sagittal indexes. Conclusions: Anthropometric measures were associated with gender, age and frailty. In men, the mean measures of size, build and muscle mass reserve were higher. In women, the mean measures of fat reserve were higher and the association of the measures with age group was more frequent. Frailty proved to be associated with muscle mass loss. The frail elderly had lower measures of size and complexion.

Lack of association of body composition and functionality variables with metabolic syndrome in the elderly.

BACKGROUND: The aging process causes alterations in body composition (decrease in lean mass and increase in fat mass), diminution of functionality (strength, mobility, and physical performance), and an increased prevalence of chronic diseases such as metabolic syndrome and obesity. The aim of this study was to investigate the association of body composition and functionality with metabolic syndrome in the elderly. METHODS: A cross-sectional study was conducted in the Outpatient Clinic of the Geriatric Service of Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul (PUCRS) involving 74 patients (14 males and 60 females). The patients were separated into two groups: Group 1=elderly with metabolic syndrome [through the National Cholesterol Education Program Adult Treatment Panel III (NECP ATP III) criteria; n=34], group 2=elderly without metabolic syndrome (n=40). The variables evaluated included age, gender, body composition (circumferences, skinfold thickness, BMI, muscle and fat thickness and muscle mass), functional variables [hand grip strength, Timed Up and Go Test (TUGT), and Sit-to-Stand Test]. RESULTS: The results showed that elderly individuals with metabolic syndrome had a higher mean of the anthropometric measures (except abdominal skinfold thickness) compared to subjects without metabolic syndrome (P<0.005). We observed significant differences for muscle mass index (higher, P=0.029), TUGT (longer time, P=0.008), and hand grip strength (lower, P=0.015) in elderly with metabolic syndrome compared with subjects without metabolic syndrome. However, when these variables were adjusted for gender, age, and body mass index (BMI), none showed a significant association with metabolic syndrome. CONCLUSION: We did not observe associations among metabolic syndrome, body composition, and functionality variables.

Healthy eating index of elderly: description and association with energy, macronutrients and micronutrients intake

The purpose of this study was to define the Healthy Eating Index (HEI) of the elderly of Southern Brazil and its association with energy, macronutrients and micronutrients intake. A cross-sectional study was conducted with 186 elderly aged 60 and older of the Geriatric Service of São Lucas Hospital, Porto Alegre , Brazil. Dietary data were collected by two 24-hour recalls, and diet quality was assessed by HEI adapted to the Brazilian population. The HEI total score was divided into three categories: inadequate diet (below 51 points), diet needs improvement (between 51 and 80 points), and healthy diet (over 80 points). The results showed that the mean HEI score was 58.8±10.5 points (ranging from 31.4 to 79.8). Most elderly (74.2%) showed a diet that needed modification and no elderly individual had a healthy diet. The quality of the diet was associated with greater intake of carbohydrates, and lower intake of total lipids, saturated fatty acids, cholesterol, and sodium. Consumption of vitamins C and D and calcium was shown to be positively correlated with the quality of the diet. Less than 1.1% of the elderly consumed a varied diet. The findings suggest that the diet of the majority of the elderly needs improvement, reinforcing the importance of care in relation to adequate nutrition in this population, and can help in guiding the activities and programs of nutritional education and public policies that stimulate increasingly healthy eating.

Índice de alimentação saudável de idosos: descrição e associação com ingestão de energia, macronutrientes e micronutrientes. O objetivo deste estudo foi descrever o Índice de Alimentação Saudável (IAS) de idosos do Sul do Brasil e sua associação com a ingestão de energia, macronutrientes e micronutrientes. Foi realizado um estudo transversal com 186 idosos com 60 anos ou mais, do Serviço de Geriatria do Hospital São Lucas, Porto Alegre, Brasil. Os dados relativos ao consumo alimentar foram coletados através de dois recordatórios de 24 horas, e a qualidade da dieta foi avaliada pelo IAS, adaptado à população brasileira e o escore total foi dividido em três categorias: dieta inadequada (abaixo de 51 pontos), dieta necessitando de adequação (entre 51 e 80 pontos), e dieta saudável (mais de 80 pontos). Os resultados mostraram que a média do IAS foi 58,8±10,5 pontos (variando de 31,4 a 79,8 pontos). A maioria dos idosos (74,2%) apresentou uma dieta que necessitava de modificação e nenhum idoso tinha uma dieta saudável. A qualidade da dieta foi associada com maior ingestão de carboidrato e baixa ingestão de gordura total, gordura saturada, colesterol e sódio. O consumo de vitaminas C e D e cálcio mostrou-se positivamente correlacionado com a qualidade da dieta. Menos de 1,1% dos idosos consumia uma dieta variada. Os resultados sugerem que a dieta da maioria dos idosos necessita de adequação, reforçando a importância dos cuidados em relação à nutrição adequada desta população e podem auxiliar na orientação de atividades e programas de educação nutricional e políticas públicas que estimulem a prática de uma alimentação mais saudável.