RESUMO
PURPOSE: To investigate the relationship of Children's Dietary Inflammatory Index (C-DII™) scores with body fat distribution and serum adipokines in Brazilian schoolchildren. METHODS: This population-based cross-sectional study enrolled 378 schoolchildren aged 8 and 9 years from Viçosa, Minas Gerais, Brazil. Food consumption was assessed using three 24-h dietary recalls from which C-DII scores were calculated. Serum adipokines [adiponectin, leptin, retinal-binding protein 4 (RBP4), and chemerin] were analyzed in blood samples. Sociodemographic characteristics and sedentary behavior were assessed using a semi-structured questionnaire. Total, truncal, android and gynoid body fat were evaluated by dual-energy X-ray absorptiometry (DXA). We compared the distributions of adiposity measures and serum adipokines by C-DII categories with linear regression, adjusting for potential confounders. RESULTS: The mean sample C-DII was 0.59 ± 0.94 and ranged from - 2.16 to + 2.75. The C-DII was not associated with central and total body fat. However, the C-DII was modestly inversely associated with adiponectin and RBP4, and modestly directly associated with chemerin. These results remained significant after adjusting for body fat. Every 1 SD of C-DII was related, respectively, to a - 0.8 (- 1.5, - 0.03) and to a - 0.1 (- 0.2, - 0.05) units lower mean of adiponectin and RBP4, and to 7.2 (0.3, 14.1) units higher of chemerin. CONCLUSION: Higher C-DII score was modestly inversely and directly associated with anti- and pro-inflammatory adipokines, respectively, in Brazilian children. The development of public health policies is needed to promote healthy eating habits during childhood to prevent the early onset of systemic inflammation and ill health effects later in life.
Assuntos
Adipocinas , Dieta , Brasil , Quimiocinas , Criança , Estudos Transversais , Humanos , Inflamação , Obesidade , Proteínas Plasmáticas de Ligação ao RetinolRESUMO
BACKGROUND: Cirrhosis is the end-stage of progressive fibrosis, in which oxidative stress and inflammation-related pathways can modulate the cellular and tissue events involved in the pathogenesis of liver fibrosis. Dietary intake of antioxidants has been suggested to protect against oxidative damage and related clinical complications. The present study aimed to investigate the potential association of the dietary total antioxidant capacity (dTAC) with anthropometric, functional and biochemical markers, as well as the severity of the disease, in cirrhotic outpatients. METHODS: Sixty-two outpatients (38 men and 24 women) with a mean (SD) age of 59.1 (9.9) years were evaluated. Dietary TAC was estimated from a food frequency questionnaire. Aetiology and severity of liver cirrhosis, lifestyle characteristics, occurrence of comorbidities and oedema, and anthropometric, functional and biochemical markers were all assessed. RESULTS: Cirrhotic outpatients with higher dTAC also had higher values of the hand-grip strength (P = 0.029) and arm muscle area (P = 0.027). After adjusting by sex, age, smoking and alcohol intake, the addition of 1 mmol day-1 of dTAC contributed to increase 0.552 kg f-1 in hand-grip strength (P < 0.05). The addition of one mmol day-1 of dTAC contributed to an arm muscle area increase 0.565 cm2 (P < 0.05) on average. CONCLUSIONS: The dTAC was positively associated with hand-grip strength and arm muscle area in cirrhotic outpatients. The implications of the present study are important in clinical practice because a diet rich in antioxidants may be an ally in the control of excessive reactive oxygen species production in cirrhotic outpatients with repercussion on muscle mass and strength.
Assuntos
Antioxidantes/análise , Cirrose Hepática/fisiopatologia , Força Muscular/efeitos dos fármacos , Pacientes Ambulatoriais/estatística & dados numéricos , Estresse Oxidativo/efeitos dos fármacos , Idoso , Antropometria , Braço/fisiopatologia , Biomarcadores/análise , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Espécies Reativas de Oxigênio/metabolismo , Índice de Gravidade de DoençaRESUMO
Pistachio is a nut with high polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), polyphenols and carotenoids content, and the synergism between these compounds appears to affect glucose metabolism. In this systematic review we analyzed studies in which the effect of chronic consumption of pistachio on markers of glucose metabolism was evaluated in pre-diabetic and type 2 diabetics. We used the PubMed, Scopus, Cochrane and Lilacs databases. The research terms used were pistachio, pre-diabetes, type 2 diabetes mellitus, insulin resistance, blood glucose, hyperglycemia and glycated hemoglobin (HbA1c). Four articles were selected, of which three tested the intake of 50 to 57 g of pistachio/day and one 20% of the daily caloric intake, for a period of 1 to 4 months. Studies reported a decrease in fasting blood glucose, insulinemia, HOMA-IR, and fructosamine, but no change in HbA1c. Lower concentrations of miR-192 and miR-375 were also found, which correlated positively with HOMA-IR. The synergism between PUFA, MUFA, polyphenols and carotenoids present in pistachios can modulate specific miRNA, increasing insulin sensitivity through the PI3K-AKT signaling pathway. This modulation can be used as a tool to monitor the response to interventions, favoring the prevention and treatment of complications related to diabetes.
Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Carboidratos da Dieta , Glucose/metabolismo , Pistacia/química , Glicemia/metabolismo , Carotenoides/farmacologia , Bases de Dados Factuais , Diabetes Mellitus/dietoterapia , Jejum , Ácidos Graxos Monoinsaturados/farmacologia , Ácidos Graxos Insaturados/farmacologia , Frutose/sangue , Hemoglobinas Glicadas , Humanos , Hiperglicemia/dietoterapia , Insulina/sangue , Resistência à Insulina , MicroRNAs , Fosfatidilinositol 3-Quinases , Polifenóis/farmacologiaRESUMO
OBJECTIVES: Many factors are associated with the increase in total and central body adiposity in children, especially eating habits. This has led to an increasing number of studies analysing food patterns, which consider the synergistic effect of food and nutrient intake on the nutritional status. The objective of this study was to identify the dietary patterns of children aged 4-7 years and associate these with different indicators of total and central body adiposity. STUDY DESIGN: Cross-sectional study METHODS: The study consisted of 403 children from a retrospective cohort in Minas Geraes, Brazil. Four indicators of body adiposity were evaluated: body mass index (BMI), waist-to-height ratio (WHtR) and percentages of total and central body fat (assessed by dual-energy X-ray absorptiometry). The dietary habits of the children were evaluated by identifying the dietary patterns using principal component analysis. The adjustment predictor variables were related to the socio-economic characteristics, lifestyle and duration of exclusive breastfeeding. Food patterns were identified by factor analysis. Linear regression was used to estimate the regression coefficient and the confidence interval, considering statistical significance of α = 5%. RESULTS: Five dietary patterns were identified, which explained 42.3% of the data variance: 'Traditional', 'Unhealthy', 'Milk and chocolate', 'Snack' and 'Healthy'. The multiple linear regression model showed that a greater adherence to the 'Traditional' and 'Unhealthy' patterns was related to higher BMI, WHtR, and total and central body adiposity. CONCLUSION: Children with a higher intake of food from the 'Traditional' and 'Unhealthy' patterns showed an increase in total and central body adiposity.
Assuntos
Adiposidade , Comportamento Alimentar , Obesidade Infantil/epidemiologia , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Obesidade Abdominal/epidemiologia , Estudos Retrospectivos , Razão Cintura-EstaturaRESUMO
BACKGROUND: The present study aimed to evaluate the nutritional status of patients undergoing haemodialysis (HD) by comparing nutritional risk scores with biochemical, anthropometric and body composition variables. METHODS: Eighty-five individuals [65.9% male, mean (SD) age 62 (14) years] participated in a cross-sectional study. Global Objective Assessment (GOA) and Modified Global Subjective Assessment (mGSA) scores, as well as biochemical, anthropometric and body composition data, were collected using standardised procedures. RESULTS: The prevalence of malnutrition ranged from 20.0% (% body fat by electrical bioimpedance) to 95.3% (by GOA), depending on the indicator or score used. According to the waist circumference, 61.2% of the individuals presented abdominal obesity and visceral adipose tissue was excessive in 20% of them. Malnutrition diagnosis by GOA showed the relationship between the anthropometric and body composition indicators, as assessed by the extent that the ratings of risk nutritional/mild malnutrition and mainly moderate malnutrition were accompanied by a significant decrease in nutritional status and body composition variables. However, with respect to categories of mGSA, no statistically significant differences were observed for nutritional status and body composition variables. In the receiver operator characteristic curve analyses, mGSA and GOA were good indicators for diagnosing malnutrition because both achieved an AUC > 0.5. CONCLUSIONS: mGSA and GOA were more sensitive with respect to identifying individuals at nutritional risk compared to the isolated anthropometric indicators, thus indicating their utility in diagnostic malnutrition. However, individuals at high nutritional risk also presented cardiometabolic risk, as diagnosed mainly by central fat indicators, suggesting the application of both malnutrition and cardiometabolic risk markers in HD patients.
Assuntos
Doenças Cardiovasculares/diagnóstico , Desnutrição/diagnóstico , Síndrome Metabólica/diagnóstico , Avaliação Nutricional , Diálise Renal/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria , Composição Corporal , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Desnutrição/sangue , Desnutrição/etiologia , Síndrome Metabólica/sangue , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Fatores de Risco , Adulto JovemRESUMO
The present cross-sectional study assessed the potential relationships of carotenoid intake with lipid and oxidative stress markers in middle-aged men. A total of 296 apparently healthy middle-aged men (mean age 50.5 (SD 5.0) years, BMI 25.8 (SD 3.5) kg/m(2)) were recruited to participate in the study. Dietary intake, anthropometry, blood pressure, lifestyle features, blood and urine biomarkers were assessed using validated procedures. The lipid markers included NEFA, Castelli index, and TAG:HDL ratio; oxidative stress markers included urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), 8-iso-PGF2α and plasma oxidised-LDL (ox-LDL). We observed a significant inverse association (P < 0.05) between NEFA concentrations and consumption of lutein plus zeaxanthin, ß-carotene, α-carotene and total carotenoid, while Castelli index was negatively associated with daily intake of lycopene, ß-carotene and total carotenoids. Regarding oxidative stress biomarkers, urinary 8-OHdG and ox-LDL concentrations were also inversely associated (P < 0.05) with consumption of lycopene, lutein plus zeaxanthin, ß-carotene, α-carotene and total carotenoids, regardless of confounding variables. Moreover, there was a negative association of urinary 8-iso-PGF2α concentration with dietary lutein plus zeaxanthin (ß - 0.135, 95% CI - 0.268, - 0.001), ß-carotene (ß - 0.156, 95% CI - 0.277, - 0.034) and with the sum of all carotenoids (ß - 0.189, 95% CI - 0.333, - 0.046). In conclusion, total daily carotenoid intake based on five investigated carotenoid types (ß-cryptoxanthin, lycopene, lutein plus zeaxanthin, ß-carotene and α-carotene) was inversely associated with relevant lipid and oxidative stress markers in middle-aged men, with emphasis on ß-carotene that was negatively associated with five of the six lipid and oxidative stress markers evaluated in the present study.
Assuntos
Carotenoides/administração & dosagem , Dano ao DNA/efeitos dos fármacos , Metabolismo dos Lipídeos/efeitos dos fármacos , 8-Hidroxi-2'-Desoxiguanosina , Adulto , Biomarcadores/sangue , Biomarcadores/urina , Índice de Massa Corporal , Carotenoides/sangue , Estudos Transversais , Desoxiguanosina/análogos & derivados , Desoxiguanosina/urina , Dinoprosta/análogos & derivados , Dinoprosta/urina , Humanos , Estilo de Vida , Lipoproteínas LDL/sangue , Luteína/administração & dosagem , Luteína/sangue , Licopeno , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estresse Oxidativo/efeitos dos fármacos , Inquéritos e Questionários , Zeaxantinas/administração & dosagem , Zeaxantinas/sangue , beta Caroteno/administração & dosagem , beta Caroteno/sangueRESUMO
The aim of this article is to assess the potential relationships between TNFα gene promoter methylation in peripheral white blood cells and central adiposity (truncal fat), metabolic features and dietary fat intake. A group of 40 normal-weight young women (21 ± 3y; BMI 21.0 ± 1.7 kg/m(2)) was included in this cross-sectional study. Anthropometric, biochemical and dietary data were assessed using validated procedures. DNA from white blood cells was isolated and 5-methylcytosine levels of the CpGs sites present in TNFα gene promoter (from -170 to +359 pb) were analyzed by Sequenom EpiTyper. Those women with high truncal fat (≥52.3%) showed lower 5-methylcytosine levels (P<0.05) in the site CpG13 (at position +207) and CpG19 (+317 pb) of the TNFα gene promoter when were compared to women with lower truncal adiposity. The methylation levels of CpG13 were also correlated with circulating TNFα levels, which were higher in those women with greater truncal adiposity. In a linear regression model, truncal fat, HDL-cholesterol, insulin, plasma TNFα, and daily n-6 PUFA intake explained the methylation levels of CpG13 site +207 by 48% and the average of CpG13 and CpG19 by 43% (P<0.001). In conclusion, women with higher truncal fat showed lower methylation levels of TNFα promoter in peripheral white blood cells and higher plasma TNFα concentrations. DNA methylation levels of TNFα promoter were associated with some metabolic features and with n-6 PUFA intake, suggesting a complex nutriepigenomic network in the regulation of this recognized pro-inflammatory marker.
Assuntos
Metilação de DNA/genética , Ácidos Graxos Insaturados/metabolismo , Leucócitos/citologia , Regiões Promotoras Genéticas/genética , Fator de Necrose Tumoral alfa/genética , 5-Metilcitosina/análise , Tecido Adiposo/metabolismo , Adiposidade/fisiologia , Adolescente , Adulto , Composição Corporal/fisiologia , Distribuição da Gordura Corporal , Peso Corporal/fisiologia , HDL-Colesterol/sangue , Estudos Transversais , Dieta , Gorduras na Dieta , Feminino , Alimentos , Humanos , Inflamação , Insulina/sangue , Leucócitos/metabolismo , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/metabolismo , Adulto JovemRESUMO
The study investigates the effect of weight-maintaining high-sucrose (HSD) and high-fat (HFD) diets on plasma glucose and insulin concentrations in lean and obese women, and verifies the correlation between insulin profile and body composition. Lean (G1 group, n=6, BMI= 21.4 (20.2-22.8) kg/m2) and overweight/obese (G2 group, n=6, BMI 28.6 (25.1-32.1) kg/m2) women participated in the study. HSD (59% total carbohydrate with 23% sucrose; 28% lipid) or HFD (42% total carbohydrate with 1.3% sucrose; 45% lipid) diets were consumed under free-living conditions for 14 days. Anthropometry and body composition were assessed before and after HSD and HFD diets following-up. Fasting and postprandial (at 30, 60, 180 and 240 min) glucose and insulin were determined. HOMA-IR and QUICK index were also calculated. Fasting and postprandial glucose and insulin concentration did not differ significantly between groups or diets. However, there was a positive and significant correlation between plasma fasting and postprandial insulin concentrations and BMI, percentage of total body fat (% TBF) and HOMA-IR index. In addition, carbohydrate and sucrose intake presented a positive and significant correlation with insulin concentration and HOMA-IR at 180 min postprandial, after adjusting for energy intake and % TBF (p<0.05). These results suggest that altering the profile of the macronutrients in the diet can modify glycemia and insulinemia homeostasis, regardless of energy intake and adiposity. On the other hand, the overweight/obese women can maintain a stable metabolic profile with the habitual diet.
Assuntos
Glicemia/metabolismo , Gorduras na Dieta/metabolismo , Insulina/sangue , Obesidade/sangue , Sobrepeso/sangue , Composição Corporal , Peso Corporal , Carboidratos da Dieta , Jejum , Feminino , Humanos , Período Pós-Prandial , Adulto JovemRESUMO
Toll-like receptors (TLR) mediate infection-induced inflammation and sterile inflammation by endogenous molecules. Among the TLR family, TLR4 is the best understood. However, while its downstream signaling pathways have been well defined, not all ligands of TLR4 are currently known. Current evidence suggests that saturated fatty acids (SFA) act as non-microbial TLR4 agonists, and trigger its inflammatory response. Thus, our present review provides a new perspective on the potential mechanism by which SFAs could modulate TLR4-induced inflammatory responses: (1) SFAs can be recognized by CD14-TLR4-MD2 complex and trigger inflammatory pathways, similar to lipopolysaccharide (LPS). (2) SFAs lead to modification of gut microbiota with an overproduction of LPS after a high-fat intake, enhancing this natural TLR4 ligand. (3) In addition, this metabolic endotoxemia leads to an oxidative stress thereby producing atherogenic lipids - oxLDL and oxidized phospholipids - which trigger CD36-TLR4-TLR6 inflammatory response. (4) Also, the high SFA consumption increases the lipemia and the mmLDL and oxLDL formation through oxidative modifications of LDL. The mmLDL, unlike oxLDL, is involved in activation of the CD14-TLR4-MD2 inflammatory pathway. Those molecules can induce TLR4 inflammatory response by MyD88-dependent and/or MyD88-independent pathways that, in turn, promotes the expression of proinflammatory transcript factors such as factor nuclear kappa B (NF-κB), which plays a crucial role in the induction of inflammatory mediators (cytokines, chemokines, or costimulatory molecules) implicated in the development and progression of many chronic diseases.
Assuntos
Aterosclerose/etiologia , Ácidos Graxos/farmacologia , Inflamação/metabolismo , Estresse Oxidativo , Receptor 4 Toll-Like/metabolismo , Aterosclerose/metabolismo , Humanos , Inflamação/complicações , Transdução de Sinais/efeitos dos fármacosRESUMO
OBJECTIVE: To assess the potential associations of branched-chain amino acids (BCAA) consumption with central obesity (CObesity) and cardiometabolic risk factors in a population of Brazilian middle-aged men. Special attention was given to leucine intake. DESIGN: Cross-sectional study. SETTING: Universidade Federal de Viçosa, Viçosa, Brazil. PARTICIPANTS: Two-hundred ninety-six middle-aged men (Age: 50.5 ± 5.0 years; Body mass index: 25.8 ± 3.5 kg/m2). MEASUREMENTS: Anthropometry, lifestyle features, blood biochemical parameters were assessed and dietary intake was estimated by a food frequency questionnaire. Participants were classified by the occurrence of CObesity, hypertriglyceridemia (HTG), hypertriglyceridemic waist phenotype (HWP) and metabolic syndrome (MetS). RESULTS: Subjects in the BCAA highest tertile (≥0.17 g/kg/d) presented lower occurrence of CObesity (36.0% vs 72.4%, P<0.01, z=-5.10), HTG (17.0% vs 30.6% P<0.032, z=-2.32), HWP (23.0% vs 46.9%, P<0.01, z=-3.57) and MetS (19.0% vs 34.7%, P<0.01, z=-2.57). They also exhibited lower values for Castelli index (total cholesterol:HDL-c) and triglycerides: HDL-c ratio than those in the first tertile, regardless of interfering factors (i.e. habitual physical activity, work position, smoking habit, and energy intake). Interestingly, leucine consumption showed similar associations with cardiometabolic risk factors, as compared to BCAA consumption (P<0.05). CONCLUSION: BCAA consumption was cross-sectionally and negatively associated with relevant cardiometabolic risk factors in a population of Brazilian middle-aged men. The content of leucine in BCAA consumption may have contributed to such relationship.
Assuntos
Aminoácidos de Cadeia Ramificada/administração & dosagem , Aminoácidos de Cadeia Ramificada/farmacologia , Leucina/administração & dosagem , Leucina/farmacologia , Obesidade Abdominal/epidemiologia , Antropometria , Índice de Massa Corporal , Brasil/epidemiologia , Colesterol/sangue , Estudos Transversais , Inquéritos sobre Dietas , Ingestão de Energia , Humanos , Hipertrigliceridemia/epidemiologia , Estilo de Vida , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Fumar/epidemiologia , Triglicerídeos/sangueRESUMO
The application of metabolomics in nutritional research may be a useful tool to analyse and predict the response to a dietary intervention. The aim of this study was to examine metabolic changes in serum samples following exposure to an energy-restricted diet (-15% of daily energy requirements) over a period of 8 weeks in overweight and obese older adults (n = 22) using a gas chromatography/mass spectrometry (GC/MS) metabolomic approach. After 8 weeks, there were significant reductions in weight (7%) and metabolic improvement (glucose and lipid profiles). Metabolomic analysis found that total saturated fatty acids (SFAs), including palmitic acid (C16:0) and stearic acid (C18:0) and monounsaturated fatty acids (MUFAs), were significantly decreased after the 8-week intervention. Furthermore, palmitoleic acid (C16:1) was found to be a negative predictor of change in body fat loss. Both the total ω-6 and ω-3 polyunsaturated fatty acids (PUFAs) significantly decreased, although the overall total amounts of PUFAs did not. The branched chain amino acid (BCAA) isoleucine significantly decreased in the serum samples after the intervention. In conclusion, this study demonstrated that the weight loss intervention based on a hypocaloric diet identified changes in the metabolic profiles of serum in overweight and obese older adults, with a reduction in anthropometric and biochemical parameters also found.
Assuntos
Aminoácidos/sangue , Ácidos Graxos/sangue , Metabolômica , Sobrepeso/sangue , Redução de Peso , Adulto , Ingestão de Energia , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , MasculinoRESUMO
The diet composition can interfere directly in the energy homeostase. In the energy metabolism, the oxidation pathway and diet-induced thermogenesis are differentiated by diet macronutrients proportion. In this respect, the high-proteindiet is the most thermogenic, compared to high-carbohydrate and high-lipid diets, while high-carbohydrate diet appears to increase the thermogenic effect more than high-lipid diet, but the studies arecontroversies. Towards energy intake, it can stimulate or inhibit the energy intake, according to the foods palatability, satiation and satiety degree, related to diet carbohydrate, protein and lipid content. A hierarchy has been observed for the satiating efficacies of the macronutrients protein, carbohydrate and fat, with protein as most satiating and fat as least satiating. In general, there are discrepancies between studies about the regulatory role of macronutrients in the components of energy expenditure and intake, due the methodological differences in the subjects, exposition time for diet, energy density, and total energy content. The present work seeks to analyze the more consistent scientific evidences toward the modulator role of diet composition on the diet induced thermogenesis and energy intake, for better understanding of obesity prevention and control by dietetic intervention.
A composição da dieta pode interferir diretamente na homeostase energética. No metabolismo energético, a via de oxidação e a termogênese induzida pela dieta são diferenciadas pela proporção de macronutrientes da dieta. Neste sentido, a dieta hiperprotéica émais termogênica que as dietas hiperglicídicas e hiperlipídicas, enquanto que as dietas ricas em carboidrato parecem ser mais termogênicas que as ricas em lipídio, mas os resultados ainda são controversos. Em relação à ingestão calórica, a composição da dieta pode estimular ou inibir a mesma, de acordo com a palatabilidade dos alimentos e o grau de saciação e saciedade, relacionadas às quantidades de carboidrato, proteína e lipídio da mesma. Uma hierarquia tem sido relatada para a capacidade dos macronutrientes em induzir saciedade em que a proteína é o mais sacietógeno ao contrário dos lipidios, que são os menos sacietógenos. De modo geral, ainda há discrepâncias entre os estudos, em relação ao papel regulador dos macronutrientes em componentes do gasto energético e na ingestão calórica, devido às diferenças metodológicas como amostra, tempo de exposição à dieta, densidade calórica e conteúdo calórico total da mesma. Desta forma, o presente trabalho tem como objetivo analisar as evidências científicas mais consistentes a respeito do papel modulador da composição da dieta na termogênese induzida pela dieta e na ingestão calórica, para melhor entendimento da prevenção e controle da obesidade pela intervenção dietética.