Eating behaviour among nutrition students and social desirability as a confounder.

INTRODUCTION: The study of eating behaviour should consider the presence of potential sources of bias, including social desirability. This is particularly relevant among students of Nutrition Sciences, since they have a higher risk of eating disorders. OBJECTIVE: To analyse the effect of social desirability in the assessment of eating behaviour dimensions among nutrition students. METHODS: In this cross-sectional study, we analysed data from 149 students of Nutrition Sciences. Participants completed a questionnaire assessing social desirability and eating behaviour dimensions (emotional, external and binge eating, flexible and rigid control, and eating self-efficacy). RESULTS: Among males, social desirability had a negative association with binge eating, while among women it had a negative association with emotional, external and binge eating and a positive association with eating self-efficacy. In both subsamples, social desirability showed no significant association with any of the two types of dietary restraint (rigid and flexible control). DISCUSSION: Overall, the association between social desirability and eating behaviour dimensions among students of Nutrition Sciences occurs in the same direction as found in students from other areas. However, alongside these similarities, there is a stronger association between social desirability and binge eating among male students of Nutrition Sciences. We hypothesize that this may be related with the different knowledge of students from different areas, and the way they perceive and face the treatment of eating disorders. CONCLUSION: Our study shows that social desirability should be considered while assessing eating behaviour among nutrition students, particularly when studying external eating, binge eating and eating self-efficacy. Moreover, when tailoring interventions to reduce the possible effects of eating behaviour on nutritionists and dieticians' practice, we should consider the influence of social desirability.

General and abdominal adiposity in a representative sample of Portuguese adults: dependency of measures and socio-demographic factors' influence.

The aims of this study were: (i) to estimate the dependency between BMI and waist:height ratio (WHtR) as measures of general and abdominal adiposity, and (ii) to evaluate the influence of socio-demographic factors on both measures and on their dependency in risk classification. Data from a cross-sectional study conducted in 2009 among a representative sample of 3529 Portuguese adults were used. Height, weight and waist were measured and socio-demographic data (sex, age, education level, occupational status, marital status, region of residence) were obtained. Using logistic regression, crude and adjusted OR for high general (BMI≥25·0 kg/m²) and abdominal (WHtR≥0·5) adiposity, and for incompatible classification between them, were calculated. Above half (50·8%) of the respondents had high BMI and 42·1% had high WHtR, and the rates were higher in men than in women. There was an inverse association between education level and both adiposity measures. The lowest prevalence of high general and abdominal adiposity was observed in students and singles, whereas the highest was found in retired, widowed and respondents from Azores, Madeira and Alentejo. Nearly a quarter of respondents (24·0%) were incompatibly classified by BMI and WHtR, with higher prevalence in men than in women and in low- than in high-educated people. Future surveys should focus on developing at least sex-specific cut-offs for both measures. Implementation of effective strategies for preventing and reducing high adiposity levels in Portugal should be directed primarily to men, older, low-educated individuals, as well as those living in the islands and poor regions of the country.

Fibroblast growth factor 23 is associated with left ventricular hypertrophy, not with uremic vasculopathy in peritoneal dialysis patients.

AIMS: Cardiovascular (CV) events are the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD), including those patients on peritoneal dialysis (PD). Fibroblast growth factor 23 (FGF23) has been associated with left ventricular hypertrophy (LVH) and mortality in patients with CKD. However, the role of FGF23 in uremic vasculopathy remains unclear. In this study, we aimed to assess the relationship between FGF23 and LVH, endothelial dysfunction, vascular calcification, and arterial stiffness in 48 stable PD patients. METHODS: Left ventricular mass index (LVMI) was assessed using 2-D echocardiography. Intact FGF23 blood levels were evaluated using an ELISA kit (Immutopics, Inc., San Clemente, CA, USA). Reactive hyperemia index (RHI) is a surrogate marker of endothelial dysfunction and the augmentation index (AI) is a surrogate marker of arterial stiffness. Both were assessed using peripheral arterial tonometry (EndoPAT 2000). Vascular calcification (VC) was assessed using the Adragão score. RESULTS: In unadjusted analysis; FGF23 was positively correlated with serum Pi (r = 0.487, p < 0.001), serum urea (r = 0.351, p = 0.015), serum creatinine (r = 0.535, p < 0.001), dialysis vintage (r = 0.309, p = 0.033), and LVMI (r = 0.369, p = 0.027) and was negatively correlated with age (r = -0.343, p = 0.017), residual renal function (r = -0.359, p < 0.012), and AI (r = -0.304, p = 0.038). In multivariate adjusted analysis, FGF23 was associated with LVMI (ß = 0.298, p = 0.041), serum Pi (ß = 0.345, p = 0.018), and age (ß = -0.372, p = 0.007) independent of dialysis vintage, gender, residual renal function (RRF), albumin, C-reactive protein and systolic blood pressure. There were no associations found between FGF23 and RHI, AI, or VC in multivariable- adjusted models. CONCLUSIONS: Our results show that FGF23 is associated with LVH but not with endothelial dysfunction, arterial stiffness, or vascular calcification in PD patients.

Eating behaviour among undergraduate students. Comparing nutrition students with other courses.

Our main aim was to compare eating behaviour between Portuguese undergraduate nutrition students and students attending other courses. Several eating behaviour dimensions were compared between 154 nutrition students and 263 students from other areas. Emotional and external eating were assessed by the Dutch Eating Behavior Questionnaire, dietary restraint was measured using the flexible and rigid control of eating behaviour subscales, binge eating was measured using the Binge Eating Scale, and eating self-efficacy using the General Eating Self-Efficacy Scale. Higher levels of flexible and rigid control were found in nutrition students from both sexes when compared to students from other courses. Female nutrition students also presented higher binge eating levels than their colleagues from other courses. To our knowledge no other work has previously assessed all eating behaviour dimensions considered in the current study among nutrition students. Besides the results by themselves, the data obtained from this study provide several clues to further studies to be developed regarding the still rarely approached issue of eating behaviour among nutrition students.

Chrononutrition, eating behaviour, and metabolic health among obese patients elected for bariatric surgery.

There is evidence of the impact of chrononutrition on weight loss and metabolic control. However, the precise chrononutrition behaviours that promote these benefits are not fully described, and there are doubts if chrononutrition may be related to other eating behaviour features. The main aim was to evaluate the associations between chrononutrition and eating behaviour, and their relationships with anthropometric and biochemical parameters among obese patients elected for bariatric surgery. Eighty participants (76.3% females, mean age = 45 years, mean BMI = 41.6 kg/m2) attending bariatric surgery consultations at Centro Hospitalar Universitário de São João (Porto, Portugal) were assessed regarding chrononutrition (Chrononutrition Profile - Questionnaire) and eating behaviour (Three-Factor Eating Questionnaire - R21 and General Eating Self-Efficacy Scale). Height, weight, waist circumference, and biochemical values (total, HDL and LDL cholesterol, triglycerides and glycated haemoglobin) were collected. Eating window midpoint was positively correlated with uncontrolled eating and negatively with eating self-efficacy. Sleep duration and midpoint on free days negatively correlated with eating self-efficacy, mainly due to later waking times, supporting that predominantly later energy consumption may negatively impact eating behaviour.

Eating behaviour patterns and BMI in Portuguese higher education students.

Our aim was to determine prototypical patterns of eating behaviour among Portuguese higher education students, and to relate these patterns with BMI. Data from 280 higher education students (63.2% females) aged between 18 and 27 years were analysed. Several eating behaviour dimensions (emotional and external eating, flexible and rigid restraint, binge eating, and eating self-efficacy) were assessed, and eating styles were derived through cluster analysis. BMI for current, desired and maximum self-reported weights and the differences between desired and current BMI and between maximum and current BMI were calculated. Women scored higher in emotional eating and restraint, whereas men showed higher eating self-efficacy. Men had higher current, desired and maximum BMI. Cluster analysis showed three eating styles in both male and female subsamples: "Overeating", "High self-efficacy" and "High restraint". High self-efficacy women showed lower BMI values than the others, and restrictive women had higher lost BMI. High self-efficacy men showed lower desired BMI than overeaters, and lower maximum and lost BMI than highly restrictive ones. Restrictive women and men differ on important eating behaviour features, which may be the cause of differences in the associations with BMI. Eating self-efficacy seems to be a central variable influencing the relationships between other eating behaviour dimensions and BMI.

Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme.

The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7-9 years (≥ 85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7-9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.

Prevalence of overweight and obesity among 7-9-year-old children in Aveiro, Portugal: comparison between IOTF and CDC references.

OBJECTIVE: To estimate the prevalence of overweight and obesity in schoolchildren from Aveiro, Portugal, according to two criteria: the International Obesity Task Force (IOTF) and the US Centers for Disease Control and Prevention (CDC) cut-offs. DESIGN: Weight, height and waist circumference were measured. Using the BMI, gender- and age-specific prevalences of overweight and obesity were determined according to the IOTF cut-offs extrapolated from an adult BMI of 25 and 30 kg/m2 and the CDC cut-off values of 85th and 95th BMI percentile. SETTING: Aveiro, Portugal. SUBJECTS: A random representative sample of 905 children (457 boys; 448 girls) aged 7-9 years. RESULTS: The prevalence of excess weight (overweight and obesity) was lowest according to IOTF cut-offs compared to CDC (28.1 % v. 31.2 %), especially obesity (8.1 % v. 14.0 %). However, the CDC and IOTF criteria have a strong agreement (Cohen's k = 0.755; P < 0.001). There were significant differences in excess weight between boys and girls according to the CDC (26.9 % v. 35.7 %; P = 0.003). Obese children are younger and the majority present abdominal obesity. CONCLUSIONS: The present study shows a high prevalence of excess weight in Aveiro children, similar to other Portuguese regions and among the highest in Europe, especially in the female gender. The IOTF cut-off values give a lower prevalence of excess weight, namely obesity.

Gut microbiota changes after metabolic surgery in adult diabetic patients with mild obesity: a randomised controlled trial.

BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery is one of the most efficient procedures for the treatment of obesity, also improving metabolic and inflammatory status, in patients with mild obesity. The underlying mechanisms have not been fully understood, but gut microbiota is hypothesized to play a key role. Our aim was to evaluate the association between gut microbiota changes and anthropometric, metabolic and inflammatory profiles after metabolic surgery compared with medical therapy, in type 2 diabetic (T2DM) adults with mild obesity (BMI 30-35 kg/m2). METHODS: DM2 was an open-label, randomised controlled clinical trial (RCT: ISRCTN53984585) with 2 arms: (i) surgical, and (ii) medical. The main outcome was gut microbiota changes after: metabolic surgery (Roux-en-Y gastric bypass-RYGB) versus standard medical therapy. Secondary outcomes included anthropometric, metabolic and inflammatory profiles. Clinical visits, blood workup, and stool samples were collected at baseline and months (M)1, 3, 6, 12. Gut microbiota was profiled using 16S rRNA targeted sequencing. RESULTS: Twenty patients were included: 10 in surgical and 10 in medical arm. Anthropometric and metabolic comparative analysis favoured RYGB over medical arm. At M12, the percentage of weight loss was 25.5 vs. 4.9% (p < 0.001) and HbA1c was 6.2 vs. 7.7% (p < 0.001) respectively. We observed a continuous increase of genus richness after RYGB up until M12. In the medical arm, genus richness ended-up being significantly lower at M12. Composition analysis indicated significant changes of the overall microbial ecosystem (permanova p = 0.004, [R2 = 0.17]) during the follow-up period after RYGB. There was a strong association between improvement of anthropometric/metabolic/inflammatory biomarkers and increase in microbial richness and Proteobacterial lineages. CONCLUSIONS: This was the first RCT studying composite clinical, analytic, and microbiome changes in T2DM patients with class 1 obesity after RYGB versus standard medical therapy. The remarkable phenotypic improvement after surgery occurred concomitantly with changes in the gut microbiome, but at a lower level. TRIAL REGISTRATION: ISRCTN53984585.

Which Factors Are Associated with a Higher Prevalence of Anemia Following Bariatric Surgery? Results from a Retrospective Study Involving 1999 Patients.

INTRODUCTION: Anemia in obese patients is common and multifactorial and is also a complication of bariatric surgery. The aim of this study is to establish which variables are associated with a higher prevalence of post-bariatric surgery anemia. METHODS: Retrospective cohort study involving 1999 patients submitted to bariatric surgery with a follow-up period of 4 years. Anthropometric, laboratorial parameters and the presence of comorbidities were evaluated before surgery and during follow-up. Patients were divided into two groups, according to whether they developed anemia, or not. Groups were compared using independent sample T-tests or Chi-squared tests, as appropriate. Univariate binary logistic regression models were used to test the association between the diagnosis of anemia during follow-up and all the possible explanatory variables. Independent variables with an association with the outcome (p < 0.1) were included in multivariate binary logistic regression models, as well as possible confounders (age, BMI, and supplementation). RESULTS: Anemia was diagnosed in 24.4% of the patients. Females present a two-fold increased risk of developing anemia (OR 2.11, 95% CI 1.48-3.01, p < 0.001). Patients subjected to gastric sleeve and gastric band surgery present approximately half the risk of anemia when compared with gastric bypass surgery (RYGB) (OR 0.46, 95% CI 0.35-0.59, p < 0.001; OR 0.51, 95% CI 0.36-0.72, p < 0.001). None of the other variables evaluated showed association with the outcome. CONCLUSION: In our study, the only factors associated with an increased risk of developing anemia were female gender and RYBG surgery. Prospective studies evaluating the risk factors for anemia in patients undergoing bariatric surgery are needed.

Evolution of body composition of obese patients undergoing bariatric surgery.

BACKGROUND & AIMS: Bariatric surgery is increasingly common in the fight against morbid obesity. However, after this intervention, it is not fully understood the evolution of weight loss and how body composition changes. The objective of this work is to study the evolution after surgery of weight and body composition of obese patients that underwent bariatric surgery. METHODS: In this retrospective and prospective study, we studied initially BMI and body composition of obese patients who attended nutritional appointments at Centro Hospitalar São João E.P.E. We collected personal data and anthropometric measurements between the pre-surgery appointment up to 60 months after surgery. RESULTS: The sample consisted of 793 patients, of which 86.5% were female and 13.5% were male, with a mean age of 43 years (SD = 10.5 years) and mean height of 1.62 m (SD = 0.079 m). Patients undergoing gastric band, sleeve gastrectomy and gastric bypass had, respectively, an initial BMI reduction of 6.3 kg/m2, 13.2 kg/m2 and 15.4 kg/m2 and an initial fat mass% reduction of 4.4%, 14.3% and 17.3%. On the other hand, they had an initial increase of 3.2%, 10.8% and 12.4% of water%, 1.4%, 3.9% and 4.6% of fat and water-free mass%, and 1.9%, 7.3% and 8.9% of skeletal muscle mass%, respectively. BMI and fat mass% on average had a large decrease in the first 12 months, increasing slightly from 24 months onwards. The opposite behaviour was observed for water%, fat and water-free mass% and skeletal muscle mass%. CONCLUSIONS: Bariatric surgery initially allows a substantial decrease in BMI as well as beneficial changes in the overall body composition of the individuals. Gastric bypass was the method that caused the most changes, followed by sleeve gastrectomy and, finally, gastric band. On average, after 24 months of follow-up, and for all surgical procedures studied, we observed a reversion in BMI and body composition values, showing the difficulties in maintaining weight and fat loss.

Psychopathological correlates of eating behavior among Portuguese undergraduate students.

OBJECTIVES: The aim of this study was to explore the relationships between eating behavior dimensions and psychopathological symptoms among Portuguese undergraduate students. METHODS: We studied 258 participants (62.4% women) regarding eating behavior dimensions (emotional, external and binge eating, flexible and rigid control of eating behavior, and eating self-efficacy), psychopathological distress (as assessed by the Brief Symptom Inventory), and body mass index. In addition to studying bivariate associations between eating behavior dimensions and psychopathological subscales and indexes, what we believe to be a novel analytical approach, considering simultaneously the effects of the overall level of psychopathological distress and the relevance of specific symptoms on the eating behavior dimensions. RESULTS: Emotional, external, and binge eating had positive correlations with psychopathological symptomatology, whereas eating self-efficacy was negatively associated. CONCLUSIONS: Multivariate analysis showed that the overall level of psychopathological distress (combined with body mass index, among women) had a larger effect on eating behavior than the relevance of specific symptoms.

Phase Angle Predicts Arterial Stiffness and Vascular Calcification in Peritoneal Dialysis Patients.

OBJECTIVES: Fluid overload (FO) is frequently present in peritoneal dialysis (PD) patients and is associated with markers of malnutrition, inflammation, and atherosclerosis/calcification (MIAC) syndrome. We examined the relationships in stable PD patients between phase angle (PhA) and the spectrum of uremic vasculopathy including vascular calcification and arterial stiffness and between PhA and changes in serum fetuin-A levels. METHODS: Sixty-one stable adult PD patients were evaluated in a cross-sectional study (ST1). Phase angle was measured by multifrequency bioimpedance analysis (InbodyS10, Biospace, Korea) at 50 kHz. Augmentation index (AI), a surrogate marker of arterial stiffness, was assessed by digital pulse amplitude tonometry (Endo PAT, Itamar Medical, Caesarea, Israel). Vascular calcification was assessed by simplified calcification score (SCS). Serum fetuin-A levels were measured by ELISA (Thermo scientific; Waltham, MA, USA). Serum albumin was used as a nutritional marker, and serum C-reactive protein (CRP) was used as an inflammatory marker. The same assessments were carried out longitudinally (ST2) in the first 33 patients who completed 1 year of evaluation in ST1. RESULTS: In ST1, patients with PhA < 6° had higher CRP levels, AI, and SCS and lower serum albumin and fetuin-A levels, in comparison with patients with PhA ≥ 6°. In addition, PhA was a predictor of both AI (ß = -0.351, p = 0.023) and SCS ≥ 3 (EXP (B) = 0.243, p = 0.005). In ST2, the increase of PhA over time was associated with decreases in both AI (r = -0.378, p = 0.042) and CRP levels (r = -0.426, p = 0.021), as well as with the increase in serum fetuin-A levels (r = 0.411, p = 0.030). CONCLUSIONS: Phase angle predicts both arterial stiffness and vascular calcification in stable PD patients.

Eating behavior in Portuguese higher education students: the effect of social desirability.

OBJECTIVES: The aim of this study was to relate social desirability with eating behavior dimensions among higher education students in Portugal, and to assess the effect of social desirability on the association between pairs of eating behavior dimensions. METHODS: Data from 266 higher education students (62.8% women) aged between 18 and 27 y were evaluated. Social desirability and several eating behavior dimensions (emotional and external eating, flexible and rigid restraint, binge eating, and eating self-efficacy) were assessed. RESULTS: In both women and men, social desirability showed negative associations with emotional, external, and binge eating, and positive associations with eating self-efficacy. For the majority of the correlations, the control for social desirability led to a decrease in the strength of the association: Social desirability showed a greater effect on the associations between external and binge eating, external eating and eating self-efficacy, binge eating and eating self-efficacy, and emotional and external eating. CONCLUSION: This study demonstrated that social desirability should be considered when assessing the dimensions of eating behavior, namely eating self-efficacy and dimensions related to overeating.

Obesity and metabolic syndrome in 7-9 years-old Portuguese schoolchildren.

BACKGROUND: Body fat is related to changes in lipid profile, blood pressure and metabolism of insulin and glucose, known as the metabolic syndrome (MS). The aim of this study was to estimate the prevalence of metabolic syndrome (MS) and its components among overweight and obese Portuguese schoolchildren, and to identify associated clinical and biochemical characteristics. METHODS: A total of 82 children (14 overweight and 68 obese; 40 boys and 42 girls) aged 7-9 years, underwent anthropometric measurements. A blood sample was obtained to assess biochemical parameters. Insulin resistance (IR) was determined by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). MS was defined by the National Cholesterol Education Program Adult Treatment Panel III criteria modified by Cook. RESULTS: The prevalence of MS was 15.8%. Abdominal obesity was present in all children. Frequency of elevated blood pressure, low HDL-cholesterol and elevated triglyceride concentrations were 62.6%, 13.4% and 11.0%, respectively. None of the children presented impaired fasting glucose, however hyperinsulinemia (7.3%) and IR (8.5%) were observed. The number of components of MS was higher in children with higher z-BMI (rho = 0.411; p < 0.001). MS was associated with higher leptin concentrations. No association was found with adiponectin or ghrelin levels. Leptin correlated positively with obesity, glucose metabolism, lipid profile, hepatic function and C-reactive protein, and negatively with HDL and Apolipoprotein A-I/B ratio. CONCLUSIONS: This study shows a significant prevalence of MS among obese schoolchildren. Abdominal obesity and elevated blood pressure were the most frequent components of this syndrome. Dyslipidemia, IR and high levels of leptin were also associated with MS in this young group.

[Nitrogen balance assessment in burn patients]. / Avaliação do balanço azotado no doente queimado.

INTRODUCTION: The burn injury probably represents the largest stimulus for muscle protein catabolism. This state is characterized by an accelerated catabolism of the lean or skeletal mass that results in a clinical negative balance of nitrogen and muscle wasting. The determination of an appropriate value for protein intake is essential, since it is positively related to the nitrogen balance (NB) and accordingly several authors argue that a positive NB is the key parameter associated with nutritional improvement of a burn patient. OBJECTIVES: Evaluation of the degree of protein catabolism by assessment of the Nitrogen Balance; Defining of nutritional support (protein needs) to implement in patients with burned surface area (BSA) = 10%. METHODS: We prospectively evaluated the clinical files and scrutinized the clinical variables of interest. The NB was estimated according to three formulae. Each gram of nitrogen calculated by the NB was then converted into grams of protein, subtracted or added to protein intake (or administered enteric or parenterically) and divided by kg of reference Weight (kg Rweight), in an attempt to estimate the daily protein needs. RESULTS: The cohort consisted of 10 patients, 6 females, with average age of 58(23) years old, a mean of BSA of 21.4(8.4)%, ranging from a minimum of 10.0% and máximum of 35.0%. On average, patients were 58 (23) years old. The average number of days of hospitalization in the burn unit was 64.8(36.5) days. We observed significant differences between the 3 methods used for calculating the NB (p = 0.004), on average the NB was positive. When the formula A was used the average value of NB was higher. Regarding the attempt to estimate the needs of g prot/kg Rweight/day most of the values did not exceed, on average, 2.6 g Prot/kg Rweight/day and no significant differences between patients with a BSA% of 10-20% and with BSA% > 20% were found. CONCLUSION: Despite being able to estimate the protein catabolism through these formulas and verifying that most values were above zero, wide individual fluctuations were visible over time. Based on the sample reference that recommends a value of 1.5-2 g Prot/kg Rweight/day, we can conclude it to be underestimated, when comparing with the mean value of 2.6 g Prot/kg Rweight/day we established.

Modulation of nutritional state in Parkinsonian patients with bilateral subthalamic nucleus stimulation.

Chronic bilateral subthalamic stimulation (DBS-STN) provides considerable clinical benefits in Parkinson disease patients, with improvement in primary symptoms and resolution of side effects of chronic pharmacological treatment. Apart from its therapeutic effects on PD symptoms, DBS-STN also appears to induce weight gain, which may itself induce critical metabolic disorders and limit the benefits of surgery. No data are available in literature showing the efficacy of a nutritional intervention to prevent rapid and/or excessive weight gain after DBSSTN. Fifty-seven PD patients were included in this study and were divided into two groups: Group 1 comprised 16 patients with a nutritional intervention immediately after surgery (1 week after); Group 2 comprised 41 patients with a nutritional intervention in a later period after surgery (mean time of 2.5 ± 1.6 years). Weight, body mass index (BMI), percentage of fat mass, levodopa daily dose (LDD) and part III of the Unified Parkinson's disease rating scale (UPDRS) were studied before and after an individualized and structured nutritional intervention. Three months after nutritional intervention, Group 1 had a mean BMI (24.1 ± 2.99), that was not significantly different (p = 0.114) from BMI before intervention, with stability of the weight and in percentage of fat mass. In Group 2 all the patients gained weight, reaching to 13.17 ± 10%; a total of 63% of patients became overweight (BMI 25 kg/m(2)). Three months after nutritional intervention, Group 2 had a mean BMI (24.80 ± 2.45) that was significantly (p = 0.03) different from BMI before intervention (26.75 ± 2.99), although percentage of fat mass was higher in women. With this study, we have conclude that nutritional intervention adequate to patient-age, disease characteristics, medical therapy with L-dopa and physical activity, is effective incontrolling weight after DBS-STN surgery.

[Prevalence of the metabolic syndrome: comparison between ATPIII and IDF criteria in a feminine population with severe obesity]. / Prevalência da sindrome metabólica: comparação entre os critérios ATPIII e IDF numa população feminina com obesidade.

INTRODUCTION: The metabolic syndrome (MS) consists of the conjoint presence of risk factors for coronary. Several study groups have developed diagnostic criteria for MS, standing out those from the "Adult Treatment Panel III" (ATPIII), due to their wide utilization. Recently, the International Diabetes Federation (IDF) developed new diagnostic criteria for MS. OBJECTIVES: To evaluate the prevalence of MS in a group of women with severe obesity. To evaluate the prevalence of each one of the diagnostic criteria for MS. To compare the results obtained with the utilization of the ATPIII and the IDF criteria. To relate the results with the patients' age and Body Mass Index (BMI). SAMPLE AND METHODS: We evaluated 128 women (mean age = 38 years, sd = 11) with BMI equal to or higher than 35.0 kg/m2 (mean BMI = 46.5 kg/m2, sd = 6.5) on anthropometric measures (weight, height and waist circumference), analytically (fasting serum levels of triglycerides, HDL cholesterol and glucose), being also registered the values of systolic and diastolic blood pressure and age. RESULTS: The prevalence of MS in our sample following the ATPIII and the IDF criteria was, respectively, of 66.4% e 70.3%. The most frequently filled in criteria are those referring to waist circumference (ATPIII: 99.2%; IDF: 100%), blood pressure (77.3%) and HDL cholesterol (69.5%). Older patients and those with higher BMI fill in more criteria, being the diagnostic of MS associated to higher mean age and BMI. CONCLUSION: The prevalence of MS in women with severe obesity is high, being similar when the ATPIII or the IDF diagnostic criteria are used.

[Circadian energy intake evaluation of a group of office workers in Porto]. / Avaliação da ingestão energética circadiana: num grupo de trabalhadores da segurança social do Porto.

The importance of food in health promotion and disease prevention is well known. The aims of our study were to evaluate the daily energy intake of an adult group; to study the association of a 24 hour recall (R24h) and a Food Frequency Questionnaire (FFQ); to analyse energy intake variation with obesity and to verify if our sample had an ingestion according to DRI's. We studied a convenience sample of Portuguese adult population of 154 office workers (121 women), with a mean of ages of 44.2 +/- 12.1 years. We used a self administered FFQ and a R24h to evaluate food habits. Middle number of meals was 4.8 +/- 1.0 meals (breakfast, lunch and dinner were the most frequent). Middle daily ingestion was 1908 +/- 559 kcal. Men had a superior energy intake at all meals, except at afternoon snack and supper. We did not find any relation between BMI and food intake, BMI is only related with age. We compared our sample ingestion with DRI's and verified that vitamins B1, B2, B12, B6, C, niacin, Fe and P, were totally reached, and the inverse was obtained in Zn, folate, vitamin D and E, pantothenic acid and biotin. We conclude that our sample ingestion of protein is higher than the recommended, carbohydrates is less consume than the recommended and only recommendations of fat and alcohol consumption were in agreement with WHO recommendations.