Comparative analysis of approaches for assessing energy intake underreporting by female bariatric surgery candidates.

OBJECTIVE: To test six variations in the Goldberg equation for evaluating the underreporting of energy intake (EI) among obese women on the waiting list for bariatric surgery, considering variations in resting metabolic rate (RMR), physical activity, and food intake levels in group and individual approaches. METHODS: One hundred obese women aged 20 to 45 years (33.3 ± 6.08) recruited from a bariatric surgery waiting list participated in the study. Underreporting assessment was based on the difference between reported energy intake, indirect calorimetry measurements and RMR (rEI:RMR), which is compatible with the predicted physical activity level (PAL). Six approaches were used for defining the cutoff points. The approaches took into account variances in the components of the rEI:RMR = PAL equation as a function of the assumed PAL, sample size (n), and measured or estimated RMR. RESULTS: The underreporting percentage varied from 55% to 97%, depending on the approach used for generating the cutoff points. The ratio rEI:RMR and estimated PAL of the sample were significantly different (p = 0.001). Sixty-one percent of the women reported an EI lower than their RMR. The PAL variable significantly affected the cutoff point, leading to different proportions of underreporting. The RMR measured or estimated in the equation did not result in differences in the proportion of underreporting. The individual approach was less sensitive than the group approach. CONCLUSION: RMR did not interfere in underreporting estimates. However, PAL variations were responsible for significant differences in cutoff point. Thus, PAL should be considered when estimating underreporting, and even though the individual approach is less sensitive than the group approach, it may be a useful tool for clinical practice.

Accuracy of visceral adiposity indices and lipid accumulation products in the identification of adults at high cardiovascular risk.

INTRODUCTION: The lipid accumulation product (LAP) and visceral adipose index (VAI) are clinical markers of visceral obesity and were proposed as simple tools to estimate cardiovascular risk and mortality. The objective of this study was to analyze the accuracy of the VAI and LAP for high cardiovascular risk patients. METHODS: A cross-sectional observational study of accuracy was carried out in 193 patients of both sexes. In addition to the variables VAI and LAP, presence of comorbidities, education, level of physical activity and anthropometric data were obtained. Cardiovascular risk was determined by the Framingham score. RESULTS: No significant difference was observed in the sample in gender distribution (44.6% women; 55.4% men), 24.4% had low cardiovascular risk, 48.7% intermediate risk and 26.9% high cardiovascular risk. Linear regression analysis showed that VAI and LAP explain, respectively, only 2.4% and 5.2% of the variation in cardiovascular risk expressed by the Framingham score. The analysis of areas under the curve (AUC) for receiver operating characteristic (ROC) indicated a significant effect only of LAP to diagnose individuals with high cardiovascular risk, but with low sensitivity and specificity. CONCLUSION: Our results indicate that VAI and LAP explain only a small percentage of the variation in the Framingham cardiovascular risk score. LAP index still deserves more attention in a cohort study, because, even with the limitations of a cross-sectional study, we observed an acceptable sensitivity for it so that the LAP can be used as a screening criterion for requesting more accurate tests.

Comparação entre as necessidadesenergéticas prescritas e administradasa pacientes em terapianutricional enteral / Comparison of the energy needs a prescribed andadministered enteral nutrition therapy in patients

Objetivo: comparar a adequação, prescrição e oferta energética da terapia de nutrição enteral em pacientes hospitalizados. Metodologia: foi realizado um levantamento retrospectivo do protocolo de evolução de TNE de 59 pacientes hospitalizados em um hospital geral da cidade de Marília/SP/BR. Os dados coletados incluíram: sexo, idade, diagnóstico clínico, dados antropométricos e dietéticos referentes a fórmula dietética prescrita, via e método de administração da nutrição enteral, o volume diário prescrito e o administrado da mesma, valor diário de energia prescrito e ofertado da dieta, assim como as intercorrências. Para avaliar o estado nutricional dos pacientes utilizou-se o índice de massa corporal(IMC), dobra cutânea tricipital (DCT) e circunferência muscular do braço (CMB). A adequação da TNE foi avaliada com base na necessidade energética diária comparada com o valor energético médio recebido diariamente durante o período de uso da TNE...

Objective: evaluating the adequacy, prescription and energy supply of enteral nutrition therapy in hospitalized patients. Methods: was performed a retrospective survey of the evolution of TNE protocol of 59 patients hospitalized in a general hospital in Marília / SP / BR. Data collected included gender, age, clinical diagnosis, anthropometric and dietary data related to the prescribed dietary formula, route and method of administration of the enteral nutrition, the daily volume prescribed and administered, the daily amount of energy required and offered in the diet, as well as possible complications. Body mass index(BMI), triceps skinfold (TSF) and arm muscle circumference (AMC) were used to establish the nutritionalstatus of the patients. The adequacy of ENT was done according to the daily energy requirement comparedto the average energy received during the daily use of ENT...

Papel dos ácidos graxos ômega 3 naresolução dos processos inflamatórios / Omega 3 fatty acid and the resolution of inflammatory processes

A inflamação é uma resposta de defesa do organismo ao trauma ou a infecções por microorganismos. Na fase de término da inflamação e retorno à homeostase ocorrem mecanismos de regulação chamados de resolução onde há alternância de prostaglandinas pró-inflamatórias e leucotrienos a mediadores pró-resolução, produzidos a partir de ácidos graxos poliinsaturados ω3 (ácido eicosapentanóico e ácido docosapentanóico). A dieta interfere na composição de ácidos graxos das membranas celulares que serão metabolizados em compostos ativos chamados de resolvinas, protectinas e maresinas. Como as doenças inflamatórias têm papel importante na saúde pública o estudo destas substâncias e o delineamento de seus efeitos podem trazer novos horizontes no tratamento das doenças inflamatórias, com redução de custos e minimização de efeitos colaterais.

Inflammation is a defensive response to the trauma, infections or injury to the organism. When inflammation is ending occurs a program for active regulation called the resolution. This is accompanied by a class of lipid mediators where there is alternation of pro-inflammatory prostaglandins and leukotrienes to proresolution mediators, produced from 3 polyunsaturated fatty acids (eicosapentaenoic and docosapentanoicacid). The diet interferes the fatty acid composition of cell membranes that will be metabolized to active compounds called resolvins, protectins and maresins. The inflammatory diseases have an important rolein public health, so the study of these substances and delineation of their effects can bring new horizons in the treatment of inflammatory diseases, reducing costs and minimizing side effects.