Treatment of childhood obesity based on the reduction of ultra-processed foods plus energy restriction: A randomised controlled trial based on the Brazilian guidelines.

Reducing ultra-processed foods (UPF) improves diet quality and may curb energy consumption. This study aimed to compare an intervention based on the reduction of UPF, according to the Dietary Guideline for the Brazilian Population (DGBP), with and without advice on energy intake. A parallel and randomised controlled trial was carried out with children with obesity from 7 to 12 years old. Both control (CG) and intervention groups (IG) participated monthly in 6 standardised educational activities based on the 10 steps of the DGBP. An individualised food plan was also provided to the IG. The rate of change for body mass index (BMI), waist circumference, body weight, and UPF consumption were investigated based on mixed-effect models. At the end of the study, the BMI declined in the IG (Δ = -0.27 kg/m2) compared to the CG (Δ = + 0.53 kg/m2) (p = .0002). Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months. Combining the qualitative approach of the DGBP with counselling on energy restriction through the diet plan proved to be effective in reducing childhood obesity. Clinical Trial Registration: This trial is registered at the Brazilian Registry of Clinical Trials (REBEC), under the RBR-3st5sn registry, available at http://www.ensaiosclinicos.gov.br/rg/RBR-3st5sn/. The datasets generated by the current study are not publicly available but are available from the corresponding author on reasonable request.

Hypocaloric diet with lower meal frequency did not affect weight loss, body composition and insulin responsiveness, but improved lipid profile: a randomized clinical trial.

Dietary approaches are essential to control obesity, but the effectiveness of changes in meal frequency (MF) as a strategy for body weight loss or maintenance remain unclear. This study aimed to evaluate the influence of MF of a hypocaloric diet on weight loss, body composition, active ghrelin levels and metabolic indicators of obese women. This is a randomized, parallel clinical trial, including 40 women divided into two groups that received a hypocaloric diet with different MFs: MF6: six meals per day, and MF3: three meals per day. Dietary, laboratory, anthropometric and body composition indicators were assessed, as well as energy expenditure (EE), before and after the 90 days of the intervention. Dietary consumption did not differ between groups, before or after intervention. The two groups reduced their energy intake after intervention, but there were no differences between the groups. Waist circumference (WC) was reduced and resting metabolic rate had increased in the MF3 group at the end compared to baseline. Moreover, there was a significant difference in the triglyceride levels between groups after intervention, with an important reduction in the MF3 group, although changes in body composition, blood glucose, plasma ghrelin levels and EE variables did not differ between the groups at the end. It is concluded that, the hypocaloric diet with different MF each day did not change weight loss, body composition or insulin responsiveness, but there was an improvement of triglyceridemia in the MF3 group. The present study suggests that eating snacks between meals is not an important factor for weight loss and improvement of metabolic health in women with obesity.

Impact of intermittent fasting on body weight in overweight and obese individuals.

OBJECTIVE: To verify the relationship of intermittent fasting in the bodyweight of overweight and obese individuals through a systematic literature review. METHODS: This is a systematic review based on randomized controlled trials. The articles were consulted in the databases: Science Direct, PubMed e BVS. This review was evaluated through the PRISMA recommendation. RESULTS: After the selection process, four articles were included in this review, comparing intermittent fasting (IF) with calorie restriction diet (CRD) as a control group. In 2 studies using similar protocols, there was no significant reduction in body weight of overweight or obese subjects. In the other two studies using different protocols, weight loss was significant in the IF group compared to the CRD group. CONCLUSIONS: Results did not provide evidence of the effect of intermittent fasting on weight loss in overweight or obese individuals.

The Effects of Physical Activity and Diet Interventions on Body Mass Index in Latin American Children and Adolescents: A Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis is to compare the effect of physical activity only with that of physical activity plus diet interventions on body mass index (BMI) in Latin American children and adolescents. We searched the Medline, Embase, Scopus, Web of Science, and Scielo databases from their inception until March 2020, including studies examining the effect of physical activity or physical activity plus diet interventions on BMI in children and adolescents and based on data from intervention studies. The DerSimonian and Laird method was used to compute a pooled standardized mean difference for BMI in terms of effect size (ES) and respective 95% confidence intervals (CIs). Eighteen studies were included. Analyses were performed based on intervention (four studies were included for physical activity only and four studies were included for physical activity plus diet). In the analysis of physical activity only versus control, there was no effect on BMI (ES = 0.00; 95% CI -0.17-0.17, I2 = 0.0%; p = 0.443). In the analysis of physical activity plus diet versus control, there was a decrease in BMI in favour of the intervention group (ES = -0.28; 95% CI -0.42--0.14, I2 = 74.5%; p = 0.001). When ES was estimated considering only the effect in intervention groups, there was no evidence of a decrease in BMI (ES = -0.17; 95% CI -0.44-0.11, I2 = 84.5%; p < 0.001) for physical activity only (eight studies). However, there was a statistically significant decrease in BMI (ES = -0.30; 95% CI -0.50-0.11, I2 = 95.8%; p < 0.001) for physical activity plus diet (ten studies). Some limitations of this review could compromise our results, but the main limitation that should be stated is the quality of the studies (mainly medium/moderate), especially as physical activity and diet interventions cannot be blinded, compromising the quality of these studies. In summary, this meta-analysis offers evidence that physical activity plus diet interventions produced a reduction in BMI in Latin American children and adolescents, but physical activity only interventions did not.

Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss.

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.

Diet associated with exercise improves baroreflex control of sympathetic nerve activity in metabolic syndrome and sleep apnea patients.

PURPOSE: We tested the hypothesis that (i) diet associated with exercise would improve arterial baroreflex (ABR) control in metabolic syndrome (MetS) patients with and without obstructive sleep apnea (OSA) and (ii) the effects of this intervention would be more pronounced in patients with OSA. METHODS: Forty-six MetS patients without (noOSA) and with OSA (apnea-hypopnea index, AHI > 15 events/h) were allocated to no treatment (control, C) or hypocaloric diet (- 500 kcal/day) associated with exercise (40 min, bicycle exercise, 3 times/week) for 4 months (treatment, T), resulting in four groups: noOSA-C (n = 10), OSA-C (n = 12), noOSA-T (n = 13), and OSA-T (n = 11). Muscle sympathetic nerve activity (MSNA), beat-to-beat BP, and spontaneous arterial baroreflex function of MSNA (ABRMSNA, gain and time delay) were assessed at study entry and end. RESULTS: No significant changes occurred in C groups. In contrast, treatment in both patients with and without OSA led to a significant decrease in weight (P < 0.05) and the number of MetS factors (P = 0.03). AHI declined only in the OSA-T group (31 ± 5 to 17 ± 4 events/h, P < 0.05). Systolic BP decreased in both treatment groups, and diastolic BP decreased significantly only in the noOSA-T group. Treatment decreased MSNA in both groups. Compared with baseline, ABRMSNA gain increased in both OSA-T (13 ± 1 vs. 24 ± 2 a.u./mmHg, P = 0.01) and noOSA-T (27 ± 3 vs. 37 ± 3 a.u./mmHg, P = 0.03) groups. The time delay of ABRMSNA was reduced only in the OSA-T group (4.1 ± 0.2 s vs. 2.8 ± 0.3 s, P = 0.04). CONCLUSIONS: Diet associated with exercise improves baroreflex control of sympathetic nerve activity and MetS components in patients with MetS regardless of OSA.

FTO rs9939609 A allele influences anthropometric outcome in response to dietary intervention, but not in response to physical exercise program.

PURPOSE: The fat mass and obesity-associated (FTO) gene is involved in energy homeostasis. The A allele of the rs9939609 (SNP; T>A) is associated with obesity and higher food intake, while its effect in energy expenditure remains unclear. The aim of this study is to examine whether FTO rs9939609 is associated with the anthropometric outcomes of a physical exercise program and a dietary intervention. METHODS: We studied two independent samples. The first was composed by children and adolescents in which overweight and obese individuals were submitted to a physical exercise program (n = 136) and normal weight participants served as a control group (n = 172). The second sample was composed by obese women submitted to a hypocaloric dietary intervention (n = 126). RESULTS: Physical exercise and dietary intervention were effective, independently of genotype. We found no association of FTO rs9939609 with obesity in children and adolescents (p = 0.67). The rs9939609 affected the response to dietary intervention in obese women: A allele carriers reduced 2.7 cm less of abdominal circumference (AC) than homozygous TT (p = 0.04), while no effect was observed in response to physical exercise in overweight and obese children and adolescents. CONCLUSIONS: The A allele is associated with a worse outcome in response to the hypocaloric dietary intervention regarding abdominal circumference reduction; the same allele did not show interaction with any anthropometric outcomes in response to the exercise program applied.

Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss

OBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.

Orange juice allied to a reduced-calorie diet results in weight loss and ameliorates obesity-related biomarkers: A randomized controlled trial.

OBJECTIVE: Assumptions have linked orange juice (OJ) consumption with weight gain and adverse effects on health due to its sugar content; however, epidemiologic studies have not shown increased risk for overweight or obesity with the consumption of 100% OJ. The aim of this study was to verify whether the combination of a reduced-calorie diet (RCD) and 100% OJ contribute to weight loss, promote changes in glucose and lipid metabolism, and improve diet quality in obese individuals. METHODS: A randomized controlled trial with 78 obese patients (age 36 ± 1 y, body mass index [BMI] 33 ± 3 kg/m2) were enrolled in two groups: Individuals in the OJ group submitted to an RCD that included OJ (500 mL/d), and individuals in the control group submitted to an RCD without OJ. Body composition, biochemical biomarkers, and dietary intake were analyzed over a 12-wk period. RESULTS: Both treatments had similar outcomes regarding body weight (-6.5 kg; P = 0.363), BMI (-2.5 kg/m2; P = 0.34), lean mass (-1 kg; P = 0.29), fat mass (-5 kg; P = 0.58), body fat (-3%; P = 0.15), and waist-to-hip ratio (-0.1; P = 0.79). Insulin levels in the OJ group decreased by 18% (P = 0.05), homeostasis model assessment-insulin resistance by 33% (P = 0.04), total cholesterol by 24% (P = 0.004), low-density lipoprotein cholesterol by 24% (P ≤ 0.001), and high-sensitivity C-reactive protein levels by 33% (P = 0.001) compared with the control group. Consumption of energy and nutrients was similar between the two groups, but vitamin C and folate increased by 62% (P ≤ 0.015) and 39% (P = 0.033), respectively, after OJ intervention. CONCLUSION: When consumed concomitantly with an RCD, OJ does not inhibit weight loss; ameliorate the insulin sensitivity, lipid profile, or inflammatory status, or contribute nutritionally to the quality of the diet.

The excessive caloric intake and micronutrient deficiencies related to obesity after a long-term interdisciplinary therapy.

OBJECTIVE: The aim of this study was to assess the effectiveness of a long-term interdisciplinary lifestyle modification therapy on food intake, body composition, and anthropometric measurements of obese women. METHODS: Seventy obese women (age 41 ± 5.9 y) attended the interdisciplinary therapy, with nutrition, physical exercise, physiotherapy, and psychological support during the course of 1 y. Usual food intake was estimated by 3-d dietary record. Dual-energy x-ray absorptiometry was performed to determine body fat and fat-free mass. Waist and hip circumferences also were measured. Student's t test and Wilcoxon test were used for comparisons among categories; P < 0.05 was considered significant. RESULTS: The assessment of dietary intake showed significant changes after interdisciplinary therapy. A reduction in intake of total calories (18.3%), carbohydrates (15.6%), and total fats (13.1%) was observed. Total micronutrient intake did not change positively after therapy, as the intake level of 16 micronutrients was still lower than recommended. The therapy was effective in reducing significantly body weight (5.9%), body mass index (6.1%), body fat (4.7%), and waist (5.2%) and hip (3.8%) circumferences. CONCLUSIONS: Long-term interdisciplinary therapy was effective in decreasing the intake of calories, carbohydrates, and fats. The therapy positively changed the body composition and reduced anthropometric measurements. However, the intake of some micronutrients after therapy was still significantly lower than recommended. These results demonstrated that the proposed interdisciplinary methodology can be effective in treating obesity; however, the present study reinforced the need to address the micronutrient deficiency in the target population.

The additional effects of a probiotic mix on abdominal adiposity and antioxidant Status: A double-blind, randomized trial.

OBJECTIVE: To investigate whether a probiotic mix has additional effects when compared with an isolated dietary intervention on the body composition, lipid profile, endotoxemia, inflammation, and antioxidant profile. METHODS: Women who had excess weight or obesity were recruited to a randomized, double-blind trial and received a probiotic mix (Lactobacillus acidophilus and casei; Lactococcus lactis; Bifidobacterium bifidum and lactis; 2 × 1010 colony-forming units/day) (n = 21) or placebo (n = 22) for 8 weeks. Both groups received a dietary prescription. Body composition was assessed by anthropometry and dual-energy X-ray absorptiometry. The lipid profile, lipid accumulation product, plasma fatty acids, lipopolysaccharide, interleukin-6, interleukin-10, tumor necrosis factor-α, adiponectin, and the antioxidant enzymes activities were analyzed. RESULTS: In comparison with the dietary intervention group, the dietary intervention + probiotic mix group showed a greater reduction in the waist circumference (-3.40% vs. -5.48%, P = 0.03), waist-height ratio (-3.27% vs. -5.00%, P = 0.02), conicity index (-2.43% vs. -4.09% P = 0.03), and plasma polyunsaturated fatty acids (5.65% vs. -18.63%, P = 0.04) and an increase in the activity of glutathione peroxidase (-16.67% vs. 15.62%, P < 0.01). CONCLUSIONS: Supplementation of a probiotic mix reduced abdominal adiposity and increased antioxidant enzyme activity in a more effective way than an isolated dietary intervention.

Whey Protein Supplementation Enhances Body Fat and Weight Loss in Women Long After Bariatric Surgery: a Randomized Controlled Trial.

BACKGROUND: The ideal nutritional approach for weight regain after bariatric surgery remains unclear. OBJECTIVE: The objective of this study is to assess the effect of whey protein supplementation on weight loss and body composition of women who regained weight 24 or more months after bariatric surgery. METHODS: This is a 16-week open-label, parallel-group, randomized controlled trial of women who regained at least 5 % of their lowest postoperative weight after a Roux-en-Y gastric bypass (RYGB). A total of 34 participants were treated with hypocaloric diet and randomized (1:1) to receive or not supplementation with whey protein, 0.5 g/kg of the ideal body weight. The primary outcomes were changes in body weight, fat free mass (FFM), and fat mass (FM), evaluated by tetrapolar bioelectrical impedance analysis (BIA). Secondary outcomes included resting energy expenditure, blood glucose, lipids, adiponectin, interleukin 6 (IL-6), and cholecystokinin levels. Statistical analyses included generalized estimating equations adjusted for age and physical activity. RESULTS: Fifteen patients in each group were evaluated: mean age was 45 ± 11 years, body mass index (BMI) was 35.7 ± 5.2 kg/m2, and time since surgery was 69 ± 23 months. Protein intake during follow-up increased by approximately 75 % in the intervention group (p = 0.01). The intervention group presented more body weight loss (1.86 kg, p = 0.017), accounted for FM loss (2.78, p = 0.021) and no change in FFM, as compared to controls (gain of 0.42 kg of body weight and 0.6 kg of FM). No differences in secondary outcomes were observed between groups. CONCLUSIONS: Whey protein supplementation promoted body weight and FM loss in women with long-term weight regain following RYGB.

Effects of two diet techniques and delivery mode on weight loss, metabolic profile and food intake of obese adolescents: a fixed diet plan and a calorie-counting diet.

The aim of this study is to compare the weight loss of obese adolescents on two different low-calorie diets: fixed diet plan and calorie-counting diet. This is a randomized clinical study with 66 obese adolescents (body mass index Z score (ZBMI)>+3, 13.7±0.7 years, 60.6% male) with anthropometric, food intake, physical activity, laboratory, body composition and stage of pubertal development data evaluated. There was a reduction in the ZBMI in both groups (P<0.0001), without significant difference between them (P=0.87). There was a significant reduction in insulin, and homeostasis model assessment insulin resistance (HOMA-IR), with no difference between groups. A reduction in total energy intake of the groups was found, with an increase in the proportion of protein and reduction in carbohydrates. In this cohort of severely obese adolescents, fixed diet plan and calorie-counting diet led to a similar reduction of ZBMI, metabolic markers and total energy intake.

Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study.

BACKGROUND: Flaxseed has received attention for its anti-inflammatory and antioxidant role. The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease. METHODS: In a prospective, single blinded 42 days protocol, subjects were allocated into two groups with low carbohydrates intake: GriceLC (35% of carbohydrate and 60g of raw rice powder per day) and GflaxLC (32% of carbohydrate and 60g of flaxseed powder per day). Blood pressure, anthropometric measures and serum levels of isoprostane, C-reactive protein, Tumor Necrosis Factor-alpha, glucose, lipidic profile, uric acid, adiponectin, leptin and insulin were measured at baseline and at the end of interventions. Serum and urinary enterodiol and enterolactione were also measured. RESULTS: A total of 27 men with cardiovascular risk factors were evaluated, with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC. Both groups experienced weight loss and systolic blood pressure reduction. A decrease in inflammatory markers (CRP and TNF-α) was observed after flaxseed intake (mean decrease of 25% and 46% for GflaxLC respectively). All groups also showed improvement in levels of total cholesterol, LDL-c, uric acid and adiponectin. Only GflaxLC group showed a decrease in triglyceride levels. CONCLUSION: This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α. TRIAL REGISTRATION: ClinicalTrials.gov NCT02132728.

Structured hypocaloric diet is more effective than behavioral therapy in reducing metabolic syndrome in Mexican postmenopausal women: a randomized controlled trial.

OBJECTIVE: This study aims to compare the effects of a lifestyle intervention using a behavioral therapy (BT) approach with the effects of a cardioprotective structured hypocaloric diet on metabolic syndrome in Mexican postmenopausal women. METHODS: This study is a randomized clinical trial (2006-2009) of Mexican postmenopausal women with metabolic syndrome (Adult Treatment Panel III criteria) who were recruited from the Postmenopause Clinic of the National Institute of Perinatology in Mexico City. Women were assigned to one of two groups--group 1 (structured hypocaloric diet; n = 63): energy restriction (-300 to -500 kcal/d) emphasizing cardioprotective dietary changes; and group 2 (BT; n = 55): goal setting, problem-solving, and stimulus control to achieve cardioprotective dietary and lifestyle recommendations. Metabolic syndrome prevalence, as well as weight, waist circumference, fat mass, and fasting biochemical markers (glucose and lipid profile), were measured at baseline and at 2, 4, and 6 months after the intervention. Metabolic syndrome risk (relative risk and absolute risk reduction), mean differences between groups, and logistic regression were evaluated using Statistical Package for the Social Sciences software, version 17.0. RESULTS: A total of 118 women were studied (mean [SD] age, 53.81 [6.43] y). No baseline differences were observed between groups. At the end of the study, a higher reduction in metabolic syndrome prevalence was observed in group 1 (-38.1%) compared with group 2 (-12.7%; relative risk, 0.237; 95% CI, 0.092-0.608; P = 0.003). The effect was maintained even when adjusted by age, hormone therapy and antihypertensive drug use. CONCLUSIONS: A cardioprotective structured hypocaloric diet is more effective than the BT approach in reducing metabolic syndrome after 6 months of intervention. Both strategies have positive effects on different individual cardiovascular risk factors.

Meal replacement based on Human Ration modulates metabolic risk factors during body weight loss: a randomized controlled trial.

PURPOSE: A meal replacement may be an effective strategy in the management of obesity to increase antioxidant intake, attenuating oxidative stress and inflammation. In the present study, we investigated the efficacy of a new nutritional supplement to reduce metabolic risk parameters in obese women. METHODS: In a randomized controlled crossover study (2 × 2), 22 women (percentage body fat 40.52 ± 3.75%; body mass index-BMI 28.72 ± 2.87 kg/m²; 35.04 ± 5.6 years old) were allocated into two treatments: hypocaloric diet and drink containing "Human Ration" (HR) consumption (CRHR), and hypocaloric diet and control drink consumption (CR). The study consisted of 2 periods of 5 weeks with 1 week of washout in two orders (CR → CRHR and CRHR → CR). Caloric restriction was 15%, based on estimated energy requirement. Anthropometric, clinical and metabolic risk parameters were assessed at baseline and at the end of each period. RESULTS: Some metabolic risk factors were favorably modulated in both interventions: reduction in body weight (CR -0.74 ± 1.27 kg; p = 0.01; CRHR -0.77 ± 1.3 kg; p = 0.02), body mass index (BMI) (CR -0.27 ± 0.51 kg/m²; p = 0.02; CRHR -0.30 ± 0.52 kg/m²; p = 0.01) and HOMA-IR (CR -0.35 ± 0.82; p = 0.02, CRHR -0.41 ± 0.83; p = 0.03). However, CRHR reduced waist circumference (-2.54 ± 2.74 cm; p < 0.01) and gynoid fat (-0.264 ± 0.28 g; p < 0.01), and increased HDL-c levels (0.08 ± 0.15 mmol/l; p = 0.04). CONCLUSION: Associated with hypocaloric diet, the intake of a nutritional supplement rich in phytochemicals as a breakfast substitute for 5 weeks had no additional effect on weight reduction than caloric restriction alone, but increased central lipolysis and improved the lipoprotein profile.

Fatores determinantes de perda de peso em adultos submetidos a intervenções dietoterápicas / Determinant factors associated with weight loss in adults on diet interventions

OBJETIVO: Analisar os fatores determinantes da perda de peso (> 5%) resultante de atendimento ambulatorial individual. SUJEITOS E MÉTODOS: Estudo de coorte retrospectivo com 318 pacientes com sobrepeso/obesidade em atendimento individual para perder peso. RESULTADOS: Quinze por cento dos pacientes não perderam peso, 35,1% apresentaram perda < 5%, 35,4% entre 5-10% e 13,9% perda > 10%. Os pacientes que perderam > 5% de peso (-7,6 ± 3,3 kg; n = 156) tiveram maior número e menor intervalo entre consultas e maior frequência de atendimentos particulares, acompanhamento por nutricionista e atendimentos multidisciplinares. Ainda, houve neste grupo menor prescrição de medicamentos antiobesidade e o valor calórico total da dieta foi maior do que nos demais pacientes. Em análises multivariadas de regressão de Cox apenas o intervalo entre consultas e o número total de consultas permaneceram inversamente associados à perda de peso. CONCLUSÕES: Os determinantes de perda de peso > 5% foram um menor número de consultas com um menor intervalo entre os atendimentos.

OBJECTIVE: To analyze the determinants for weight loss (> 5%) resulting from outpatient individual appointments. SUBJECTS AND METHODS: A retrospective cohort study was conduct in 318 overweight/obese patients seeking individual care to lose weight. RESULTS: Fifteen percent of the patients did not lose weight; 35.1% had lost < 5%; 35.4% had lost between 5 and 10%; and 13.9% had lost > 10%. Patients who lost > 5% body weight (-7.6 ± 3.3 kg, n = 156) had a greater number of visits at a shorter interval, and greater frequency of visits with a registered dietitian and multidisciplinary care. This group had a lower prescription of anti-obesity drugs and their total calorie intake was higher than the other patients. In multivariate Cox regression, only the interval between appointments and the total number of visits remained inversely associated with weight loss. CONCLUSIONS: The determinants of > 5% weight loss were fewer visits with a shorter interval between appointments.

Prevalence of weight-loss strategies of young adults from the 1982 birth cohort in Pelotas, RS / Prevalencia de estrategias para perder peso de jovens adultos da coorte de nascimentos de 1982 de Pelotas, RS

The objective of this article was to identify, among the members of the 1982 birth cohort in Pelotas, those who were trying to lose weight at the age of 23, and which strategies they used. From 2004 to 2005, 4,297 individuals from the 1982 cohort were interviewed. The effects of demographic, socioeconomic and behavioral factors on the prevalence of any strategy to lose weight in the past year were assessed in a cross-sectional analysis with the Poisson regression. Out of all the youngsters interviewed, 28.5% reported having used some strategy to lose weight. In the adjusted analysis, gender, schooling, family income, body mass index and smoking were associated with the use of some strategy. The strategy used by most of the young people was diet followed by physical activity. The results showed that appropriate preventive measures and body weight control are necessary, along with public policies aimed at encouraging healthy habits among young people, including physical and dietary education.

O objetivo deste artigo é identificar, entre os membros da Coorte de Nascimentos de 1982 de Pelotas, aqueles que estavam tentando perder peso aos 23 anos e quais as estratégias utilizadas por eles. Entre 2004 - 2005, foram entrevistados 4.297 indivíduos da Coorte de 1982. Os efeitos das variáveis demográficas, socioeconômicas e comportamentais sobre a prevalência do uso de estratégia para emagrecer no último ano foram analisados em uma análise transversal utilizando regressão de Poisson. Do total de jovens entrevistados, 28,5% referiram ter utilizado alguma estratégia para perder peso. Na análise ajustada o sexo, a escolaridade, a renda familiar, o índice de massa corporal e o tabagismo estiveram associados ao uso de alguma estratégia, sendo que a mais utilizada pela maioria dos jovens foi dieta seguida de exercício físico. Os resultados mostraram que medidas adequadas de prevenção e de controle do peso corporal são necessárias, com políticas públicas voltadas para a população jovem, incentivando hábitos saudáveis como atividade física e educação alimentar.

[Determinant factors associated with weight loss in adults on diet interventions]. / Fatores determinantes de perda de peso em adultos submetidos a intervenções dietoterápicas.

OBJECTIVE: To analyze the determinants for weight loss (> 5%) resulting from outpatient individual appointments. SUBJECTS AND METHODS: A retrospective cohort study was conduct in 318 overweight/obese patients seeking individual care to lose weight. RESULTS: Fifteen percent of the patients did not lose weight; 35.1% had lost < 5%; 35.4% had lost between 5 and 10%; and 13.9% had lost > 10%. Patients who lost > 5% body weight (-7.6 ± 3.3 kg, n = 156) had a greater number of visits at a shorter interval, and greater frequency of visits with a registered dietitian and multidisciplinary care. This group had a lower prescription of anti-obesity drugs and their total calorie intake was higher than the other patients. In multivariate Cox regression, only the interval between appointments and the total number of visits remained inversely associated with weight loss. CONCLUSIONS: The determinants of > 5% weight loss were fewer visits with a shorter interval between appointments.