Consumption of Food Offered by Delivery Applications (Apps).

This study aimed to investigate whether the use of food delivery applications is related to food consumption practices. METHODS: Data collection was carried out between 5 and 20 June 2020 in a Brazilian capital with a final sample of 2113 individuals. The instrument included questions about socioeconomic characteristics, anthropometric data, and information about eating practices and the use of delivery apps. Logistic regression models were developed with the consumption of each food group as the outcome variable and the use of the application as the exposure variable. RESULTS: Of those interviewed, 78.1% used delivery apps to purchase food. The frequencies of the consumption of foods considered markers of healthy eating were higher for individuals who did not use the applications (59.7% vs. 38.7% for the daily consumption of fresh fruit, respectively, p < 0.0001). The frequencies of the consumption of items considered markers of unhealthy eating were higher for individuals who used apps to purchase food prepared outside the home compared to those who did not (53.7 vs. 38.1 for weekly consumption of hamburgers, respectively, p < 0.0001). CONCLUSION: The use of delivery applications influenced the users' eating practices through the acquisition of food within the digital scope and is related to a greater frequency of the consumption of unhealthy items by users.

Impact of Chemotherapy Regimens on Body Composition of Breast Cancer Women: A Multicenter Study across Four Brazilian Regions.

This study aimed to investigate the effect of chemotherapy (CT) and its different types of regimens on the anthropometry and body composition of women with breast cancer. Three-hundred-and-four women with breast cancer were enrolled in this multicenter study. The participants were evaluated before the infusion of the first cycle of CT (pre-CT), and until two weeks after CT completion (post-CT), regarding body weight, body mass index (BMI); waist circumference (WC); waist-to-height ratio (WHtR); conicity index (C-index); fat mass index (FMI); and fat-free mass index (FFMI). CT regimens were classified as anthracycline-based (AC-doxorubicin or epirubicin); anthracyclines and taxane (ACT); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); or isolated taxanes (paclitaxel or docetaxel). Women significantly increased BMI and FMI post-CT (p < 0.001 and p = 0.007, respectively). The ACT regimen increased FMI (p < 0.001), while FFMI increased after AC (p = 0.007). It is concluded that the CT negatively impacted body composition and the type of regime had a strong influence. The ACT regimen promoted an increase in FMI compared to other regimens, and the AC increased FFMI. These findings reinforce the importance of nutritional monitoring of breast cancer patients throughout the entire CT treatment.

Evaluation of the relationship between nutritional status, levels of physical activity and physical strength in adolescents.

BACKGROUND & AIMS: The study aimed at evaluating the relationship among anthropometric measurements, levels of physical activity and physical fitness in schoolchildren. METHODS: A cross-sectional study was carried out in public schools, with 173 adolescents from 10 to 17 years of age. Socioeconomic data were obtained by a structured questionnaire. Anthropometric measures were assessed and classified according to Body Mass Index (BMI)/age and Waist Circumference (WC). The long version of the International Physical Activity Questionnaire (IPAQ) was used to assess the level of physical activity, while the physical fitness level was assessed using the Projeto Esporte Brasil (PROESP) test protocol. RESULTS: 72,3% of the adolescents were eutrophic and 24.3% were overweight and 22.6% were at high risk for cardiovascular disease, with no statistical difference between the sexes (p > 0.05). 53.8% were physically inactive, regardless of sex and nutritional status. 86.1% of the adolescents showed low physical fitness, more significantly for sit-and-reach andsquare tests of females. BMI was directly correlated with physical fitness in the assessment ofupper limb power and agility (medicine ball throw and square test) and indirectly with aerobic capacity and lower limb power (abdominal resistance, horizontal jump and general resistance). The opposite was observed in the correlation of endurance (abdominal and general) and medicine ball throw with WC. Also, there was a likely visceral obesity and consequent cardiovascular risk in females more than in males. CONCLUSIONS: These findings reinforce the connection between physical activity and the presence of overweight and obesity in adolescents and also the need to effectively intervene in this groupin order to ensure the prevention of chronic non-communicable diseases in adulthood.

Carbon Footprint of Away-From-Home Food Consumption in Brazilian Diet.

Environmentally unsustainable diets are often characterized by being high in calories, processed foods, and red meats, characteristics related to away-from-home food (AFHF). The aim of this study is to evaluate if AFHF consumption is related to environmental sustainability. Data of 20,780 adults from 24 h recalls collected in the 2017-2018 Brazilian National Dietary Survey (NDS) were used to estimate carbon footprint coefficients. The mean carbon footprint was estimated among individuals who consumed AFHF and non-consumers. Linear regression models were used to evaluate differences between away-from-home eating and the carbon footprint of the diet, adjusting for age and income. A total of 41% of Brazilians consumed AFHF during the previous day. The mean carbon footprint from foods consumed away from home represented 18% of the total carbon footprint. AFHF was positively associated with increased total carbon footprint (ß: 204.1; p-value: 0.0145). In conclusion, the consumption of foods away from home in urban areas of Brazil was associated with atmospheric greenhouse gas emissions independently of age and income. Away-from-home food consumption should be considered to reinforce the influence of diet on individual and planet health.

Tumor aggressiveness is associated with cell integrity changes in breast cancer-surviving women: a follow-up study.

INTRODUCTION: Introduction: cell integrity and fat mass had been studied as a prognostic marker for cancer survival. Objective: our aim was to evaluate the association between tumor aggressiveness and cell integrity changes and adiposity in breast cancer (BC) survivors. Methods: women with BC (n = 114) were evaluated at diagnosis and 5 years later. Percentage of lean mass, fat mass, phase angle (PA), resistance (R) and reactance (Xc) were obtained by bioimpedance (450-50 kHz). Plasma leptin was assessed by immunoassay. Changes in body composition were assessed by the paired t-test or Wilcoxon's test. The disease effect associated with the time of diagnosis was assessed by a generalized linear model. Regression models were structured to assess the prevalence ratio between tumor aggressiveness and body composition changes adjusted for age, income, and level of schooling. Results: patients with N+ (p = 0.02) and % Ki67 > 14 (p = 0.00) show a reduction in Xc. Patients with advanced clinical staging (CS) (p = 0.02), tumors > 2 cm (p = 0.01), N+ (p = 0.01), non-luminal tumors (p = 0.02), ER- (p = 0, 00) and PR- (p = 0.02) show a PA reduction, and N+ patients (p = 0.01) show a reduction in leptin during follow-up. Tumors  2 cm (CI: 0.33-0.95; p = 0.03), initial CS (CI: 0.20-0.93; p = .0.03), and luminal tumors (CI: 0.01-0.95; p = 0.04) are related to a lower reduction in PA. Initial CS (CI: 0.00-0.00; p = 0.00) are related to increased leptin. Conclusion: tumor aggressiveness is associated with cell integrity changes in women who are BC survivors.

INTRODUCCIÓN: Introducción: se han estudiado la integridad celular y la masa grasa como marcadores pronósticos de supervivencia al cáncer. Objetivo: nuestro objetivo fue evaluar la asociación entre la agresividad del tumor y los cambios en la integridad celular y la adiposidad en supervivientes de cáncer de mama (CM). Métodos: las mujeres con CM (n = 114) se evaluaron al diagnóstico y 5 años después. El porcentaje de masa magra, masa grasa, ángulo de fase (PA), resistencia (R) y reactancia (Xc) se obtuvo mediante bioimpedancia (450-50 kHz). La leptina plasmática se evaluó mediante inmunoensayo. Los cambios en la composición corporal se evaluaron mediante la prueba de la t pareada o la prueba de Wilcoxon. El efecto de la enfermedad asociado con el momento del diagnóstico se evaluó mediante un modelo lineal generalizado. Los modelos de regresión se estructuraron para evaluar la razón de prevalencia entre la agresividad del tumor y los cambios en la composición corporal ajustados por edad, ingresos y nivel de escolaridad. Resultados: las pacientes con N+ (p = 0,02) y % Ki67 > 14 (p = 0,00) muestran una reducción de Xc. Las pacientes con estadificación clínica (EC) avanzada (p = 0,02), tumores > 2 cm (p = 0,01), N+ (p = 0,01), tumores no luminales (p = 0,02), ER- (p = 0, 00) y PR- (p = 0,02) muestran una reducción de la AP, y los pacientes N+ (p = 0,01) muestran una reducción de la leptina durante el seguimiento. Los tumores  2 cm (IC: 0,33-0,95; p = 0,03), el EC inicial (IC: 0,20-0,93; p = 0,03) y los tumores luminales (IC: 0,01-0,95; p = 0,04) se relacionan con un menor reducción de la PA. Los EC iniciales (IC: 0,00-0,00; p = 0,00) están relacionados con un aumento de leptina. Conclusión: la agresividad del tumor se asocia con cambios en la integridad celular en las mujeres que sobreviven al CM.

Hypertriglyceridemia promotes dysfunctions in high-density lipoprotein increasing the cardiovascular risk

Abstract Hypertriglyceridemia is associated with several metabolic diseases. The triglycerides (TG) disrupt the cholesterol reverse transport and contribute to increased levels of low-density lipoprotein (LDL). High-density lipoprotein (HDL) acts in cholesterol reverse transport as an anti-inflammatory and antioxidant. This study aims to investigate the role of hypertriglyceridemia in the functionality of HDL. Individuals were divided into 4 groups based on high or low HDL-c and triglycerides levels. Biochemical and anthropometric analysis were performed. This study demonstrated that triglycerides promote dysfunctions on HDL, increasing the cardiovascular risk. Blood pressure was higher in subjects with low HDL. Women presented higher levels of HDL-c and low percentage of fat mass. The highest levels of triglycerides were observed in older age. In addition, high levels of triglycerides were associated with higher total cholesterol and LDL-c levels, non-HDL-c, non-esterified fatty acids, and blood glucose, increasing in the ratio of non-HDL-c/HDL-c and ApoB/ApoA-I. The increase of triglycerides levels progressively impairs the antioxidant capacity of HDL, probably due to a higher occurrence of fatty acid peroxidation in individuals with hypertriglyceridemia. Patients with high HDL and low TG levels increased the Lag Time. Furthermore, a positive correlation was found between TG versus HDL particle size, variables that depend on age and anthropometric parameters.

[Inadequacy of macro and micronutrients on offer in two full-time public schools in Northeastern Brazil]. / Inadequação de macro e micronutrientes oferecidos em duas escolas de tempo integral públicas no Nordeste do Brasil.

The National School Food Program guarantees the food of students in public and philanthropic schools by means of the transfer of funds. During adolescence, which is an important period of nutritional vulnerability, a healthy diet is responsible for the rates of physical growth and changes in body composition. The objective was to analyze the adequacy of macro- and micronutrients provided to adolescents in full-time public schools in northeastern Brazil. The menus were evaluated using the parameters to meet 70% of the daily nutritional needs in terms of macronutrients and micronutrients of the students involved. It was found that, for most age groups, energy requirements were not met, attaining the maximum adequacy of 86.2%, and protein ingestion was only sufficient on four days. The average amount of carbohydrates and lipids was below the recommended dose for all age groups. The levels of Vitamin C, zinc and calcium were insufficient in most of the meals on offer, though the iron quota was adequate for all age groups. The conclusion drawn is that enhanced planning needs to be incorporated in the preparation of menus to attempt to attain the requirements stipulated in the Program.

O Programa Nacional de Alimentação Escolar garante por meio da transferência de recursos financeiros a alimentação de alunos em escolas públicas e filantrópicas. Na adolescência, a boa nutrição é influenciada pelas taxas de crescimento físico e de alterações na composição corporal, sendo um período importante de vulnerabilidade nutricional. Objetivou-se analisar a adequação de macro e micronutrientes oferecidos aos adolescentes de escolas públicas de tempo integral no Nordeste do Brasil. Os cardápios foram avaliados utilizando os parâmetros para o atendimento de 70% das necessidades nutricionais diárias de macronutrientes e micronutrientes dos alunos beneficiários. Nota-se que, na maioria das faixas etárias, não houve o atendimento das necessidades energéticas, atingindo o percentual máximo de adequação de 86,2%. Houve adequação de proteínas em quatro dias apenas. O valor médio de carboidratos e lipídios estiveram abaixo do recomendado para todos os grupos etários. Os teores de Vitamina C, zinco e cálcio estiveram abaixo na maioria das preparações oferecidas. A quantidade de ferro foi alcançada em todas as faixas etárias. Conclui-se que deve haver um melhor planejamento na elaboração dos cardápios para tentar alcançar as necessidades previstas pelo Programa.

Inadequação de macro e micronutrientes oferecidos em duas escolas de tempo integral públicas no Nordeste do Brasil / Inadequacy of macro and micronutrients on offer in two full-time public schools in Northeastern Brazil

Resumo O Programa Nacional de Alimentação Escolar garante por meio da transferência de recursos financeiros a alimentação de alunos em escolas públicas e filantrópicas. Na adolescência, a boa nutrição é influenciada pelas taxas de crescimento físico e de alterações na composição corporal, sendo um período importante de vulnerabilidade nutricional. Objetivou-se analisar a adequação de macro e micronutrientes oferecidos aos adolescentes de escolas públicas de tempo integral no Nordeste do Brasil. Os cardápios foram avaliados utilizando os parâmetros para o atendimento de 70% das necessidades nutricionais diárias de macronutrientes e micronutrientes dos alunos beneficiários. Nota-se que, na maioria das faixas etárias, não houve o atendimento das necessidades energéticas, atingindo o percentual máximo de adequação de 86,2%. Houve adequação de proteínas em quatro dias apenas. O valor médio de carboidratos e lipídios estiveram abaixo do recomendado para todos os grupos etários. Os teores de Vitamina C, zinco e cálcio estiveram abaixo na maioria das preparações oferecidas. A quantidade de ferro foi alcançada em todas as faixas etárias. Conclui-se que deve haver um melhor planejamento na elaboração dos cardápios para tentar alcançar as necessidades previstas pelo Programa.

Abstract The National School Food Program guarantees the food of students in public and philanthropic schools by means of the transfer of funds. During adolescence, which is an important period of nutritional vulnerability, a healthy diet is responsible for the rates of physical growth and changes in body composition. The objective was to analyze the adequacy of macro- and micronutrients provided to adolescents in full-time public schools in northeastern Brazil. The menus were evaluated using the parameters to meet 70% of the daily nutritional needs in terms of macronutrients and micronutrients of the students involved. It was found that, for most age groups, energy requirements were not met, attaining the maximum adequacy of 86.2%, and protein ingestion was only sufficient on four days. The average amount of carbohydrates and lipids was below the recommended dose for all age groups. The levels of Vitamin C, zinc and calcium were insufficient in most of the meals on offer, though the iron quota was adequate for all age groups. The conclusion drawn is that enhanced planning needs to be incorporated in the preparation of menus to attempt to attain the requirements stipulated in the Program.

Bioelectrical impedance vector applied to body composition evaluation of women survivors of breast cancer: A longitudinal study.

BACKGROUND AND AIMS: Thus, the aim of this study was to assess the changes in the body composition of the women survivors of breast cancer and its association with clinical staging, using the bioelectrical impedance vector analysis (BIVA), over five years of follow-up. METHODS: At baseline time 114 patients (T0) were selected and after 5 years (T1) of follow-up (n = 35) data of weight, body mass index, waist circumference, phase angle, resistance/height, reactance/height, %fat free mass and %fat mass were monitored. Bioelectrical impedance vector analysis (BIVA) and the vector displacement assessment took place according to the initial and advanced clinical staging (CS 1 and 2, respectively) and time of follow-up and have been showed using mean graph and RXc score graph. RESULTS: Patients on CS 1 showed a reduction in reactance/height, phase angle, %fat free mass and an increase in %fat mass. The same group presented during the follow-up significant vector displacement by mean graph and a change to the 95% ellipse by the RXc score graph. CONCLUSIONS: Women with breast cancer in the initial CS showed a more significant displacement of bioelectric vectors, indicating worsening in body composition.

Consumo de Alimentos Ultraprocessados por Mulheres Sobreviventes do Câncer de Mama / Intake of Ultra-Processed Foods by Women Surviving Breast Cancer / Consumo de Alimentos Ultra Procesados por Mujeres Supervivientes del Cáncer de Mama

Introdução: A elevada prevalência de câncer de mama no Brasil em paralelo ao aumento no consumo de alimentos ultraprocessados sugere relação estreita entre esses fatores.Objetivo: Avaliar o consumo de alimentos ultraprocessados em mulheres sobreviventes do câncer de mama. Método: Estudo transversal com 100 mulheres com câncer de mama acompanhadas em centro de tratamento oncológico. Utilizando um questionário de frequência alimentar, os itens alimentares consumidos foram agrupados em in natura, processados e ultraprocessados, conforme classificação NOVA. A contribuição energética de cada grupo de alimento deu-se pela razão entre caloria proveniente do grupo e caloria total. As pacientes foram categorizadas em elevado e baixo consumo de ultraprocessados e as diferenças entre os dois grupos (variáveis categóricas) foram testadas por X2 de Pearson. A relação entre a ingestão de calorias provenientes de ultraprocessados e a ingestão de energia e de nutrientes específicos foi baseada em modelos de regressão linear brutos e ajustados por idade, escolaridade e índice de massa corporal. Resultados: Das calorias ingeridas pelas pacientes, 27,1% eram de ultraprocessados. As com alto consumo de ultraprocessados tinham menor ingestão de proteínas (p=0,0372) e fibras (p=0,0458) e maior de gordura poli-insaturada (p=0,0019) e sódio (p=0,0068). O consumo de ultraprocessados implicou em menor ingestão de in natura e maior de sódio, gordura total e de suas frações (p<0,05). Conclusão: Mulheres sobreviventes do câncer de mama têm um terço da sua alimentação composto por ultraprocessados associados à redução no consumo de in natura, proteínas e fibras.

Introduction: High prevalence of breast cancer in Brazil along with the increase in intake of ultra-processed foods suggests a narrow relation between these two factors. Objective: To evaluate the intake of ultra-processed foods in women surviving breast cancer. Method: Cross-sectional study with 100 women with breast cancer followed at an oncology treatment center. Based in a food frequency questionnaire, foods items ingested were grouped in in natura, processed and ultra-processed, according to NOVA classification. The energetic contribution of each food group was given by the ratio between calories from the group and total calory. Patients were categorized in high and low intake of ultra-processed and the differences between the two groups (categorical variables) were tested by Pearson's X2test. The relationship between calories intake from ultra-processed foods and the intake of energy and specific nutrients was based inn linear regression models adjusted per age, education and body mass index. Results: Of the calories ingested by the patients, 27.1% were ultra-processed foods. Those with high ingestion of ultra-processed foods had lower intake of protein (p=0.0372) and fibers (p=0.0458) and higher intake of polyunsaturated fat (p=0.0019) and sodium (p=0.0068). The ingestion of ultra-processed foods was related to lower intake of in natura foods and higher intake of sodium, total fat and its fractions (p<0.05). Conclusion: Women who survived breast cancer had one third of their diet formed by ultra-processed foods associated with reduced intake of in natura, proteins and fibers.

Introducción: La elevada prevalencia de cáncer de mama en Brasil ha aumentado junto con el aumento del consumo de alimentos ultraprocesados. Objetivo: Evaluar el consumo de alimentos ultraprocesados de mujeres supervivientes del cáncer de mama. Método: Estudio transversal con 100 mujeres con cáncer de mama asistidas en un centro de tratamiento oncológico. Utilizando un cuestionario de frecuencia alimentaria, se ha dividido los ítems consumidos en naturales, procesados y ultraprocesados según la clasificación NOVA. La contribución energética de cada grupo de alimento se dio por la división entre la caloría del grupo y la total. Se ha categorizado a las pacientes en alto y bajo consumo de ultraprocesados y se ha testado las diferencias entre los dos grupos mediante la prueba de chi-cuadrado. Se ha basado en modelos de regresión lineal ajustados por edad, educación e índice de masa corporal para la relación entre la ingesta de calorías de los alimentos ultraprocesados y de energía y nutrientes específicos Resultados: De las calorías ingeridas por las pacientes, 27,1% fueran de ultraprocesados. Las de alto consumo de ultraprocesados tenían menos ingesta de proteínas (p=0,0372) y fibras (p=0,0458) y mayor ingesta de grasa poli-insaturada (p=0,0019) y sodio (p=0,0068). El consumo de ultraprocesados ha llevado a menos ingesta de alimentos naturales y mayor ingesta de sodio, de grasa total y de sus fracciones (p<0,05). Conclusión:Las mujeres supervivientes del cáncer de mama tuvieron un tercio de su alimentación formado por ultraprocesados asociados a la disminución del consumo de alimentos naturales, proteínas y fibras.

Breast cancer survivors have less lean mass and lower phase angle after cancer treatment / Sobreviventes do câncer de mama tem menos massa magra e menor ângulo de fase após o tratamento oncológico

Objective: To evaluate the weight status and body composition of women who survived breast cancer after cancer treatment. Methods: This is a before and after clinical study, in which 27 breast cancer survivors were evaluated before (T0) and after (T1) cancer treatment (surgical and clinical). Current weight and height were measured to determine the body mass index (BMI). Body composition was assessed by tetrapolar bioelectrical impedance. The percentage of fat and lean mass and the phase angle were calculated. We used Student's t-test to assess the difference among means of anthropometric variables and body composition between T0 and T1, and the McNemar's test to evaluate differences in the prevalence of overweight, adopting a 5% significance. Results: Patients have a mean increase of 2.6 kg in weight after treatment (p=0.00) and 1.15 km/m2 in BMI (p=0.00). The percentage of fat mass increased by 0.6% (p=0.003) in T1, while the lean mass decreased (p=0.03). Concerning the phase angle, the mean decrease is 0.6 (p=0.026) after treatment. Conclusion: Breast cancer survivors have increased adiposity, decreased lean mass, and compromised cell integrity after cancer treatment, suggesting elevated risk factors for disease recurrence.

Objetivo: Avaliar o estado do peso e a composição corporal de mulheres sobreviventes do câncer de mama após tratamento oncológico. Metodologia: Trata-se de estudo clínico do tipo antes e depois, em que 27 pacientes sobreviventes do câncer de mama foram avaliadas antes (T0) e depois (T1) do tratamento oncológico (cirúrgico e clínico). Aferiram-se peso atual e estatura para definição do índice de massa corporal (IMC). A avaliação da composição corporal deu-se por impedância bioelétrica tetrapolar, sendo aferidos percentual de massa gorda e de massa magra e ângulo de fase. Aplicou-se o teste t de Student para avaliar a diferença de médias das variáveis antropométricas e de composição corporal entre T0 e T1, bem como o teste de McNemar para avaliar diferenças na prevalência de sobrepeso, adotando significância de 5%. Resultados: As pacientes têm aumento médio de 2,6 kg após o tratamento (p=0,00) e 1,15 kg/m2 no IMC (p=0,00). O percentual de massa gorda aumenta 0,6% (p=0,003) e há redução na massa magra (p=0,03) no T1. Em relação ao ângulo de fase, há diminuição média de 0,6 (p=0,026) após o tratamento. Conclusão: Mulheres sobreviventes do câncer de mama têm aumento de adiposidade, redução da massa magra e piora da integridade celular após o tratamento oncológico, o que sugere acréscimo de fatores de risco para recidiva da doença.

Plasma and erythrocyte ω-3 and ω-6 fatty acids are associated with multiple inflammatory and oxidative stress biomarkers in breast cancer.

OBJECTIVES: The aim of this study was to assess the association of plasma and erythrocyte ω-3 and ω-6 fatty acids with multiple oxidative stress biomarkers in breast cancer patients. METHODS: Ninety-five women with recently diagnosed breast cancer and no previous treatment were selected for this study. The socioeconomic, clinical, and demographic profile of the patients was determined using a structured questionnaire and medical records. Body weight and height were measured to calculate body mass index. Blood samples were drawn after a 12-h fast for biochemical analyses. The oxidative stress biomarkers low-density lipoprotein (-) and its anti-low-density lipoprotein (-) antibodies, α-tocopherol, ß-carotene, high-density lipoprotein cholesterol, thiobarbituric acid reactive substance, and adiponectin were measured. Plasma and erythrocyte fatty acids were assessed by gas chromatography. Factor and principal component analysis was used to identify three factors called factor 1 (anti-inflammatory), factor 2 (antioxidant), and factor 3 (oxidant). Linear regression, adjusted for confounding variables, was used to estimate the association of these factors with plasma and erythrocyte ω-3 and ω-6 fatty acids and their ratios. RESULTS: ω-3 series fatty acids showed a positive association with Factor 1. A positive association of plasma and erythrocyte ω-6 fatty acids with factors 1 and 2, respectively, was found. ω-6/ω-3 ratio (plasma) was inversely associated with the anti-inflammatory factor. CONCLUSION: Polyunsaturated fatty acids of the plasma and erythrocyte ω-3 and ω-6 series were associated with multiple inflammatory and oxidative stress biomarkers in breast cancer.

Label-Free Proteome Analysis of Plasma from Patients with Breast Cancer: Stage-Specific Protein Expression.

Breast cancer is one of the most commonly diagnosed types of cancer among women. Breast cancer mortality rates remain high probably because its diagnosis is hampered by inaccurate detection methods. Since changes in protein expression as well as modifications in protein glycosylation have been frequently reported in cancer development, the aim of this work was to study the differential expression as well as modifications of glycosylation of proteins from plasma of women with breast cancer at different stages of disease (n = 30) compared to healthy women (n = 10). A proteomics approach was used that depleted albumin and IgG from plasma followed by glycoprotein enrichment using immobilized Moraceae lectin (frutalin)-affinity chromatography and data-independent label-free mass spectrometric analysis. Data are available via ProteomeXchange with identifier PXD003106. As result, 57,016 peptides and 4,175 proteins among all samples were identified. From this, 40 proteins present in unbound (PI-proteins that did not interact with lectin) and bound (PII-proteins that interacted with lectin) fractions were differentially expressed. High levels of apolipoprotein A-II were detected here that were elevated significantly in the early and advanced stages of the disease. Apolipoprotein C-III was detected in both fractions, and its level was increased slightly in the PI fraction of patients with early-stage breast cancer and expressed at higher levels in the PII fraction of patients with early and intermediate stages. Clusterin was present at higher levels in both fractions of patients with early and intermediate stages of breast cancer. Our findings reveal a correlation between alterations in protein glycosylation, lipid metabolism, and the progression of breast cancer.

Influência do tratamento antineoplásico sobre os vetores de bioimpedância elétrica em pacientes com câncer de mama / Influence of Antineoplastic Treatment on Bioelectrical Impedance Vector in Women with Malignant Breast Neoplasm / Influencia del Tratamiento Antineoplásico en la Bioimpedancia Vectorial Eléctrica en Pacientes con Cáncer de Mama

Introdução: A quimioterapia aparece como promotora do aumento no peso e no percentual de gordura, os quais estão em conexão com o desenvolvimento da carcinogênese mamária. Objetivo: Avaliar a influência do tratamento antineoplásico sobre a composição corporal e vetores de impedância bioelétrica em mulheres com neoplasia da mama. Método: Estudo observacional, tipo antes e depois, realizado de março de 2012 a junho de 2013, no Hospital Geral de Fortaleza (Ceará, Brasil), com 30 mulheres com tumor na mama, avaliadas após o diagnóstico e antes do tratamento antineoplásico (M1), e após o tratamento antineoplásico (M2). Coletaram-se dados antropométricos, de composição corporal e valores de resistência (R) e reactância (Xc) para análise vetorial de impedância bioelétrica (BIVA). Resultados: Os percentuais de gordura corporal estiveram acima do recomendado nos dois momentos [M1= 35,6% (4,9) e M2= 35,3% (4,7)] e os valores de massa magra foram, respectivamente, 64,3% (4,9), 64,6% (4,7) sem diferenças significativas. A Reactância (p=0,001) e o ângulo de fase (p=0,000) apresentaram-se diminuídos no M2. Os vetores de impedância, quando comparados M1 e M2, não mostraram deslocamento significativo (p=0,053). Entretanto, ao serem comparados com o vetor médio de uma população de referência, apresentaram deslocamento significativo antes (T2=95,2; p=0,000) e após (T2=53,2; p=0,000) o tratamento antineoplásico, indicando alterações nas propriedades elétricas dos tecidos, retenção hídrica e perda de massa celular. Conclusão: A composição corporal não se alterou após o tratamento antineoplásico. As modificações nos vetores de impedância foram sugestivas de alterações nas propriedades elétricas dos tecidos, indicando pior prognóstico clínico.

Introduction: Chemotherapy appears to promote increased weight and fat percentage, which are in connection with the development of mammary carcinogenesis. Objective: To evaluate the influence of the anti-cancer treatment on body composition and bioelectrical impedance vectors in women with breast cancer. Method: Observational study, both before and after, held from March 2012 to June 2013 at the General Hospital of Fortaleza (Ceará, Brazil), with 30 women with breast tumors, assessed after diagnosis and before the anti-cancer treatment (M1), and after the anticancer treatment (M2). The study collected anthropometric data, body composition and resistance values (R) and reactance (Xc) for vector analysis of bioelectrical impedance (BIVA). Results: The percentage of body fat was above the recommended levels in both instances [M1 = 35.6% (4.9) and M2 = 35.3% (4.7)] and lean body mass values were, respectively, 64 3% (4.9) 64.6% (4.7), without significant differences. The reactance (p=0.001) and the phase angle (p = 0.000) had become reduced in M2. The impedance vectors, when M1 and M2 were compared, showed no significant shift (p=0,053). However, when compared with the mean vector of a reference population, it presented a significant displacement before (T2=95,2; p=0,000) and after (T2=53,2; p=0,000) the antineoplastic treatment, indicating alterations in the electrical properties of the tissue, fluid retention and loss of cell mass. Conclusion: Body composition did not change after the anti-cancer treatment. Changes in impedance vectors were suggestive of changes in the electrical properties of tissue, indicating a poorer clinical prognosis.

Introducción: Quimioterapia promueve el aumento en porcentaje en peso y la grasa corporal que están en conexión con el desarrollo de la carcinogénesis mamaria. Objetivo: Evaluar la influencia del tratamiento antineoplásico en la composición corporal y en la bioimpedancia vectorial eléctrica en mujeres con cáncer de mama. Método: Estudio observacional incluyendo el antes y el después, llevado de marzo de 2012 a junio de 2013 en el Hospital Geral de Fortaleza (Ceará, Brasil), con 30 mujeres con tumores de mama, evaluadas después del diagnóstico y antes del tratamiento antineoplásico (M1) y después del tratamiento antineoplásico (M2). Fueron recogidos los datos antropométricos, la composición corporal y valores de resistencia (R) y de reactancia (Xc) para Análisis de Bioimpedancia Vectorial Eléctrica (BIVA). Resultados: Los porcentajes de grasa corporal estuvieron por encima de los niveles recomendados en ambos momentos [M1=35,6%(4,9) y M2=35,3%(4,7)] y los valores de masa corporal magra fueron, respectivamente, 64,3% (4,9) 64,6% (4,7), sin diferencias significativas. La reactancia (p=0,001) y el ángulo de fase (p=0,000) se redujeron en M2. Los vectores de impedancia cuando se comparan M1 y M2 no mostraron cambio significativo (p = 0,053). Sin embargo, cuando se compara con el vector medio de una población de referencia, dichos vectores mostraron un cambio significativo antes (T2=95,2; p=0,000) y después (T2=53,2; p=0,000) del tratamiento antineoplásico, lo que indica cambios en las propiedades eléctricas del tejido, retención de líquidos y la pérdida de masa celular. Conclusión: La composición corporal no cambió después del tratamiento antineoplásico. Los cambios en los vectores de impedancia son indicadores de los cambios en las propiedades eléctricas de los tejidos, lo que indica un peor pronóstico clínico.

Effect of chemotherapy on dietary glycemic index and load in patients with breast cancer and their relationships to body fat and phase angle.

Dietary glycemic index (GI) and glycemic load (GL) are indicators of carbohydrate consumption and widely used in studies evaluating the risk for breast cancer. However, the effect of chemotherapy on these indices has been scarcely studied. The aim of this study was to evaluate dietary levels of GI and GL in women with breast cancer during chemotherapy treatment and their relationships to body fat and phase angle. Twenty-five patients were assessed according to demographic, clinical, anthropometric, and food consumption data. Dietary intake was assessed by 24-h dietary recalls applied on nonconsecutive days. Anthropometric measures and body composition were determined at all study timepoints: prior to the first chemotherapy cycle (T0), immediately after the last chemotherapy cycle (T1), and 2 months after T1 (T2). There was no difference in mean GI and GL among study timepoints. However, a high prevalence of inadequate GI and GL values was noted, independent of study timepoint. GI and GL were associated with phase angle at T1. GI was associated with percentage fat at T0 only. Dietary GI and GL were unchanged during chemotherapy, but were associated with indicators of clinical outcome, such as percentage fat and phase angle.

Papel da adiposidade sobre a concentração de biomarcadores de oxidação e adipocitocinas na neoplasia maligna da mama / Abdominal obesity and concentration of oxidative markers and adipokines in breast malignant neoplasm

Introdução: A neoplasia maligna da mama é a mais frequentes entre as mulheres, respondendo, no Brasil, por 26,3 por cento de todos os cânceres no sexo feminino e por 14 por cento dos óbitos. Sabe-se que a obesidade é também uma doença crônica, que apresenta um panorama epidemiológico crescente, capaz de modificar as concentrações de hormônios esteroides, hormônios do crescimento, que envolve processos inflamatórios crônicos e de baixa intensidade os quais favorecem a proliferação celular e redução da apoptose. Portanto, é plausível que mulheres com câncer de mama que tenham excesso de peso e adiposidade apresentem maior risco para um prognóstico clínico menos favorável. Objetivo: Avaliar o papel da adiposidade sobre a oxidação e as adipocitocinas na neoplasia mamária. Material e Métodos: Estudo observacional do tipo caso-controle, com 101 mulheres com tumor de mama (Caso) e 100 mulheres sem câncer (Controle), selecionadas no Hospital Geral de Fortaleza (Fortaleza-CE), nos anos de 2011 e 2012. Realizou-se avaliações socioeconômicas, clínica (estado de menopausa, uso de terapia de reposição hormonal-TRH, história reprodutiva, amamentação, tabagismo, sedentarismo e história familiar de câncer; estadiamento clínico (EC), tamanho do tumor e presença de linfonodos comprometidos), antropométrica (peso, índice de massa corporal -IMC, circunferência da cintura - CC) e de composição corporal ( por cento Massa Gorda - por cento MG; por cento Massa Magra - por cento MM; Ângulo de fase - AF) por impedância bioelétrica. Após jejum de 12h obteve-se alíquotas de sangue e a partir do plasma analisou-se marcadores de estresse oxidativo [TBARS; LDL(-); anti-LDL(-); 8-OHdG; vitaminas antioxidantes] e adipocitocinas (leptina e adiponectina).

Introduction: Breast malignant neoplasm is more frequent among women. In Brazil, it corresponds to 26, 3 per cent of all cancers in the female gender and to 14 per cent of the causes of death. It is well known that obesity is also a chronic disease, which presents an increasing epidemiological panorama, capable of modifying the concentrations of steroids hormones, the growth hormones, which involves chronic and low-intensity inflammatory processes, enabling cellular proliferation and the reduction of apoptosis. Therefore, it is plausible that women with breast cancer who are overweight and have adiposity present a higher risk of a less favorable clinical prognosis. Objective: To evaluate the role of adiposity over oxidation and the adipokines on breast neoplasia. Material and Methods: It was an observational study of the case-control type, with 101 women with a breast tumor (Case) and 100 women without cancer (Control), selected at Hospital Geral de Fortaleza (Fortaleza-CE), in the years of 2011 and 2012. Socio-economic evaluations were accomplished, clinic (menopause, use of Hormone Replacement Therapy (HRT), reproductive history, breastfeeding, smoking, sedentarism and family-history of cancer; clinic staging (CS), size of the tumor and presence of affected lymph nodes), anthropometrics (weight, body mass index BMI, waist circumference - WC) and of body composition ( per cent Fat Mass - per cent FM; per cent Lean Mass - per cent LM; Phase Angle - PA) by bioelectrical impedance. After a 12-hour-fasting, blood aliquots were obtained and markers of oxidative stress were analyzed from the plasma [TBARS; LDL(-); ANTI-LDL (-); 8-OHdG, antioxidant vitamins] and adipokines (leptin and adiponectin).

Influência da educação nutricional no conhecimento sobre a relação dieta-doença de mulheres mastectomizadas / Influence of nutrition education in the knowledge of the diet-disease relation of mastectomized women

In this study, we aimed to investigate the influence of educational activities (EAs) in the nutrition knowledge (NK) of women with breast cancer. This is a longitudinal interventional study, with quantitative and qualitative approach, carried out in the Cancer Center of Fortaleza, Ceara state, in the following moments: T0 - Nutritional assessment (NA) and measurement of NK; T1 - Development of Eas; and T2 - NA and measurement of NK after EAs. The sample comprised 11 women. In T0 and T2, weight, height, body mass index (BMI) and waist circumference (WC) were assessed, and NK was measured by the Nutrition Knowledge Scale (NCS). In T1, three EAs were carried out, and through round-table con¬versation, the reports of these women were organized into thematic categories: the origin of breast cancer, attitudes that would prevent the cancer, beliefs about diet-disease relation and conceptions about fibers. The largest portion of the sample (n=6, 54.5%) presented nutritional diagnosis of overweight. There were no significant differences in weight, BMI and WC between times T0 and T2. In T2, we found a significant increase (p<0.05) in the NCS score, where the majority (n=8, 72.7%) began to reveal higher knowledge. The speeches of the participants showed the understanding of important aspects of breast cancer etiology. The NK improved significantly; however, it was not sufficient to modify the nutritional status of these women. Before the reports, we observed that isolated knowledge is not capable of promoting changes in eating behavior, probably because it is influenced by several factors.

El objetivo del trabajo fue investigar la influencia de las actividades educativas (AEs) en los conocimientos sobre nutrición de las mujeres con cáncer de mama. Se trata de un estudio longitudinal y de intervención, cuanti-cualitativo, realizado en un Centro de Oncología de Fortaleza, Ceará, Brasil, en los momentos T0 - Evaluación nutricional y medida del conocimiento nutricional (CN); T1 (desarrollo de AEs) y y T2 - Evaluación nutricional y medición de CN después de las AEs. La muestra estuvo compuesta por 11 mujeres. En los momentos T0 y T2 se evaluaron peso, altura, índice de masa corporal (IMC) y circunferencia de la cintura (CC); el CN fue evaluado por la Escala de Conocimientos sobre Nutrición (ECN). En el momento T1 se realizaron tres AEs y, por medio de ruedas de conversación, se organizaron los testimonios de las mujeres en categorías temáticas: origen del cáncer de mama, actitudes que evitarían la aparición del cáncer, creencias sobre la relación entre dieta-enfermedad y concepciones sobre fibras. La mayor parte de la muestra (n=6; 54,5%) presentó diagnóstico nutricional de sobrepeso. No se encontraron diferencias significativas en peso, IMC y CC entre los momentos T0 y T2. En T2 se encontró un aumento significativo (p<0,05) en la puntuación del ECN, en el que la mayoría (n=8; 72,7%) reveló incrementos en sus conocimientos. Los testimonios de las participantes mostraron una comprensión de los aspectos importantes de la etiología del cáncer de mama. El conocimiento nutricional mejoró significativamente, sin embargo, no fue suficiente para modificar el estado nutricional de las mujeres estudiadas. Frente a los relatos, se constató que, aisladamente, el conocimiento no es capaz de promover cambios en la conducta alimentaria, probablemente porque ésta está influenciada por varios factores.

O objetivo do trabalho foi verificar a influência de atividades educativas (AEs) no conhecimento nutricional de mulheres com neoplasia mamária. Estudo longitudinal e de intervenção, quantiqualitativo, realizado em um Centro de Oncologia em Fortaleza, Ceará, nos momentos: T0 ? Avaliação nutricional e mensuração do conhecimento nutricional (CN); T1 ? Desenvolvimento de AEs, e T2 ? Avaliação nutricional e mensuração do CN após as AEs. Amostra composta por 11 mulheres. Nos momentos T0 e T2, foram avaliados peso, altura, índice de massa corporal (IMC) e circunferência da cintura (CC), sendo o CN mensurado pela Escala deConhecimento Nutricional (ECN). No momento T1, realizaram-se três AEs e, por meio de roda de conversa, os relatos dessas mulheres foramorganizados em categorias temáticas: origem do câncer de mama; atitudes que evitariam o surgimento do câncer; crenças sobre a relaçãodieta-doença e concepções sobre fibras. A maior parcela da amostra (n=6; 54,5%) apresentou diagnóstico nutricional de sobrepeso. Não foramverificadas diferenças significativas de peso, IMC e CC entre os momentos T0 e T2. No T2, verificou-se aumento significativo (p<0,05) no escore da ECN, em que a maioria (n=8; 72,7%) passou a revelar alto conhecimento. As falas das participantes revelaram o entendimento sobre aspectos importantes da etiologia do câncer de mama. O conhecimento nutricional melhorou significativamente; entretanto, não foi suficiente para modificar o estado nutricional dessas mulheres. Diante dos relatos, observou-se que,isoladamente, o conhecimento não é capaz de promover mudanças no comportamento alimentar, provavelmente por este ser influenciado pordiversos fatores.

Conhecimento nutricional de mulheres com câncer de mama e sua relação com o estado nutricional / El conocimiento nutricional de mujeres con cáncer de mama y su relación con el estado nutricional / Nutritional knowledge of women with breast cancer and its relationship with nutritional status

Objetivo: Avaliar o conhecimento nutricional de mulheres com câncer de mama sob a interface dieta-doença e sua relação com o estado nutricional. Métodos: Estudo observacional, transversal e analítico, realizado entre junho e setembro de 2011 com 59 mulheres diagnosticadas com câncer de mama, em tratamento quimio ou radioterápico, maiores de 19 anos, que não receberam orientação nutricional prévia. Não foram incluídas mulheres que fossem vegetarianas ou tivessem finalizado o tratamento há mais de 2 anos. As pacientes eram atendidas num centro oncológico de referência em Fortaleza-CE. Os dados clínicos e socioeconômicos foram coletados mediante entrevista direta e busca em prontuários. A avaliação do conhecimento nutricional (CN) se deu pela aplicação da Escala de Conhecimento Nutricional, desenvolvida pelo National Health Interview Survey Cancer Epidemiology, validada para o Brasil, aplicada por um entrevistador treinado. O estado nutricional foi avaliado através do índice de massa corporal (IMC) e da circunferência da cintura (CC). Os dados foram analisados estatisticamente pelo software SPSS 16.0. Resutados: Entre 59 pacientes avaliadas, 18 (30,5%) apresentaram baixo conhecimento sobre a relação dietadoença. O IMC médio foi 29 kg/m2 (±4,4) e 47 (79,7%) tinham excesso de peso (sobrepeso ou obesidade). Não foi verificada correlação entre conhecimento nutricional e IMC (p=0,64). Os escores de conhecimento nutricional foram semelhantes entre as pacientes com excesso de peso e as eutróficas (p=0,89). Conclusão: As mulheres estudadas apresentaram baixo conhecimento sobre a interface dieta-doença, encontravam-se com excesso de peso, mas não mostraram relação entre conhecimento nutricional e estado nutricional.

Objective: To assess the nutritional knowledge of women with breast cancer on the dietdisease interface and its association with nutritional status. Methods: Observational, crosssectional and analytical study, conducted between June and September 2011, with 59 women diagnosed with breast cancer, undergoing chemotherapy or radiotherapy treatment, older than 19, who did not receive prior nutritional counseling. Vegetarian women or those whose treatment had been completed more than two years prior to the study were not included. The patients were treated at a cancer care reference center, in Fortaleza-CE. Clinical and socioeconomic data was collected through direct interview and searching in medical records. The assessment of nutritional knowledge (NK) was performed with the Nutrition KnowledgeScale, developed by the National Health Interview Survey Cancer Epidemiology, validated for Brazil, applied by a trained interviewer. Nutritional status was assessed through body mass index (BMI) and waist circumference. Data was analyzed statistically by SPSS 16.0. Results: Among 59 patients evaluated, 18 (30.5%) women had a limited knowledge of the diet-disease association. The mean BMI was 29 kg/m2 (± 4.4) and 47 (79.7%) women presented excessive weight (overweight or obesity). There was no correlation between nutritional knowledge and BMI (p = 0.64). Nutrition knowledge scores were similar among patients with overweight and normal weight (p = 0.89). Conclusion: Women in this study had a limited knowledge of the interface between diet and disease, were overweight, but there was no correlation between their nutritional knowledge and nutritional status.

Objetivo: Evaluar el conocimiento nutricional de las mujeres com cáncer de mama sobre el aspecto dieta-enfermedad y su relación con el estado nutricional. Métodos: Estudio observacional, trasversal y analítico, realizado entre junio y septiembre de 2011 con 59 mujeres con el diagnóstico de cáncer de mama, en tratamiento de quimioterapia o radioterapia, mayores de 19 años y que no recibieron orientación nutricional previa. No fueron incluidas las mujeres que eran vegetarianas o que tuvieran finalizado el tratamiento hace más de 2 años. Las pacientes eran atendidas en un centro de oncología de referencia en Fortaleza-CE. Los datos clínicos y socioeconómicos fueron recogidos a través de una entrevista directa y análisis de las historias clínicas. La evaluación del conocimiento nutricional (CN) se dio con La aplicación de la Escala de Conocimiento Nutricional desarrollada por el National Health Interview Survey Cancer Epidemiology validada para Brasil, aplicada por un entrevistador entrenado para ello. El estado nutricional fue evaluado a través del índice de masa corporal (IMC) y de la circunferencia de La cintura (CC). Los datos fueron analizados estadísticamente por El software SPSS 16.0. Resultados: De las 59 pacientes evaluadas, 18 (30,5%) presentaron bajo nivel de conocimiento sobre La relación dieta-enfermedad. El IMC medio fue de 29 kg/m2 (±4,4) y 47 (79,7%) tenían exceso de peso (sobrepeso u obesidad). No se verificó la correlación entre el conocimiento nutricional y el IMC (p=0,64). Las puntuaciones del conocimiento nutricional fueron similares en las pacientes con exceso de peso y las eutróficas (p=0,89). Conclusión: Las mujeres estudiadas presentaron bajo conocimiento sobre la interface dieta-enfermedad, se presentaron con exceso de peso, pero no mostraron relación entre el conocimiento nutricional y el estado nutricional.

Qualidade da dieta de mulheres com câncer de mama e sua relação com o conhecimento nutricional e o estado nutricional / Quality of diet among women with breast cancer and their relation with nutritional knowledge and nutritional status

Objetivos: avaliar a qualidade da dieta de mulheres com câncer de mama e sua relação com conhecimento nutricional e estado nutricional. Métodos: estudo observacional de corte transversal realizado com 58 mulheres com neoplasia mamária acompanhada[s em um centro especializado em tratamento oncológico na cidade de Fortaleza. Foram avaliados: I. perfil socioeconômico e clínico; II. conhecimento nutricional; III. estado nutricional (IMC e circunferência da cintura); e IV. qualidade da dieta. Resultados: a idade variou de 40 a 60 anos, sendo 94,8% (55) com carcinoma ductal, 62,1% (36) em EC III e 34,5% (20) tratadas com quimioterapia associada à radioterapia. A ECN mostrou 7,6 (±2,6), apresentando moderado conhecimento nutricional. O excesso de peso esteve presente em 75,8% (44) das pacientes, e o IMC indicou sobrepeso (29±4,5kg/m²). A CC estava >88cm em 91,4% (53) dos casos, indicando risco cardiovascular associado à obesidade. A média IQD foi 81 (±10,1) pontos, e 95% (55) das pacientes obtiveram valor ±65, sugerindo dieta saudável. O consumo médio de verduras e legumes e de cereais totais foi de 2 (±2,2) e 3,8 (±2) porções, respectivamente. Houve maior prevalência do consumo abaixo do recomendado (Grupo I) para frutas (44,8%; 26); verduras e legumes (82,8%;48); cereais totais (70,7%;41), leite e derivados (62,1%; 36), e na variedade da dieta (75,9%; 44). Houve correlação entre ECN e IQD (p=0,04). Conclusões: o IQD sugeriu qua a maioria das pacientes estaca com dieta saudável. entretanto, o consumo dos componentes alimentares avaliado individualmente por grupos indicou ingestão abaixo do recomendado. A correlação do CN com o IQD avigora a influência da educação nutricional sobre as escolhas alimentares.

Objective: To evaluate the quality of the diet among women with breast cancer and their relation with nutritional knowledge and nutritional state. Method: observational cross-sectional study with 58 women with breast tumor who underwent oncologic treatment in the city of Fortaleza, Ceara, Brazil. The following were evaluated: I. clinical and social economic profile; II. nutritional knowledge; III. nutritional State and IV. quality of the diet. Results: Age ranged between 40 and 60 years; 94.8% (55) with ductal carcinoma; 62.1% in clinical stage III; and 34.5% (20) treated with chemotherapy associated with radiotherapy. NKS presented 7.6 (±2.6), showing moderate nutritional knowledge. Excess weight was present in 75.8% (44) of the patients, and BMI indicated overweight (29±4,5 kg/m²). CW was >88 cm in 91.4% (53) of the cases, indicating cardiovascular risk associated to obesity. The average HEQ was 81 (±10.1) points and 95% (55) had ≥65 score, indicating a healthy diet. The average on vegetables and total grains intake was 2 (±2.2) and 3.8 (±2) portions, respectively. There was a high prevalence of intake below recommended (Group 1) for fruits (44.8%; 26); vegetables (82.8%; 48), total grains (70.7%; 41), milk and dairy products (62.1%; 36) and diet variety (75.9%; 44). There was a correlation between NKS and HIQ (p=0.04). Conclusion: HIQ suggested that the majority of patients had a healthy diet. However, the intake of food components, when evaluated individually per groups, indicated lower ingestion as to what is recommended. Correlation between nutritional knowledge and HIQ reinforced the influence of nutritional education on food choices.

Educação nutricional: uma ferramenta para alimentação saudável / Nutritional education: a tool for healthy feeding

Em 2007, no Brasil, as doenças do aparelho circulatório levaram 308.466 pessoas ao óbito, contribuindo com 31,89% de todas as mortes. Em conjunto, elas representaram uma taxa de 162,9 óbitos por cem mil habitantes. As neoplasias, no ano referido, dentro dos grandes grupos de causas de morte, resultaram numa carga de 159.092 óbitos, contribuíram com 16,7% de todas as mortes e conceberam uma taxa de mortalidade específica de 84,0 óbitos por cem mil habitantes(1). Essas doenças têm importantes fatores de risco, claramente descritos na literatura. Entre eles, encontramos os fatores ambientais como tabagismo,alcoolismo, prática de atividade física e alimentação. Alimentação saudável. Muitos são os conceitos dados ao ato de alimentarse. Quando falamos em alimentação saudável devemos pensar em qualidadee quantidade do que ingerimos. Os alimentos saudáveis têm sido colocados em diferentes mídias como promotores de saúde e os estudos epidemiológicos mostram uma relação inversa entre o consumo de frutas e vegetais, associados à prática de atividade física, com a redução do risco de doenças crônicas, como as cardiovasculares e o câncer(2). O efeito protetor da alimentação inicia-se com as práticas alimentares da infância, com o ato de amamentar e de oferecer uma alimentação equilibrada para as crianças. O consumo alimentar dos pais, certamente é determinante nas escolhas alimentares das crianças e, portanto, responsável pela provável garantia de uma alimentação promotora de saúde. O poder aquisitivo das famílias nem sempre é garantidor de escolhas alimentares saudáveis. Doces, enlatados, embutidos,churrascos refrigerantes são alimentos frequentes no consumo alimentar dos indivíduos, independente do seu poder aquisitivo. Ao contrário, frutas, vegetais, cereais integrais são alimentos de segunda escolha e seu baixo consumo está associado ao aumento do risco de obesidade, câncer, dislipidemias...