RESUMEN
BACKGROUND: Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. OBJECTIVE: To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). METHODS: Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. RESULTS: 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). CONCLUSIONS: Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals.
FUNDAMENTO: Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. OBJETIVO: Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). MÉTODOS: Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. RESULTADOS: Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). CONCLUSÕES: A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos.
Asunto(s)
Enfermedades Cardiovasculares , Humanos , Masculino , Femenino , Enfermedades Cardiovasculares/prevención & control , Brasil , Estudios Transversales , Persona de Mediana Edad , Anciano , Política Nutricional , Estado Nutricional , Dieta/normas , Factores Socioeconómicos , Factores Sexuales , Registros de DietaRESUMEN
BACKGROUND AND AIM: Increased consumption of ultra-processed foods has been linked to both mortality and cardiovascular risk. Copeptin levels may serve as potential risk markers for cardiovascular death and events. This cross-sectional analysis seeks to assess the potential correlation between the intake of ultra-processed foods and copeptin levels in outpatients diagnosed with type 2 diabetes, based on estimates of cardiovascular risk. METHODS AND RESULTS: Outpatients underwent clinical and nutritional assessments. Dietary information was gathered using a validated quantitative food frequency questionnaire, and the consumption of all foods, beverages, and food products was assessed according to the NOVA food classification system. Fasting plasma-EDTA samples were collected and preserved at -80 °C. Plasma copeptin measurements were analyzed using an enzyme-linked immunosorbent assay based on the competition principle. Participants were categorized into two groups: high risk and very high risk, based on cardiovascular risk calculated by the HEARTS calculator. A total of 190 participants were included in the evaluation, with an average age of 60 ± 9 years, glycated hemoglobin of 8.4 ± 1.4%, and a diabetes duration of 11 (5-19) years. Patients at a very high cardiovascular risk exhibited higher plasma copeptin levels compared to those at high cardiovascular risk. Notably, 92.1% of patients reported consuming more than 10% of total energy intake from ultra-processed foods, although this proportion did not differ between the two groups. CONCLUSION: This patient sample reported elevated consumption of ultra-processed foods; nevertheless, the correlation between ultra-processed foods and plasma copeptin has not been substantiated.
Asunto(s)
Biomarcadores , Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Glicopéptidos , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Estudios Transversales , Glicopéptidos/sangre , Persona de Mediana Edad , Masculino , Femenino , Anciano , Biomarcadores/sangre , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/etiología , Medición de Riesgo , Comida Rápida/efectos adversos , Evaluación Nutricional , Factores de Riesgo , Ingestión de AlimentosRESUMEN
BACKGROUND: An individual's dietary pattern contributes in different ways to the prevention and control of recurrent cardiovascular events. However, the quality of the diet is influenced by several factors. The present study aimed to evaluate the quality of the diet of individuals with cardiovascular diseases and determine whether there is an association between sociodemographic and lifestyle factors. METHODS: This is a cross-sectional study carried out with individuals with atherosclerosis (coronary artery disease, cerebrovascular disease or peripheral arterial disease) recruited from 35 reference centres for the treatment of cardiovascular disease in Brazil. Diet quality was assessed according to the Modified Alternative Healthy Eating Index (mAHEI) and stratified into tertiles. For comparing two groups, the Mann-Whitney or Pearson's chi-squared tests were used. However, for comparing three or more groups, analysis of variance or Kruskal-Wallis was used. For the confounding analysis, a multinomial regression model was used. p < 0.05 was considered statistically significant. RESULTS: In total, 2360 individuals were evaluated: 58.5% male and 64.2% elderly. The median (interquartile range [IQR]) of the mAHEI was 24.0 (20.0-30.0), ranging from 0.4 to 56.0 points. When comparing the odds ratios (ORs) for the low (first tertile) and medium (second tertile) diet quality groups with the high-quality group (third tertile), it was observed that there was an association between diet quality with a family income of 1.885 (95% confidence intervals [CI] = 1.302-2.729) and 1.566 (95% CI = 1.097-2.235), as well as physical activity of 1.391 (95% CI = 1.107-1.749) and 1.346 (95% CI = 1.086-1.667), respectively. In addition, associations were observed between diet quality and region of residence. CONCLUSIONS: A low-quality diet was associated with family income, sedentarism and geographical area. These data are extremely relevant to assist in coping with cardiovascular disease because they enable an assessment of the distribution of these factors in different regions of the country.
Asunto(s)
Enfermedades Cardiovasculares , Humanos , Masculino , Anciano , Femenino , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Brasil , Estudios Transversales , Dieta , Dieta SaludableRESUMEN
BACKGROUND: An individual's dietary pattern contributes in different ways to the prevention and control of recurrent cardiovascular events. However, the quality of the diet is influenced by several factors. The present study aimed to evaluate the quality of the diet of individuals with cardiovascular diseases and determine whether there is an association between sociodemographic and lifestyle factors. METHODS: This is a cross-sectional study carried out with individuals with atherosclerosis (coronary artery disease, cerebrovascular disease or peripheral arterial disease) recruited from 35 reference centres for the treatment of cardiovascular disease in Brazil. Diet quality was assessed according to the Modified Alternative Healthy Eating Index (mAHEI) and stratified into tertiles. For comparing two groups, the Mann-Whitney or Pearson's chi-squared tests were used. However, for comparing three or more groups, analysis of variance or Kruskal-Wallis was used. For the confounding analysis, a multinomial regression model was used. p < 0.05 was considered statistically significant. RESULTS: In total, 2360 individuals were evaluated: 58.5% male and 64.2% elderly. The median (interquartile range [IQR]) of the mAHEI was 24.0 (20.0-30.0), ranging from 0.4 to 56.0 points. When comparing the odds ratios (ORs) for the low (first tertile) and medium (second tertile) diet quality groups with the high-quality group (third tertile), it was observed that there was an association between diet quality with a family income of 1.885 (95% confidence intervals [CI] = 1.302-2.729) and 1.566 (95% CI = 1.097-2.235), as well as physical activity of 1.391 (95% CI = 1.107-1.749) and 1.346 (95% CI = 1.086-1.667), respectively. In addition, associations were observed between diet quality and region of residence. CONCLUSIONS: A low-quality diet was associated with family income, sedentarism and geographical area. These data are extremely relevant to assist in coping with cardiovascular disease because they enable an assessment of the distribution of these factors in different regions of the country.
Asunto(s)
Enfermedades Cardiovasculares , Dieta , Brasil , AterosclerosisRESUMEN
Background: Diabetes mellitus (DM) is associated with a higher prevalence of metabolic syndrome (MS) and cardiovascular mortality. However, few Brazilian studies evaluated MS in diabetic individuals with cardiovascular disease (CVD). Nevertheless, the objective of this study was to compare the prevalence of MS in cardiac patients with and without DM. Methods: Cross-sectional study of BALANCE Program Trial with patients with CVD, ≥45 years old, who had been attending specialized ambulatories on cardiovascular health, in eight states in the Northeast of Brazil. The components of MS were evaluated by following the criteria of National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) and Joint Interim Statement (JIS). In addition, there were investigated different indexes of abdominal obesity, variables related to lifestyle, and food intake. The statistical analysis included descriptive statistics and the Student's t-test, Mann-Whitney, and chi-squared tests for the comparison of groups. There were significant values of P < 0.05. Results: Six hundred forty-seven individuals were evaluated with average (standard deviation) age of 63.1 (9.3) years, being 50.5% females and 40.3% diabetic patients. When the groups of patients who were diabetic and the nondiabetic ones, the first showed higher percentage of obesity (38.5% vs. 23.2%, P < 0.001), of high waist circumference (84.8% vs. 71.9%; P < 0.001), higher waist-height ratio [0.6 (0.6-0.7) vs. 0.6 (0.5-0.6); P < 0.001], conicity index [1.35 (1.29-1.39) vs. 1.32 (1.27-1.38); P = 0.004], and prevalence of MS, because of the criteria of NCEP ATP III (98.8% vs. 80.4%; P < 0.001), as well as the criteria of JIS (99.2% vs. 89.3%; P < 0.001). The component of higher frequency was high blood pressure and/or hypertension (95.0%), followed by hypertriglyceridemia (93.0%). There were no differences regarding age, lifestyle, and food intake. Conclusions: Diabetic individuals with CVD showed more prevalence of MS and more abdominal obesity than nondiabetic individuals. ClinicalTrials.gov ID: NCT01620398.
Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus , Síndrome Metabólico , Anciano , Brasil/epidemiología , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Masculino , Síndrome Metabólico/epidemiología , Persona de Mediana EdadRESUMEN
INTRODUCTION: Among the non-pharmacologic measures for the prevention and treatment of cardiovascular diseases (CVD), which are the first cause of death worldwide, the adequate intake of dietary fibers (DF) has shown an important role. OBJECTIVE: To evaluate the association between the intake of DF and the cardio-metabolic risk factors in individuals on a secondary prevention for CVD. METHODS: Transversal study with basal data of the study's DICA Br participants belonging to collaborative centers in the states of Maranhão (MA), Bahia (BA) and Rio de Janeiro (RJ). Sociodemographic and clinical data were used, as well as the daily intake of DF in individuals of both sexes, with age ≥ 45 years and manifest evidence of arteriosclerosis. The association between the intake of dietary fibers and the cardio-metabolic risk factors was obtained through Poisson's regression model. RESULTS: With 141 evaluated individuals, high frequency of non-appropriateness of DF intake was observed. The participants in the centers of RJ (PR = 0.63; CI 95% = 0.49-0.80) and BA (PR = 0.79; CI 95% = 0.66-0.95), former smokers (PR = 0.59; CI 95% = 0.45-0.78) and non-smokers (PR = 0.62; CI 95% = 0.66-0.95) had fewer chances of having non appropriate intake of DF. On the other hand, overweight individuals showed 28.0% more chances of non-appropriate intake of DF. CONCLUSION: Results showed that the majority of the observed population presented non-appropriate intake of DF and that this low intake was significantly associated with overweight, smoking and location of the collaborative center.
Asunto(s)
Enfermedades Cardiovasculares/dietoterapia , Enfermedades Cardiovasculares/prevención & control , Fibras de la Dieta , Enfermedades Metabólicas/dietoterapia , Enfermedades Metabólicas/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Encuestas sobre Dietas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Prevención Secundaria , Fumar , Factores SocioeconómicosRESUMEN
Introduction: Among the non-pharmacologic measures for the prevention and treatment of cardiovascular diseases (CVD), which are the first cause of death worldwide, the adequate intake of dietary fibers (DF) has shown an important role. Objective: To evaluate the association between the intake of DF and the cardio-metabolic risk factors in individuals on a secondary prevention for CVD. Methods: Transversal study with basal data of the studys DICA Br participants belonging to collaborative centers in the states of Maranhão (MA), Bahia (BA) and Rio de Janeiro (RJ). Sociodemographic and clinical data were used, as well as the daily intake of DF in individuals of both sexes, with age ≥ 45 years and manifest evidence of arteriosclerosis. The association between the intake of dietary fibers and the cardio-metabolic risk factors was obtained through Poissons regression model. Results: With 141 evaluated individuals, high frequency of non-appropriateness of DF intake was observed. The participants in the centers of RJ (PR = 0.63; CI 95% = 0.49-0.80) and BA (PR = 0.79; CI 95% = 0.66-0.95), former smokers (PR = 0.59; CI 95% = 0.45-0.78) and non-smokers (PR = 0.62; CI 95% = 0.66-0.95) had fewer chances of having non appropriate intake of DF. On the other hand, overweight individuals showed 28.0% more chances of non-appropriate intake of DF. Conclusion: Results showed that the majority of the observed population presented non-appropriate intake of DF and that this low intake was significantly associated with overweight, smoking and location of the collaborative center (AU)
Introducción: entre las medidas no farmacológicas para la prevención y el tratamiento de enfermedades cardiovasculares (ECV), que representan la principal causa de muerte en el mundo, la ingesta adecuada de fibra dietética (FD) ha mostrado desempeñar un papel importante. Objetivo: evaluar la asociación entre el consumo de FD y los factores de riesgo cardiometabólico en pacientes en prevención secundaria de ECV. Métodos: estudio transversal con datos de referencia de los participantes en el estudio DICA Br pertenecientes a los centros examinadores en los estados de Maranhão (MA), Bahía (BA) y Río de Janeiro (RJ). Se utilizaron medidas sociodemográficas, clínicas, conductuales, antropométricas y el consumo diario de FD de individuos de ambos sexos, con edades ≥ 45 años y manifiesta evidencia de aterosclerosis. La asociación entre en el consumo de FD y los factores de riesgo cardiometabólico se obtuvo por el modelo de regresión de Poisson. Resultados: fueron evaluados 141 sujetos y se observó alta frecuencia de consumo insuficiente de FA. Los participantes de los centros de RJ (RP = 0,63; IC 95% = 0,49-0,80), BA (RP = 0,79; IC 95%: 0,66-0,95), los ex fumadores (RP = 0,59; IC 95% = 0,78-0,45) y los no fumadores (OR = 0,62; IC 95%: 0,66-0,95) eran menos propensos a tener un consumo insuficiente FD. Las personas con sobrepeso mostraron un 28,0% más de probabilidades de tener una ingesta inadecuada de FD. Conclusión: los resultados indicaron que la mayoría de la población observada presentaba una ingesta inadecuada de FD y que el consumo bajo se asoció significativamente con el sobrepeso, el tabaquismo y el centro de desarrollo (AU)
Asunto(s)
Humanos , Fibras de la Dieta , Síndrome Metabólico/dietoterapia , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Prevención Secundaria/métodos , Estudios Transversales/métodos , Antropometría/métodos , Distribución de Poisson , Sobrepeso/complicacionesRESUMEN
Considering the controversies existent on the subject, the aim of this review is to discuss adherence to diet in obese adolescents. The selection of articles was made in the SCOPUS, COCHRANE, APA Psyc Net, SciELO, LILACS, CAPES Journals, PUBMED/MEDLINE and GOOGLE ACADEMIC databases. Studies published between 2002 and 2012 were selected. There was lack of evidence of conceptual discussion about adherence to diet in obesity in the child-youth context, in addition to scarcity of data on adherence to diet itself in obese adolescents and the methods of evaluating this. Lastly, multiple interdependent factors were found which both facilitated and made the process of adherence to diet difficult for obese youngsters. The majority of these (factors) belong to the socioeconomic and cultural dimension, in addition to pointing out cognitive and psychological factors and those associated with health services and professionals (AU)
Considerando las actuales controversias sobre el tema, el objetivo de esta revisión es discutir la adhesión a la dieta en adolescentes obesos. Los artículos publicados entre 2002 y 2012 fueron seleccionados en las siguientes basis de datos SCOPUS, COCHRANE, APA Psyc Net, SciELO, LILACS, Revistas CAPES, PubMed/MEDLINE y GOOGLE ACADÉMICO. Observa-se ausencia de discusión conceptual sobre el tema, así como escasez de datos sobre adherencia a la dieta en adolescentes obesos y de métodos de evaluación para aferir esta adherencia. Por último, fueron identificados varios factores ínter-dependientes que facilitan y obstaculizan la adhesión a la dieta en jóvenes obesos. La mayoría de estas dimensiones se refieren a los factores socio-económicos y culturales, además de los cognitivos, psicológicos y aquellos relacionados con los servicios de salud y los profesionales (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Obesidad/dietoterapia , Dieta Reductora , Cooperación del Paciente/estadística & datos numéricos , Evaluación de Resultados de Intervenciones Terapéuticas , Factores de Riesgo , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Factores Socioeconómicos , Factores CulturalesRESUMEN
Considering the controversies existent on the subject, the aim of this review is to discuss adherence to diet in obese adolescents. The selection of articles was made in the SCOPUS, COCHRANE, APA Psyc Net, SciELO, LILACS, CAPES Journals, PUBMED/MEDLINE and GOOGLE ACADEMIC databases. Studies published between 2002 and 2012 were selected. There was lack of evidence of conceptual discussion about adherence to diet in obesity in the child-youth context, in addition to scarcity of data on adherence to diet itself in obese adolescents and the methods of evaluating this. Lastly, multiple interdependent factors were found which both facilitated and made the process of adherence to diet difficult for obese youngsters. The majority of these (factors) belong to the socioeconomic and cultural dimension, in addition to pointing out cognitive and psychological factors and those associated with health services and professionals.
Considerando las actuales controversias sobre el tema, el objetivo de esta revisión es discutir la adhesión a la dieta en adolescentes obesos. Los artículos publicados entre 2002 y 2012 fueron seleccionados en las siguientes basis de datos SCOPUS, COCHRANE, APA Psyc Net, SciELO, LILACS, Revistas CAPES, PubMed/MEDLINE y GOOGLE ACADÉMICO. Observa-se ausencia de discusión conceptual sobre el tema, así como escasez de datos sobre adherencia a la dieta en adolescentes obesos y de métodos de evaluación para aferir esta adherencia. Por último, fueron identificados varios factores ínter-dependientes que facilitan y obstaculizan la adhesión a la dieta en jóvenes obesos. La mayoría de estas dimensiones se refieren a los factores socio-económicos y culturales, además de los cognitivos, psicológicos y aquellos relacionados con los servicios de salud y los profesionales.
Asunto(s)
Cooperación del Paciente , Obesidad Infantil/dietoterapia , Adolescente , Niño , Dieta , Humanos , Obesidad Infantil/psicología , Factores SocioeconómicosRESUMEN
BACKGROUND: Postprandial lipemia (PL) in adults has been extensively studied, but little explored in youth. The aim of this study was to evaluate the influence of weight excess on postprandial lipemia in adolescents. METHODS: Eighty-three adolescents were classified into Groups 1 (n= 49, overweight) and 2 (n=34, eutrophic). Total cholesterol (TC), triglycerides (TG), HDL and LDL cholesterol were measured before, 2 and 4 hours after a standardized 25 g lipid and 25 g of carbohydrate test meal; glycemia and insulin measured only at baseline. Anthropometric evaluation was performed. RESULTS: Basal TG were higher in Group 1 (p= 0.022). The total increase (Δ-TG), corresponding to the difference between the maximum and the basal TG level was similar in both groups (29.8 ± 21.5 mg/dl vs. 28.2 ± 24.5 mg/dl, p= 0.762). TC, HDL and LDL did not change significantly throughout the test. By analyzing all the adolescents together, the waist circumference was positively correlated with TG at fasting (r = 0.223; p= 0.044) and at 4 hours (r = 0.261; p= 0.019). Only overweight adolescents with hypertriglyceridemia, who also had higher HOMA-IR, presented significant elevation of TG levels 2 and 4 hours after the overload. CONCLUSION: The behavior of lipoproteins in the post-prandial state is similar in eutrophic and overweight adolescents. Thus, apparently the weight excess does not induce post prandial lipemic alterations.
Asunto(s)
HDL-Colesterol/sangre , LDL-Colesterol/sangre , Hiperlipidemias/sangre , Sobrepeso/sangre , Triglicéridos/sangre , Adolescente , Antropometría , Peso Corporal , Niño , Femenino , Humanos , Hiperlipidemias/fisiopatología , Masculino , Sobrepeso/fisiopatología , Periodo Posprandial , Circunferencia de la CinturaRESUMEN
En los últimos cincuenta años, la obesidad se ha transformado en una epidemia global y figura en la lista de los principales problemas de salud pública en varios países del mundo. La adolescencia representa un periodo crítico para el control del peso. Los factores determinantes de la obesidad incluyen un complejo conjunto de factores biológicos, comportamentales y ambientales que se interrelacionan y se potencializan mutuamente. En niños y adolescentes, la obesidad se asocia a la aparición precoz de enfermedades cardiovasculares, diabetes mellitus tipo 2, acanthosis nigricans, complicaciones respiratórias y músculo-esqueléticas, además de problemas psicológicos. Las manifestaciones clínicas de las enfermedades cardiovasculares comienzan a partir de la mediana edad. Sin embargo, estudios indican que el proceso aterosclerótico empieza en la infancia. La hiperlipemia postprandial es un proceso fisiológico que ocurre varias veces al día después de la absorción completa de una dieta con lípidos y es sugerido cómo factor de riesgo para enfermedad arterial coronaria. Nuevas áreas de estudio incluyen los efectos de los diferentes ácidos grasos, las fuentes de los lípidos (endógenos y exógenos) y el efecto de la bebida alcohólica durante la alimentación. Con la evidencia de que la lipemia postprandial es un factor de riesgo independiente para enfermedad arterial coronaria, es de fundamental importancia el establecimiento de valores normativos en niños y adolescentes, pues, de esa forma, medidas preventivas y terapéuticas más efectivas y eficaces podrán ser adoptadas (AU)
In the last 50 years, obesity has become a global epidemic and is one of the main public health problems in many parts of the world. Adolescence is a critical period regarding weight control. The factors determining obesity include a complex group of interrelated biological, behavioral and environmental factors which reinforce each other. In children and adolescents, obesity is associated with premature cardiovascular diseases, diabetes mellitus type 2, acanthosis nigricans, respiratory and skeletal muscle problems, as well as psychological problems. The clinical manifestations of cardiovascular disease begin in middle age. Nevertheless, studies indicate that the atherosclerotic process begins to develop during childhood. Postprandial hyperlipemia is a physiological process that occurs several times a day after the complete absorption of a diet including lipids and has been suggested as a risk factor for coronary heart disease (CHD). New study areas include the effects of different fatty acids, lipid sources (endogenous and exogenous), and the effect ingesting alcoholic beverages during meals. Given the evidence that postprandial lipidemia is an independent risk factor for CHD, it is vital to establish normative values for children and adolescents such that more effective and efficient preventive and therapeutic measures can be adopted (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Obesidad/metabolismo , Lípidos/sangre , Enfermedades Cardiovasculares/epidemiología , Periodo Posprandial/fisiología , Factores de RiesgoRESUMEN
In the last 50 years, obesity has become a global epidemic and is one of the main public health problems in many parts of the world. Adolescence is a critical period regarding weight control. The factors determining obesity include a complex group of interrelated biological, behavioral and environmental factors which reinforce each other. In children and adolescents, obesity is associated with premature cardiovascular diseases, diabetes mellitus type 2, acanthosis nigricans, respiratory and skeletal muscle problems, as well as psychological problems. The clinical manifestations of cardiovascular disease begin in middle age. Nevertheless, studies indicate that the atherosclerotic process begins to develop during childhood. Postprandial hyperlipemia is a physiological process that occurs several times a day after the complete absorption of a diet including lipids and has been suggested as a risk factor for coronary heart disease (CHD). New study areas include the effects of different fatty acids, lipid sources (endogenous and exogenous), and the effect ingesting alcoholic beverages during meals. Given the evidence that postprandial lipidemia is an independent risk factor for CHD, it is vital to establish normative values for children and adolescents such that more effective and efficient preventive and therapeutic measures can be adopted.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Hiperlipidemias/complicaciones , Obesidad/complicaciones , Adolescente , Aterosclerosis/etiología , Enfermedades Cardiovasculares/epidemiología , Niño , Humanos , Inflamación/etiología , Periodo Posprandial , Factores de RiesgoRESUMEN
BACKGROUND: Heart Failure (HF) is a common disease with a high rate of mortality. Anemia and renal failure (RF) are often found in patients with HF associated with higher severity of the heart disease and a worse prognosis. OBJECTIVE: To evaluate the prevalence of anemia and RF, as well as the association between these two conditions, in non-hospitalized patients with HF. METHODS: Patients treated at the HF Outpatient Clinic of a university hospital were followed from July 2003 to November 2006. Anemia was defined as hemoglobin levels < 13 mg/dl for men and 12 mg/dl for women. Renal function was assessed by the glomerular filtration rate (GFR), calculated by the simplified formula of the MDRD (Modification of Diet in Renal Disease) study. RESULTS: Of the 345 patients included in this study, 26.4% (n = 91) had anemia and 29.6% had moderate to severe renal failure (GFR < 60 ml/min). The association between anemia and a higher prevalence of renal failure was statistically significant (41.8% vs. 25.2%; p = 0.005). The patients at functional class III and IV presented a higher incidence of anemia (39.0% vs. 19.4%; p <0.001) and renal failure (38.2% vs. 24.8%; p = 0.007). No association was observed between anemia or renal failure and history of hypertension, diabetes, systolic function or etiology of HF. CONCLUSION: The prevalence of anemia and renal failure was high in this population and was associated with the severity of the HF (functional classes III and IV).
Asunto(s)
Anemia/epidemiología , Insuficiencia Cardíaca/complicaciones , Pacientes Ambulatorios/estadística & datos numéricos , Insuficiencia Renal/epidemiología , Anemia/complicaciones , Brasil/epidemiología , Estudios Transversales , Femenino , Insuficiencia Cardíaca/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Valores de Referencia , Insuficiencia Renal/complicacionesRESUMEN
FUNDAMENTOS: Insuficiência cardíaca (IC) é uma doença comum com alta taxa de mortalidade. Anemia e insuficiência renal (IR) são frequentemente encontradas em portadores de IC associadas com maior gravidade da doença cardíaca e pior prognóstico. OBJETIVO: Avaliar a prevalência de anemia e insuficiência renal, bem como a associação entre esses dois quadros, em portadores de IC não hospitalizados. MÉTODOS: Foram observados pacientes acompanhandos na clínica de IC de um hospital universitário de julho de 2003 a novembro de 2006. Anemia foi definida como níveis de hemoglobina abaixo de 13 mg/dl para homens e de 12 mg/dl para mulheres. A função renal foi avaliada por meio da taxa de filtração glomerular (TFG), calculada pela fórmula simplificada do estudo MDRD (Modification of Diet in Renal Disease). RESULTADOS: Dos trezentos e quarenta e cinco pacientes incluídos neste estudo, 26,4 por cento (n = 91) tinham anemia e 29,6 por cento tinham insuficiência renal moderada a grave (TFG < 60 ml/min). A associação entre anemia e maior prevalência de insuficiência renal foi estatisticamente significante (41,8 por cento vs. 25,2 por cento; p = 0,005). Os pacientes em classe funcional III e IV apresentaram maior incidência de anemia (39,0 por cento vs. 19,4 por cento; p <0,001) e insuficiência renal (38,2 por cento vs. 24,8 por cento; p = 0,007). Não foi observada associação entre anemia ou insuficiência renal e história de hipertensão, diabetes, função sistólica ou etiologia de insuficiência cardíaca. CONCLUSÃO: A prevalência de anemia e insuficiência renal foi elevada nessa população e foi associada com a gravidade da insuficiência cardíaca (classes funcionais III e IV).
BACKGROUND: Heart Failure (HF) is a common disease with a high rate of mortality. Anemia and renal failure (RF) are often found in patients with HF associated with higher severity of the heart disease and a worse prognosis. OBJECTIVE: To evaluate the prevalence of anemia and RF, as well as the association between these two conditions, in non-hospitalized patients with HF. METHODS: Patients treated at the HF Outpatient Clinic of a university hospital were followed from July 2003 to November 2006. Anemia was defined as hemoglobin levels < 13 mg/dl for men and 12 mg/dl for women. Renal function was assessed by the glomerular filtration rate (GFR), calculated by the simplified formula of the MDRD (Modification of Diet in Renal Disease) study. RESULTS: Of the 345 patients included in this study, 26.4 percent (n = 91) had anemia and 29.6 percent had moderate to severe renal failure (GFR < 60 ml/min). The association between anemia and a higher prevalence of renal failure was statistically significant (41.8 percent vs. 25.2 percent; p = 0.005). The patients at functional class III and IV presented a higher incidence of anemia (39.0 percent vs. 19.4 percent; p <0.001) and renal failure (38.2 percent vs. 24.8 percent; p = 0.007). No association was observed between anemia or renal failure and history of hypertension, diabetes, systolic function or etiology of HF. CONCLUSION: The prevalence of anemia and renal failure was high in this population and was associated with the severity of the HF (functional classes III and IV).
FUNDAMENTO: La insuficiencia cardiaca (IC) es una enfermedad común con alta tasa de mortalidad. La anemia y la insuficiencia renal (IR), encontradas frecuentemente en portadores de IC, son asociadas a mayor severidad de la enfermedad cardiaca y peor pronóstico. OBJETIVO: Evaluar la prevalencia de anemia e insuficiencia renal, así como la asociación entre esos dos cuadros, en portadores de IC no hospitalizados. MÉTODOS: Se observaron a pacientes seguidos en la clínica de IC de un hospital universitario de julio de 2003 a noviembre de 2006. Se definió la anemia como niveles de hemoglobina abajo de 13 mg/dl para varones y de 12 mg/dl para mujeres. La función renal se evaluó por medio de la tasa de filtración glomerular (TFG), calculada por la fórmula simplificada del estudio MDRD (Modification of Diet in Renal Disease). RESULTADOS: Teniendo en cuenta los trescientos y cuarenta y cinco pacientes incluidos en este estudio, el 26,4 por ciento (n = 91) tenía anemia y el 29,6 por ciento presentaba insuficiencia renal de moderada a severa (TFG < 60 ml/min). La asociación entre anemia y mayor prevalencia de insuficiencia renal fue estadísticamente significante (el 41,8 por ciento vs el 25,2 por ciento; p = 0,005). Los pacientes en clase funcional III e IV presentaron mayor incidencia de anemia (el 39,0 por ciento vs el 19,4 por ciento; p <0,001) e insuficiencia renal (el 38,2 por ciento vs el 24,8 por ciento; p = 0,007). No se observó asociación entre anemia o insuficiencia renal e historia de hipertensión, diabetes, función sistólica o etiología de insuficiencia cardiaca. CONCLUSIÓN: La prevalencia de anemia e insuficiencia renal se elevó en esa población y se asoció con la severidad de la insuficiencia cardiaca (clases funcionales III e IV).
Asunto(s)
Femenino , Humanos , Masculino , Persona de Mediana Edad , Anemia/epidemiología , Insuficiencia Cardíaca/complicaciones , Pacientes Ambulatorios/estadística & datos numéricos , Insuficiencia Renal/epidemiología , Anemia/complicaciones , Brasil/epidemiología , Estudios Transversales , Insuficiencia Cardíaca/epidemiología , Prevalencia , Valores de Referencia , Insuficiencia Renal/complicacionesRESUMEN
A insuficiência cardíaca é um problema grave e crescente de saúde pública em todo o mundo, sendo a via final comum da maioria das cardiopatias. Apesar dos recentes avanços da medicina, pouca atenção vem sendo dada ao tratamento não farmacológico, em particular à terapia nutricional. A evolução clínica dos pacientes com insuficiência cardíaca, via de regra, caminha para quadros variáveis de desnutrição, de causa multifatorial e que não está necessariamente relacionada ao índice de massa corporal. Assim, o objetivo deste trabalho foi revisar a literatura na busca por evidências sobre a composição adequada da dieta no tratamento de pacientes com insuficiência cardíaca. Realizou-se uma revisão sistemática nas bases de dados Medline, Pubmed, Lilacs, SciELO e dos comitês nacionais e internacionais de saúde, dos artigos publicados no período compreendido entre 1981 e 2006. Observou-se que existem poucos estudos bem elaborados, sobre a adequação da dietoterapia na insuficiência cardíaca e que esta ainda é muito restrita ao controle do sal e de líquido, sendo dada pouca atenção à quantidade e à qualidade dos demais nutrientes. Existe uma crescente evidência de que a dieta é um fator importante no prognóstico e no tratamento desses pacientes, porém futuros estudos, incluindo ensaios clínicos com adequado número de participantes, se fazem necessários para que se possa prescrever, com segurança, suplementos nutricionais.
Heart failure is a serious and increasing public health problem around the world, and is the common endpoint of most heart diseases. Despite recent medical advances, little attention has been given to the non-pharmacological treatments, specifically, to nutritional therapy. The clinical course of patients with heart failure constantly progresses to varying degrees of malnutrition caused by different factors and not necessarily related to body mass index. Thus, the objective of this study was to search the literature for evidences of a proper diet composition for heart failure patients. The Medline, Pubmed, Lilacs and SciELO databases, and the national and international health committees were systematically searched for articles published between 1981 and 2006. There were few well-designed studies on proper diet therapies for heart failure patients. The ones reviewed focused on restricting table salt and liquids but gave little attention to the amount and quality of other nutrients. There is growing evidence that diet is an important factor in the prognosis and treatment of these patients. However, future studies, including clinical trials with adequate numbers of participants, are necessary if nutritional supplements are to be safely prescribed.