Impact of Caffeine Intake Strategies on Heart Rate Variability During Post-Exercise Recovery: A Systematic Review and Meta-Analysis.

OBJECTIVES: The objective of this systematic review and meta-analysis is to evaluate the influence of caffeine (CAF) intake strategies, taking into account their form, timing, and dosage, on heart rate variability (HRV) indices in the post-exercise recovery period. METHODS: The meta-analysis adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and is registered in the PROSPERO database (CRD42023425885). A comprehensive literature search was carried out across MEDLINE, Web of Science, LILACS, and SCOPUS, concluding in May 2023. We concentrated on randomized clinical trials comparing CAF supplementation effects to placebo on HRV indices post-exercise in active adults aged 18 and above. The primary endpoint was the assessment of HRV indices, measured both prior to and following exercise. RESULTS: Of the 10 studies included, 7 were used for the meta-analysis, and all contributed to the systematic review. The research explored a variety of CAF strategies, spanning different forms (capsule, drink, gum), times (10, 45, 60 min) and doses (2.1 to 6.0 mg/kg). The outcomes revealed no substantial variations between the placebo and CAF conditions in terms of both the square root of the average of successive squared differences between adjacent RR intervals (RMSSD) (standardized mean difference (SMD) -0.03, 95% CI -0.265 to 0.197, p=0.77) and high frequency (HF) index (SMD -0.061, 95% CI -0.272 to 0.150, p=0.57). Furthermore, metaregression analysis, employing a fixed-effects model and accounting for the administered CAF doses, revealed no significant correlation between caffeine doses and HRV indices (p>0.05). CONCLUSION: In conclusion, there is moderate-certainty evidence suggesting that different CAF intake strategies, encompassing aspects such as form, time, and dose, do not have a significant impact on HRV indices recovery post-exercise (i.e., vagal modulation).

Construção e validação de um material educativo como estratégia de promoção da alimentação adequada e saudável na Atenção Básica / Construction and validation of an educational material as a strategy to promote proper and healthy food in Primary Care

Introdução: Os materiais educativos e didáticos distribuídos na Atenção Básica constituem importantes estratégias de promoção da saúde e de Educação Alimentar e Nutricional. Objetivo: Apresentar o processo de construção e validação de um material educativo sobre a alimentação de crianças menores de dois anos, dirigido aos profissionais de saúde. Método: Realizou-se estudo quantitativo com delineamento estruturado em duas etapas: construção e validação do material educativo. O processo de construção do material educativo se deu a partir da revisão da literatura e das atividades práticas desenvolvidas com mães e profissionais de saúde das unidades de saúde no município de Macaé-RJ. Na validação, o material educativo foi encaminhado por e-mail aos especialistas e, da mesma forma, após ajustes, enviado aos juízes. Calcularam-se as médias aritméticas, tendo como ponto de corte a nota ≥7 de cada item para verificar a importância/adequação atribuída e os desvios-padrão, tendo como ponto de corte o valor <3 para estimar o grau de consenso entre os especialistas e juízes. Resultados: O miniguia apresenta três módulos temáticos: Aleitamento materno, Alimentação Complementar partes 1 e 2. Na validação pelos especialistas, a média(±DP) foi 8,5(±1,2), sendo o material considerado importante/adequado e consensuado por todos; pelos juízes, a média(±DP) foi 9,9(±0,3), sendo considerado importante/adequado e consensuado por todos. Conclusão: O miniguia foi considerado "importante/adequado" e consensuado pelos avaliadores. (AU)

Introduction: Educational and didactic materials available at the Primary Care units are important strategies to promote health and food and nutrition education. Objective: To present the construction and validation process of an educational material about feeding of children under the age of two years, designed to healthcare professionals. Method: a quantitative study was carried out with a design structured in two stages: construction and validation of the educational material. The construction process was based on a literature review and practical activities developed with mothers and health professionals in primary care units in the city of Macaé- RJ. For validation, the educational material was sent by e-mail to specialists and, likewise, after adjustments, to a panel of judges. Arithmetic means were calculated, having the score ≥7 as the cutoff point of each item to verify the assigned importance/adequacy and standard deviations. The cutoff value of <3 was set to estimate the degree of consensus among specialists and judges. Results: The miniguide has three thematic modules: Breastfeeding, Complementary Feeding ­ Parts 1 and 2. In the validation by specialists, the mean value(±SD) was 8.5(±1.2), and they all consensually considered the material important/appropriate; by judges, the mean value(±SD) was 9.9(±0.3), being consensually considered important/appropriate. Conclusion: All evaluators in consensus agreed that the miniguide was "important/appropriate". (AU)

Ganho de peso na gestação, segundo estado nutricional prévio e idade de puérperas atendidas na maternidade de um hospital público de Macaé, Rio de Janeiro / Weight gain during pregnancy, according to previous nutritional status and age of postpartum women assisted in the maternity department of a public hospital in Macaé, Rio de Janeiro

Introdução: A gestação é uma etapa fisiológica que requer acompanhamento de saúde adequado, com vistas ao desfecho positivo para mãe e bebê. Dentre outros cuidados previstos no acompanhamento pré-natal, o ganho de peso é parâmetro a ser monitorado sistematicamente, diante de sua relevância para a saúde materno-infantil e da relação entre ganho de peso inadequado e intercorrências na saúde. Objetivo: Descrever o perfil de ganho de peso gestacional de puérperas assistidas em uma maternidade pública, segundo estado nutricional prévio e idade materna. Método: Estudo epidemiológico transversal descritivo, de base primária (prontuário hospitalar) e secundária (entrevista), realizado em 2014, com amostra de 113 mulheres de 20 a 40 anos com até 48h pós-parto. O estado nutricional pré-gestacional foi avaliado por meio do Índice de Massa Corporal (IMC) e a avaliação da adequação do ganho de peso gestacional considerou as recomendações do Institute Of Medicine (IOM). Resultado: 73,5% tinham idade entre 20-29 anos; 69,9% realizaram seis ou mais consultas de pré-natal e 42,2% tinham excesso de peso (sobrepeso ou obesidade) prévio à gestação. O estado nutricional pré-gestacional, segundo idade, revelou que 35,5%(n=79) daquelas entre 20-29 anos e 60%(n=30) das entre 30-40 anos apresentavam excesso de peso prévio. Houve associação significativa (p<0,01) entre as variáveis "ganho de peso gestacional" e "estado nutricional prévio". Dentre as que tiveram ganho de peso excessivo, 73,1% tinham excesso de peso prévio. Conclusão: Parte expressiva das puérperas já possuía excesso de peso e teve ganho ponderal excessivo na gestação, sobretudo as mais velhas. Sugerem-se a idade materna e o estado nutricional prévio como fatores determinantes do ganho de peso e recomendam-se maior capilaridade e cobertura do acompanhamento nutricional pré-natal no sistema público de saúde como possibilidade de enfrentamento do ganho de peso excessivo, que contribui para o agravamento da epidemia de obesidade no Brasil. (AU)

Introduction: Pregnancy is a physiological stage that requires adequate health monitoring, with a view to achieving a positive outcome for the mother and the baby. Among prenatal care activities, regular monitoring of weight gain is important because of the role such parameter plays in maternal and child health; moreover, inadequate weight gain may lead to health complications. Objective: To describe the pattern of gestational weight gain of postpartum women assisted at a public maternity hospital, according to their previous nutritional status and maternal age. Method: Descriptive cross-sectional epidemiological study, whose data were collected from primary (hospital record) and secondary (interview) sources, in 2014, with a sample of 113 women aged 20 to 40 years up to 48 hours after childbirth. Pregestational nutritional status was assessed using the Body Mass Index (BMI), and gestational weight gain adequacy was assessed on the basis of the recommendations of the Institute of Medicine (IOM). Result: 73.5% were aged 20-29 years; 69.9% made six or more prenatal visits, and 42.2% had excess weight (overweight or obese) prior to pregnancy. Agespecific data on pregestational nutritional status showed that 35.5% (n = 79) of the women between 20-29 years old and 60% (n = 30) of those between 30-40 years old had previous excess weight. There was a significant association (p <0.01) between the variables "gestational weight gain" and "previous nutritional status". Among those who had excess weight gain, 73.1% had previous excess weight. Conclusion: Most of the postpartum women had previous excess weight, and had excess weight gain during pregnancy - especially the older ones. Maternal age and previous nutritional status can be considered as determinants of weight gain. Also, widespread adoption and coverage of prenatal nutritional monitoring are needed in the public health system to help control excessive weight gain, which may aggravate the obesity epidemic in Brazil. (AU)