Mindful eating questionnaire: Validation and reliability in Brazilian adults with type 2 diabetes mellitus.

OBJECTIVE: The objective was to evaluate the psychometric properties of the Mindful Eating Questionnaire (MEQ) in Brazilian subjects with type 2 diabetes mellitus (T2DM) and validate a Brazilian version of the MEQ for adults with T2DM (MEQ-DM). METHODOLOGY: Baseline data from the multicentre Nutritional Strategy for Glycaemic Control in Patients with Type 2 Diabetes Mellitus (NUGLIC) trial were used. Construct validity was assessed using exploratory factor analysis (EFA). The root mean square error of approximation (RMSEA), comparative fit index (CFI) and Tucker‒Lewis index (TLI) fit indices indicated the adequacy of the model. The reliability of the questionnaire was evaluated considering the different factor loadings. Criterion validity was tested by correlating the MEQ-DM with sociodemographic variables, body mass index (BMI) and physical activity levels. RESULTS: A total of 370 participants were included, who were mostly female (60.8 %) and had a median age of 61 (54-67) years. The EFA results supported the two-factor structure of the 25-item MEQ-DM: disinhibition and awareness. The results of the fit indices (RMSEA = 0.04; CFI = 0.95 and TLI = 0.94) and composite reliability (disinhibition = 0.84 and awareness = 0.81) were consistent. The criterion validity analysis indicated a significant association between MEQ-DM scores and age, sex, civil status, education level, BMI and physical activity (p < 0.05). CONCLUSION: When explored with Brazilian adults with T2DM, the MEQ-DM presented a factorial model with two dimensions: disinhibition and awareness. This model must be confirmed in future studies with Brazilians with T2DM.

Relationship between adherence to dietary treatment and binge-eating disorder in obese patients.

Introduction: Introduction: the binge eating disorder (BED) is the eating disorder that most affects the obese population, and BED is an aspect that possibly interferes with the rate of adherence to nutritional treatment, which is also low in individuals with chronic non-communicable disease. Objective: to examine the relationship between adherence to dietary treatment and BED presence in obese individuals. Methods: this cohort study was conducted with a sample of 73 obese individuals at a nutrition and metabolic disease outpatient unit. Anthropometric data were collected, and a three-day food record was used for dietary assessment. BED was identified using the Binge Eating Scale, and patients were divided into two groups (BED and non-BED controls). Patients were reassessed at three-month follow-up. Data were analyzed using Student's t-tests and generalized estimating equations with Bonferroni correction. Adherence to dietary treatment was assessed by calculating differences between recommended and actual energy intakes. Results: BED was identified in 28.7 % of obese individuals. There was no significant difference in adherence to dietary treatment between BED and control patients. Both groups showed similar eating habits and physical activity levels throughout the study period. Conclusion: obesity is one of the factors contributing to the lack of adherence to nutritional guidelines. The importance of cognitive methods in dietary treatment programs should be further investigated.

Introducción: Introducción: el trastorno por atracón compulsivo (TA) es el trastorno alimentario que más afecta a la población obesa, y el TA es un aspecto que posiblemente interfiere en la tasa de adherencia al tratamiento nutricional, que también es baja en individuos con enfermedades crónicas no transmisibles. Objetivo: examinar la relación entre la adherencia al tratamiento dietético y la presencia de TA en individuos obesos. Métodos: este estudio de cohorte se realizó con una muestra de 73 personas obesas en una unidad de nutrición y enfermedades metabólicas ambulatorias. Se recogieron datos antropométricos y se utilizó un registro alimentario de tres días para la evaluación dietética. El trastorno por atracón compulsivo (BED, por sus siglas en inglés) se identificó usando la Binge Eating Scale, y los pacientes se dividieron en dos grupos (BED y controles sin BED). Los pacientes fueron reevaluados a los tres meses de seguimiento. Los datos se analizaron utilizando pruebas t de Student y ecuaciones de estimación generalizadas con corrección de Bonferroni. La adherencia al tratamiento dietético se evaluó calculando las diferencias entre la ingesta energética recomendada y la real. Resultados: se identificó BED en el 28,7 % de los individuos obesos. No hubo diferencias significativas en la adherencia al tratamiento dietético entre los pacientes con BED y los de control. Ambos grupos mostraron hábitos alimentarios y niveles de actividad física similares durante todo el periodo de estudio. Conclusión: la obesidad es uno de los factores que contribuyen a la falta de adherencia a las pautas nutricionales. La importancia de los métodos cognitivos en los programas de tratamiento dietético debe investigarse más a fondo.

Positive psychological characteristics in patients with metabolic syndrome associated with prospective changes in diet and anthropometric factors.

The prevalence of metabolic syndrome (MetS) is increasing worldwide, and diet therapy plays a key role in treating this disease. Since most patients show difficulties in adhering to nutritional interventions, research on the association of positive psychological characteristics with greater engagement in physical health is relevant to this field. The present study aimed to evaluate the association between positive psychology attributes (optimism, hope, self-esteem, positive/negative affect and life satisfaction) and changes in diet quality and anthropometric parameters of individuals with MetS who received nutritional counseling. The study assessed 63 patients at a nutrition outpatient clinic. Anthropometric parameters and 24-hour food recall data (for evaluation of the Brazilian Healthy Eating Index-Revised-BHEI-R) were collected at the first visit and subsequent return visit (on average five months later). Psychological data were collected at the first visit using validated and standardized scales. The results were adjusted in relation to the depression scores of the patients, which were evaluated using the Beck Depression Inventory-II (BDI-II). Changes in anthropometric factors and in the BHEI-R were assessed, and their associations with the psychological attributes were investigated. The results indicated that positive affect and hope were associated with improvement in the BHEI-R scores (Cohen effect sizes -0.65 and -0.58; p = 0.012 and 0.025, respectively). A significant association was also observed between optimism and a reduction in abdominal circumference (Cohen effect size 0.56; p = 0.031). The associations remained significant even after adjusting for the BDI-II scores (p = 0.022, p = 0.037 and p = 0.05, respectively). No statistically significant associations were observed for the other attributes assessed.The study suggests that some attributes may have a greater influence on the nutritional treatment of MetS and that future studies should be conducted in order to enable effective multidisciplinary interventions to treat MetS.

Green Juice in Human Metabolism: A Randomized Trial.

OBJECTIVE: Fruits and vegetables contain many compounds presenting potential antioxidant activity. The objective of this study was to evaluate the effect of a green juice recipe in adult metabolism in order to identify new preventive dietary sources. METHOD: This was a single-blind randomized controlled clinical trial. Recruitment and data were, respectively, made and collected at the Universidade Federal de Ciências da Saúde de Porto Alegre. Individuals who met all the inclusion criteria during the period of recruitment were included. Green juice (experimental group) or placebo (control group) were consumed from Monday to Friday between 8 and 9 am, in the amount of 300 mL for 60 days (except Saturdays and Sundays). To verify the effect of green juice on metabolism, the following were evaluated: (a) glycemia, plasma lipid profile, renal and liver functions, redox profile, and antioxidant enzymes; (b) anthropometry; and (c) well-being and anxiety. RESULTS: This study included 14 participants in the test group (juice group) and 13 controls (placebo group), with mean ages of 31.07 and 30.15 years, respectively. We did not observe a significant difference between the treatments. Dietary properties of vegetable and fruit juices are an area of significant interest. CONCLUSIONS: Together with an analysis of previous works, we suggest that green juice did not cause an improvement in metabolic function and there is a need for further research on this issue, mainly through different interventions and other samples.

Nutritional knowledge and body mass index: A cross-sectional study / Conhecimento nutricional e índice de massa corporal: um estudo transversal

Summary Objective: To verify the knowledge about food and nutrition and its association with the nutritional status of obese patients with noncommunicable diseases (NCDs), and to identify the relationship between information sources and level of knowledge. Method: Cross-sectional study that included 263 outpatients of a cardiology referral hospital in Porto Alegre, Rio Grande do Sul, Brazil. The participants filled out a questionnaire on socioeconomic data and knowledge about food and nutrition and had their nutritional status evaluated by body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR). Results: BMI showed a significant inverse association with the percentage of correct answers (p=0.002), as well as WC (p=0.000) and WHR (p<0.001). This was also true for education (p<0.001) and female gender (p=0.005) compared to males. More than 60% of patients reported using television and 23% reported using newspaper as sources of nutritional information. Conclusion: Our study revealed a significant association between BMI and the level of knowledge about foods, showing that there is need for more information on obesity-related NCDs for greater understanding by patients.

Resumo Objetivo: Verificar os conhecimentos sobre alimentação e nutrição e sua associação com o estado nutricional de pacientes obesos portadores de doenças crônicas, e identificar a relação das fontes de informação com o nível de conhecimentos. Método: Estudo transversal realizado com 263 pacientes ambulatoriais de um hospital de referência em cardiologia em Porto Alegre, RS. Os indivíduos preencheram um questionário sobre dados socioeconômicos e conhecimentos sobre alimentação e nutrição, tendo seu estado nutricional avaliado por meio de índice de massa corporal (IMC), circunferência da cintura (CC) e relação cintura quadril (RCQ). Resultados: O IMC apresentou associação inversa e significativa com o percentual de acertos (p=0,002), assim como a CC (p<0,001) e a RCQ (p<0,001). E também a escolaridade (p<0,001) e o sexo feminino (p=0,005) em relação ao masculino. Mais de 60% dos pacientes relataram utilizar televisão e 23% jornal como fontes de informação sobre alimentação. Conclusão: No presente estudo, houve associação significativa entre IMC e nível de conhecimento sobre alimentação, demonstrando que há necessidade de maior divulgação sobre as doenças crônicas não transmissíveis (DCNT) para que haja maior entendimento por parte dos pacientes.

Nutritional knowledge and body mass index: A cross-sectional study.

OBJECTIVE: To verify the knowledge about food and nutrition and its association with the nutritional status of obese patients with noncommunicable diseases (NCDs), and to identify the relationship between information sources and level of knowledge. METHOD: Cross-sectional study that included 263 outpatients of a cardiology referral hospital in Porto Alegre, Rio Grande do Sul, Brazil. The participants filled out a questionnaire on socioeconomic data and knowledge about food and nutrition and had their nutritional status evaluated by body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR). RESULTS: BMI showed a significant inverse association with the percentage of correct answers (p=0.002), as well as WC (p=0.000) and WHR (p<0.001). This was also true for education (p<0.001) and female gender (p=0.005) compared to males. More than 60% of patients reported using television and 23% reported using newspaper as sources of nutritional information. CONCLUSION: Our study revealed a significant association between BMI and the level of knowledge about foods, showing that there is need for more information on obesity-related NCDs for greater understanding by patients.

Nutritional and neuropsychological profile of the executive functions on binge eating disorder in obese adults.

OBJECTIVE: To examine the relationships between obese patients with and without binge eating disorder (BED) and the neuropsychological profiles of their executive functions. METHODS: Data from 36 obese individuals (BMI ≥ 30 kg/m2) were divided into two groups, where one group was found to be positive for signs of BED according to the Binge Eating Scale. Two neuropsychological tests of executive function were carried out: the Go/No-go Task and the Iowa Gambling Task (IGT). Nutritional status was evaluated by measures of body weight, height and abdominal circumference, and from these, body mass indexes (BMI) were calculated. RESULTS: Both groups presented similar nutritional characteristics; there were no differences when it came to the health status of individuals with or without BED. Participants found positive for signs of BED had the lowest IGT scores (p = 0.004), and Go/No-go omission scores (p = 0.015) and commission scores (p = 0.04). Further statistically significant differences were also observed here between the two groups. Statistical differences in the IGT results correlated with BED, and were associated categorically (p = 0.005). CONCLUSION: Obese individuals frequently present deficits in selective attention, inhibitory control, decision-making and planning that can be directly related to binge eating and which is linked to BED. Nutritional status did not differ between the two groups studied, and did not show any connection with the disorder.

Nutritional and neuropsychological profile of the executive functions on binge eating disorder in obese adults / Perfil nutricional y neuropsicológico de las funciones ejecutivas en el transtorno por atracón en adultos obesos

Objective: To examine the relationships between obese patients with and without binge eating disorder (BED) and the neuropsychological profiles of their executive functions. Methods: Data from 36 obese individuals (BMI ≥ 30 kg/m2) were divided into two groups, where one group was found to be positive for signs of BED according to the Binge Eating Scale. Two neuropsychological tests of executive function were carried out: the Go/No-go Task and the Iowa Gambling Task (IGT). Nutritional status was evaluated by measures of body weight, height and abdominal circumference, and from these, body mass indexes (BMI) were calculated. Results: Both groups presented similar nutritional characteristics; there were no differences when it came to the health status of individuals with or without BED. Participants found positive for signs of BED had the lowest IGT scores (p = 0.004), and Go/No-go omission scores (p = 0.015) and commission scores (p = 0.04). Further statistically significant differences were also observed here between the two groups. Statistical differences in the IGT results correlated with BED, and were associated categorically (p = 0.005). Conclusion: Obese individuals frequently present deficits in selective attention, inhibitory control, decision-making and planning that can be directly related to binge eating and which is linked to BED. Nutritional status did not differ between the two groups studied, and did not show any connection with the disorder (AU)

Objetivo: examinar las relaciones entre los pacientes obesos con y sin trastorno por atracón (TA) y los perfiles neuropsicológicos de sus funciones ejecutivas. Métodos: los datos de 36 individuos obesos (IMC ≥ 30 kg/m2) se dividieron en dos grupos, donde se encontró que un grupo era positivo para los signos de BED de acuerdo con la escala de Binge Eating Scale. Se realizaron dos pruebas neuropsicológicas de la función ejecutiva: la Tarea Ir/No-ir y la Tarea de Juego de Iowa (IGT). El estado nutricional fue evaluado por medidas de peso corporal, estatura y circunferencia abdominal, y de estos se calcularon los índices de masa corporal (IMC). Resultados: ambos grupos presentaron características nutricionales similares; No hubo diferencias en cuanto al estado de salud de las personas con o sin BED. Los participantes encontraron positivos para los signos de BED que tuvieron los puntajes IGT más bajos (p = 0,004), y puntuaciones de omisión IR/No-ir (p = 0,015) y comisiones (p = 0,04). Otras diferencias estadísticamente significativas también se observaron aquí entre los dos grupos. Las diferencias estadísticas en los resultados IGT se correlacionaron con BED, y se asociaron categóricamente (p = 0,005). Conclusión: los individuos obesos frecuentemente presentan deficiencias en la atención selectiva, el control inhibitorio, la toma de decisiones y la planificación que pueden estar directamente relacionados con el atracón y que está relacionado con la BED. El estado nutricional no difirió entre los dos grupos estudiados, y no mostró ninguna relación con el trastorno (AU)

Hypertensives' Knowledge About High-Sodium Foods and Their Behavior / Conhecimento e Atitudes Sobre Alimentos Ricos em Sódio por Pacientes Hipertensos

Abstract Background: In Brazil, the prevalence of systemic arterial hypertension (SAH) is approximately 30% of the total population. In 2010, SAH was the cause of death of about 9.4 million people worldwide. A healthy dietary pattern is important to maintain proper blood pressure levels and, consequently, disease control. Objectives: To describe the knowledge and practices of hypertensive patients cared for at a public hypertension outpatient clinic, and its relationship with high-sodium food. Methods: We applied a questionnaire to patients with questions related to sociodemographics, dietary pattern, frequency of ingestion of certain foods, and knowledge about their own disease. Results: We studied 221 patients, 56.1% of whom were women, and 53.8% had only elementary education. Their mean age was 57.7 ±13.5 years, and 75.6% of them reported having high blood pressure, and 11.3%, diabetes mellitus. Regarding dietary pattern, 62% used ready-to-use seasonings, but 94.1% reported not adding extra salt to their ready meals. Regarding patients' knowledge about high-sodium foods and SAH, only 8 patients had 100% of right answers, 37 patients had 73.8%, and 42 patients, 57% of right answers. Conclusion: Knowledge about SAH prevention and high-sodium foods was insufficient. Based on this study's findings, more effective educational strategies targeted at this population can be developed.

Resumo Fundamento: No Brasil, a prevalência de hipertensão arterial sistêmica (HAS) é aproximadamente 30% do total da população. No mundo, HAS é a causa de morte de cerca de 9,4 milhões de pessoas. Um padrão alimentar saudável é importante para a manutenção de níveis pressóricos adequados e, consequentemente, controle da doença. Objetivos: Descrever o conhecimento e as práticas alimentares de pacientes hipertensos sobre a HAS, relacionando-a com alimentos ricos em sódio. Métodos: Aplicou-se aos pacientes um questionário contendo perguntas relacionadas ao seu padrão alimentar, hábitos e frequência de consumo de determinados alimentos e conhecimento sobre a doença e condições sociodemográficas. Resultados: Avaliaram-se 221 pacientes, sendo 56,1% mulheres, 53,8% com ensino fundamental incompleto, e média de idade de 57,7±13,5 anos. Desses, 75,6% referiram ser portadores de HAS e 11,3% eram diabéticos. Em relação ao padrão alimentar, verificou-se que 62% utilizam temperos prontos para o preparo das refeições, porém 94,1% referiram não adicionar sal à refeição pronta. Em relação ao conhecimento dos pacientes quanto aos alimentos com alto teor de sódio e à HAS, apenas 8 acertaram 100% das questões do questionário (14 acertos = 100%), 37 pacientes tiveram 73,8% de acertos e 42 pacientes, 57% de acertos. Conclusão: O conhecimento sobre prevenção da HAS e alimentos ricos em sódio foi considerado insuficiente. Com base nesses achados, será possível elaborar estratégias educativas mais efetivas e direcionadas para essa população.

Hypertensives' Knowledge About High-Sodium Foods and Their Behavior.

BACKGROUND: In Brazil, the prevalence of systemic arterial hypertension (SAH) is approximately 30% of the total population. In 2010, SAH was the cause of death of about 9.4 million people worldwide. A healthy dietary pattern is important to maintain proper blood pressure levels and, consequently, disease control. OBJECTIVES: To describe the knowledge and practices of hypertensive patients cared for at a public hypertension outpatient clinic, and its relationship with high-sodium food. METHODS: We applied a questionnaire to patients with questions related to sociodemographics, dietary pattern, frequency of ingestion of certain foods, and knowledge about their own disease. RESULTS: We studied 221 patients, 56.1% of whom were women, and 53.8% had only elementary education. Their mean age was 57.7 ±13.5 years, and 75.6% of them reported having high blood pressure, and 11.3%, diabetes mellitus. Regarding dietary pattern, 62% used ready-to-use seasonings, but 94.1% reported not adding extra salt to their ready meals. Regarding patients' knowledge about high-sodium foods and SAH, only 8 patients had 100% of right answers, 37 patients had 73.8%, and 42 patients, 57% of right answers. CONCLUSION: Knowledge about SAH prevention and high-sodium foods was insufficient. Based on this study's findings, more effective educational strategies targeted at this population can be developed.

Relação entre o uso de terapia nutricional enteral e o controle glicêmico em pacientes críticos / Relationship between the use of enteral nutritional therapy and glycemic control in critically ill patients

Introdução: O controle glicêmico está relacionado com a diminuição da mortalidade segundo estudos randomizados que avaliam terapia insulínica e terapia nutricional em pacientes críticos. Existem poucos estudos que abordam estratégias eficazes na terapia nutricional enteral (TNE) para o controle glicêmico. Sabendo que a TNE é um fator que influi no controle da glicemia de pacientes críticos, a dieta efetivamente ofertada ao paciente pode ser avaliada como potencializadora de efeitos positivos ou negativos na glicemia. Objetivos: Avaliar o controle glicêmico e a relação com a oferta da nutrição enteral em pacientes internados em uma Unidade de Terapia Intensiva. Métodos: Estudo de coorte histórico com 201 pacientes internados em uma unidade de terapia intensiva no Sul do Brasil no período de janeiro a dezembro de 2014 que receberam a nutrição enteral por pelo menos 72 horas após a internação. Foram extraídos dados de prontuário eletrônico. Para avaliar o controle glicêmico, foram coletados dados de glicemia da internação, 24 horas após o início da dieta e uma semana após o início da dieta. Houve estratificação de grupo de diabéticos e não-diabéticos. O estado nutricional dos pacientes foi classificado pelo IMC (n=76). A adequação da dieta foi avaliada em percentual. O tipo de dieta foi classificado de acordo com as características das fórmulas. Foram avaliados tempo de internação na UTI e evolução clínica. Resultados: A média de idade dos pacientes foi 63,6 anos (± 15,4), maioria sexo masculino (55,7%). Diabéticos foram 27,4% da população. Uma redução média de 18,4 mg/dL na glicemia depois de uma semana de dieta foi vista no grupo de pacientes diabéticos, porém não significativa (p =0,075). O percentual de adequação da dieta foi semelhante entre os grupos e no total, tanto para valor energético total (97,2%±20,5), quanto para proteínas (84,3%±23,1). O tempo de internação na UTI em mediana foi de 17 dias, maior em pacientes diabéticos (21 dias), porém não significativo. No grupo de pacientes não diabéticos a glicemia de uma semana após o início da dieta foi significativamente maior nos que foram à óbito quando comparados com pacientes não diabéticos que evoluíram para alta (p=0,033). Não houveram associações significativas entre glicemia e IMC, percentual de adequação de energia e proteínas, tempo de UTI, tipo de dieta e uso de módulos proteicos, tanto para o grupo de diabéticos quanto para o grupo de não-diabéticos (p>0,10). Discussão: A glicemia tende a reduzir mais naqueles pacientes em TNE com fórmulas de baixo carboidrato. O controle glicêmico mostra relação com a evolução clínica de pacientes críticos, dispondo maior sobrevida em pacientes com valores de glicemia seguros. Conclusões: O controle glicêmico de pacientes internados em uma unidade de terapia intensiva tende a ser efetivo após uma semana de TNE em pacientes diabéticos e a hiperglicemia após uma semana de TNE aumenta a prevalência de óbitos em pacientes não diabéticos (AU)

Introduction: According to random studies that evaluate insulin therapy and nutritional therapy in critically ill patients, glycemic control is related to the decreasing of mortality. There are only a few studies that address effective strategies in enteral nutritional therapy for glycemic control. Knowing that ENT is a factor that influences the glycemic control in critically ill patients, the diet actually offered to the patient can be evaluated as a potentiator for positive or negative effects on blood glucose. Objective: Evaluate the glycemic control and its relation with the supply of enteral nutrition for patients admitted to an Intensive Care Unit. Methods: A cohort historic study of 201 patients admitted to an ICU in Southern Brazil, from January to December of 2014, who received enteral nutrition for at least 72 hours after admission. Data from electronic medical records were extracted. To evaluate the glycemic control, blood glucose data were collected at the admission, 24 hours after the beginning of the treatment and one week after the diet’s initiation. Diabetic and non-diabetic patients were separated in two groups. The patients’ nutritional status was classified by the BMI (n = 76). The adequacy of the diet was evaluated as a percentage. The type of diet was classified according to the characteristics of the formulas. The patient’s time in ICU and their clinical outcome were also evaluated. Results: The patients’ average age was 63.6 years (± 15,4), most of them were men (55.7%). Diabetics were 27.4% of the population. An average reduction of 18.4 mg/dL in blood glucose after a week of diet was observed in the group of diabetic patients but it was not significant (p = 0.075). The diet adequacy percentage was similar in both groups, for both total energy (97.2% ± 20.5) and protein (84.3% ± 23.1). The average time that patients stayed in the ICU was 17 days. This period was a little longer for diabetic patients (21 days), but it’s not a significant difference. In the non-diabetic group, glucose levels one week after the initiation of the diet were significantly higher in patients who died, compared to the ones that left the intensive care unit (p = 0.033). There were no significant associations with blood glucose and BMI, adequate energy percentage and protein, ICU time, type of diet and use of protein modules, for both the diabetic and non-diabetic groups (p> 0.10). Discussion: Blood glucose tends to further reduce in those patients submitted to ENT with low carbohydrate formulas. The glycemic control relates to the clinical advancements in critically ill patients, providing longer survivability in patients with safe blood glucose levels. Conclusions: The glycemic control in patients admitted to an ICU tends to be effective after a week of ENT in diabetic patients and the hyperglycemia, after a week of ENT, increases the prevalence of deaths in non-diabetic patients (AU)

Nutritional and metabolic assessment in overweight patients with and without hyperprolactinemia caused by prolactinoma / Evaluación nutricional y metabólica en pacientes con sobrepeso con y sin hiperprolactinemia causada por prolactinoma

Introduction: prolactinomas are pituitary adenomas that express and secrete prolactin. These patients are overweight and the mechanisms are being studied. Goals: assess nutritional and metabolic status of overweight patients with and without hyperprolactinemia caused by prolactinoma and compare them. Materials and methods: cross-sectional study, patients with body mass index (BMI) greater than or equal to 25 kg/m2 with and without prolactinoma: 1) 20 normoprolactinemic (NPrl) with prolactinoma; 2) 23 hyperprolactinemic (HPrl) with prolactinoma; 3) 28 controls without prolactinoma or alterations in prolactin levels. Evaluated through anthropometric, dietetics, and biochemical assessment. Results: of the 71 patients evaluated, most were obese women with macroprolactinomas. All three groups had diets with low caloric and monounsaturated fatty acid (MUFA) intake, the NPrl group had low carbohydrate (CHO) intake and high lipid (LIP) and saturated fatty acid (SFA) intake, and the NPrl and HPrl groups had appropriate intake of polyunsaturated fatty acids (PUFA). The HPrl group had elevated total cholesterol. HDL cholesterol was below the recommended threshold for most patients. No statistically significant differences were found in anthropometric and biochemical variables among the groups. Conclusions: most patients with prolactinomas and controls are obese and metabolically similar regardless of prolactin levels. All groups presented low caloric and MUFA intake. Protein, LIP, SFA, and cholesterol were significantly different among the groups, the NPrl group ingested less amount of protein and greater of fat. Snacking between meals and changes of food consumption on weekends was reported by most patients. This is the first study comparing patients with prolactinomas and controls, both with overweight, regarding food consumption and feeding behavior (AU)

Introducción: los prolactinomas son adenomas hipofisarios que expresan y secretan prolactina. Estos pacientes tienen sobrepeso y el mecanismo está en estudio. Objetivos: evaluar el estado nutricional y metabólico de los pacientes con sobrepeso con y sin hiperprolactinemia causada por prolactinoma y compararlos. Materiales y métodos: es un estudio transversal con pacientes con índice de masa corporal (IMC) más o menos 25 kg/m2 con y sin prolactinoma: 1) 20 normoprolactinémicos (NPrl) con prolactinoma; 2) 23 hiperprolactinémicos (HPrl) con prolactinoma; 3) 28 controles sin prolactinoma o alteraciones en los niveles de prolactina. Evaluados a través de estudios antropométricos evaluación dietética y bioquímica. Resultados: de los 71 pacientes evaluados, la mayoría eran mujeres obesas con macroprolactinomas. Los tres grupos tenían dietas con baja ingesta de calorías y ácidos grasos monoinsaturados (MUFA), el grupo NPrl tenía ingesta baja en carbohidratos (CHO) y alta en lípidos (LIP) y ácidos grasos saturados (SFA), y los grupos NPrl y HPrl tenían ingesta apropiada de ácidos grasos poliinsaturados (PUFA). El grupo HPrl tenía el colesterol sérico por encima del valor recomendado, mientras el colesterol HDL estaba por debajo del valor recomendado en la mayoría de los pacientes. No se encontraron diferencias estadísticamente significativas en las variables antropométricas y bioquímicas entre los grupos. Conclusiones: la mayoría de los pacientes con prolactinomas y los controles son obesos y metabólicamente similares, independientemente de los niveles de prolactina. Todos los grupos presentaron baja ingesta de calorías y de ácidos grasos monoinsaturados. Proteínas, LIP, SFA y colesterol fueron significativamente diferentes entre los grupos, el grupo de NPrl ingiere menos cantidad de proteína y mayor de grasa. La mayoría de los pacientes manifiestan picar entre las comidas y cambios en el consumo de alimentos los fines de semana. Este es el primer estudio que compara a pacientes con prolactinomas y controles, ambos con sobrepeso, en cuanto a consumo de alimentos y comportamiento alimentario (AU)

Association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil: cross-sectional study.

CONTEXT AND OBJECTIVE: Osteoporosis is a skeletal abnormality characterized by reduction and alteration of bone microarchitecture that results in increased fragility and greater predisposition to fractures. Age and low bone mass are the main non-modifiable risk factors for osteoporotic fractures. The modifiable factors include sedentary lifestyle, inadequate calcium intake, excessive alcohol and/or caffeine consumption, smoking and low body weight. The aim here was to evaluate the association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil. DESIGN AND SETTING: Cross-sectional study conducted in Porto Alegre and Canoas, Rio Grande do Sul, Brazil. METHODS: Women (n = 155) of mean age 53.6 ± 9.5 years were evaluated through a cross-sectional study in Southern Brazil. Food frequency questionnaires, bone mass evaluation using calcaneal ultrasound and anthropometric assessment were used. RESULTS: The prevalence of overweight was 67.7%. In the bone mass screening, 30.3% had low bone mass and 4.5% had osteoporosis. The median calcium intake was 574.94 mg/day and the caffeine intake was 108.11 mg/day. No association was found between bone mass and anthropometric parameters, calcium intake or caffeine intake. It was found that 38.4% of the women had low bone mass. CONCLUSIONS: No association was found between calcium and caffeine intake and bone mass. High prevalence of low bone mass was observed.

Doença de Parkinson em idosos: ingestão alimentar e estado nutricional / Parkinson's disease: dietary intake and nutritional status

OBJETIVO: Avaliar o estado nutricional e ingestão alimentar dos idosos portadores da doença de Parkinson. MÉTODOS: Estudo transversal, realizado com pacientes portadores da doença de Parkinson (DP), atendidos em ambulatório. O estado nutricional foi avaliado utilizando a mini-avaliação nutricional (MAN), registro de consumo alimentar estimado de três dias e antropometria. Para avaliação da adequação de ingestão de nutrientes e energia, utilizou-se a ingestão dietética de referência, considerando valores da ingestão adequada, requerimento médio estimado e ingestão dietética recomendada. RESULTADOS: Foram avaliados 36 indivíduos, com idade média de 70,9±7,3 anos, sendo que 55% dos pacientes apresentaram risco de desnutrição de acordo com a MAN. Todavia, quando classificados pelo índice de massa corporal (IMC), 33% dos pacientes apresentaram sobrepeso e 39% não apresentaram perda nos últimos três meses. A ingestão energética foi de 1.632 e 1.840kcal/dia; proteínas, 71,2 e 61,9g/dia; ferro, 15,8 e 15,6mg/dia; sódio, 1.798 e 1.843mg/dia, para homens e mulheres, respectivamente, e ficaram acima das recomendações. Verificou-se ingestão inferior à recomendação para fibras (13,5 e 13,6g/dia), cálcio (694 e 552mg/dia) e potássio (1.637 e 1.476mg/dia). A ingestão energética apresentou correlação com ferro e proteína (r=0,581 e r=0,582) e a proteína apresentou correlação com a ingestão de ferro (r=0,600). CONCLUSÃO: Embora a ingestão energética da maioria se apresente adequada, observou-se o desequilíbrio dietético, com consumo insuficiente de fibras, cálcio e potássio. Além disso, metade da população encontrava-se em risco nutricional, segundo a MAN.

OBJECTIVE: To evaluate the dietary intake of elderly patients with Parkinson's disease and to correlate it with nutritional status. METHODS: Cross-sectional study with patients with Parkinson's disease (PD) treated as outpatients. Nutritional status was evaluated by the Mini Nutritional Assessment (MAN) and food intake was assessed by three-day estimated food record. The Dietary Reference Intakes were used to assess the adequacy of nutrients and energy intake, considering adequate intake values, estimated average requirement and recommended dietary allowance. RESULTS: We evaluated 36 subjects with mean age of 70.9±7.3 years; 55% of patients were at risk of malnutrition according to MNA. However, when classified by body mass index (BMI), 33% of patients were overweight and 39% had no weight loss in the past three months. Energy intake was 1,632 and 1,840kcal/day; proteins, 71.2 and 61.9g/day; iron, 15.8 and 15.6mg/day; sodium, 1,798 and 1,843mg/day for men and women, respectively, and were above recommendations. There was less than the recommended intake for fiber (13.5 and 13.6g/day), calcium (694 and 552mg calcium/day), and potassium (1,637 and 1,476mg/day). Energy intake was correlated with iron and protein (r=0.581 and r=0.582) and protein correlated with iron intake (r=0.600). CONCLUSION: Although energy intake of the majority was adequate, dietary imbalance was observed, with insufficient intake of fiber, calcium, and potassium. Moreover, half the population was at nutritional risk according to the MNA.

Avaliação antropométrica em idosos: estimativas de peso e altura e concordância entre classificações de IMC / Anthropometry assessment in the elderly: estimates of weight and height and agreement between BMI ratings

OBJETIVO: Avaliar a concordância entre diferentes classificações de Índice de Massa Corporal (IMC) e verificar modelos de fórmulas propostas para estimativa de peso e altura que podem ser aplicadas na população idosa do Sul do Brasil. MÉTODO: Estudo transversal que avaliou 131 idosos residentes de três instituições de longa permanência para idosos (ILPIs) no Sul do Brasil, por meio de uma avaliação antropométrica, utilizando peso, estatura, altura do joelho, dobra cutânea subescapular, circunferência da panturrilha, circunferência do braço, circunferência abdominal e hemienvergadura. RESULTADOS: A idade média da amostra foi de 78,9 anos, sendo 41,2% homens e 58,8% mulheres. De acordo com a classificação da Organização Mundial da Saúde (OMS), apenas dois idosos (1,5%) apresentaram baixo-peso, 63 idosos (48,1%) foram classificados como eutróficos e 66 (50,4%) foram classificados com sobrepeso, obesidade grau I e II. Já os pontos de corte estipulados por Lipschitz determinaram que 21 idosos (16%) se encontram com baixo-peso, 69 (52,7%) eutróficos e 41 (31,3%) com sobrepeso. Ao comparar as medidas de peso e altura aferidas com as mesmas medidas estimadas, percebe-se que a única que não mostrou diferença significativa foi a fórmula de estimativa de altura de Rabito. CONCLUSÃO: Os pontos de corte utilizados apresentaram moderada concordância, sendo que Lipschitz salienta uma maior faixa de risco para desnutrição. Comparando as medidas de peso e altura aferidas com as medidas estimadas, foi observado que somente a fórmula de estimativa de altura de Rabito pode ser aplicada para esta população.

OBJECTIVE: Assessing the concordance between different classifications of body mass index (BMI) and verify if the formulas to estimate weight and height, that can be applied to the elderly population in Southern Brazil. METHOD: Cross-sectional analysis was applied to 131 elders from three long-stay institutions in Southern Brazil. They were evaluated through anthropometric assessment, considering weight, knee height, sub-scapular skin fold, as well as, calf, arm and waist circumferences and anthropometry. RESULTS: The average age of the samples was 78.9 (41.2% males and 58% females). According to the WHO scale, only two elders (1.5), were considered underweight; 63 of them (48.1) were classified as eutrophic and 66 (50.4%) were classified as being overweight, obesity degrees I and II. On the other hand, cut-off points set by Lipschitz considered 21 elders (16%) as being underweight, 69 ( 52.7%) eutrophic and 41 (31%) as overweight. By comparing standard weight and height measurement to the same estimated measures, it was clear that Rabito's formula for estimated height and weight showed no significant difference. CONCLUSION: The cut-off points showed moderate concordance. Lischitz emphasizes a higher range of risk for malnutrition. Comparing weight and height standard measurements to the estimated ones, it was concluded that just Rabito's formula can be applied to this population.

Association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil: cross-sectional study / Associacao entre baixa massa ossea e ingestao de calcio e cafeina em mulheres climatericas na regiao Sul do Brasil: estudo transversal

CONTEXT AND OBJECTIVE: Osteoporosis is a skeletal abnormality characterized by reduction and alteration of bone microarchitecture that results in increased fragility and greater predisposition to fractures. Age and low bone mass are the main non-modifiable risk factors for osteoporotic fractures. The modifiable factors include sedentary lifestyle, inadequate calcium intake, excessive alcohol and/or caffeine consumption, smoking and low body weight. The aim here was to evaluate the association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil. DESIGN AND SETTING: Cross-sectional study conducted in Porto Alegre and Canoas, Rio Grande do Sul, Brazil. METHODS: Women (n = 155) of mean age 53.6 ± 9.5 years were evaluated through a cross-sectional study in Southern Brazil. Food frequency questionnaires, bone mass evaluation using calcaneal ultrasound and anthropometric assessment were used. RESULTS: The prevalence of overweight was 67.7%. In the bone mass screening, 30.3% had low bone mass and 4.5% had osteoporosis. The median calcium intake was 574.94 mg/day and the caffeine intake was 108.11 mg/day. No association was found between bone mass and anthropometric parameters, calcium intake or caffeine intake. It was found that 38.4% of the women had low bone mass. CONCLUSIONS: No association was found between calcium and caffeine intake and bone mass. High prevalence of low bone mass was observed. .

CONTEXTO E OBJETIVO: A osteoporose é uma alteração esquelética caracterizada pela redução e pela alteração da microarquitetura óssea, que resultam em aumento da fragilidade e maior predisposição a fraturas. A idade e a baixa massa óssea são os principais fatores de risco não modificáveis para fraturas osteoporóticas. Os fatores modificáveis incluem sedentarismo, inadequada ingestão de cálcio, excessivo consumo de álcool e/ou cafeína, tabagismo e baixo peso corporal. O objetivo foi avaliar associação entre baixa massa óssea e ingestão de cálcio e cafeína por mulheres climatéricas no Sul do Brasil. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado em Porto Alegre e Canoas, Rio Grande do Sul, Brasil. MÉTODOS: Mulheres (n = 155) com idade média de 53,6 ± 9,5 anos foram avaliadas em um estudo transversal na região Sul do Brasil. Foram utilizados questionários de frequência alimentar, avaliação da massa óssea por ultrassonometria de calcâneo e avaliação antropométrica. RESULTADOS: A preval ência de sobrepeso foi de 67,7%. No rastreamento de massa óssea, 30,3% apresentou baixa massa óssea e 4,5%, osteoporose. A ingestão mediana de cálcio foi de 574,94 mg/dia e de cafeína foi de 108,11 mg/dia. Não foi encontrada associação entre massa óssea e os parâmetros antropométricos, ingestão de cálcio ou de cafeína. Verificou-se que 38,4% das mulheres apresentaram perda de massa óssea. CONCLUSÕES: Não foi encontrada associação entre a ingestão de cálcio e cafeína com a massa óssea. Foi observada alta prevalência de baixa massa óssea. .

Identificação de fatores de risco cardiovascular em pais/cuidadores de crianças cardiopatas / Identification of cardiovascular risk factors in parents/caregivers of children with heart diseases

FUNDAMENTO: As doenças cardiovasculares representam uma das principais causas de morbimortalidade no mundo. No Brasil, constituem a principal causa de óbitos. OBJETIVO: Identificar fatores de risco cardiovasculares em pais/cuidadores de crianças cardiopatas, mediante avaliação do estado nutricional, condições de saúde e estilo de vida. MÉTODOS: Estudo transversal, com 150 pais ou cuidadores de crianças cardiopatas que frequentavam um ambulatório de cardiologia pediátrica. Dados de identificação, estilo de vida e condições de saúde foram coletados por meio de questionário estruturado. Para análise dos hábitos alimentares utilizou-se questionário de frequência alimentar, e para avaliação do estado nutricional foram realizadas aferições de peso, estatura e circunferência da cintura e cálculo e classificação do Índice de Massa Corporal (IMC). RESULTADOS: Foram avaliados 155 pais de crianças cardiopatas, predominantemente do sexo feminino, 91,6%; a média de idade foi 35,0 ± 10,6 anos. Os fatores de risco observados em maior prevalência foram sedentarismo (85,2%), obesidade (28%) e hipertensão (22,6%). Em relação aos hábitos alimentares foi identificada elevada frequência de consumo de carne vermelha, margarina, azeite, açúcar e baixo consumo de peixes. A comparação entre os gêneros apresentou diferença significativa em relação à obesidade, detectada pelo IMC, e hipertensão, e ambas foram mais presentes entre mulheres. A medida da circunferência da cintura também evidenciou maior risco cardiovascular nas mulheres. CONCLUSÃO: Foram identificados fatores de risco para doenças cardiovasculares nos pais/cuidadores avaliados, como excesso de peso, sedentarismo e hipertensão, além de hábitos alimentares inadequados como elevada frequência de consumo de gorduras saturadas e colesterol e baixa frequência de consumo de gorduras insaturadas.

BACKGROUND: Cardiovascular diseases are one of the major causes of morbidity and mortality worldwide. In Brazil, they are the major cause of death. OBJECTIVE: To identify cardiovascular risk factors in parents/caregivers of children with heart diseases by assessing their nutritional status, health conditions, and life style. METHODS: Cross-sectional study of 150 parents or caregivers of children with heart diseases who attended a cardiology outpatient clinic. Data on identification, lifestyle and health conditions were collected by means of a structured questionnaire. For the assessment of the eating habits, a questionnaire on eating frequency was used; for the assessment of the nutritional status, weight, height, and waist circumference were measured, and the body mass index (BMI) was calculated and classified. RESULTS: A total of 155 parents of children with heart diseases, predominantly of the female gender (91.6%), were evaluated; their mean age was 35.0 ± 10.6 years. The most prevalent risk factors were sedentary lifestyle (85.2%), obesity (28%) and hypertension (22.6%). As regards the eating habits, a high frequency of intake of red meat, margarine, vegetable oil, and sugar and low intake of fish were observed. Comparison between genders showed a significant difference in relation to obesity, as detected by BMI, and hypertension, both more frequent among women. Waist circumference measurement also showed a higher cardiovascular risk in women. CONCLUSION: Cardiovascular risk factors such as excess weight, sedentary lifestyle, and hypertension as well as inadequate eating habits such as a high frequency of intake of saturated fat and cholesterol and low intake of unsaturated fat were identified in the parents/caregivers assessed.

Identification of cardiovascular risk factors in parents/caregivers of children with heart diseases.

BACKGROUND: Cardiovascular diseases are one of the major causes of morbidity and mortality worldwide. In Brazil, they are the major cause of death. OBJECTIVE: To identify cardiovascular risk factors in parents/caregivers of children with heart diseases by assessing their nutritional status, health conditions, and life style. METHODS: Cross-sectional study of 150 parents or caregivers of children with heart diseases who attended a cardiology outpatient clinic. Data on identification, lifestyle and health conditions were collected by means of a structured questionnaire. For the assessment of the eating habits, a questionnaire on eating frequency was used; for the assessment of the nutritional status, weight, height, and waist circumference were measured, and the body mass index (BMI) was calculated and classified. RESULTS: A total of 155 parents of children with heart diseases, predominantly of the female gender (91.6%), were evaluated; their mean age was 35.0 ± 10.6 years. The most prevalent risk factors were sedentary lifestyle (85.2%), obesity (28%) and hypertension (22.6%). As regards the eating habits, a high frequency of intake of red meat, margarine, vegetable oil, and sugar and low intake of fish were observed. Comparison between genders showed a significant difference in relation to obesity, as detected by BMI, and hypertension, both more frequent among women. Waist circumference measurement also showed a higher cardiovascular risk in women. CONCLUSION: Cardiovascular risk factors such as excess weight, sedentary lifestyle, and hypertension as well as inadequate eating habits such as a high frequency of intake of saturated fat and cholesterol and low intake of unsaturated fat were identified in the parents/caregivers assessed.

Intervenção nutricional e o impacto na adesão ao tratamento em pacientes com síndrome Metabólica / Nutritional intervention and the impact on adherence to treatment in patients with metabolic syndrome

FUNDAMENTO: A síndrome metabólica representa um conjunto de fatores de risco, associados a doenças cardiovasculares e a diabete melito tipo 2. O tratamento inclui mudanças no estilo de vida, dieta, atividade física e medicamentos. A adesão do paciente é crucial ao tratamento da doença. Objetivo: Avaliar dois modelos de intervenção dietoterápica e a relação com a adesão ao tratamento e o impacto na melhora clínica de pacientes com síndrome metabólica. MÉTODOS: Ensaio clínico randomizado, com duração de quatro meses. Os pacientes foram randomizados em grupos intervenção e controle. Todos seguiram dieta específica por quatro meses. O grupo Intervenção recebeu pacote de intervenção, com dieta individualizada, manual de orientação, aconselhamento via telefone e material educativo. Foram realizadas anamnese nutricional, avaliação antropométrica, avaliação dietética, orientação dietética individualizada e exames bioquímicos. RESULTADOS: Os pacientes que chegaram mais motivados foram aqueles que tiverem maior redução nos valores do índice de massa corporal (p < 0,001), que reduziu de 31,7 kg/m² (DP ± 3,9) para 30,9 kg/m² (DP ± 3,8), na circunferência abdominal a redução foi de 108,1 cm (DP ± 9,8) para 105,9 cm (DP ± 9,5). As associações estatisticamente significativas se deram nas correlações entre índice de massa corporal, glicemia e triglicerídeos, redução do consumo de leite integral (p = 0,002), aumento no consumo de cereais integrais (p = 0,008) e de leite desnatado (p = 0,010), e entre o aumento no consumo de vegetais e a redução dos triglicerídeos. CONCLUSÃO: Ambos os grupos mostraram melhora significativa nos parâmetros clínicos, que foi significativamente associada a motivação prévia. Os pacientes que chegaram mais motivados foram aqueles que responderam melhor ao tratamento.

BACKGROUND: Metabolic syndrome is associated with increased risk of cardiovascular events disease and type 2 diabetes. Treatment includes modifications on life style, diet and physical activity. Treatment adherence plays a crucial role in the successful treatment of this disease. OBJECTIVE: To evaluate two models of dietary intervention, and the relationship with adherence to treatment and impact on clinical improvement of patients with metabolic syndrome. METHODS: Randomized clinical trial, lasting four months. Participants were randomized assigned to the intervention or control group. Both groups were instructed to follow a diet for 4 months. Subjects in the intervention group additionally received an intervention package, with metabolic syndrome manual book, telephone counseling and nutrition education leaflets. In both groups nutritional anamnesis, anthropometric assessment, dietary assessment, individualized dietary and biochemical tests were done. RESULTS: Patients who arrived more motivated were those who has the greatest reduction in the values of body mass index, which decreased from 31.7 kg/m² (SD ± 3.9) to 30.9 kg/m² (SD ± 3.8), reduction in waist circumference was 108.1 cm (SD ± 9.8) to 105.9 cm (SD ± 9.5). The statistically significant associations were in the correlation between body mass index, blood glucose and triglycerides, reducing the consumption of whole milk, increased consumption of whole grains and skimmed milk and between the increase in vegetable intake and reducing triglycerides. CONCLUSION: Both groups showed significant improvement in all clinical parameters that was significantly associated with the previous motivation. Patients who arrived more motivated were those who responded better to treatment.

Nutritional intervention and the impact on adherence to treatment in patients with metabolic syndrome.

BACKGROUND: Metabolic syndrome is associated with increased risk of cardiovascular events disease and type 2 diabetes. Treatment includes modifications on life style, diet and physical activity. Treatment adherence plays a crucial role in the successful treatment of this disease. OBJECTIVE: To evaluate two models of dietary intervention, and the relationship with adherence to treatment and impact on clinical improvement of patients with metabolic syndrome. METHODS: Randomized clinical trial, lasting four months. Participants were randomized assigned to the intervention or control group. Both groups were instructed to follow a diet for 4 months. Subjects in the intervention group additionally received an intervention package, with metabolic syndrome manual book, telephone counseling and nutrition education leaflets. In both groups nutritional anamnesis, anthropometric assessment, dietary assessment, individualized dietary and biochemical tests were done. RESULTS: Patients who arrived more motivated were those who has the greatest reduction in the values of body mass index, which decreased from 31.7 kg/m² (SD ± 3.9) to 30.9 kg/m² (SD ± 3.8), reduction in waist circumference was 108.1 cm (SD ± 9.8) to 105.9 cm (SD ± 9.5). The statistically significant associations were in the correlation between body mass index, blood glucose and triglycerides, reducing the consumption of whole milk, increased consumption of whole grains and skimmed milk and between the increase in vegetable intake and reducing triglycerides. CONCLUSION: Both groups showed significant improvement in all clinical parameters that was significantly associated with the previous motivation. Patients who arrived more motivated were those who responded better to treatment.