The Effect of Exogenous Melatonin on Eating Habits of Female Night Workers with Excessive Weight.

BACKGROUND AND AIMS: Melatonin is a pineal hormone that plays an important role as an endogenous synchronizer of circadian rhythms and energy metabolism. As this circadian component has been closely related to eating behavior, an important question on this topic would be whether melatonin administration could influence eating habits. However, this topic has been rarely studied in the literature in individuals with excessive weight and chronic circadian misalignment, such as shift workers. Therefore, the present study aims to evaluate the effects of exogenous melatonin administration on the quali/quantitative aspects and temporal distribution of food intake in female night workers with excessive weight (overweight and obesity). An additional aim is to evaluate the association of the referred outcomes with circadian misalignment and chronotype. METHODS: A randomized, double-blind, placebo-controlled, crossover clinical trial was conducted with 27 female nursing professionals with excessive weight who worked permanent night shifts. The protocol was implemented under real-life conditions for 24 weeks, in two randomly allocated conditions (12 weeks of melatonin and 12 weeks of placebo). The quali/quantitative aspects of food intake (NOVA classification, total energy intake and the proportion of calories from macronutrients) and meal timing were assessed using food diaries. Timing for every meal recorded in the diaries was assessed to evaluate the temporal distribution of food intake. Generalized estimating equations were performed for each dependent variable. RESULTS: No significant modifications in total energy intake, macronutrient distribution, types of foods consumed, and meal timing were observed after melatonin administration. Different levels of circadian misalignment and chronotype did not interfere with these results. CONCLUSION: Eating habits of female night workers with excessive weight remained unchanged after melatonin administration, and no association of these results with circadian misalignment and chronotype was found. These results suggest that the metabolic effects of melatonin may occur independently of food intake.

Eating habits, sleep, and a proxy for circadian disruption are correlated with dyslipidemia in overweight night workers.

OBJECTIVE: The aim of this study was to evaluate the relationship between proxy for circadian disruption, eating habits, sleep characteristics, and dyslipidemic parameters. METHODS: This was a randomized, double-blind, crossover controlled clinical trial, and for this study, only baseline data were used. The sample was composed of 36 overweight female nurses who worked on a fixed night shift (12 × 36 h). Linear regression models were used to assess the relationship between the mentioned variables. RESULTS: The participants' average age was 39.4 y (Standard error (SE) 1 y) and the average nighttime sleep duration was 5.76 h (SE 0.16 h). The average chronotype indicated a moderate early type (03:03 h; SE 20 min) and the average social jetlag was 03:42 h (SE 10 min). It was found that 1 h less of nighttime sleep increased very-low-density lipoprotein cholesterol levels by 2.75 mg/dL and triacylglyceride levels by 3.62 mg/dL. Additionally, higher social jetlag was associated with higher low-density lipoprotein cholesterol levels. On the other hand, each additional hour in the chronotype increased high-density lipoprotein cholesterol levels by 3.06 mg/dL and a time interval >2 h between the last meal and sleep onset was associated with higher high-density lipoprotein cholesterol levels. CONCLUSION: Short duration of nighttime sleep and high social jetlag are risk factors for dyslipidemia, whereas the late type and the longer time interval between the last meal and sleep onset appear to be protective factors for dyslipidemia.

Trabalho noturno e sintomas de fadiga estão associados aos indicadores de monitoramento clínico de trabalhadores vivendo com HIV / Night work and fatigue symptoms are associated with clinical monitoring indicators among workers living with HIV

Introdução: A infecção pelo vírus da imunodeficiência adquirida (HIV) assumiu características de doença crônica, tornando necessário seu acompanhamento em longo prazo. Nesse aspecto, a organização do trabalho pode tanto prevenir quanto aumentar a vulnerabilidade a um pior prognóstico clínico. Objetivo: Avaliar os indicadores de monitoramento clínico do HIV de acordo com o turno de trabalho, capacidade para o trabalho e sintomas de fadiga entre trabalhadores vivendo com HIV. Métodos: Estudo transversal com 115 trabalhadores vivendo com HIV (97 diurnos e 18 noturnos), em seguimento clínico pelo Serviço de Assistência Especializada de Santos, São Paulo. Para comparação da carga viral, contagem de linfócitos T CD4 e relação CD4/CD8 em função do turno, capacidade para o trabalho e sintomas de fadiga, foram realizados modelos lineares generalizados (post-hoc LSD) ajustados por sexo, idade, tempo de diagnóstico, tempo de terapia antirretroviral, uso de efavirenz, substâncias psicoativas e distúrbio emocional. Resultados: Verificou-se associação dos sintomas de fadiga com linfócitos T CD4 e relação CD4/CD8, em que trabalhadores com moderada necessidade de recuperação após o trabalho apresentaram maior contagem de linfócitos T CD4 (p=0,02) e trabalhadores com maior necessidade apresentaram maior relação CD4/CD8 (p=0,03). Também se verificou associação limítrofe entre turno e linfócitos T CD4, em que trabalhadores noturnos apresentaram menor contagem de linfócitos T CD4 (p=0,05). Não houve diferença nos indicadores em função da capacidade para o trabalho. Conclusões: Trabalhadores noturnos apresentam piores indicadores de monitoramento clínico do HIV, enquanto trabalhadores com mais sintomas de fadiga apresentam melhores indicadores. A capacidade para o trabalho não influencia os indicadores de monitoramento clínico do HIV.

Background: Infection with the human immunodeficiency virus (HIV) acquired the features of a chronic disease, thus requiring long-term follow-up. Different forms of work organization might prevent or increase the likelihood of poorer clinical prognosis. Objective: To analyze HIV clinical monitoring indicators according to work shift, work ability and fatigue symptoms relative to workers living with HIV. Methods: Cross-sectional study conducted with 115 workers (daytime: 97; night shift: 18) living with HIV followed up at the Specialized Care Service of Santos, Sao Paulo, Brazil. Generalized linear models (with LSD as post hoc test) were fitted to compare viral load, CD4+ T cell count and CD4+/CD8+ ratio according to work shift, work ability and fatigue symptoms adjusted for sex, age, time since diagnosis, duration of antiretroviral therapy, use of efavirenz and psychoactive substances, and emotional disorders. Results: We found association of fatigue symptoms with CD4+ T cell count and CD4+/CD8+ ratio; the CD4+ T cell count was higher among the participants with moderate need for recovery after work (p=0.02) and the CD4+/CD8+ ratio among those with lower need for recovery (p=0.03). We also found a borderline relationship (p=0.05) between work shift and CD4+ T cell count, which was lower for night workers. Difference was not found in the analyzed indicators as a function of work ability. Conclusion: HIV clinical monitoring indicators were poorer for night workers and better for those with more severe fatigue symptoms. Work ability did not influence HIV clinical monitoring indicators

Transtornos Mentais Comuns estão associados a maior carga viral em Pessoas Vivendo com HIV / Common Mental Disorders are associated with higher viral load in People Living with HIV

RESUMO O presente estudo teve como objetivo investigar a associação entre Transtornos Mentais Comuns (TMC) e carga viral de Pessoas Vivendo com Vírus da Imunodeficiência Humana - HIV (PVHIV) em seguimento clínico. Foi realizado um estudo transversal com 307 PVHIV com ≥ 18 anos de idade que estavam em terapia antirretroviral no Serviço de Assistência Especializada do município de Santos (SP) em 2016. A variável dependente de estudo foi a quantificação da carga viral; e a variável independente compreendeu os transtornos mentais comuns, avaliados pelo Self-Reporting Questionnaire (SRQ-20). Para comparação das médias das variáveis, foram realizados modelos lineares generalizados com nível de significância de 5%. Conclui-se que os TMC estão associados a uma maior carga viral entre PVHIV em seguimento clínico.

ABSTRACT The present study aimed to investigate the association between Common Mental Disorders (CMD) and viral load in People Living with Human Immunodeficiency Virus - HIV (PLHIV) in clinical follow-up. A cross-sectional study was performed with 307 PLHIV aged ≥ 18 years who were on antiretroviral therapy at the Specialized Care Service of the city of Santos (SP) in 2016. The dependent variable of the study was the quantification of viral load and the independent variable comprised the minor psychic disorders assessed by the Self-Reporting Questionnaire (SRQ-20). To compare the mean levels of the variables, generalized linear models were performed with significance level of 5%. It is concluded that CMD are associated with a higher viral load among PLHIV in clinical follow-up.

Fatores associados à não diminuição do índice de massa corporal em mulheres após intervenção nutricional / Factors associated with non-reduction of body mass index in women after nutritional intervention

Introdução: As elevadas prevalências de sobrepeso e obesidade continuam a representar um desafio para os sistemas de saúde. Diante disso, programas de intervenção nutricional que têm como base a comunidade são relevantes à saúde pública e precisam ser melhor investigados. Objetivo: Analisar os fatores associados à não diminuição do índice de massa corporal (IMC) de mulheres adultas e idosas após a participação em um programa de intervenção nutricional. Métodos: Estudo quase-experimental para avaliação de uma intervenção nutricional individualizada com 2.512 mulheres (2.129 adultas e 383 idosas) atendidas por um ambulatório de nutrição. Foi realizada análise de regressão logística bivariada e múltipla para avaliar os fatores associados à não diminuição do IMC após a intervenção. Resultados: A maioria das mulheres apresentou redução do peso corporal após a intervenção, sendo a maior proporção entre as idosas. Para as mulheres adultas, possuir assistência médica privada e participar do programa por um período menor ou igual a 30 dias foram fatores associados à não diminuição do IMC. Para as idosas, os fatores associados foram problemas de deglutição e participar do programa por um período menor ou igual a 30 dias. Discussão: Os resultados demonstram a efetividade do programa de intervenção nutricional. Concomitantemente, apontam para a necessidade de que outros fatores envolvidos no processo de emagrecimento sejam trabalhados em conjunto para que a intervenção seja ainda mais eficaz, uma vez que a redução observada não foi suficiente para alterar a classificação do IMC das participantes. Conclusões: A intervenção foi efetiva na diminuição do IMC, no entanto, fatores relacionados ao tempo de adesão à intervenção, saúde, aspectos individuais e sociais influenciam na não diminuição IMC de mulheres adultas e idosas

Introduction: The high prevalence of overweight and obesity continues to pose a challenge for health systems. Therefore, community-based nutrition intervention programs are relevant to public health and need to be better investigated. Objective: To analyze the factors associated to the non-reduction of the body mass index (BMI) of adult and elderly women after participating in a nutritional intervention program. Methods: A quasi-experimental study was carried out to evaluate an individualized nutritional intervention with 2,512 women (2,129 adults and 383 elderly) attended by a nutrition clinic. A bivariate and multiple logistic regression analysis was performed to evaluate the factors associated with no decrease in BMI after the intervention. Results: Most of the women presented a reduction of the body weight after the intervention, being the greater proportion among the elderly women. For adult women, having private medical care and participating in the program for a period of less than or equal to 30 days were factors associated with not decreasing BMI. For the elderly, the associated factors were deglutition problems and to participate in the program for a period of less than or equal to 30 days. Discussion: The results demonstrate the effectiveness of the nutritional intervention program. Concomitantly, they point to the need for other factors involved in the weight loss process to be worked together to make the intervention even more effective, since the observed reduction was not enough to change the BMI classification of the participants. Conclusions: The intervention was effective in reducing BMI; however, factors related to the time of adherence to the intervention, health, individual and social aspects influence the non-BMI decrease in adult and elderly women

No disponible