The increase of dairy intake is the main dietary factor associated with reduction of body weight in overweight adults after lifestyle change program / El aumento de la ingesta de lácteos es el principal factor dietético asociado con la reducción del peso corporal en adultos con sobrepeso después de un programa de cambio de estilo de vida

This study evaluated which was the main nutritional change associated with weight reduction of overweight adult participants of a lifestyle change program. It was hypothesized that increases in dairy intake could be an important nutrition intervention in a lifestyle change program. 117 individuals, male (19.5%) and female (80.5%), with a minimum age of 36 years (54.2±10.4). All study participants were enrolled in a lifestyle change program consisting of nutritional counseling and physical activity during 20 weeks. All participants were grouped in three groups according to Body Mass Index (BMI) delta median (-0.87 kg/m2 ) of individuals that showed weight loss: G1 - lost more than 0.87 kg/m2 of BMI (n=38); G2 - lost 0 to 0.87 kg/m2 of BMI (n=36); and G3 - increased BMI (n=43). G1 increased dairy, fruit and vegetables intake and after forward stepwise multiple regression analysis, it was noted that an increase in dairy product intake of 0.40 servings per day had an impact of 9.6% on the loss of one kg/m2 of BMI. In conclusion, an increase in dairy product intake was the main dietary factor associated with reductions in body weight in overweight adults after 20 weeks of lifestyle change program (AU)

Este estudio evaluó cuál era el cambio nutricional principal asociado con la reducción de peso de los participantes adultos con sobrepeso de un programa de cambio de estilo de vida. La hipótesis era que el aumento de la ingesta de lácteos podría ser una importante intervención nutricional en un programa de cambio de estilo de vida. 117 personas, de sexo masculino (19,5%) y mujeres (80,5%), con una edad mínima de 36 años (54,2±10,4). Todos los participantes en el estudio fueron incluidos en un programa de cambio de estilo de vida que consiste en el asesoramiento nutricional y la actividad física durante 20 semanas. Todos los participantes fueron agrupados en tres grupos de acuerdo con el Índice de Masa Corporal (IMC) medio delta (-0,87 kg/m2 ): G1 - perdieron más de 0,87 kg/m2 (n=38); G2 - perdió 0-0,87 kg/m2 (n=36); y G3 - aumentó el IMC (n=43). El G1 aumentó lácteos, frutas y verduras y después de un análisis de regresión múltiple por pasos hacia adelante se observó un aumento en la ingesta de productos lácteos de 0,40 porciones por día que tuvo un impacto del 9,6% en la pérdida de un kg/ m2 de IMC. En conclusión, el aumento en la ingesta de productos lácteos fue el principal factor dietético asociado con reducciones en el peso corporal en adultos con sobrepeso después de 20 semanas de programa de cambio de estilo de vida (AU)

Therapeutic interventions to reduce the risk of progression from prediabetes to type 2 diabetes mellitus.

Clinical trials have demonstrated that it is possible to prevent diabetes through lifestyle modification, pharmacological intervention, and surgery. This review aims to summarize the effectiveness of these various therapeutic interventions in reducing the risk of progression of prediabetes to diabetes, and address the challenges to implement a diabetes prevention program at a community level. Strategies focusing on intensive lifestyle changes are not only efficient but cost-effective and/or cost-saving. Indeed, lifestyle intervention in people at high risk for type 2 diabetes mellitus (T2DM) has been successful in achieving sustained behavioral changes and a reduction in diabetes incidence even after the counseling is stopped. Although prediabetes is associated with health and economic burdens, it has not been adequately addressed by interventions or regulatory agencies in terms of prevention or disease management. Lifestyle intervention strategies to prevent T2DM should be distinct for different populations around the globe and should emphasize sex, age, ethnicity, and cultural and geographical considerations to be feasible and to promote better compliance. The translation of diabetes prevention research at a population level, especially finding the most effective methods of preventing T2DM in various societies and cultural settings remains challenging, but must be accomplished to stop this worldwide epidemic.

A variedade da dieta é fator protetor para a pressão arterial sistólica elevada / Dietary variety is a protective factor for elevated systolic blood pressure

FUNDAMENTO: A dieta influencia diretamente a hipertensão arterial (HAS), que é um dos principais fatores de risco da doença cardiovascular. OBJETIVO: Associar a HAS com fatores dietéticos de adultos clinicamente selecionados para programa de mudança de estilo de vida. MÉTODOS: Estudo transversal composto por 335 indivíduos, com idade entre 44 e 65 anos, clinicamente selecionados para um programa de mudança de estilo de vida. Foram avaliados os dados antropométricos (IMC, % de gordura e circunferência abdominal), os componentes bioquímicos (concentrações plasmáticas de glicose, triglicerídeos, colesterol total, HDL-c e LDL-c) e a dieta, por meio do recordatório de 24 horas. A qualidade da dieta foi avaliada pelo Índice de Alimentação Saudável. A pressão arterial foi mensurada de acordo com a V Diretriz Brasileira de Hipertensão Arterial e classificada de acordo com o NCEP-ATPIII. A regressão logística foi realizada para determinar a probabilidade de alterações na PAS e PAD de acordo com a ingestão dietética. Adotou-se como significante o valor de p < 0,05. RESULTADOS: Observou-se correlação positiva da pressão arterial diastólica com o consumo de colesterol e açúcar; e negativa com a ingestão de fibras, porções de óleo e qualidade da dieta. A variedade da dieta ≥ 8 itens alimentares apresentou efeito protetor para alterações da pressão arterial sistólica; OR = 0,361 (0,148-0,878). CONCLUSÃO: A maior variedade da dieta ofereceu efeito protetor para alteração da pressão arterial sistólica.

BACKGROUND: Diet directly influences systemic arterial hypertension (SAH), which is one of the main risk factors for cardiovascular disease. OBJECTIVE: To associate hypertension with dietary factors in adults clinically selected for a change-of-lifestyle program. METHODS: Cross-sectional study comprising 335 individuals, aged between 44 and 65 years, clinically selected for a change-of-lifestyle program. We evaluated anthropometric data (BMI, %body fat and waist circumference), biochemical components (plasma glucose, triglycerides, total cholesterol, HDL-C and LDL-c) and diet, through the 24-hour recall method. The quality of the diet was assessed by the Healthy Eating Index. Blood pressure was measured according to the V Brazilian Guidelines on Hypertension and classified according to NCEP-ATPIII. Logistic regression was performed to determine the likelihood of changes in SBP and DBP according to dietary intake. The level of significance was set at p <0.05. RESULTS: There was a positive correlation between diastolic blood pressure and sugar and cholesterol intake, and a negative one with intake of fiber, portions of oil and fats and diet quality. Dietary variety with ≥ 8 food items showed a protective effect for alterations in systolic blood pressure, OR = 0.361 (0.148 to 0.878). CONCLUSION: A greater dietary variety had a protective effect on the systolic blood pressure.

Dietary variety is a protective factor for elevated systolic blood pressure.

BACKGROUND: Diet directly influences systemic arterial hypertension (SAH), which is one of the main risk factors for cardiovascular disease. OBJECTIVE: To associate hypertension with dietary factors in adults clinically selected for a change-of-lifestyle program. METHODS: Cross-sectional study comprising 335 individuals, aged between 44 and 65 years, clinically selected for a change-of-lifestyle program. We evaluated anthropometric data (BMI, %body fat and waist circumference), biochemical components (plasma glucose, triglycerides, total cholesterol, HDL-C and LDL-c) and diet, through the 24-hour recall method. The quality of the diet was assessed by the Healthy Eating Index. Blood pressure was measured according to the V Brazilian Guidelines on Hypertension and classified according to NCEP-ATPIII. Logistic regression was performed to determine the likelihood of changes in SBP and DBP according to dietary intake. The level of significance was set at p <0.05. RESULTS: There was a positive correlation between diastolic blood pressure and sugar and cholesterol intake, and a negative one with intake of fiber, portions of oil and fats and diet quality. Dietary variety with ≥ 8 food items showed a protective effect for alterations in systolic blood pressure, OR = 0.361 (0.148 to 0.878). CONCLUSION: A greater dietary variety had a protective effect on the systolic blood pressure.

Metabolic syndrome and dietary components are associated with coronary artery disease risk score in free-living adults: a cross-sectional study.

BACKGROUND: Coronary artery disease (CAD) is among the main causes of death in developed countries, and diet and lifestyle can influence CAD incidence. OBJECTIVE: To evaluate the association of coronary artery disease risk score with dietary, anthropometric and biochemical components in adults clinically selected for a lifestyle modification program. METHODS: 362 adults (96 men, 266 women, 53.9 ± 9.4 years) fulfilled the inclusion criteria by presenting all the required data. The Framingham score was calculated and the IV Brazilian Guideline on Dyslipidemia and Prevention of Atherosclerosis was adopted for classification of the CAD risks. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m2) and muscle-mass index (MMI kg/m2). Dietary intake was estimated through 24 h dietary recall. Fasting blood was used for biochemical analysis. Metabolic Syndrome (MS) was diagnosed using NCEP-ATPIII (2001) criteria. Logistic regression was used to determine the odds of CAD risks according to the altered components of MS, dietary, anthropometric, and biochemical components. RESULTS: For a sample with a BMI 28.5 ± 5.0 kg/m2 the association with lower risk (<10% CAD) were lower age (<60 years old), and plasma values of uric acid. The presence of MS within low, intermediary, and high CAD risk categories was 30.8%, 55.5%, and 69.8%, respectively. The independent risk factors associated with CAD risk score was MS and uric acid, and the protective factors were recommended intake of saturated fat and fiber and muscle mass index. CONCLUSION: Recommended intake of saturated fat and dietary fiber, together with proper muscle mass, are inversely associated with CAD risk score. On the other hand, the presence of MS and high plasma uric acid are associated with CAD risk score.

[Relationship of pattern hyperlipidic intake with quality of diet, insulin resistance and homocysteinemia in adults]. / Associação do padrão de ingestão lípidica com a qualidade da dieta, resistência insulínica e homocisteinemia em adultos.

OBJECTIVES: To evaluate the association between the consumption of different dietary fats with the quality of the diet, insulin resistance, and hyperhomocysteinemia in adults. METHODS: Cross-sectional study conducted with 624 overweight subjects (73.7% females). Assessments of food intake (24h food recall and health eating index-HEI), anthropometry, and biochemical assays of fasting glucose, insulin (HOMA-IR and ß calculus) and homocysteinemia were performed. RESULTS: The low quality of diet was associated with the vegetable oil at 3rd quintile (≥1.5-2.0 servings) showed risk 2.9 times and cholesterol at quintiles 2nd, 3rd, and 4th was 2.0 times. HOMA-IR was higher at 5th quintile of saturated fat (≥10,7% - total caloric value) with risk of 60% and hyperhomocysteinemia the vegetable oil at 3rd quintile (>1.5-2.0 servings) with risk of 12.0 times and 5th (≥3.5 servings) 7.1 times. However, significance disappeared when adjusted for anthropometric variables. CONCLUSION: Dietary fats were associated with the harm diet quality, insulin resistance, andhyperhomocysteinemia. However, associations are dependant of demographic variables, dietetic, and nutritional state.

Dental and gastrointestinal changes as indicators of nutritional depletion in elderly inpatients.

OBJECTIVE: The objective of this study was to identify the associations between the nutritional status of elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. CASUISTIC AND METHOD: This cross-sectional study analyzed anthropometric and food intake indicators, dental and gastrointestinal changes and length of hospital stay of 441 elderly patients of both genders. The Pearson's correlation coefficient was used to verify the correlation between the nutritional status of the elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. The significance level was set at P < 0.05. RESULTS: Dietary and anthropometric variables as well as length of hospital stay were similar for patients with and without dental changes. Patients with gastrointestinal changes consumed less energy (P < 0.05) than patients without gastrointestinal changes. Length of hospital stay was inversely correlated with body mass index (r = -0.15; P < 0.05); arm circumference was inversely correlated with presence of dental changes (r = -0.12; P < 0.05) and mid-arm muscle circumference was inversely correlated with gastrointestinal changes (r = -0.12; P < 0.05). CONCLUSION: Dental and gastrointestinal changes are important indicators of nutritional depletion and dietary intake of inpatients.

Association of dyslipidemia with intakes of fruit and vegetables and the body fat content of adults clinically selected for a lifestyle modification program / Associación de la dislipidemia con la ingestión de frutas y vegetales y el contenido de grasa corporal de adultos seleccionados para un programa de modificación del estilo de vida

To investigate the relationship of dyslipidemia with demographic distribution and patterns of body fat and dietary intakes. From a universe of adults clinically selected for a lifestyle modification program 979 subjects (409 males and 570 females, 52.2 ± 9.6 years) fulfilled the inclusion criteria. Overnight-fasting plasma was assayed (dry chemistry) for triglycerides (TG), total (TC) and HDL fraction of cholesterol given the non-HDL (n-HDL) fraction by the difference. Anthropometric assessment included body weight (kg), height (m), fat (bioelectrical impedance) and waist circumference (WC). Food intake was assessed by the 24-hour recall questionnaire and the food groups evaluated through recommendations from an adapted food pyramid. The chances of dyslipidemia from other variable changes were determined by logistic regression with p2 servings). Dietary intakes have protective effects against hypertriglyceridemia with whole grains, odds ratio (OR) 0.342 (CI 95%, 0.154-0.760), fruits >3 servings (OR 0.523, 0.290-0.941) and vegetables >4 servings (OR 0.360, 0.176-0.735). In general total body and abdominal adiposity influenced all dyslipidemia markers while dietary intake of fruits and vegetables protected against triglyceridemia.

Investigar las relaciones de dislipidemia con distribución demográfica y patrones de masa corporal e ingestión de alimentos. De un universo de adultos clínicamente seleccionados para un programa de modificación de estilo de vida, 979 sujetos (409 hombres y 570 mujeres, 52,2 ± 9,6 años) cumplieron con los criterios de inclusión. Se examinó el plasma cosechado tras ayuno nocturno (química seca) para averiguar si hay la presencia de triglicéridos (TG), colesterol total (CT) y fracción de colesterol dada la fracción no HDL por diferencia. Una evaluación antropométrica incluyó peso corporal (kg), altura (m), grasa (impedancia bioeléctrica) y circunferencia de la cintura (CC). Se evaluó la ingestión de alimentos con el cuestionario de tipo recordatorio de 24 horas y los grupos de alimentos evaluados por la pirámide de alimentos recomendada. Se determinaron las probabilidades de dislipidemia de otros cambios variables con regresión logística p2 porciones). El consumo en la dieta protege de hipertrigliceridemia con odds ratio de granos integrales (OR) 0,342 (CI 95%, 0,154-0,760), frutas >3 porciones (OR 0.523, 0.290-0.941) y hortalizas >4 porciones (OR 0.360, 0.176-0.735). En general la adiposidad corporal total y abdominal influenció todos los marcadores de dislipidemia y solamente la trigliceridemia fue protegida por ingestión de frutas y hortalizas en la dieta.

Determinação do índice glicêmico e da carga glicêmica de dietas hospitalares para indivíduos com diabetes. / Identification of glycemic index and glycemic load in hospital meals for individuals with diabetes.

O índice glicêmico (IG) e a carga glicêmica (CG) vêm se tornando uma nova ferramenta para auxiliar no controle da glicemia e na elaboração de dietas para pessoas com diabetes mellitus (DM). Com o objetivo de identificar a CG e o IG de dietas hospitalares oferecidas para pacientes com DM, realizou-se uma pesquisa a partir da análise das refeições oferecidas aos indivíduos com DM internados em três hospitais do município de Campinas (h1,h2,h3). O IG e a CG das dietas foram determinados, calculados e classificados de acordo com o recomendado pela literatura. Os valores de CG e IG das refeições nos três hospitais foram semelhantes e apresentaram-se, em sua maioria, inadequados. A presença de frutas, hortaliças e laticínios nas refeições influenciou o IG e a CG das dietas. O IG apresentou correlação positiva e significativa (r=0,83, p=0,04) com a CG no h2. Já no h3, o IG apresentou correlação negativa (r=0,91, p=0,02) com a CG. As dietas hospitalares apresentaram inadequados IG e CG, e a inclusão de frutas, hortaliças e alimentos lácteos pode contribuir para a diminuição do IG e CG global dessas dietas.

Glycemic index (GI) and glycemic load (GL) have become new tools for controlling glicemia and elaborating diet plans for patients with diabetes mellitus. This study aimed to identify the GI and GL of meals offered to patients with diabetes at three public hospitals (h1,h2,h3) located in Campinas, São Paulo, Brazil. The GI and GL of the meals were determined and analyzed according to literature. The mean values of GI and GL of meals were similar in all hospitals and their meals were classified as inappropriate. Fruits, vegetables and dairy products were seen to influence GI and GL of meals. GL presented a positive and significant association (r=0.83, p=0.04) with GL in h2. In h3, GI showed negative correlation (r= 0.91, p=0.02) with GL. The meals offered to patients with diabetes at the three hospitals were classified as inappropriate. The inclusion of fruits, vegetables and dairy products may contribute to a decrease of GI and GL of these meals.

Associação do consumo de gorduras e do nível socioeconômico sobre as medidas antropométricas de adultos. / Association of fat intake and socioeconomic status on anthropometric measurements of adults.

O objetivo do estudo foi identificar a influência das gorduras dietéticas sobre o índice de massa corporal (IMC) e a circunferência abdominal (CA) em uma amostra populacional de adultos. O estudo tranversal foi realizado com 448 adultos, entre 35 e 85 anos, de janeiro de 2004 a dezembro de 2007. Os indivíduos foram divididos em dois grupos de acordo com a renda familiar: Grupo 1 (G1) com maior renda, e Grupo 2 (G2) com menor renda. Foram levantadas variáveis socioeconômicas e demográficas, juntamente com variáveis antropométricas, índice de alimentação saudável (IAS) e perfil dietético. Os grupos foram semelhantes quanto ao gênero, à idade, ao IMC, e à CA. O IAS foi maior no G1 em decorrência do maior consumo de proteínas (+12,8%), laticínios (p<0.001), maior consumo de hortaliças (p<0,01), frutas (p<0,001), e menor de gordura (-9,8%). A maior contribuição das gorduras foi a saturada para o G1 (+5,0%) e a polinsaturada para o G2 (+14,4%). Apesar das diferenças socioeconômicas os grupos foram similares quanto ao IMC e à adiposidade abdominal. As diferenças no perfil do consumo de gorduras foram correlacionadas com as medidas antropométricas e puderam ser explicadas pelo menor consumo de óleo entre os indivíduos de renda mais elevada.

We aimed to identify the influence of dietary fat profile on body mass index (BMI) and waist circumference (WC) in a middle-class general population sample. A cross-sectional study of 448 adults aged 35-85 years was carried out from January 2004 to December 2007. Patients were divided in two groups according to family income: Group 1 (G1) with higher income, and Group 2 (G2) with lower income. Demographic and socioeconomic status were identified, along with anthropometric data, health eating index (HEI) and dietary profile. The groups were similar with respect to gender, age, BMI and WC. HEI was higher in G1 due to a higher intake of protein (+12.8%), dairy products (p<0.001), higher intake of vegetables (p<0.01), fruit (p<0.001), and less dietary fat (-9.8%). The main contribution of fats was saturated fat for G1 (+5.0%) and polyunsaturated fat for G2 (+14.4%). Besides differences in socioeconomic status the groups had similar BMI and abdominal fatness. Only differences in fat profile were correlated with the anthropometric measures mostly explained by the lower vegetable oil intake in higher income participants.

Estado nutricional e composição corporal de pacientes hospitalizados: reflexos da transição nutricional / Nutritional status and body composition of inpatients: the effects of nutritional transition

Objetivos: Investigar o reflexo da transição nutricional sobre o estado nutricional e a composição corporal de pacientes hospitalizados. Métodos: Avaliaram-se 819 pacientes hospitalizados (435 homens e 384 mulheres) sob aspectos clínicos, antropométricos e dietéticos. As variáveis antropométricas estudadas foram: peso atual (PA), altura (A), circunferência da cintura (CC), circunferência do quadril (CQ), circunferência braquial (CB), prega cutânea triciptal (PCT), e prega cutânea subescapular (PCSE). A partir destas medidas foram calculados: o índice de massa corporal (IMC), a relação entre a cintura e o quadril (RCQ), a relação entre a cintura e a altura (RCA), a circunferência muscular do braço (CMB), a área muscular do braço (AMB) e a área adiposa do braço (AAB). Para o diagnóstico da adiposidade central utilizou-se a relação entre a circunferência da cintura e a do quadril. Resultados: A idade média da população foi de 53,7±16,0 anos, com permanência hospitalar de 8 dias, sendo maior entre os idosos sendo maior entre os idosos (p<0,01).Parte dos pacientes (47,8%) apresentou sobrepeso/obesidade, 48,6% valores alterados de circunferência dacintura e 76,4% adiposidade central. As doenças cardiovasculares representaram 45,4%do total de internações, sendo 60,4% entre os idosos. Conclusão: Esse estudo mostrou elevada prevalência de obesidade e adiposidade central entre os pacientes hospitalizados independente do gênero, da idade, e do motivo de internação, tornando evidente o reflexo datransição nutricional na população estudada.

Objectives: To investigate the effects of nutritional transition on the nutritional status and body composition of inpatients. Methods: We assessed 819 inpatients (435 men and 384women) regarding clinical, anthropometric and dietary aspects. The anthropometric variables studied were: current weight (CW), height (H), waist circumference (WC), hip circumference (HC), arm circumference (AC), triceps skinfold (TSF) and subscapular skinfold thickness (SST). From these measures were determined: the body mass index (BMI), the waist and hip ratio (WHR), the waist and height ratio (RCA), the arm muscle circumference (AMC), the arm muscle area (AMA) and arm fat area (AFA). For the diagnosis of central adiposity, we used the relationship between waist and hip circumferences. Results: The mean age was 53.7 ± 16.0 years, with hospital stay of 8 days, being higher among the elderly (p <0.01). Most patients (47.8%) were overweight or obese, 48.6% presented altered values of waist circumference and 76.4% had central adiposity. Cardiovascular disease accounted for 45.4% of total admissions, and 60.4% among the elderly. Conclusion: This study showed high prevalence of obesity and central adiposity among inpatients regardless of gender, age, and the reason for admission, evidencing the effects of nutritional transition in the studied population.

Association of dyslipidemia with intakes of fruit and vegetables and the body fat content of adults clinically selected for a lifestyle modification program.

To investigate the relationship of dyslipidemia with demographic distribution and patterns of body fat and dietary intakes. From a universe of adults clinically selected for a lifestyle modification program 979 subjects (409 males and 570 females, 52.2 +/- 9.6 years) fulfilled the inclusion criteria. Overnight-fasting plasma was assayed (dry chemistry) for triglycerides (TG), total (TC) and HDL fraction of cholesterol given the non-HDL (n-HDL) fraction by the difference. Anthropometric assessment included body weight (kg), height (m), fat (bioelectrical impedance) and waist circumference (WC). Food intake was assessed by the 24-hour recall questionnaire and the food groups evaluated through recommendations from an adapted food pyramid. The chances of dyslipidemia from other variable changes were determined by logistic regression with p < 0.05. Normal values of BMI and WC were protective against all dyslipidemia markers whereas only hypercholesterolemia was influenced by diet (meat intake >2 servings). Dietary intakes have protective effects against hypertriglyceridemia with whole grains, odds ratio (OR) 0.342 (CI 95%, 0.154-0.760), fruits > or =3 servings (OR 0.523, 0.290-0.941) and vegetables > or =4 servings (OR 0.360, 0.176-0.735). In general total body and abdominal adiposity influenced all dyslipidemia markers while dietary intake of fruits and vegetables protected against triglyceridemia.

Avaliação da qualidade de vida de pacientes afásicos / Aphasic patients life quality assessment

Qualidade de vida é um novo conceito discutido na área de saúde que vem crescendo em importância como medida de avaliação de resultados de tratamento em medicina e nutrição. O objetivo desta pesquisa foi traduzir e produzir uma versão preliminar do instumento Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) que possa ser submetida ao processo de validação quantitativa. Como parte deste processo,o instrumento SAQOL-3 foi aplicado em 16 pacientes cadastrados nos grupos de atendimentos semanal em uma clínica de fonoaudiologia de Campinas, São Paulo.Os domínios avaliados pelo instrumento são: físico, psicossocial, da comunicação e de energia. Os itens do instrumento foram avaliados em relação ao grau de dificuldade através de uma escala dividida em cinco níveis. A pontuação média da população avaliada foi de 3,638 (grau 3), variando de 3,455 para o domínio de comunicação até 3,849 para o domínio físico. A investigação da qualidade de vida em pacientescom afasia é útil para compreender as relações do paciente com sua enfermidade e melhorar a percepção individual de qualidade de vida que deve levar em consideração seus sentimentos, comportamentos e sua condição de saúde.

Determinantes do grau de satisfação de pacientes internados referente a refeições oferecidas em um hospital universitário internados referente a refeições oferecidas em um hospital universitário / Determinants of the degree of inpatients: satisfaction with university hospital meals

Objetivo O ambiente hospitalar pode influenciar de forma negativa a aceitação da dieta pelos pacientes. Nesse sentido, o objetivo deste trabalho foi identificar o grau de satisfação dos pacientes em relação às dietas oferecidas em um hospital universitário e sua relação com o tempo de internação, gênero e idade dos pacientes. Métodos Foram estudados 206 pacientes, 52,4% (n=108) eram mulheres e 47,6% (n=98) eram homens, com idade entre 16 e 83 anos, com tempo de permanência hospitalar de pelo menos dois dias e que estivessem recebendo alimentação exclusivamente via oral. Foi aplicado um questionário quantitativo e qualitativo avaliando quatro refeições oferecidas pelo hospital, de acordo com cinco atributos (aparência, temperatura, sabor/tempero, quantidade e cortesia). Resultados Os dados mostraram interferência do gênero e idade no grau de satisfação em relação à dieta, assim como o tipo de dieta e enfermaria. Predominantemente houve menor satisfação para dieta hipossódica e dieta branda hipossódica para diabetes nos quesitos temperatura (satisfatório e indiferente a satisfatório, respectivamente), aparência (satisfatório e satisfatório, respectivamente) e sabor/tempero (pouco satisfatório a satisfatório nos dois casos). Conclusão O estudo constatou que o gênero e a idade são determinantes do grau de satisfação em relação às refeições oferecidas pelo hospital, bem como a temperatura, o sabor/tempero, consistência e composição modificadas. Medidas direcionadas para melhora da palatabilidade da dieta, por meio da utilização de temperos (ervas), podem contribuir para a melhor aceitação e maior grau de satisfação de refeições hospitalares

Objective The hospital environment has a negative influence on patients? meal acceptance. The objective of this work is to identify the degree of patients? satisfaction with the meals offered in a University Hospital and its relation with the length of stay, gender, and age. Methods Two hundred and six patients were interviewed, 52.4% (n=108) women and 47.6% (n=98) men, aged 16 to 83 years, minimum length of stay of 2 days, and receiving oral feeding. A quantitative and qualitative questionnaire was used to evaluate four meals offered by the hospital focusing on the following five attributes: appearance, temperature, flavor, serving size and courtesy. Results The results showed that gender and age, as well as type of diet and length of stay, influence the degree of satisfaction with the food. Low-sodium diet and pureed diabetic low-sodium diet had the lowest degree of satisfaction regarding temperature (satisfactor y and indifferent to satisfactory, respectively), appearance (satisfactory and satisfactory, respectively) and flavor (little satisfactory - satisfactory and little satisfactory - satisfactory, respectively). Conclusion The study showed that gender and age, as well as temperature, flavor, modified consistency and composition, are determinants of the degree of satisfaction with hospital meals. Measures to improve taste by using natural herbs may contribute to a better acceptance and a higher degree of satisfaction with the hospital meals

Estudo comparativo de indicadores nutricionais em pacientes com neoplasias do trato digestório / Comparative study of nutritional status indicators among patients with gastrointestinal neoplasms

RACIONAL: O câncer tem sido considerado atualmente como um dos principais problemas de saúde pública em todo o mundo e os tumores mais frequentes são os dos tratos gastrintestinal e o respiratório. OBJETIVO: Comparar indicadores do estado nutricional em pacientes portadores de neoplasias do trato digestório. MÉTODO: Estudo comparativo de indicadores nutricionais (antropométricos, laboratoriais e dietéticos), entre 28 pacientes portadores de neoplasias do trato digestório (esofágicas, gástricas e intestinais), em um hospital universitário. RESULTADOS: Não foi encontrada diferença significativa entre os três grupos de neoplasia para os indicadores laboratoriais, de consumo alimentar e antropométricos, exceto para a circunferência do braço (P=0,0471). A perda de peso ocorrida durante a internação foi observada em 46,4 por cento dos pacientes estudados e a dieta enteral foi a prescrição dietética mais prevalente entre os pacientes, especialmente nos portadores de neoplasia de esôfago. CONCLUSÃO: Pacientes com diagnóstico de neoplasia de trato digestório apresentam comprometimento no estado nutricional e necessitam de acompanhamento nutricional no decorrer do tratamento destas enfermidades.

BACKGROUND: Cancer nowadays is considered one of the biggest health problem all over the world and the digestive and respiratory tumors are the most frequent among them. AIM: To compare nutritional indicators among patients with esophageal, stomach and intestinal neoplasms. METHODS: A comparative study was carried out assessing indicators of nutritional status (anthropometry, biochemistry and diet) of 28 patients with digestive neoplasms. RESULTS: Groups were statistically paired by gender, biochemical tests, food intake and anthropometrics measurements, except for the upper arm circumference (P=0.0471). Weight loss was verified for 46.4 percent of the studied patients and the tube diet was the most prevalent dietary prescription for the patients, especially among those with esophageal neoplasms. CONCLUSION: Patients with esophageal, stomach and intestinal neoplasms have poor nutritional status and need continuous dietary care during the treatment of their diseases.