Diet Quality and Associated Factors in Atherosclerotic Cardiovascular Disease Patients with and without Diabetes at a Specialized Outpatient Clinic in the City of Pelotas, Brazil

Abstract Background In most cases, atherosclerotic cardiovascular disease (ACVD) is preventable through primary prevention and control of traditional risk factors, such as smoking cessation, regular physical activity, and adherence to healthy dietary patterns. The assessment of diet quality of ACVD patients would be important for a dietary intervention. Objectives This study aimed to evaluate diet quality of ACVD patients and its association with clinical conditions. Methods This cross-sectional study was nested within a randomized clinical trial entitled "Programa Alimentar Cardioprotetor Brasileiro." Baseline data of 80 patients from Pelotas, Brazil, were obtained. Food consumption was assessed using 24-h food recall and the Revised Diet Quality Index (IQD-R). Data on smoking status and comorbidities were reported by the patients during medical history taking. To analyze the associations between IQD-R and clinical variables, unpaired Student's t-test or the analysis of variance was performed. The significance level was 5%. Results Most of the sample consisted of men (66.5%), elderly individuals (52.50%), patients with hypertension (78.75%), dyslipidemia (58.75%), and overweight (73.75%). The average IQD-R score was 56.7 ± 12.6 points. Better quality of diet was observed for patients with diabetes compared to those without diabetes (61.1 ± 11.8 versus 54.0 ± 12.6 points; p=0.014). Conclusion There is a need to improve diet quality of ACVD patients. Patients ACVD and diabetes had better diet quality compared to those without diabetes.

Factors associated to serum paraoxonase 1 activity in patients with cardiovascular disease

ABSTRACT Objectives: Paraoxonase 1 (PON1) is an enzyme that has antioxidant potential, which confers a protective effect against the atherosclerotic process. However, studies associating genetics, dietary patterns and PON1 activity in individuals with cardiovascular disease (CVD) are scarce. Thus, the aim of the current study was to evaluate the influence of dietary factors on serum PON1 in CVD patients. Subjects and methods: Cross-sectional, sub-study of the BALANCE Program Trial. All patients aged 45 years or older and had evidence of established atherosclerotic disease in the preceding 10 years. Body weight, height, waist circumference, blood pressure, lipid profile and fasting glucose were collected. Food intake was assessed with 24-h dietary recall. Data was analyzed using SAS University Edition and a P value ≤ 0.05 was considered statistically significant. Sample was divided into three groups, according to the PON1 T(-107)C genotype (CC, CT and TT) and serum PON1 activity (Low, Medium, High). Results: There were no genotype differences for major factors. However, the systolic blood pressure was lower for CT individuals (p<0.05). Intake of cholesterol, saturated fatty acids (SFA) and monounsaturated fatty acids (MUFAS) was higher in patients with lower PON1 activity. Lipid ingestion tended to be higher in patients with lower PON1 activity (p=0.08). In the multivariate logistic regression model, SFA intake (P=0.03), genotype (P=0.09), gender (P=0.04), age (P=0.07) and carbohydrate intake (P=0.16) contributed the most to the serum PON1 activity. Conclusion: Based on these findings, nutritional guidance for these patients becomes essential, since dietary components interact with serum PON1 activity more than genotype.

Factors associated to serum paraoxonase 1 activity in patients with cardiovascular disease.

OBJECTIVE: Paraoxonase 1 (PON1) is an enzyme that has antioxidant potential, which confers a protective effect against the atherosclerotic process. However, studies associating genetics, dietary patterns and PON1 activity in individuals with cardiovascular disease (CVD) are scarce. Thus, the aim of the current study was to evaluate the influence of dietary factors on serum PON1 in CVD patients. METHODS: Cross-sectional, sub-study of the BALANCE Program Trial. All patients aged 45 years or older and had evidence of established atherosclerotic disease in the preceding 10 years. Body weight, height, waist circumference, blood pressure, lipid profile and fasting glucose were collected. Food intake was assessed with 24-h dietary recall. Data was analyzed using SAS University Edition and a P value ≤ 0.05 was considered statistically significant. Sample was divided into three groups, according to the PON1 T(-107)C genotype (CC, CT and TT) and serum PON1 activity (Low, Medium, High). RESULTS: There were no genotype differences for major factors. However, the systolic blood pressure was lower for CT individuals (p<0.05). Intake of cholesterol, saturated fatty acids (SFA) and monounsaturated fatty acids (MUFAS) was higher in patients with lower PON1 activity. Lipid ingestion tended to be higher in patients with lower PON1 activity (p=0.08). In the multivariate logistic regression model, SFA intake (P=0.03), genotype (P=0.09), gender (P=0.04), age (P=0.07) and carbohydrate intake (P=0.16) contributed the most to the serum PON1 activity. CONCLUSION: Based on these findings, nutritional guidance for these patients becomes essential, since dietary components interact with serum PON1 activity more than genotype.

Consumption of sugar-sweetened beverages in patients with established atherosclerosis disease. / Consumo de bebidas açucaradas em pacientes com doença aterosclerótica manifesta.

This study investigated the association between consumption of sugar-sweetened beverages and anthropometric and biochemical variables in a cross-sectional study conducted with secondary data from the first visit of the randomized clinical trial of the Brazilian Cardioprotective Nutritional Program (BALANCE Program) (2013-2014). Weight, height, waist circumference, lipid profile and fasting glycemia and a 24-hour diet recall were collected. Differences between consumption and non-consumption of sugar-sweetened beverages were evaluated by Student's t-test. The Chi-square test was employed to analyze the association between consumption and non-consumption of sugar-sweetened beverages and biochemical and anthropometric factors. The sample consisted of 2,172 individuals, mostly men (58.5%), elderly (63.6%), C-rated economic class (57.3%), and overweight (62.7%). A statistically significant difference was found between the consumption of sugar-sweetened beverages and higher BMI values (p=0.029), waist circumference (p=0.004) and triglycerides (p=0.023). These results emphasize the need for nutritional intervention regarding the consumption of sugar-sweetened beverages as part of the dietary treatment of this population.

O presente estudo investigou a associação entre o consumo de bebidas açucaradas e variáveis antropométricas e bioquímicas em análise transversal, realizado com dados secundários referentes à primeira consulta do ensaio clínico randomizado Dieta Cardioprotetora Brasileira (2013-2014). Foram coletados peso, altura, circunferência da cintura, perfil lipídico e glicemia de jejum e dados de um recordatório alimentar de 24 horas. Diferenças entre o consumo e não consumo de bebidas açucaradas foram avaliadas pelo teste T de student. Para analisar a associação entre o consumo de bebidas açucaradas e fatores bioquímicos e antropométricos foi utilizado o teste qui quadrado. A amostra foi de 2.172 indivíduos, sendo a maioria homens (58,5%), idosos (63,6%), do nível econômico C (57,3%), com ensino fundamental (45,8%) e com excesso de peso (62,7%). Houve associação significativa entre o consumo de bebidas açucaradas e maior valores de índice de massa corporal (p=0,029), circunferência da cintura (p=0,004) e triglicerídeos (p=0,023). Esses resultados reforçam a necessidade de intervenção nutricional quanto ao consumo de bebidas açucaradas como parte do tratamento dietético desta população.

Consumo de bebidas açucaradas em pacientes com doença aterosclerótica manifesta / Consumption of sugar-sweetened beverages in patients with established atherosclerosis disease

Resumo O presente estudo investigou a associação entre o consumo de bebidas açucaradas e variáveis antropométricas e bioquímicas em análise transversal, realizado com dados secundários referentes à primeira consulta do ensaio clínico randomizado Dieta Cardioprotetora Brasileira (2013-2014). Foram coletados peso, altura, circunferência da cintura, perfil lipídico e glicemia de jejum e dados de um recordatório alimentar de 24 horas. Diferenças entre o consumo e não consumo de bebidas açucaradas foram avaliadas pelo teste T de student. Para analisar a associação entre o consumo de bebidas açucaradas e fatores bioquímicos e antropométricos foi utilizado o teste qui quadrado. A amostra foi de 2.172 indivíduos, sendo a maioria homens (58,5%), idosos (63,6%), do nível econômico C (57,3%), com ensino fundamental (45,8%) e com excesso de peso (62,7%). Houve associação significativa entre o consumo de bebidas açucaradas e maior valores de índice de massa corporal (p=0,029), circunferência da cintura (p=0,004) e triglicerídeos (p=0,023). Esses resultados reforçam a necessidade de intervenção nutricional quanto ao consumo de bebidas açucaradas como parte do tratamento dietético desta população.

Abstract This study investigated the association between consumption of sugar-sweetened beverages and anthropometric and biochemical variables in a cross-sectional study conducted with secondary data from the first visit of the randomized clinical trial of the Brazilian Cardioprotective Nutritional Program (BALANCE Program) (2013-2014). Weight, height, waist circumference, lipid profile and fasting glycemia and a 24-hour diet recall were collected. Differences between consumption and non-consumption of sugar-sweetened beverages were evaluated by Student's t-test. The Chi-square test was employed to analyze the association between consumption and non-consumption of sugar-sweetened beverages and biochemical and anthropometric factors. The sample consisted of 2,172 individuals, mostly men (58.5%), elderly (63.6%), C-rated economic class (57.3%), and overweight (62.7%). A statistically significant difference was found between the consumption of sugar-sweetened beverages and higher BMI values (p=0.029), waist circumference (p=0.004) and triglycerides (p=0.023). These results emphasize the need for nutritional intervention regarding the consumption of sugar-sweetened beverages as part of the dietary treatment of this population.

Estilo de vida e estado nutricional de trabalhadores de uma rede bancária do município de Pelotas (RS) / Lifestyle and nutritional status of employees of a chain of banks in Pelotas, Rio Grande do Sul, Brazil

INTRODUÇÃO: O ambiente estressante, as longas jornadas de trabalho e a característica sedentária das atividades realizadas no setor bancário refletem no estilo de vida dos trabalhadores, com repercussões importantes na saúde. OBJETIVO: Descrever o estilo de vida e o estado nutricional de funcionários de uma rede bancária de Pelotas. MÉTODO: Estudo transversal descritivo, com trabalhadores com idade igual ou superior a 18 anos de uma rede bancária de Pelotas. Foram coletadas informações referentes ao perfil demográfico, econômico, nutricional e de estilo de vida por meio do questionário Perfil do Estilo de Vida Individual (PEVI) e medidas antropométricas. As análises estatísticas foram realizadas no programa STATAâ versão 12.0. RESULTADOS: A amostra foi composta de 82 trabalhadores, a maioria homens (67,1%). Quanto ao estilo de vida, constataram-se hábitos alimentares inadequados (com alto consumo de alimentos gordurosos/doces e baixo consumo de frutas/verduras) e comportamento sedentário. Por outro lado, notou-se que os componentes comportamento preventivo, relacionamento social e controle do stress apresentaram estilo de vida saudável, demonstrando que os bancários costumam conhecer a pressão arterial e os níveis de colesterol, manter-se calmos e cultivar amizades. Observou-se prevalência de sobrepeso e circunferência da cintura elevada. Entre os sexos, houve diferença significativa em ingestão de alimentos gordurosos e doces, conhecimento e controle da pressão arterial e dos níveis de colesterol e circunferência da cintura. CONCLUSÃO: Os resultados apresentaram um estilo de vida inadequado nos componentes nutrição e atividade física, além de sobrepeso entre os funcionários, evidenciando a necessidade de ações para melhorar o estilo de vida e o estado nutricional desses indivíduos.

BACKGROUND: The stressful work environment, long working hours and sedentary activities inherent to jobs in banks reflect on the employees' lifestyle with consequent effects on their health. OBJECTIVE: To describe the lifestyle and nutritional status of employees of a chain of banks in Pelotas, Brazil. Method: Cross-sectional descriptive study conducted with employees aged 18 or older of a chain of banks in Pelotas. We collected information on the demographic, economic, nutritional and lifestyle profile by means of questionnaire Individual Lifestyle Profile (ILP) and anthropometric measurements. Statistical analysis was performed with software STATA® 12.0. RESULTS: The sample comprised 82 employees, most of whom were male (67.1%). We detected poor dietary habits (high fat-rich food and sweets and low fruit/vegetable intake) and sedentary behavior. The results for domains preventive behavior, social relationships and stress control pointed to a healthy lifestyle: the participants were usually aware of their blood pressure and cholesterol levels, succeeded in keeping calm and reported to actively seek friendships. Overweight and elevated waist circumference prevailed. Fat-rich food and sweets intake, knowledge and control of blood pressure and cholesterol and waist circumference significantly differed as a function of sex. CONCLUSION: The results evidenced poor dietary habits and physical activity, in addition to overweight, which point to the need for actions to improve the lifestyle and nutritional status of the analyzed population of workers.

Lifestyle and nutritional status of employees of a chain of banks in Pelotas, Rio Grande do Sul, Brazil.

BACKGROUND: The stressful work environment, long working hours and sedentary activities inherent to jobs in banks reflect on the employees' lifestyle with consequent effects on their health. OBJECTIVE: To describe the lifestyle and nutritional status of employees of a chain of banks in Pelotas, Brazil. METHOD: Cross-sectional descriptive study conducted with employees aged 18 or older of a chain of banks in Pelotas. We collected information on the demographic, economic, nutritional and lifestyle profile by means of questionnaire Individual Lifestyle Profile (ILP) and anthropometric measurements. Statistical analysis was performed with software STATA® 12.0. RESULTS: The sample comprised 82 employees, most of whom were male (67.1%). We detected poor dietary habits (high fat-rich food and sweets and low fruit/vegetable intake) and sedentary behavior. The results for domains preventive behavior, social relationships and stress control pointed to a healthy lifestyle: the participants were usually aware of their blood pressure and cholesterol levels, succeeded in keeping calm and reported to actively seek friendships. Overweight and elevated waist circumference prevailed. Fat-rich food and sweets intake, knowledge and control of blood pressure and cholesterol and waist circumference significantly differed as a function of sex. CONCLUSION: The results evidenced poor dietary habits and physical activity, in addition to overweight, which point to the need for actions to improve the lifestyle and nutritional status of the analyzed population of workers.

INTRODUÇÃO: O ambiente estressante, as longas jornadas de trabalho e a característica sedentária das atividades realizadas no setor bancário refletem no estilo de vida dos trabalhadores, com repercussões importantes na saúde. OBJETIVO: Descrever o estilo de vida e o estado nutricional de funcionários de uma rede bancária de Pelotas. MÉTODO: Estudo transversal descritivo, com trabalhadores com idade igual ou superior a 18 anos de uma rede bancária de Pelotas. Foram coletadas informações referentes ao perfil demográfico, econômico, nutricional e de estilo de vida por meio do questionário Perfil do Estilo de Vida Individual (PEVI) e medidas antropométricas. As análises estatísticas foram realizadas no programa STATAâ versão 12.0. RESULTADOS: A amostra foi composta de 82 trabalhadores, a maioria homens (67,1%). Quanto ao estilo de vida, constataram-se hábitos alimentares inadequados (com alto consumo de alimentos gordurosos/doces e baixo consumo de frutas/verduras) e comportamento sedentário. Por outro lado, notou-se que os componentes comportamento preventivo, relacionamento social e controle do stress apresentaram estilo de vida saudável, demonstrando que os bancários costumam conhecer a pressão arterial e os níveis de colesterol, manter-se calmos e cultivar amizades. Observou-se prevalência de sobrepeso e circunferência da cintura elevada. Entre os sexos, houve diferença significativa em ingestão de alimentos gordurosos e doces, conhecimento e controle da pressão arterial e dos níveis de colesterol e circunferência da cintura. CONCLUSÃO: Os resultados apresentaram um estilo de vida inadequado nos componentes nutrição e atividade física, além de sobrepeso entre os funcionários, evidenciando a necessidade de ações para melhorar o estilo de vida e o estado nutricional desses indivíduos.

Monitoramento da terapia nutricional enteral em unidade de terapia intensiva: adequação calóricoproteica e sobrevida / Monitoring of enteral nutrition therapy in intensive care unit: energy and protein adequacy and survival

Objetivos: Avaliar o estado nutricional, a adequação da terapia nutricional enteral, os fatores que interferem na sua administração e a sobrevida de pacientes críticos. Método: Estudo observacional prospectivo, com pacientes internados na Unidade de Terapia Intensiva de um Hospital Universitário. Foram incluídos pacientes com idade superior a 18 anos que receberam nutrição enteral por período superior a 72 horas.O estado nutricional foi avaliado pela Avaliação Subjetiva Global e a terapia nutricional enteral foi considerada adequada quando superior a 70% (valor prescrito/administrado quanto a calorias e proteínas). A sobrevida após seis meses da alta foi analisada pelo teste de Mann Whitney. Resultados: Foram avaliados 32 pacientes, com idade média de 56,4±17,4 anos, sendo 59,4% homens. Na admissão, 75% dos pacientes apresentavam algum grau de desnutrição. A adequação foi de 72,3% para valor calórico e 70,2% para proteínas. A principal causa de interrupção da nutrição enteral foi pausa para procedimentos e exames (81,3%). Pacientes bem nutridos no momento da internação apresentaram sobrevida significativamente maior que pacientes com algum grau de desnutrição após seis meses (p=0,03). Conclusão: A maior parte dos pacientes apresentou desnutrição na admissão e a meta calóricaproteica proposta foi alcançada pela maioria. A sobrevida em seis meses dos pacientes bem nutridos foi significativamente maior do que os demais.(AU)

Objectives: To evaluate the nutritional status, the adequacy of enteral nutritional therapy, the factors that influence enteral nutrition management and the survival analysis of critically ill patients. Methods: A prospective, observational study conducted with patients admitted to the intensive care unit of a university hospital. Patients above 18 years under exclusive enteral nutrition therapy for at least 72 hours were included. Nutritional status was evaluated by the Subjective Global Assessment and enteral nutritional therapy was considered adequate up to 70% of the prescribed (energy and protein). Survival after six months of discharge was analyzed by Mann Whitney test. Results: 32 patients were included; the mean of age was 56.4±17.4 years and 59.4% were man.On admission, 75% of patients had some degree of malnutrition. The adequacy was 72.3% for calories and 70.2% for proteins. The main cause of interruption of enteral nutrition was breaks procedures and tests (81.3%). Well-nourished patients at admission had a significantly longer survival than patients with some degree of malnutrition after six months (p=0.03). Conclusion: Most of the patients presented malnutrition at admission and the proposed caloric-protein target was reached by the majority. The survival rate at six months of well-nourished patients was higher than others.(AU)

Avaliação e indicação nutricional em pacientes oncológicos no início do tratamento quimioterápico / Nutritional assessment and recommendation in cancer patients initiating chemotherapy / Evaluación e indicación nutricional en pacientes con cáncer que inician el tratamiento de quimioterapia

Introdução: O diagnóstico precoce de problemas nutricionais pode melhorar o prognóstico dos pacientes oncológicos. Objetivo: Identificar pela Avaliação Subjetiva Global Produzida Pelo Paciente (ASG-PPP), a necessidade de intervenção nutricional e seus fatores associados em pacientes prestes a iniciar quimioterapia. Método: Estudo transversal realizado com dados secundários. Todos os pacientes acima de 18 anos, que iniciaram quimioterapia no Hospital Escola da Universidade Federal de Pelotas, entre maio de 2011 a dezembro de 2012, foram incluídos. Foi aplicada a todos os pacientes a ASG-PPP. As demais variáveis foram obtidas dos prontuários dos pacientes. Os dados foram digitados no programa Microsoft Excel 2007®. As análises estatísticas foram realizadas no programa Stata® 11.2. Realizaram-se análises bivariadas por meio de testes qui-quadrado e regressão de Poisson com variância robusta, adotando-se um nível de significância de 5%. Resultados: 40,4%; 46,8%; e 12,8 dos pacientes foram classificados como bem nutridos, moderadamente desnutridos e gravemente desnutridos, respectivamente. A maior pontuação da ASG-PPP associou-se com idade superior a 60 anos (p<0,001), doença em estadiamento III (p=0,030) e tumores de cabeça e pescoço, e pulmão (p=0,006). Pacientes idosos e com doença avançada apresentaram, respectivamente, 1,53 e 1,85 vezes mais necessidade crítica de intervenção nutricional quando comparados aos pacientes adultos e os com estadiamentos I e II. Conclusão: A maioria dos pacientes estava moderadamente ou gravemente desnutrida, com necessidade crítica de intervenção nutricional nos idosos, com estadiamento III e com tumores de cabeça e pescoço, e de pulmão. Apresentaram probabilidade maior de intervenção nutricional crítica os idosos e os com doença avançada.

Introduction: Early diagnosis and management of nutritional problems can improve the prognosis of cancer patients. Objective: Identify the need of nutritional intervention through Patient-Generated Subjective Global Assessment produced by patient (PG-SGA) and associated factors in patients in the beginning of chemotherapy. Methods: This cross sectional study used secondary data. It included patients over 18 years old that started chemotherapy treatment in the Chemotherapy Service of the Universidad Federal de Pelotas from May/2011 to December/2012. Variables were collected from PG-SGA and medical records. Data were plotted in Microsoft Excel 2007® and the statistical analyzes were performed in Stata® 11.2. Statistical tests applied were chi square test and Poisson regression, considering a significance level of 5%. Results: It was demonstrated that 40.4% of patient evaluated were classified as well nourished, 46.8% as having moderate malnourishment and 12.8% as having severe malnourishment. The highest PG-SGA scores were associated with being aged over 60 y (p<0.001), stage III (p=0.0030) and having head or neck and lung cancer (p=0.006). It was also observed that elderly patients and those whose cancer was at advanced stages presented a 1.53 and 1.85 fold higher probability, respectively, of needing nutritional intervention, compared to adult patients and those with stage I and II of the disease. Conclusion: The majority of patients had moderate or severe malnourishment, with critical need for nutritional intervention. Elderly patients, with stage III and with head, neck and lung cancer presented more probability of needing nutritional intervention.

Introducción: El diagnóstico precoz de los problemas de nutrición puede mejorar el pronóstico de los pacientes con cáncer. Objetivo: Identificar la Evaluación Subjetiva Global Producido por paciente (ASG-PPP), la necesidad de intervención nutricional y sus factores asociados en pacientes que van a comenzar la quimioterapia. Método: Estudio transversal con datos secundarios. Todos los pacientes mayores de 18 años que comenzaron la quimioterapia en el Hospital Escuela de la Universidad Federal de Pelotas, entre mayo/2011 a diciembre/2012 se incluyeron. Se aplicó a todos los pacientes ASG-PPP. Las otras variables se obtuvieron de las historias clínicas. Los datos fueron introducidos en el programa Microsoft Excel 2007®. Los análisis estadísticos se realizaron en 11,2 programa Stata®. Held, análisis bivariante mediante pruebas de chi-cuadrado y la regresión de Poisson con varianza robusta, adoptando un nivel de significación del 5%. Resultados: 40,4%, 46,8% y el 12,8 de los pacientes fueron clasificados como bien nutrido, moderadamente desnutridos y desnutrición severa, respectivamente. La puntuación más alta de ASG-PPP se asoció con edad mayor de 60 años (p<0,001) en la estadificación de la enfermedad III (p=0,030) y los tumores de cabeza y cuello, y pulmón (p=0,006). Los pacientes ancianos con enfermedad avanzada y presentado, respectivamente, 1,53 y 1,85 veces la necesidad más crítica para la intervención nutricional en comparación con pacientes adultos y aquellos con estadios I y II. Conclusión: La mayoría de los pacientes estaban moderada o severamente desnutridos, con necesidad crítica de intervención nutricional en pacientes de edad avanzada con tumores en estadio III y la cabeza y el cuello, y pulmón.

Lipid profiles of rats fed with diets supplemented with vitamins niacin and pyridoxine

Hypercholesterolemia is a major risk factor for cardiovascular disease. Supplements containing the vitamins niacin (B3) and pyridoxine (B6) can promote the reduction of total cholesterol and an increase in HDL cholesterol. In this study, the effects of diets supplemented with niacin (B3) and pyridoxine (B6) on the hepatic and serum lipid profiles of Wistar rats were assessed. The diets were prepared with combinations of three concentrations of niacin (3, 4 and 5 g/kg) and pyridoxine (6, 12 and 18 mg/kg) and one with neither vitamin. The animals were divided into eleven experimental groups of six animals per group, and nine groups were fed on a standard diet with 7.5% fat and vitamin supplementation. Another group was fed with 7.5% fat without vitamin supplements. A control group received the standard diet (AIN-93M) without modifications (4% fat). The weight gain, food intake, serum and hepatic total cholesterol, serum cholesterol fractions (HDL, LDL, and VLDL), serum and hepatic triacylglycerols and hepatic and fecal lipid contents were measured after 30 days. The diet with the highest concentration of niacin and lowest concentration of pyridoxine had the lowest level of total hepatic cholesterol. Hepatic triacylglycerols were reduced by the highest concentration of niacin (5 g/kg), and this reduction was enhanced by increasing the pyridoxine concentration. The diets supplemented with niacin and pyridoxine reduced the levels of serum total cholesterol, LDL, VLDL, triacylglycerols and hepatic lipids. These effects on the lipid profile varied with the concentrations of the two vitamins and the interactions between them.

Can nutritional status influence the quality of life of cancer patients? / O estado nutricional pode influenciar a qualidade de vida de pacientes com câncer?

Objective This study aimedto evaluate the influence of nutritional status on the quality of life of a cohort of cancer patients submitted to chemotherapy. Methods Patients receiving chemotherapy for the first time in a University Hospital in Pelotas (RS), Brazil, were evaluated prospectively. Their nutritional risk was determined by the Patient-Generated Subjective Global Assessment scores and their quality of life by the World Health Organization's quality of life questionnaire, administered at the beginning and end of the study. Results One hundred and forty-three patients were studied, 76.2 percent being females. The prevalence of malnutrition at baseline was 14.0 percent. The present study found that malnourished patients had a poor quality of life. The nutritional risk of 41.6 percent of the patients increased after chemotherapy. A significant association was found between the presence of symptoms and increased nutritional risk (p<0.001). Additionally, there was a significant negative correlation between physical domain and nutritional risk scores, showing that quality of life increases as nutritional risk decreases. Conclusion Nutritional risk is inversely associated with quality of life in cancer patients after chemotherapy. Early nutritional interventions could minimize the side effects of treatment with a positive impact on quality of life.

Objetivo Avaliar a influência do estado nutricional sobre a qualidade de vida em uma coorte de pacientes submetidos à quimioterapia. Métodos Avaliaram-se prospectivamente pacientes em quimioterapia de um hospital universitário de Pelotas (RS), Brasil. O estado nutricional foi avaliado por meio dos escores obtidos pela Avaliação Subjetiva Global Produzida Pelo Paciente e a qualidade de vida foi avaliada a partir da versão abreviada do questionário de qualidade de vida da Organização Mundial da Saúde. A Avaliação Subjetiva Global Produzida Pelo Paciente e o questionário de qualidade de vida foram aplicados no início e no final do estudo. Resultados Foram avaliados 143 pacientes, dos quais 76,2 por cento eram mulheres. A prevalência de desnutrição na avaliação inicial foi de 14,0 por cento. Observou-se que, tanto no início quanto no final do estudo, os pacientes desnutridos apresentaram pior qualidade de vida. Houve aumento do risco nutricional em 41,6 por cento dos pacientes. Foi encontrada associação significativa entre a presença de sintomas e o aumento do risco nutricional (p<0,001). Além disso, houve correlação negativa estatisticamente significativa entre a variação dos escores do domínio físico e risco nutricional, evidenciando que conforme o risco nutricional diminui, melhora a qualidade de vida. Conclusão Conclui-se que as modificações no risco nutricional estão associadas a mudanças na qualidade de vida em pacientes com câncer. Sugere-se que o acompanhamento multidisciplinar desses pacientes poderia minimizar os efeitos colaterais do tratamento, diminuindo o risco de desnutrição, com repercussões positivas na qualidade de vida.