BODY COMPOSITION ASSESSED BY DUAL-ENERGY X-RAY ABSORPTIOMETRY ON METABOLIC PROFILE AND CARDIOVASCULAR RISK IN OBESE PATIENTS PRIOR TO BARIATRIC SURGERY.

BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19-5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19-5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76-4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.

Body composition assessed by dual-energy x-ray absorptiometry on metabolic profile and cardiovascular risk in obese patients prior to bariatric surgery / Composição corporal avaliada pela absortometria radiológica de dupla energia sobre o perfil metabólico e o risco cardiovascular em obesos antes da cirurgia bariátrica

ABSTRACT BACKGROUND: Fat, muscle, and bone are endocrine organs capable of affecting the metabolic profile and cardiovascular risk. Relating these components is important to the establishment of early intervention strategies for overweight patients. AIMS: This study aimed to evaluate the influence of body mass components on the metabolic profile and cardiovascular risk in the preoperative period of bariatric surgery. METHODS: A cross-sectional study was conducted with patients admitted for bariatric surgery at a university hospital in the city of Recife, Brazil, between 2018 and 2019. Body composition was determined using dual-energy x-ray absorptiometry. Cardiovascular risk was assessed using the Framingham risk score. Data were collected on anthropometric, clinical, and lifestyle characteristics. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides), blood glucose, and vitamin D were determined using the standard methods of the hospital laboratory. RESULTS: A total of 60 patients were analyzed, 86.7% of whom had comorbidities, 33.3% had moderate/high cardiovascular risk, and 71.4% had vitamin D insufficiency/deficiency. Lower lean body mass (adjusted PR 3.24; 95%CI 1.19-5.77) was independently associated with the severity of obesity. The body mass index and waist circumference were negatively correlated with lean body mass (r=-0.52; p<0.01)/r=-0.36; p<0.01). Lean body mass was negatively correlated with fat mass (r=-0.26; p<0.05), trunk fat (r=-0.29; p<0.05), fasting glucose (r=-0.26; p<0.05), and bone mineral density (r=-0.26; p<0.05). A total of 84.2% of individuals with less trunk fat tended to have low cardiovascular risk (p=0.05). However, physical inactivity (adjusted PR 2.14; 95%CI 1.19-5.54) and the risk of alcohol dependence (adjusted PR 2.41; 95%CI 1.76-4.15) were the only variables independently associated with cardiovascular risk. CONCLUSION: Obese patients in the preoperative period of bariatric surgery with less trunk fat tended to have low cardiovascular risk. However, the other components of body mass were also not associated with cardiovascular risk.

RESUMO RACIONAL: O tecido adiposo, músculos e ossos representam órgãos endócrinos, capazes de interferir no perfil metabólico e risco cardiovascular. Relacionar esses componentes será importante para estratégias de intervenção precoce, em obesos. OBJETIVOS: Avaliar a influência dos compartimentos da massa corporal, sobre o perfil metabólico e risco cardiovascular, no pré-operatório de cirurgia bariátrica. MÉTODOS: Estudo transversal, com pacientes admitidos para cirurgia bariátrica, em hospital universitário. A composição corporal foi avaliada pela absortometria radiológica de dupla energia e o risco cardiovascular pelo escore de risco de Framingham. Foram analisadas variáveis antropométricas, clínicas e de estilo de vida. Foi avaliado perfil lipídico (colesterol total, HDL-c, LDL-c, triglicerídeos), glicemia e vitamina D, utilizando a metodologia padrão. RESULTADOS: Foram analisados 60 pacientes, 86,7% apresentavam comorbidades, 33,3% risco cardiovascular moderado/elevado e 71,4% insuficiência/deficiência de vitamina D. Menor massa corporal magra associou-se à gravidade da obesidade. O índice de massa corpórea e a circunferência da cintura correlacionaram-se negativamente com a massa corporal magra (r=-0,52; p<0,01)/r=-0,36; p<0,01). A massa corporal magra correlacionou-se negativamente com a massa gorda (r=-0,26; p<0,05), gordura troncular (r=-0,29; p<0,05), glicemia de jejum (r=-0,26; p<0,05) e densidade mineral óssea (r=-0,26; p<0,05). Ao todo, 84,2% dos indivíduos com menos gordura troncular apresentaram tendência a baixo risco cardiovascular (p=0,05). Contudo, inatividade física (razão de prevalência ajustada 2,14; IC95% 1,19-5,54) e risco de dependência alcoólica foram as únicas variáveis independentemente associadas ao risco cardiovascular. CONCLUSÕES: Os pacientes obesos em pré-operatório de cirurgia bariátrica com menos gordura troncular, apresentaram tendência a baixo risco cadiovascular. Contudo, o risco cardiovascular também não foi associado aos demais componentes da massa corporal.

Dietary patterns among adolescent freshmen attending a public university / Padrões alimentares de adolescentes recém-ingressos em uma universidade pública

ABSTRACT Objective To identify the association between dietary patterns and nutritional status in adolescent freshmen at a public university in Northeastern Brazil. Methods In this cross-sectional study anthropometric variables, body composition and food intake were collected and assessed using the food frequency questionnaire. Dietary patterns were evaluated through factor analysis using the principal component extraction method. Results Two dietary patterns were identified: "Western" pattern, consisting of foods with high energy density and low nutritional value, and the "traditional Brazilian" pattern, with foods from Brazilian cuisine such as rice, beans, corn, roots and tubers, fruits, greens and vegetables. The multiple regression analysis revealed a negative association between the "traditional Brazilian" pattern and both excess weight and body fat in females. Conclusion A healthy dietary pattern with typical local cuisine foods can offer protection to health and should be encouraged.

RESUMO Objetivo Identificar a associação entre padrões alimentares e estado nutricional em adolescentes recém-ingressos em uma universidade pública do Nordeste brasileiro. Métodos Neste estudo transversal foram coletados dados antropométricos, composição corporal e consumo alimentar, verificado pelo questionário de frequência alimentar. Os padrões alimentares foram derivados através da análise fatorial pelo método de extração de componentes principais. Resultados Dois padrões alimentares foram identificados: o padrão "Ocidental", composto por alimentos de elevada densidade energética e de baixo valor nutricional, e o padrão "tradicional brasileiro", contendo alimentos da culinária brasileira como arroz, feijão, milho, raízes e tubérculos, frutas, verduras e legumes. A análise de regressão múltipla mostrou associação negativa entre o excesso de peso e de gordura corporal e o padrão alimentar "tradicional brasileiro" no sexo feminino. Conclusão Um padrão alimentar saudável e com alimentos típicos da culinária local pode conferir proteção à saúde, devendo ser incentivado.

Eating disorders in the preoperative phase of bariatric surgery / Transtornos alimentares durante o pré-operatório de cirurgia bariátrica

Introduction: Bariatric surgery is considered the most effective obesity treatment. Obese patients have a high prevalence of eating disorders. Objectives: Evaluate the occurrence of eating disorders and eating patterns in candidates for bariatric surgery and associate eating disorders with sociodemographic and clinical characteristics. Methods: A retrospective study was conducted using electronic charts of candidates for bariatric surgery. Data were collected on sex, age, marital status, schooling, occupation, non-communicable diseases, body mass index (BMI), eating disorders, and eating patterns. Results: Among the 281 patients evaluated, eating disorders were detected in 26.7%; 10.3% had binge eating disorder, 6.6% had bulimia nervosa, and 5.3% had the night-eating syndrome. The specific eating patterns were overeating (46.6%), binge eating during periods of stress (9.3%), eating sweets (4%), and snaking (1.3%). BMI ranged from 35.38 to 59.03 kg/m² (mean: 44.37 ± 5.89). All individuals (100%) had systemic arterial hypertension, and 23.3% had type 2 diabetes mellitus or dyslipidemia. Conclusions: The frequency of eating disorders was low in the sample studied, the most common of which was binge eating disorder. Non-communicable diseases were associated with eating disorders. Among the eating patterns observed, the most frequent was overeating (AU)

Introdução: A cirurgia bariátrica é considerada o tratamento mais eficaz para a obesidade. Pacientes obesos possuem elevada prevalência de transtornos alimentares. Objetivos: Avaliar a presença de transtornos alimentares e padrões alimentares em candidatos à cirurgia bariátrica, associando os transtornos alimentares aos dados sociodemográficos e clínicos. Métodos: Estudo retrospectivo de cunho documental, com base em prontuários eletrônicos de pacientes candidatos à cirurgia bariátrica. Foram obtidas variáveis como sexo, idade, estado civil, nível de escolaridade, ocupação, doenças crônicas não transmissíveis, índice de massa corporal (IMC), transtorno e padrão alimentar. Resultados: Dos 281 pacientes avaliados, foi detectado 26,7% de transtornos alimentares, sendo 10,3% transtorno de compulsão alimentar periódica, 6,6% de bulimia nervosa e 5,3% de síndrome do comer noturno. Os padrões alimentares específicos encontrados foram: glutões (46,6%), compulsivos alimentares em períodos de estresse (9,3%), comedores de doces (4%) e beliscadores (1,3%). O IMC variou de 35,38 a 59,03 kg/m² (44,37±5,89), com 100% do grupo apresentando Hipertensão Arterial Sistêmica e 23,3% com Diabetes Mellitus tipo 2 ou dislipidemia. Conclusões: Constatou-se baixa frequência de transtornos alimentares na amostra estudada, sendo o transtorno de compulsão alimentar periódica o mais observado. Doenças crônicas não transmissíveis foram associadas com a presença de transtornos alimentares. Dentre os padrões alimentares observados, os glutões foram os mais frequentes (AU)

Triagem nutricional por meio da avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) em câncer ginecológico / Nutritional screening through patient-generated subjective global assessment (PG-SGA) in gynecological cancer

O câncer é considerado importante causa de morbimortalidade, estando relacionado ao comprometimento da condição nutricional, que por sua vez, repercute diretamente no manejo clínico e na qualidade de vida. Neste contexto, buscou-se identificar o estado nutricional de mulheres com câncer ginecológico e investigar a associação do estado nutricional por triagem nutricional específica com o estado nutricional pelo índice de massa corporal (IMC), faixa etária e características clínicas através de um estudo transversal, realizado nas enfermarias de ginecologia e oncologia de um hospital universitário, durante julho a dezembro de 2017. Foram avaliadas pacientes com idade ≥ 20 anos, diagnosticadas com câncer ginecológico. O estado nutricional foi identificado utilizando-se a avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) que classifica em bem nutrido, desnutrição moderada ou desnutrição grave. A altura e peso atual foram obtidos através de balança mecânica e o peso usual foi referido pelas pacientes, sendo utilizados na determinação do IMC e no percentual de peso perdido. Foram estudadas 60 mulheres, com idade média de 54,5 ± 14,17 anos, com diagnóstico predominante de câncer de útero (68,3%). O estadiamento IV foi o mais prevalente (65%), a frequência de desnutrição foi elevada (68,3%), principalmente entre as idosas (81,5%), a perda ponderal ocorreu em 60% do grupo e a necessidade de intervenção nutricional em 91,7% dos casos. Constatou-se nesta amostra de mulheres adultas e idosas, elevada frequência de desnutrição através da ASG-PPP, esses achados ressaltam a importância desta ferramenta na identificação do estado nutricional em pacientes com câncer ginecológico.

Cancer is considered an important cause of morbidity and mortality, and is related to the impairment of nutritional status, which in turn directly affects clinical management and quality-of-life. In this context, we sought to identify the nutritional status of women with gynecological cancer and to investigate the association of nutritional status by specific screening with nutritional status according to body mass index (BMI), age group, and clinical characteristics through a cross-sectional study, carried out in the gynecology and oncology wards of a university hospital, from July to December 2017. Patients aged ≥ 20 years old, diagnosed with gynecological cancer were evaluated. Nutritional status was identified using the patient-generated subjective global assessment (PG-SGA), which classifies well nourished, moderately malnourished, or severely malnourished individuals. Current height and weight were obtained using a mechanical scale and the usual weight was reported by the patients, which were used to determine the BMI and the percentage of weight lost. Sixty women were studied, with a mean age of 54.5 ± 14.17 years old, with a predominant diagnosis of uterine cancer (68.3%). Stage IV was the most prevalent (65%), the frequency of malnutrition was high (68.3%), especially among the elderly (81.5%), weight loss occurred in 60% of the group, and there was a need for intervention in 91.7% of cases. In this sample of adult and elderly women, a high frequency of malnutrition through the PG-SGA was identified. These findings highlight the importance of this tool in the identification of nutritional status in patients with gynecological cancer.

Food consumption, anthropometry and body composition of patients diagnosed with Parkinson's disease / Consumo alimentar, antropometria e composição corporal de pacientes diagnosticados com doença de Parkinson

ABSTRACT Objective The aim of the present study was to evaluate the consumption of risk and protective foods for chronic noncommunicable diseases and to investigate associations with anthropometric parameters and body composition in individuals with Parkinson's disease. Methods A case-series study was conducted with 79 adult and elderly patients of both genders in outpatient care. Food intake was evaluated using a food frequency questionnaire for the identification of foods with greater daily consumption, stratified by gender. The consumption frequency of each food was converted into scores of two food groups characteristics: risk and protection. The conceptual model took into account sociodemographic, behavioral and anthropometric variables as well as body composition. Results A total of 72.1% of the participants in the sample had excess weight based on the body mass index and 43.5% had excess body fat. The consumption of protective foods was greater among individuals with a higher body mass index and with a greater rate of body fat. Conclusion The data indicate a situation of reverse causality and reveal the complexity of the relationship among food intake, body fat and chronic noncommunicable diseases.

RESUMO Objetivo Este estudo visou avaliar o consumo de alimentos de risco e proteção para as doenças crônicas não transmissíveis e sua associação com parâmetros antropométricos e de composição corporal em pacientes com doença de Parkinson. Métodos Estudo do tipo série de casos, com 79 pacientes adultos e idosos, de ambos os sexos, atendidos ambulatorialmente. O consumo alimentar desses pacientes foi avaliado por um questionário de frequência alimentar, sendo identificados inicialmente os alimentos com maior frequência de consumo diário por sexo e, em seguida, a frequência de consumo de cada alimento foi convertida em escores, sendo constituídos dois grupos de alimentos: risco e proteção. O modelo conceitual considerou variáveis sociodemográficas, comportamentais, antropométricas e de composição corporal. Resultados Ao todo, 72,1% dos pacientes apresentaram excesso de peso segundo o índice de massa corporal e 43,5% apresentaram excesso de gordura corporal. O consumo de alimentos protetores foi maior nos pacientes com maior índice de massa corporal e maior percentual de gordura corporal. Conclusão Os dados apontam para uma condição de causalidade reversa e revelam a complexidade envolvida na relação entre consumo alimentar, gordura corporal e doenças crônicas não transmissíveis.

Associations between nutritional risk at hospital admission and incidence of complications, hospitalization time and mortality

ABSTRACT The early identification of nutritional risk is essential for the earliest possible implementation of nutritional therapy. The aim of the present study was to evaluate the association between nutritional risk and the incidence of clinical complications. An observational study was conducted at the internal medicine infirmary of a Brazilian public hospital involving patients admitted between January 2016 and December 2017. The NRS-2002, anthropometrics and laboratory exams (initial and final) were used for the evaluation of nutritional risk. The prevalence of nutritional risk was 63.6%. Nutritional risk upon admission to hospital was associated with the occurrence of complications, a longer hospitalization time and death. In correlation analysis, considering anthropometrics and laboratory exams compared to hospitalization time and time elapsed prior to the onset of the diet, serum albumin was inversely correlated with both hospitalization time and nutritional risk. Based on the present findings, knowledge on the nutritional status of patients and adequate nutritional therapy can lead to fewer complications during hospitalization.

RESUMEN La identificación del riesgo nutricional precoz es esencial para que un procedimiento nutricional sea implementado. El objetivo fue evaluar la asociación entre el riesgo nutricional con incidencia de complicaciones clínicas. Estudio observacional, realizado en la enfermería de una clínica médica de un hospital público brasileño, con pacientes admitidos entre enero de 2016 y diciembre de 2017. Para evaluación nutricional, se utilizaron la NRS-2002, antropometría y análisis laboratoriales inicial y final. La frecuencia de riesgo nutricional fue del 63,6%. El riesgo nutricional en la admisión se mostró asociado a incidencia de complicaciones, mayor tiempo de hospitalización y muerte. La albúmina sérica mostró una correlación inversa con el tiempo de internamiento y riesgo nutricional. Se concluye que el conocer el estado nutricional de los pacientes y el acompañamiento nutricional adecuado minimizará las complicaciones durante el internamiento.

Frecuencia de la sarcopenia, la caquexia y los factores asociados en los pacientes con enfermedad renal crónica en terapia dialítica / Frequency of sarcopenia, cachexia, and associated factors in patients with chronic kidney disease in dialysis treatment

INTRODUCCIÓN: la sarcopenia y la caquexia son síndromes que producen una reducción de la masa muscular esquelética y que se asocian al proceso de envejecimiento y a muchas enfermedades crónicas. OBJETIVO: verificar la frecuencia de la sarcopenia, la caquexia y los factores asociados en pacientes en tratamiento dialítico. METODOLOGÍA: estudio transversal realizado en dos centros de tratamiento dialítico de Recife entre marzo y septiembre de 2016. El diagnóstico de sarcopenia se realizó según el criterio del Consenso Europeo de Sarcopenia, mientras que el de caquexia se hizo por el criterio de la Society for Cachexia and Wasting Disorders (SCWD). Las variables de asociación fueron demográficas (sexo y edad), analíticas (proteína C-reactiva, albúmina sérica, hemoglobina, paratohormona y creatinina sérica) y antropométricas: índice de masa corporal (IMC), circunferencia del brazo (CB), circunferencia muscular del brazo (CMB) y pliegue cutáneo tricipital (PCT). RESULTADOS: se estudió a 66 pacientes: el 43,9 % eran hombres y el 56,1 % mujeres, con una media de edad de 53,15 ± 15,24 años. El 43,9 % eran ancianos. La sarcopenia estuvo presente en el 59,1 % de los pacientes y, entre estos, el 15,2 % presentaban sarcopenia grave. La pre-sarcopenia se verificó en el 4,5 %. En cuanto a la caquexia, se diagnosticó en el 15,2 %. Las variables asociadas a la sarcopenia fueron la albúmina sérica reducida (p = 0,013) y la caquexia (p = 0,039); las relacionadas con la caquexia fueron el sexo femenino (p = 0,036) y el IMC (p < 0,001). CONCLUSIÓN: la principal constatación es la elevada frecuencia de la sarcopenia en los pacientes que realizan terapia dialítica. En los pacientes estudiados, la sarcopenia se asoció significativamente a la disminución de la albúmina sérica. La albúmina sérica reducida es un predictor de mortandad en los pacientes en terapia renal sustitutiva. La frecuencia de la sarcopenia fue elevada en los pacientes estudiados. De este modo, las herramientas actualmente disponibles para evaluar la masa y la fuerza muscular deben aplicarse en la medida de lo posible en la práctica clínica, viabilizando la incorporación de las intervenciones preventivas y terapéuticas apropiadas

INTRODUCTION: sarcopenia and cachexia are syndromes that result in a reduction of skeletal muscle mass, being associated with the aging process and many chronic diseases. OBJECTIVE: to assess the frequency of sarcopenia as well as of cachexia and their associated factors in patients in dialysis treatment. METHODOLOGY: a cross-sectional study conducted in two dialysis treatment centers in Recife between March and September 2016. The diagnosis of sarcopenia was made according to the criteria issued by the Sarcopenia European Consensus, while that of cachexia was made in consonance with the Society for Cachexia and Wasting Disorders (SCWD). The association variables were demographic (age and sex), laboratory (C-reactive protein, serum albumin, hemoglobin, parathyroid hormone, serum creatinine), and anthropometric indicators (body mass index BMI, arm circumference AC, midarm muscular circumference MMC, triceps skinfold thickness TST). RESULTS: the study involved 66 patients, 43.9 % men, 56.1 % women, with a mean age of 53.15 ± 15.24 years; 43.9 % were elderly subjects. Sarcopenia occurred in 59.1 % of patients; of these, 15.2 % presented with severe sarcopenia. Pre-sarcopenia was found in 4.5 %. With regard to cachexia, 15.2 % were diagnosed with this syndrome. The variables associated with sarcopenia were reduced serum albumin (p = 0.013) and cachexia (p = 0.039), and those associated with cachexia were female gender (p = 0.036) and BMI (p < 0.001). CONCLUSION: the main finding of the present study was the high frequency of sarcopenia found in patients on treatment with dialysis. In the patients studied, sarcopenia was significantly associated with a decrease in serum albumin. Reduced serum albumin is a predictor of mortality in patients on renal replacement therapy. A high frequency of sarcopenia has been observed among study patients. Thus, the tools currently available to assess muscle mass and muscle strength should be implemented as much as possible in clinical practice to enable the incorporation of appropriate preventive and therapeutic interventions

[Frequency of sarcopenia, cachexia, and associated factors in patients with chronic kidney disease in dialysis treatment]. / Frecuencia de la sarcopenia, la caquexia y los factores asociados en los pacientes con enfermedad renal crónica en terapia dialítica.

INTRODUCTION: Introduction: sarcopenia and cachexia are syndromes that result in a reduction of skeletal muscle mass, being associated with the aging process and many chronic diseases. Objective: to assess the frequency of sarcopenia as well as of cachexia and their associated factors in patients in dialysis treatment. Methodology: a cross-sectional study conducted in two dialysis treatment centers in Recife between March and September 2016. The diagnosis of sarcopenia was made according to the criteria issued by the Sarcopenia European Consensus, while that of cachexia was made in consonance with the Society for Cachexia and Wasting Disorders (SCWD). The association variables were demographic (age and sex), laboratory (C-reactive protein, serum albumin, hemoglobin, parathyroid hormone, serum creatinine), and anthropometric indicators (body mass index BMI, arm circumference AC, midarm muscular circumference MMC, triceps skinfold thickness TST). Results: the study involved 66 patients, 43.9 % men, 56.1 % women, with a mean age of 53.15 ± 15.24 years; 43.9 % were elderly subjects. Sarcopenia occurred in 59.1 % of patients; of these, 15.2 % presented with severe sarcopenia. Pre-sarcopenia was found in 4.5 %. With regard to cachexia, 15.2 % were diagnosed with this syndrome. The variables associated with sarcopenia were reduced serum albumin (p = 0.013) and cachexia (p = 0.039), and those associated with cachexia were female gender (p = 0.036) and BMI (p < 0.001). Conclusion: the main finding of the present study was the high frequency of sarcopenia found in patients on treatment with dialysis. In the patients studied, sarcopenia was significantly associated with a decrease in serum albumin. Reduced serum albumin is a predictor of mortality in patients on renal replacement therapy. A high frequency of sarcopenia has been observed among study patients. Thus, the tools currently available to assess muscle mass and muscle strength should be implemented as much as possible in clinical practice to enable the incorporation of appropriate preventive and therapeutic interventions.

INTRODUCCIÓN: Introducción: la sarcopenia y la caquexia son síndromes que producen una reducción de la masa muscular esquelética y que se asocian al proceso de envejecimiento y a muchas enfermedades crónicas. Objetivo: verificar la frecuencia de la sarcopenia, la caquexia y los factores asociados en pacientes en tratamiento dialítico. Metodología: estudio transversal realizado en dos centros de tratamiento dialítico de Recife entre marzo y septiembre de 2016. El diagnóstico de sarcopenia se realizó según el criterio del Consenso Europeo de Sarcopenia, mientras que el de caquexia se hizo por el criterio de la Society for Cachexia and Wasting Disorders (SCWD). Las variables de asociación fueron demográficas (sexo y edad), analíticas (proteína C-reactiva, albúmina sérica, hemoglobina, paratohormona y creatinina sérica) y antropométricas: índice de masa corporal (IMC), circunferencia del brazo (CB), circunferencia muscular del brazo (CMB) y pliegue cutáneo tricipital (PCT). Resultados: se estudió a 66 pacientes: el 43,9 % eran hombres y el 56,1 % mujeres, con una media de edad de 53,15 ± 15,24 años. El 43,9 % eran ancianos. La sarcopenia estuvo presente en el 59,1 % de los pacientes y, entre estos, el 15,2 % presentaban sarcopenia grave. La pre-sarcopenia se verificó en el 4,5 %. En cuanto a la caquexia, se diagnosticó en el 15,2 %. Las variables asociadas a la sarcopenia fueron la albúmina sérica reducida (p = 0,013) y la caquexia (p = 0,039); las relacionadas con la caquexia fueron el sexo femenino (p = 0,036) y el IMC (p < 0,001). Conclusión: la principal constatación es la elevada frecuencia de la sarcopenia en los pacientes que realizan terapia dialítica. En los pacientes estudiados, la sarcopenia se asoció significativamente a la disminución de la albúmina sérica. La albúmina sérica reducida es un predictor de mortandad en los pacientes en terapia renal sustitutiva. La frecuencia de la sarcopenia fue elevada en los pacientes estudiados. De este modo, las herramientas actualmente disponibles para evaluar la masa y la fuerza muscular deben aplicarse en la medida de lo posible en la práctica clínica, viabilizando la incorporación de las intervenciones preventivas y terapéuticas apropiadas.

Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults.

OBJECTIVE: To investigate the discriminative power of Nutritional Risk Screening 2002. METHODS: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. RESULTS: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). CONCLUSION: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.

Food consumption and its association with nutritional status, physical activity and sociodemographic factors of bariatric surgery candidates. / Consumo alimentar e sua associação com estado nutricional, atividade física e fatores sociodemográficos de candidatos à cirurgia bariátrica.

OBJECTIVE: to evaluate the association of food consumption with nutritional status, physical activity and sociodemographic factors in the bariatric surgery period preoperative. METHODS: we conducted a cross-sectional study from 2018 to 2019, with patients admitted for bariatric surgery at the Oswaldo Cruz University Hospital, Federal University of Pernambuco. We collected data sociodemographic and nutritional data such as body mass index (BMI), waist circumference, highest weight and pre-surgical weight. We evaluated food consumption with the food frequency questionnaire based on the food pyramid adapted for bariatric patients and physical activity. RESULTS: the study involved 60 patients, 78.3% were female, mean age was 38.8±9.6 years, 53.3% were married, and 70% had more than 12 years of education. As for physical activity, 31.7% were sedentary. Regarding nutritional status, the mean BMI was 47.3±6.96kg/m2. Preoperative weight, highest weight reached before surgery and waist circumference were higher in males (p<0.05). There was an association between physical activity and food intake, and sedentary individuals consumed more carbohydrates (p=0.041). On the other hand, sociodemographic data and nutritional status were not associated with food consumption. CONCLUSION: the level of physical activity showed significant association only with carbohydrate consumption.

OBJETIVO: avaliar a associação do consumo alimentar com estado nutricional, atividade física e fatores sociodemográficos no pré-operatório de cirurgia bariátrica. MÉTODOS: estudo transversal, realizado no período de 2018 a 2019, com pacientes internados para a cirurgia bariátrica no Hospital Universitário Oswaldo Cruz da Universidade Federal de Pernambuco. Foram obtidos dados sociodemográficos, estado nutricional pelo índice de massa corporal (IMC), circunferência da cintura, maior peso e peso pré-cirúrgico, consumo alimentar obtido pelo questionário de frequência alimentar baseado na pirâmide alimentar adaptada para o paciente bariátrico e atividade física. RESULTADOS: participaram do estudo 60 pacientes, sendo 78,3% do sexo feminino, com idades de 38,8±9,6 anos, 53,3% casados e 70% dos indivíduos com mais de 12 anos de estudo. Na prática de atividade física, 31,7% eram sedentários. Sobre o estado nutricional, a média de IMC observada foi de 47,3±6,96kg/m2. O peso pré-operatório, maior peso atingido antes da cirurgia e circunferência da cintura foi maior no sexo masculino (p<0,05). Houve associação entre atividade física e consumo alimentar, sendo que indivíduos sedentários consumiam mais carboidratos (p=0,041). Por outro lado, dados sociodemográficos e estado nutricional não apresentaram associações com o consumo. CONCLUSÃO: o nível de atividade física evidenciou associação significativa apenas com o consumo de carboidratos.

Associações do Risco nutricional com tempo de internamento e complicações hospitalares: estudo em pacientes de ginecologia do NE do Brasil / Nutritional risk among ginecology patients

OBJETIVO: Identificar o risco nutricional em pacientes admitidas na clínica de ginecologia e associá-lo ao tempo de internamento e às complicações hospitalares. MÉTODOS: Estudo transversal, com amostra de conveniência, realizado no período de 6 meses, pacientes de ginecologia (mulheres adultas e idosas). A avaliação do risco nutricional foi realizada nas primeiras 48 horas da admissão utilizando-se a Triagem de Risco Nutricional 2002 - Nutritional Risk Screening 2002 (NRS 2002) adaptada por Hertlein et al. para pacientes de ginecologia. O tempo de internamento (em dias) correspondeu à diferença entre o dia da admissão e o da alta hospitalar, e as complicações foram transcritas do prontuário diariamente para cada paciente. Para análise estatística foram usados os testes qui-quadrado de Pearson, Teste exato de Fisher, Teste de Mann-Whitney e coeficiente de correlação de Spearman, O valor de p < 0,05 foi considerado estatisticamente significante. RESULTADOS: Foram estudas 111 pacientes≤ 60 anos (73%), com 32,4%em risco nutricional. Deste grupo, 88,2% tinham ingestão alimentar <50% que o habitual, 70,8% apresentou perda de peso significativa nos últimos seis meses, 53,7% tinham neoplasias, 75% tinham o IMC<20,5 e 21,8% foram tratadas cirurgicamente. Foi verificada correlação positiva e significativa entre o risco nutricional e o tempo de internamento (r=0,392; p < 0,001). O risco não esteve associado à faixa etária e presença de complicações hospitalares. CONCLUSÕES: Um número significativo de mulheres estava em risco nutricional, o que sugere a importância deste diagnóstico em pacientes de ginecológicos. Este risco foi associado com maior tempo de hospitalização

OBJECTIVE: Identify nutritional risk among patients admitted to a gynecological clinic and associate this risk with hospitalization stay and clinical complications. METHODS: A cross-sectional study was conducted with a convenience sample for 6 months, involving 111 gynecological patients (adults and older adults). The assessment of nutritional risk was performed in the first 48 hours after admission using the 2002 Nutritional Risk Screening (NRS 2002) adapted by Hertlein et al. for gynecology patients. Internment time (in days) was calculated as the difference between the day of admission and discharge. Complications were transcribed from daily entries in the patient charts. Statistical analysis involved Pearson's chi-square test, Fisher's exact text, the Mann-Whitney test and the calculation of Spearman's correlation coefficients. A p-value <0.05 was considered statistically significant. RESULTS: A total of 32.4% of the patients were classified in a state of nutritional risk, 88.2% of whom had food intake < 50% of habitual intake, 70.8% of whom experienced significant weight loss in the previous six months, 53.7% of whom had a diagnosis of neoplasm, 75% of whom had a body mass index < 20.5 and 21.8% of whom had been submitted to surgery. A significant, positive correlation was found between nutritional risk and hospitalization stay (r=0.392; p < 0.001). Nutritional risk was not associated with age group or the clinical complications. CONCLUSIONS: A significant number of women in the present study were in a state of nutritional risk, which underscores the importance of diagnosing this condition among gynecological patients. Nutritional risk was associated with a longer hospitalization stay

Discriminative power of an adapted version of Nutritional Risk Screening 2002 applied to Brazilian older adults / Poder diagnóstico discriminativo da versão adaptada do Nutritional Risk Screening 2002 administrada em idosos brasileiros

ABSTRACT Objective: To investigate the discriminative power of Nutritional Risk Screening 2002. Methods: A cross sectional study involving one hundred participants aged ≥60 years. The original and adapted versions of Nutritional Risk Screening 2002 and the Mini Nutritional Assessment were used. Nutritional Risk Screening 2002 adaptation consisted of a lower age cutoff (60 years or older) for addition of one extra point to the final score. Results: Screening using Nutritional Risk Screening 2002 revealed higher nutritional risk among patients aged ≥70 years (p=0.009), whereas screening using the adapted version of Nutritional Risk Screening 2002 revealed similar nutritional risk in both age groups (60-69 years and ≥70 years; p=0.117). Frequency of nutritional risk was highest when the Mini Nutritional Assessment was administered (52.7%), followed by the adapted and original versions of Nutritional Risk Screening 2002 (35.5% and 29.1%, respectively). Conclusion: The adapted version of Nutritional Risk Screening 2002 was more effective than the original version. However, further studies are needed to confirm these findings.

RESUMO Objetivo: Avaliar o poder de discriminação diagnóstica da ferramenta Nutritional Risk Screening 2002. Métodos: Estudo transversal com cem participantes com idade ≥60 anos. Foram aplicados o Nutritional Risk Screening 2002 original, o Nutritional Risk Screening 2002 adaptado e o Mini Nutritional Assessment. A adaptação do Nutritional Risk Screening 2002 consistiu em diminuir o critério de idade, incluindo pontuação adicional para 60 anos de idade ou mais. Resultados: Maior risco nutricional ocorreu nos ≥70 anos quando aplicado o Nutritional Risk Screening 2002 original (p=0,009), enquanto o Nutritional Risk Screening 2002 adaptado apresentou risco nutricional semelhante em ambos os grupos (60-69 anos e ≥70 anos; p=0,117). A frequência de risco nutricional foi maior no Mini Nutritional Assessment (52,7%), seguido do Nutritional Risk Screening 2002 adaptado (35,5%) e do Nutritional Risk Screening 2002 original (29,1%). Conclusão: A adaptação do Nutritional Risk Screening 2002 mostrou-se descritivamente mais eficaz do que a original, porém mais estudos devem ser realizados para confirmar os achados.

Síndrome metabólica em idosos diabéticos tipo 2 atendidos em ambulatório de uma capital brasileira / Metabolic syndrome in elderly type 2 diabetics treated at an outpatient clinic in a Brazilian capital

Objetivo: identificar a prevalência de síndrome metabólica e seus fatores associados em idosos com diabetes mellitus tipo 2. Métodos: estudo descritivo observacional realizado com idosos diagnosticados com diabetes mellitus tipo 2, no período de 2017-2018, recrutados no Ambulatório de Nutrição/Diabetes do Núcleo de Assistência ao Idoso da Universidade Federal de Pernambuco. Foram coletados os dados: sexo e faixa etária e, para a avaliação antropométrica dos participantes, foram mensurados o índice de massa corporal e a circunferência de cintura. Também foram coletados os valores de colesterol total e frações, além de glicemia em jejum, hemoglobina glicosilada e diagnóstico prévio de hipertensão arterial. Para analisar os dados obtidos foram utilizados os testes t de Student, Qui-quadrado de Pearson e teste de MannWhitney. Para as análises, foi adotado um intervalo de confiança de 95% e nível de significância de 0,05. Resultados: a amostra foi de 273 participantes, com média de idade de 68,77±5,65 anos e cerca de 89,8% (n=158) apresentaram síndrome metabólica. A presença dessa condição foi associada a valores maiores de peso corporal (p=0,04), índice de massa corporal (p=0,003), circunferência de cintura (p<0,001) e glicemia em jejum (p=0,007). Conclusões: ocorreu alta prevalência de síndrome metabólica nos idosos estudados com essa condição associada a valores maiores de peso corporal, índice de massa corporal, circunferência de cintura e glicemia em jejum. Esses achados demonstram a importância na identificação precoce e na intervenção preventiva dessas condições na população idosa, diminuindo a morbimortalidade por ocorrência de eventos cardiovasculares e melhorando sua qualidade de vida.

Aims: to identify the prevalence of metabolic syndrome and its associated factors in the elderly with type 2 diabetes mellitus.Methods: observational descriptive study conducted with elderly diagnosed with type 2 diabetes mellitus, in the period 2017-2018, recruited at the Nutrition / Diabetes Outpatient Clinic of the Elderly Care Center of the Federal University of Pernambuco. Gender and age group were collected, and for the anthropometric evaluation of the participants, the body mass index and waist circumference were measured. We also collected the values of total cholesterol and fractions, as well as fasting glucose, glycosylated hemoglobin and previous diagnosis of hypertension. To analyze the obtained data, Student's t-test, Pearson's chi-square and Mann-Whitney test were used. For the analyzes, a confidence interval of 95% and a significance level of 0.05 were adopted.Results: the sample consisted of 273 participants, with a mean age of 68.77±5.65 years and 89.8% (n=158) presented metabolic syndrome. The presence of this condition was associated with higher values of body weight (p=0.04), body mass index (p= 0.003), waist circumference (p<0.001) and fasting blood glucose (p=0.007). Conclusions: there was a high prevalence of metabolic syndrome in the elderly studied with this condition associated with higher values of body weight, body mass index, waist circumference and fasting glucose. These findings demonstrate the importance of early identification and preventive inter-vention of these conditions in the elderly population, reducing morbidity and mortality due to cardiovascular events and improving the quality of life in the elderly.

Nutritional status and cardiovascular risk in women with breast cancer

Objective: To evaluate the nutritional status and the cardiovascular risk in women with breast cancer and identify factors associated with excessive body weight. Methods: A descriptive, cross-sectional, quantitative study was carried out in an oncology outpatient clinic and, gynecology/oncology wards at the Hospital das Clínicas da Universidade Federal de Pernambuco, from March to August 2019. The data analyzed was related to sociodemographic, gynecologic, clinic, anthropometric and lifestyle factors. Nutritional status was assessed using Body Mass Index, considering excessive body weight when > 25 kg/m2 for adults and > 27 kg/m2 for elderly. Obesity was considered > 30 kg/m2. Cardiovascular risk was defined by waist circumference (≥ 80 cm), neck circumference (≥ 34 cm) and waist-to-height ratio (> 0.5). Results: A total of 46 patients were included, with a mean age of 51.9 years, and the majority in outpatient follow-up. The population was mostly Caucasian women, who were married or in a civil union, who had had at least one pregnancy, were in menopause, and were sedentary. High frequencies of excessive body weight (76.1%) and obesity (43.5%) were observed, and anthropometric parameters revealed an elevated frequency of cardiovascular risk in this population, waist circumference (97.8%), neck circumference (84.8%), and waist-to-height ratio (95.7%). Unemployment (p = 0.020), and waist (p = 0.001) and neck (p = 0.001) circumferences were statistically associated factors to excessive body weight. Conclusions: The anthropometric profile of women with breast cancer indicated excess body weight and elevated cardiovascular risk, which suggests to the need for nutrition intervention and follow-up after the diagnosis.

Terapia nutricional em pacientes oncológicos: realidade de um hospital de referência em Pernambuco / Nutritional therapy in cancer patients: reality of a referral hospital in Pernambuco

INTRODUÇÃO: o câncer aumenta o risco de desnutrição e desordens metabólicas, decorrente do tumor e/ou tratamentos anticancerígenos. A terapia nutricional é recomendada visando manutenção ou melhoria do estado nutricional destes pacientes. OBJETIVO: analisar as características da terapia nutricional em pacientes oncológicos hospitalizados. MÉTODOS: realizou-se um estudo retrospectivo do tipo série de casos, de 2016 a 2019, onde avaliou-se a terapia nutricional (enteral e parenteral), realizada no Hospital de Câncer de Pernambuco. Foram coletadas informações demográficas, clínicas, antropométricas, risco nutricional e características das terapias administradas. RESULTADOS: incluiu-se 365 pacientes (58,64 ± 13,1 anos), 62,5% homens, em clínica predominante cirúrgica (49,3%) e neoplasias de cabeça e pescoço (35%). Teve como indicações principais para terapia nutricional: a obstrução tumoral e o rebaixamento do nível de consciência na UTI. A terapia enteral foi predominante (72,6%), com uso de fórmulas industrializadas do tipo polimérica, normocalóricas e hiperproteicas administradas exclusivamente por sonda nasogástrica (82,3%). A terapia parenteral mais frequente foi a do tipo 3 em 1, administrada exclusivamente por acesso central em 88,7%. O período de uso da enteral foi de 11,31 ± 12,61 dias e da parenteral de 10,31 ± 9,37 dias. DISCUSSÃO: Na literatura são escassas pesquisas que avaliem as características nutricionais das terapias, porém esta terapêutica tem importância significativa na recuperação do estado nutricional deste tipo de enfermidade, visto que a desnutrição é comumente encontrada entre estes pacientes. CONCLUSÃO: a nutrição enteral foi a mais utilizada com predominância de fórmulas poliméricas normocalóricas e hiperproteicas, onde pacientes com neoplasias de cabeça e pescoço foram os que mais fizeram uso desta terapêutica

INTRODUCTION: Cancer increases the risk of malnutrition and metabolic disorders due to tumor and anticancer treatments. Nutritional therapy is recommended to maintain or improve the nutritional status of these patients. OBJECTIVE: To analyze the characteristics of nutritional therapy in hospitalized cancer patients. METHODS: A retrospective case series study was conducted from 2016 to 2019, in which nutritional therapy (enteral and parenteral) was evaluated performed at the Cancer's Hospital of Pernambuco. Demographic, clinical, anthropometric, nutritional risk and characteristics of the therapies administered informations were collected. RESULTS: included 365 patients (58.64 + 13.1 years), 62.5% men, predominantly surgical clinic (49.3%) and head and neck cancer (35%). The indication for nutritional therapy was tumoral obstruction and lowering the level of consciousness in the ICU. Enteral therapy was predominant (72.6%), using industrialized, polymeric, normocaloric and hyperprotein formulas, administered exclusively by nasogastric tube (82.3%). The most frequent parenteral therapy was type 3 in 1, administered exclusively by central access in 88.7%. The period of enteral use was 11.31 ± 12.61 days and parenteral use was 10.31 ± 9.37 days. DISCUSSION: There is a few research in the literature to assess the nutritional characteristics of therapies, but this therapy is of significant importance in recovering the nutritional status of this type of disease, since malnutrition is commonly found among these patients. CONCLUSION: enteral nutrition was the most used with predominance of normocaloric and hyperproteic polymeric formulas, where patients with head and neck cancer made the most use of this therapy

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Consumo de macro e micronutrientes de idosos com diabetes mellitus tipo 2 atendidos no núcleo de apoio ao idoso / Consumption of macro and micronutrients of elderly people with type 2 diabetes mellitus assisted at the nucleus to support for the elderly

Objetivo: Avaliar o consumo de macro e micronutrientes em idosos diabéticos atendidos no Núcleo de Aten-ção ao Idoso da Universidade Federal de Pernambuco (NAI/UFPE). Métodos: Estudo transversal com idosos saudáveis (n=66) e com diabetes (n=55) do NAI/UFPE. Obteve-se dados de prontuários e/ou questionários de frequência alimentar. Análise dietética realizada através do DietWin Professional 2008 e para estatística utilizou-se teste t-Student, admitindo-se nível de significância para p<0,05. Resultados: Os resultados mostraram a prevalência do sexo feminino em ambos os grupos (73,8% no grupo saudável e 86,6% no grupo de idosos com diabetes), sendo idosos saudáveis com média de idade de 72,5 ± 6,2 anos, e grupo com diabetes com média de idade de 61,8 ± 5,0 anos (p<0,05). O excesso de peso prevaleceu no grupo com diabetes (67%) quando comparado ao grupo saudável (49,2%; p<0,027). A ingestão calórica dos pa-cientes com diabetes foi maior (1257,94 kcal) em relação aos indivíduos saudáveis (970,81 kcal; p=0,01). O mesmo ocorreu para consumo de sódio (1810,12 mg x 592,92 mg), cálcio (721,44 mg x 286,23 mg), zinco (8,73 mg x 6,26 mg), magnésio (266,22 mg x 128,60 mg), vitamina A (442,35 µg x 131,83 µg) e E (4,59 mg x 1,45 mg) (p<0,01 para todas as variáveis). Por outro lado, observou-se consumo inferior de po-tássio (1580,83 mg x 2349,23 mg; p<0,01) e proteína (9% x 17%; p<0,01). Conclusão: Foi identificado umpadrão alimentar hipercalórico nos idosos com diabetes, acompanhado de excesso de sódio, cálcio, magnésio e zinco, com reduzido consumo proteico e de potássio (AU)

Objective: Evaluating the macro and micronutrient intake in elderly diabetic patients treated at the Elderly Care Center of the Federal University of Pernambuco, Brazil. Methods: A cross-sectional study was conducted with diabetic (n = 55) and non-diabetic (n = 66) older adults. Data were collected from patient charts and food frequency questionnaires. The analysis of diet was performed using the Diet Win Professional 2008. The Student's t-test was used for the statistical analysis, with a 5% significance level. Results: The female sex accounted for 86.6% of the group with diabetes and 73.8% of the group without diabetes. Mean age was 61.8 years and 72.5 years, respectively. The excess weight was more frequent in the group with diabetes (67%) when compared to the group without diabetes (49.2%, p <0.027). The caloric intake of patients with diabetes was higher (1257.94 kcal) than in those without diabetes (970.81 kcal, p = 0.01). With the same statistical significance, we found the same for sodium (1810.12 mg x 592.92 mg), calcium (721.44 mg x 286.23 mg), zinc (8.73 mg x 6.26 mg), magnesium (266.22 mg) mg x 128.60 mg), vitamin A (442.35 µg x 131.83 µg) and E (4.59 mg x 1.45 mg). On the other hand, lower potassium intake (1580.83 mg x 2349.23 mg, p <0.01) and protein (9% x 17%, p <0.01) were observed. Conclusion: A hypercaloric eating pattern was identified in the elderly with diabetes, followed by an excess of sodium, calcium, magnesium, and zinc, with reduced protein and potassium consumption. Keywords: Aged. Diabetes Mellitus. Food Consumption. Diet. INTRODUÇÃO O bem-estar físico e psicológico do idoso está diretamente relacionado à sua habilidade funcional. Dentro desse contexto, a nutrição desempenha im-portante papel na saúde desses indivíduos. Ao com-parar idosos com adultos jovens, observa-se déficit de nutrientes, como ferro, cálcio, magnésio, potássio e zinco entre os indivíduos de maior faixa etária, com maior risco de desenvolver doenças carenciais.1,2,3O desequilíbrio no consumo de nutrientes neste público é consequência de alterações psíquicas, somáticas e sociais.² Estudos mostram que 76% da população brasileira acima dos 40 anos apresenta inadequação do consumo de micronutrientes essenciais, como cálcio, fósforo e magnésio.4 Um padrão dietético ocidentalizado, caracterizado por alto consumo de energia e de combustíveis energéticos, como carboidratos e gorduras saturadas, coincidindo com baixa ingestão de gorduras saudáveis e antioxidantes, contribui para a inflamação e desenvolvimento das doenças crônicas não transmissíveis, dentre elas o diabetes mellitus (DM) tipo 2.5 Dados de 20166 confirmam o potencial protetor de um padrão alimentar baseado em vegetais na prevenção primária do diabetes, em particular entre indivíduos de meia-idade, provavelmente pelo teor reduzido de carboidratos e elevada presença de micronutrientes. No entanto, o impacto que o estilo de vida tem no curso da resistência à insulina depende da adesão individual.A prescrição da dieta balanceada e individualizada é imprescindível e deve ser realizada considerando-se aspectos nutricionais, socioeconômicos, culturais e psicológicos do indivíduo. Além dos de-terminantes sociais, o envelhecimento e a presença de diabetes também podem influenciar direta ou in-diretamente na escolha da qualidade do alimento. As alterações corporais e o estado nutricional próprios do envelhecimento, além da presença de Doenças Crônicas não transmissíveis (DCNT), comprometem o estado de saúde e a necessidade nutricional do in-divíduo idoso.7 Quando se trata de idosos portadores de DM, a literatura é escassa, tanto a nível nacional, quanto internacional. Porém, estudo realizado no Japão que avaliou 207 idosos diabéticos, mostrou que o consumo adequado de vitamina B2, pantotenato, cálcio e vegetais podem ajudar a prevenir o declínio cognitivo em homens idosos com diabetes mellitus, reforçando a importância de uma nutrição adequada tanto em macro como em micronutrientes para essa faixa etária 8O objetivo desse trabalho foi identificar aspec-tos alimentares de macro e micronutrientes em ido-sos diabéticos. MÉTODOS Estudo transversal do tipo série de casos, realizado no período de janeiro a dezembro de 2015, com idosos saudáveis (IS) e idosos portadores de diabetes mellitus tipo 2 (DM), selecionados por conveniência no Núcleo de Apoio ao Idoso da Universidade Federal de Pernambuco (NAI/UFPE), que atende em média 354 idosos, em todas as especialidades de saúde (2018). Participaram da pesquisa aqueles que concordaram e, posteriormente assinaram um termo de consentimento. (AU)

Consumo alimentar e sua associação com estado nutricional, atividade física e fatores sociodemográficos de candidatos à cirurgia bariátrica / Food consumption and its association with nutritional status, physical activity and sociodemographic factors of bariatric surgery candidates

RESUMO Objetivo: avaliar a associação do consumo alimentar com estado nutricional, atividade física e fatores sociodemográficos no pré-operatório de cirurgia bariátrica. Métodos: estudo transversal, realizado no período de 2018 a 2019, com pacientes internados para a cirurgia bariátrica no Hospital Universitário Oswaldo Cruz da Universidade Federal de Pernambuco. Foram obtidos dados sociodemográficos, estado nutricional pelo índice de massa corporal (IMC), circunferência da cintura, maior peso e peso pré-cirúrgico, consumo alimentar obtido pelo questionário de frequência alimentar baseado na pirâmide alimentar adaptada para o paciente bariátrico e atividade física. Resultados: participaram do estudo 60 pacientes, sendo 78,3% do sexo feminino, com idades de 38,8±9,6 anos, 53,3% casados e 70% dos indivíduos com mais de 12 anos de estudo. Na prática de atividade física, 31,7% eram sedentários. Sobre o estado nutricional, a média de IMC observada foi de 47,3±6,96kg/m2. O peso pré-operatório, maior peso atingido antes da cirurgia e circunferência da cintura foi maior no sexo masculino (p<0,05). Houve associação entre atividade física e consumo alimentar, sendo que indivíduos sedentários consumiam mais carboidratos (p=0,041). Por outro lado, dados sociodemográficos e estado nutricional não apresentaram associações com o consumo. Conclusão: o nível de atividade física evidenciou associação significativa apenas com o consumo de carboidratos.

ABSTRACT Objective: to evaluate the association of food consumption with nutritional status, physical activity and sociodemographic factors in the bariatric surgery period preoperative. Methods: we conducted a cross-sectional study from 2018 to 2019, with patients admitted for bariatric surgery at the Oswaldo Cruz University Hospital, Federal University of Pernambuco. We collected data sociodemographic and nutritional data such as body mass index (BMI), waist circumference, highest weight and pre-surgical weight. We evaluated food consumption with the food frequency questionnaire based on the food pyramid adapted for bariatric patients and physical activity. Results: the study involved 60 patients, 78.3% were female, mean age was 38.8±9.6 years, 53.3% were married, and 70% had more than 12 years of education. As for physical activity, 31.7% were sedentary. Regarding nutritional status, the mean BMI was 47.3±6.96kg/m2. Preoperative weight, highest weight reached before surgery and waist circumference were higher in males (p<0.05). There was an association between physical activity and food intake, and sedentary individuals consumed more carbohydrates (p=0.041). On the other hand, sociodemographic data and nutritional status were not associated with food consumption. Conclusion: the level of physical activity showed significant association only with carbohydrate consumption.

Indicadores nutricionais em pacientes portadores de HIV/SIDA / Nutritional indicators in patients with HIV/AIDS: ambulatorial and hospital reality

Objetivos: Avaliar e comparar o estado clínico-nutricional de pacientes infectados pelo HIV/SIDA internados e atendidos no ambulatório de nutrição do Hospital das Clínicas de Pernambuco (HC/UFPE). Métodos: Estudo transversal observacional realizado no HC/UFPE, com pacientes HIV/SIDA positivo internados na enfermaria e pacientes atendidos no ambulatório de nutrição, de ambos os sexos, com faixa etária entre 20 e 60 anos. Foram avaliadas e comparadas medidas antropométricas (peso, prega cutânea triciptal, circunferência do braço e da cintura, relação cintura/estatura, IMC, circunferência muscular do braço e percentual de perda de peso) e dosagens bioquímicas (albumina, hemoglobina, hematócrito, linfócitos totais e perfil lipídico) entre os dois grupos. Resultados: Os pacientes internos apresentaram uma baixa adesão a Terapia antirretroviral, elevado percentual de desnutrição, perda de peso e depleção tanto do compartimento muscular quanto adiposo, anemia e hipoalbuminemia. Nos externos, verificou-se boa adesão a TARV, excesso de peso, risco elevado para complicações metabólicas representados pela elevada Circunferência da Cintura e pela razão cintura/ estatura, hipercolesterolemia, glicose alterada, HDL-C baixo e elevado LDL-C. Conclusão: A síndrome lipodistrófica prevaleceu nos externos e a não adesão a TARV, encontrada nos internos, reporta uma maior frequência da síndrome consumptiva

Objetive: To evaluate and compare the clinical and nutritional status of HIV / AIDS patients hospitalized and attended at the nutrition clinic of Hospital das Clínicas de Pernambuco (HC / UFPE). Methods: Evaluated 86 pacients, 60.5% (52) inpatients and 39.5% (34) outpatients of both sexes, HIV/AIDS in the HC/UFPE, from March to August 2008, to evaluate and compare the clinical and nutritional status through anthropometric measurements and biochemical values. Results: The inpatients had a low adherence to antiretrovital therapy (ART) (22%), high percentage of malnutrition (46.2%), weight loss (78.8%) and depletion of both the muscular compartment (92.4 %) and fat (82.7%), anemia (92.3%) and hypoalbuminemia (69.2%). However in outpatients, there was good adherence to ART (97%), overweight (50%), high risk for metabolic complications represented by waist circumference (WC) (47.1%) as the reason circle waist/height (CC/Alt) (70.6%), hypercholesterolemia (70.6%), altered glucose (38.2%), low HDL-C (58%) and high LDL-C (47.1 %).Conclusion: It follows then that the syndrome Lipodystrophy prevailed in the outpatients and non-adherence to ART, found in the inpatients, reports to the beginning of the HIV/AIDS, which high frequency of the syndrome consuptiva

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Dosagem sérica de 25-hidroxivitamina D em pacientes idosas diabéticas tipo 2 / Serum dosage of 25-hydroxyvitamin D in early diabetic type2

Objetivos: Associar os níveis séricos de vitamina D com variáveis sociodemográficas, estado nutricional, prática de atividade física e tempo de exposição solar em idosas diabéticas tipo 2. Método: Estudo transversal realizado com idosas diagnosticadas com diabetes mellitus tipo 2, recrutadas no ambulatório de nutrição do Núcleo de assistência ao idoso da UFPE. Foi aplicado um formulário abordando questões sociodemográficas e hábitos relacionados à prática de atividade física e exposição ao sol. Posteriormente o IMC foi aferido e foi realizada a dosagem sérica da 25-hidroxivitamina D. Resultados: A amostra foi de 54 participantes, com 69,37 ± 5,02 anos, pardas (64,8%) e com renda de até um salário mínimo (40,7%). Predominou o excesso de peso (53,7%) e cerca de 94,4% se expunham ao sol com frequência maior que 3 vezes na semana (61,1%). A mediana da 25-hidroxivitamina D foi de 30,96 ng/mL. A raça branca (p=0,046) foi associada à suficiência de vitamina D e o tempo de estudo maior que 8 anos (p=0,024), à deficiência da vitamina. Conclusão: Ocorreu baixa frequência de hipovitaminose D na população estudada, resultado provavelmente justificado pelo elevado tempo de exposição solar e pela prática de atividade física. Futuros estudos são necessários para confirmação destes achados em população idosa diabética

Objectives: Associate serum levels of vitamin D with socio- demographic variables, nutritional status, physical activity practice and time of sun exposure in type 2 diabetic women. Method: A cross-sectional study with elderly women diagnosed with type 2 diabetes mellitus, recruited at the nutrition clinic of the Elderly Assistance Center of UFPE. A form was applied addressing sociodemographic issues and habits related to the practice of physical activity and exposure to the sun. Subsequently, the BMI was measured and serum levels of 25 hydroxyvitamin D were performed. Results: The sample was 54 participants, with 69.37 ± 5.02 years, browns (64.8%) and income up to a minimum wage (40.7%). Overweight was predominant (53.7%) and about 94.4% were exposed to the sun more frequently than 3 times a week (61.1%). The median of 25-hydroxyvitamin D was 30.96 ng / mL. The white race (p = 0.046) was associated with vitamin D sufficiency and study time greater than 8 years (p = 0.024), to vitamin deficiency. Conclusion: There was a low frequency of hypovitaminosis D in the studied population, a result probably due to the high time of sun exposure and the practice of physical activity. Future studies are needed to confirm these findings in the elderly diabetic population

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