Ortorexia nervosa em estudantes de nutrição: associações com o estado nutricional, satisfação corporal e período cursado / Orthorexia nervosa in nutrition students: association with nutritional status, body satisfaction and coursed period

RESUMO Objetivo Identificar a prevalência de comportamentos com tendência a ortorexia nervosa (ON) e suas associações com o estado nutricional, satisfação corporal e período cursado em estudantes de nutrição. Métodos Participaram do estudo 141 estudantes (com idade média de 21,5 ± 3,5 anos). A tendência à ON foi avaliada por meio do questionário para identificação da ON (ORTO-15) e a satisfação corporal, pelo Body Shape Questionnaire. A classificação do estado nutricional foi feita pelo IMC (kg.m-2). Associações entre as variáveis foram avaliadas pelo teste do qui-quadrado (p < 0,05). Resultados Comportamentos alimentares com tendência a ON foram identificados em 87,2% dos estudantes. Os estudantes com ON apresentaram mais insatisfação corporal (χ2 = 7,48; p = 0,005) e excesso de peso (χ2 = 6,56; p = 0,010). Não foi observada associação entre a ON e o período cursado. Conclusão Os resultados demonstram que os estudantes de nutrição parecem ser uma população especialmente em risco para tendência à ON, independentemente do período cursado. A maior frequência de estudantes com ON e excesso de peso e insatisfação corporal pode sugerir que tais condições, que comumente cursam com preocupações com alimentação saudável, podem facilitar o início do desenvolvimento de comportamentos alimentares associados a ON.

ABSTRACT Objective To identify the prevalence of orthorexia nervosa (ON)'s risky behaviors and their association with nutritional status, body satisfaction and coursed period in nutrition students. Methods The study included 141 students (mean age 21.5 ± 3.5 years). The risk behavior to ON was assessed by using the questionnaire to identify ON (ORTHO-15) and body satisfaction with the Body Shape Questionnaire. The classification of nutritional status was evaluated by BMI (kg.m-2). Association between variables was evaluated by chi-square test (p < 0.05). Results Eating behaviors at risk for ON were identified in 87.2% of students. Students with ON had more body dissatisfaction (χ2 = 7.48; p = 0.005) and overweight (χ2 = 6.56; p = 0.010). No association was observed between the ON and coursed period. Conclusion The results show that Nutrition students seem to be a population at a particular risk for ON, regardless of the coursed period studied. The higher frequency of students with ON and overweight and body dissatisfaction may suggest that such conditions, which commonly occur with concerns about healthy eating, may facilitate the initiation of the development of eating behaviors associated with ON.

Effects of a high-fat meal on postprandial incretin responses, appetite scores and ad libitum energy intake in women with obesity.

BACKGROUND: Considering the possible role of triglycerides (TG), glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) in the regulation of appetite, this study aimed to compare high fat meal-induced response of GIP and GLP-1, appetite scores and ad libitum energy intake in women with obesity, according to postprandial increment in triglyceridemia (∆TG).  Methods: Thirty-three no-diabetic women (BMI = 35.0 ± 3.2 kg.m-2) were divided into two groups: Group with ∆TG ≤ median were called "Low TG change -LTG" and ∆TG > median, "High TG change - HTG". Plasma concentrations of GIP, GLP-1 and appetite sensations were measured prior to, and every 30 min for 180 min after ingestion of a high-fat breakfast. An ad libitum lunch was served 3 h after the test meal. RESULTS: The AUC incrementalGIP were significant lower in HTG vs. LTG group (p = 0.03). The same was observed for GIP levels at 150 min (p = 0.03) and at 180 min (p < 0.01). Satiety was lower in HTG at 120 min (p = 0.03) and 150 min (p < 0.01). The AUC totalGLP1 were similar between groups and there were no between-group differences for the GLP-1 at each time point. Ad libitum food intake were also similar between groups. CONCLUSIONS: The HTG group exhibited differences in satiety scores and lower postprandial secretion of GIP, however with no impact on ad libitum food intake in short term.

Effects of a high-fat meal on postprandial incretin responses, appetite scores and ad libitum energy intake in women with obesity / Efectos de una comida rica en grasas en la respuesta posprandial de las incretinas, del apetito y en la ingestión de energía ad libitum en mujeres con obesidad

Background: Considering the possible role of triglycerides (TG), glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) in the regulation of appetite, this study aimed to compare high fat meal-induced response of GIP and GLP-1, appetite scores and ad libitum energy intake in women with obesity, according to postprandial increment in triglyceridemia (ΔTG). Methods: Thirty-three no-diabetic women (BMI = 35.0 ± 3.2 kg.m-2) were divided into two groups: Group with ΔTG ≤ median were called «Low TG change -LTG» and ΔTG > median, «High TG change - HTG». Plasma concentrations of GIP, GLP-1 and appetite sensations were measured prior to, and every 30 min for 180 min after ingestion of a high-fat breakfast. An ad libitum lunch was served 3 h after the test meal. Results: The AUC incrementalGIP were signifi cant lower in HTG vs. LTG group (p = 0.03). The same was observed for GIP levels at 150 min (p = 0.03) and at 180 min (p < 0.01). Satiety was lower in HTG at 120 min (p = 0.03) and 150 min (p < 0.01). The AUC totalGLP1 were similar between groups and there were no between-group differences for the GLP-1 at each time point. Ad libitum food intake were also similar between groups. Conclusions: The HTG group exhibited differences in satiety scores and lower postprandial secretion of GIP, however with no impact on ad libitum food intake in short term (AU)

Introducción: teniendo en cuenta las posibles acciones de los triglicéridos (TG), del glucose-dependent insulinotropic polypeptide (GIP) y del glucagon-like peptide-1 (GLP-1), en la regulación del apetito (hambre y saciedad), este estudio tuvo como objetivo comparar la respuesta posprandial inducida por una comida rica en grasas en los niveles del GIP y GLP-1, en el apetito y en la ingestión de energía ad libitum en mujeres con obesidad, clasifi cadas de acuerdo con el aumento de la trigliceridemia postprandial (ΔTG). Métodos: treinta y tres mujeres sin diabetes (IMC = 35,0 ± 3,2 kg.m-2) fueron clasifi cadas en dos grupos: grupo con ΔTG ≤ mediana («bajo cambio en los TG - LTG») y grupo ΔTG > mediana («alto cambio en los TG-HTG»). Los niveles plasmáticos del GIP, GLP-1 y del apetito fueron evaluados antes y cada 30 minutos durante 180 minutos después de la ingestión de un desayuno rico en grasas. Un almuerzo ad libitum fue servido 3 h después del desayuno. Resultados: el área bajo la curva (AUC) del aumento del GIP (AUC aumentoGLP1) fue significativamente menor en el grupo HTG vs. LTG (p = 0,03). Lo mismo se observó para los niveles del GIP en los 150 minutos (p = 0,03) y en los 180 minutos (p < 0,01). La saciedad fue menor en el grupo HTG en los 120 minutos (p = 0,03) y en los 150 minutos (p < 0,01). La AUC totalGLP1 fue similar entre los grupos y no hubo diferencias entre ellos para los niveles del GLP-1 en los tiempos evaluados. La ingesta alimentaria ad libitum también fue similar entre los grupos. Conclusiones: el grupo HTG presentó diferencias en la saciedad y menor secreción posprandial del GIP, sin embargo, sin impacto en la ingesta de alimentos ad libitum en el corto plazo (AU)

Short-term impact of sugar consumption on hunger and ad libitum food intake in young women.

The hypothesis of this study was that greater sugar consumption at breakfast promotes a stronger sensation of hunger and a later increase in energy consumption. The objective was to assess the relation between sugar consumption in a meal and the subsequent sensations of hunger and ad libitum food consumption. Sixteen women consumed a breakfast accompanied by 2 drinks sweetened ad libitum with sugar. After 3 h, a lunch was offered to evaluate ad libitum food consumption. During the period from breakfast to lunch, hunger sensations were evaluated at 30 min intervals. Women were divided according to the median amount of sugar used to sweeten the breakfast drinks (20 g). The group who consumed sugar above the median showed a greater hunger sensation in the preprandial period, and a greater ad libitum intake at lunch (390 ± 130 g × 256 ± 67 g, P = 0.002), compared to the group who had a lower sugar consumption. The amount of sugar consumed at breakfast was correlated positively with the sensation of preprandial hunger and food intake at lunch. We concluded that foods with a high glycemic index can modulate the appetite within a short period of time.

Can an adequate energy intake be able to reverse the negative nitrogen balance in mechanically ventilated critically ill patients?

PURPOSE: Adequate energy provision and nitrogen losses prevention of critically ill patients are essentials for treatment and recovery. The aims of this study were to evaluate energy expenditure (EE) and nitrogen balance (NB) of critically ill patients, to classify adequacy of energy intake (EI), and to verify adequacy of EI capacity to reverse the negative NB. METHODS: Seventeen patients from an intensive care unit were evaluated within a 24-hour period. Indirect calorimetry was performed to calculate patient's EE and Kjeldhal for urinary nitrogen analysis. The total EI and protein intake were calculated from the standard parenteral and enteral nutrition infused. Underfeeding was characterized as EI 90% or less and overfeeding as 110% or greater of EE. The adequacy of the EI (EI EE(-1) × 100) and the NB were estimated and associated with each other by Spearman coefficient. RESULTS: The mean EE was 1515 ± 268 kcal d(-1), and most of the patients (11/14) presented a negative NB (-8.2 ± 4.7 g.d(-1)). A high rate (53%) of inadequate energy intake was found, and a positive correlation between EI EE(-1) and NB was observed (r = 0.670; P = .007). CONCLUSION: The results show a high rate of inadequate EI and negative NB, and equilibrium between EI and EE may improve NB. Indirect calorimetry can be used to adjust the energy requirements in the critically ill patients.

Harris-Benedict equation for critically ill patients: are there differences with indirect calorimetry?

PURPOSE: The aim of this study was to compare the measured energy expenditure (EE) and the estimated basal EE (BEE) in critically ill patients. MATERIALS AND METHODS: Seventeen patients from an intensive care unit were randomly evaluated. Indirect calorimetry was performed to calculate patient's EE, and BEE was estimated by the Harris-Benedict formula. The metabolic state (EE/BEE x 100) was determined according to the following criteria: hypermetabolism, more than 130%; normal metabolism, between 90% and 130%; and hypometabolism, less than 90%. To determine the limits of agreement between EE and BEE, we performed a Bland-Altman analysis. RESULTS: The average EE of patients was 6339 +/- 1119 kJ/d. Two patients were hypermetabolic (11.8%), 4 were hypometabolic (23.5%), and 11 normometabolic (64.7%). Bland-Altman analysis showed a mean of -126 +/- 2135 kJ/d for EE and BEE. Only one patient was outside the limits of agreement between the 2 methods (indirect calorimetry and Harris-Benedict). CONCLUSIONS: The calculation of energy needs can be done with the equation of Harris-Benedict associated with lower values of correction factors (approximately 10%) to avoid overfeeding, with constant monitoring of anthropometric and biochemical parameters to assess the nutritional changing and adjust the infusion of energy.

Valores de referência de ingestão de nutrientes para avaliação e planejamento de dietas de crianças de um a oito anos / Dietary reference intakes for the evaluation and planning of diets for children aged one to eight years

Os valores de referência de ingestão dietética (Dietary Reference Intakes - DRIs) foram desenvolvidos para auxiliar no planejamento alimentar e avaliação da ingestão de nutrientes de indivíduos e populações. Foram propostos a partir do final da década de 90, em substituição às recomendações estabelecidas em 1989 (RDAs), visando a implementação de inovações como a criação de novos conceitos de avaliação e planejamento de dietas, devido à disponibilidade de informações atualizadas sobre necessidades e ingestão de nutrientes; o estabelecimento dos níveis máximos de ingestão com o surgimento do conceito de redução do risco de doenças crônico-degenerativas e a subdivisão dentro de cada faixa etária, devido às demandas diferenciadas de nutrientes para cada etapa da vida. Considerando a importância da avaliaçãodo consumo alimentar na atenção integral à saúde da criança e a fim de subsidiar os profissionais de saúde no diagnóstico e acompanhamento nutricional, o objetivo deste trabalho foi apresentar de maneira prática as recomendações nutricionais e seu modo de aplicação em crianças de um a oito anos de idade baseando-se na metodologia das DRIs.

Dietary Reference Intakes (DRIs) have been developed in order to help dietary planning and the assessment of nutrient intake for individuals and populations. These values were proposed in the late nineties to replace the recommended daily allowances (RDAs), innovating and creating new concepts of dietary planning and assessment due to the recently updated information about nutrient requirements, the establishment of maximum intake levels in need to include the concept of risk-reduction of chronic-degenerative diseases, and a subdivision within each age range due to the different nutrient requirements in each stage of life. Considering the food consumption assessment important in full-range attention to the children’s health, and enabling funds to health professionals in nutritional monitoring and diagnosis, the main objective of the current study was to present, in a practice way, the nutritional recommendations and their applications for children aged 1 to 8 years old, based on the DRIs Methodology.