Hábitos de vida durante a pandemia da COVID-19: repercussões no peso corporal e nos níveis de ansiedade / Living habits during the COVID-19 pandemic: repercussions on body weight and anxiety levels

A pandemia do COVID-19 tem alterado a rotina de vida das pessoas pela obrigatoriedade de permanência em casa, o que pode resultar em mudanças de comportamento. Objetivo: Identificar alterações nos hábitos de vida durante a pandemia da COVID-19, relacionando às alterações de peso corporal e aos níveis de ansiedade relatados. Método: Estudo transversal com adultos, de ambos os sexos, no qual os dados foram coletados por meio de questionário online, com auxílio da ferramenta Google Docs. Resultados: Participaram 258 pessoas, sendo 192 (74,4%) mulheres, eutróficos com idade entre 18 e 73 anos. Observou-se que 146 (56,6%) ganharam peso e, dentre estes, 105 (71,9%) utilizaram mais aplicativos para pedido de refeições, 104 (74,7%) relataram maior ingestão de doces e 105 (71,9%) de lanches calóricos, além de maior tempo de tela e ansiedade. Alterações negativas no estado emocional foram relatadas por 175 (67,8%) participantes, 150 (58,1%) afirmaram que a ansiedade aumenta seu apetite; 206 (79,8%) relataram aumento de ansiedade e dentre estes 133 (64,6%) utilizaram mais aplicativos de pedido de refeições e 65% relataram maior ingestão de doces e lanches. Conclusão: As alterações nos hábitos de vida ocorridas durante a pandemia relatada pela maioria dos entrevistados estavam associadas ao ganho de peso e aumento nos níveis de ansiedade, fatores que podem afetar a imunidade e elevar o risco a COVID-19.

The COVID-19 pandemic has changed people's life routines due to the obligation to stay at home, which can result in changes in behavior. Objective: To identify changes in lifestyle habits during the COVID-19 pandemic, relating to changes in body weight and reported levels of anxiety. Method: Cross-sectional study with adults of both sexes, in which data were collected through an online questionnaire, with the aid of the Google Docs tool. Results: 258 people participated, 192 (74.4%) women, eutrophic aged between 18 and 73 years. It was observed that 146 (56.6%) gained weight and among these 105 (71.9%) used more applications to order meals, 104 (74.7%) reported higher intake of sweets and 105 (71.9%) of high-calorie snacks, in addition to longer screen time and anxiety. Negative changes in emotional state were reported by 175 (67.8%) participants, 150 (58.1%) stated that anxiety increases their appetite; 206 (79.8%) reported increased anxiety and among these 64.6% used more meal ordering apps and 65% reported higher intake of sweets and snacks. Conclusion: The changes in lifestyle that occurred during the pandemic reported by most respondents were associated with weight gain and increased levels of anxiety, factors that can affect immunity and increase the risk of COVID-19.

[Combating smoking in Brazil: the strategic importance of government actions]. / Combate ao Tabagismo no Brasil: a importância estratégica das ações governamentais.

Brazil is a world benchmark in combating smoking and promoting actions through the National Program for Tobacco Control and other Risk Factors for Cancer (PNCTOFR). This literature review was conducted in order to outline the actions of PNCTOFR and identify evidence of their effectiveness in reducing the prevalence of smoking in Brazil. The documents available in the electronic portals of INCA, the National Policy on Health Promotion, the National Tobacco Control Observatory, the World Health Organization and the Pan American Health Organization were used, in addition to the Lilacs, PubMed Central, SciELO and ScienceDirect databases. The reference bases for analysis of the actions were the areas/dimensions proposed by the International Union for Health Promotion and Education. The restriction of the availability, control of marketing and commercialization, educational activities in schools, assistance in primary care for health professionals and the general population, control of consumption in public places and work are some of the actions that contributed to reduction in the prevalence of smoking in Brazil from 32.7% in 1997 to 14.8% in 2011. The results indicate the effectiveness of the actions of PNCTOFR, albeit smoking is still a public health problem and needs to be curbed.

Women with metabolic syndrome improve antrophometric and biochemical parameters with green banana flour consumption / Las mujeres con síndrome metabólico mejoran los parámetros antropométricos y bioquímicos con el consumo de «green banana flour»

Background: Consumption of green banana flour (GBF) may promote health benefits, such as, decreased appetite, weight loss, glycemic control, intestinal function and lipid profile improvement, aging delay, cancer and heart disease prevention. The aim of this study was to evaluate the effects of green banana flour consumption on anthropometric and biochemical parameters in overweight women. Methods: The glycemic index of flour in the study was determined. The effects of consumption of 20 g of green banana flour/day on weight, body mass index (BMI), blood pressure, waist and hip circumference, body composition, hemoglobin, lipid profile, glucose, insulin, insulin resistance, liver function and energy intake were evaluated in 25 overweight women for 45 days. Results: The glycemic index of the flour under study was classified as low. Reduction (p < 0.05) in systolic blood pressure, hip circumference and fasting glucose levels were found in women who had metabolic syndrome criteria. Conclusions: Consumption of green banana flour (20 g/day) for 45 days did not promote weight loss or changes in body composition in overweight women. It was noted, however, decreased hip circumference. Significant health parameter improvements were also noted in individuals with metabolic syndrome, which showed a reduction in systolic blood pressure and fasting glucose (AU)

Introducción: El consumo de «green banana flour» (GBF) puede contribuir para la salud como, por ejemplo, aumento en las sensaciones de saciedad , pérdida de peso , control de la glucemia y mejora de la función intestinal y el perfil lipídico, retraso del envejecimiento y la prevención del cáncer y de las enfermedades del corazón. El objetivo del estudio fue evaluar los efectos del consumo de GBF sobre los parámetros antropométricos y bioquímicos de las mujeres con exceso de peso. Métodos: Se determinó el índice glucémico de la harina en el estudio. Los efectos del consumo diario de 20 g de GBF en peso, índice de masa corporal (IMC), presión arterial, circunferencia de la cintura y de la cadera, la composición corporal, los niveles de hemoglobina, glucosa e insulina, resistencia insulínica, en la función del hígado y la ingesta alimentaria se evaluaron en 25 mujeres con exceso de peso durante 45 días. Resultados: El índice glucémico de harina estudiada fue clasificado como bajo. Fue encontrado reducción (p < 0,05) en la presión arterial sistólica, en la circunferencia de la cadera y en la glicemia en mujeres que tenían los criterios de síndrome X metabólico. Conclusiones: El consumo de harina de plátano sin madurar durante 45 días no promueve la pérdida de peso o los cambios en la composición corporal en mujeres con sobrepeso. Sin embargo, hubo una reducción de la circunferencia de la cadera. Se observó también una mejoría significativa en importantes factores de salud en mujeres con síndrome X metabólico, tales como una reducción en la presión arterial sistólica y de la glucemia (AU)

Capacidade cognitiva de indivíduos com doença renal crônica: relação com características demográficas e clínicas / Cognitive capacity in individuals with chronic kidney disease: relation to demographic and clinical characteristics

Introdução: O comprometimento da cognição e memória (CM) é comum em indivíduos com Doença Renal Crônica (DRC) em hemodiálise, o que prejudica a aderência ao tratamento. Objetivo: Avaliar a capacidade cognitiva de indivíduos renais crônicos em hemodiálise por meio do Miniexame do Estado Mental (MEEM) e a relação com as características sociodemográficas e clínicas desses indivíduos. Métodos: Foram obtidas informações clínicas e sociodemográficas de 75 indivíduos. Para avaliação da MC, foi aplicado o MEEM, o qual foi analisado segundo os diversos pontos de corte propostos na literatura. Após classificar os participantes de acordo com as diferentes propostas e pelas causas da DRC, os indivíduos foram alocados em grupos com e sem comprometimento da CM, na tentativa de identificar diferenças entre eles. Resultados: A maioria dos participantes eram homens, com idade média de 59,2 anos. O escore médio do MEEM foi 24,16 pontos e não houve diferença (p < 0,05) quanto às diferentes causas da DRC. Os escores do MEEM se correlacionaram (p < 0,05) positivamente com os anos de escolaridade e renda per capita e inversamente com a idade. Segundo os diversos pontos de corte, seis a 34 participantes apresentaram comprometimento da CM e apenas três desses foram classificados com déficit de CM por todas as propostas avaliadas. Conclusão: O escore do MEEM reduziu com o aumento da idade e se elevou com os anos de estudo e com a renda per capita. Não foram encontradas relações que justificassem efeitos prejudiciais do processo dialítico sobre a CM. .

Introduction: The life expectancy of individuals with Chronic Kidney Disease (CKD) on hemodialysis has increased, however, with over years in treatment, there is impairment of cognitive function that affect adherence to therapy and dialysis. Objective: To evaluate the cognitive ability of individuals on hemodialysis through the Mini Mental State Examination (MMSE) and the relation to sociodemographic and clinical characteristics of these individuals. Methods: We obtained demographic and clinical information of 75 individuals. To assess memory and cognition MMSE was applied, which was analyzed according to the different cutoff points proposed in the literature. After classifying the participants according to proposal of different studies, the causes of CKD and sociodemographic characteristics, individuals were divided into groups with and without cognitive impairment in an attempt to identify differences between them. Results: Most participants were men with a mean age of 59.2 years. The mean MMSE score was 24.16 points and there was no difference (p < 0.05) in MMSE results between the different causes of CKD. MMSE scores were correlated (p < 0.05) positively with years of schooling and income and inversely with age. According to the different cutoff points, six to 34 participants showed cognitive impairment and memory, and only three of these were classified with cognitive impairment for all cutoff points evaluated. Conclusion: The average MMSE score declined with increasing age and increased with years of schooling and income per capita. No relationships were found to justify the harmful effects of dialysis process on cognition and memory. .

Tratamento conservador: influência sobreparâmetros clínicos de indivíduos emhemodiálise / Conservative treatment: influence on clinical parameters ofsubjects on hemodialysis

O diagnóstico precoce da Doença Renal Crônica (DRC) possibilita a implementação de medidas que adiam a entrada emhemodiálise (HD) e melhoram parâmetros clínicos. O objetivo deste estudo foi analisar as características epidemiológicase clínicas dos indivíduos com DRC em HD que realizaram ou não tratamento conservador (TC). Foram coletados dadosde prontuários médicos de 65 participantes, os quais foram entrevistados sobre diagnóstico e tratamento da DRC. Paraanálise dos dados, os indivíduos foram divididos entre os que realizaram TC ou não e, quanto ao tempo de TC, menor,igual ou maior que seis meses. A hipertensão arterial e o diabetes mellitus foram as principais causas da DRC, a qual foidiagnosticada, na maioria dos casos, por um nefrologista. A maior parte dos indivíduos que não realizaram tratamentoconservador teve diagnóstico da DRC realizado em um hospital. Indivíduos que realizaram TC apresentaram melhoresparâmetros bioquímicos, especialmente aqueles que o fizeram por mais de seis meses. O TC, sobretudo, realizado porequipes multidisciplinares, pode contribuir para melhoria dos desfechos da DRC tanto no período pré-dialítico quantodurante o tratamento de HD.

Early diagnosis of Chronic Kidney Disease (CKD) leads to the implementation of measures that are delaying undergoinghemodialysis (HD) and improve clinical parameters. The aim of this study was to analyze the epidemiological and clinicalcharacteristics of individuals with CKD who underwent HD or not conservative treatment (CT). Data were collected frommedical records of 65 participants who were interviewed about the diagnosis and treatment of CKD. For data analysis,subjects were divided between those who underwent CT or not and as to the time of CT less than, equal to or greater thansix months. Hypertension and diabetes mellitus were the main causes of CRD, which were diagnosed, in most cases, by anephrologist. Most individuals which did not receive a conservative treatment were diagnosed as having CRD in a hospitalsettting. Individuals who underwent CT showed better biochemical parameters, especially those who did so for more thansix months. The TC mainly conducted by multidisciplinary teams, can contribute to improving the outcomes of CKD inboth pre-dialysis and during HD treatment.

Intestinal microbiota; relevance to obesity and modulation by prebiotics and probiotics / Microbiota intestinal; relevancia para la obesidad y la modulación de los prebióticos y probióticos

INTRODUCTION: The intestinal microbiota has several beneficial functions related to host health. Studies suggest that it may be related to the presence of metabolic diseases, including obesity. OBJECTIVE: A bibliographic survey was carried out upon the relationship between the intestinal microbiota and obesity and the possible impacts of the use of prebiotics and probiotics, aiming to understand this complex and promising interaction. METHODS: A search was conducted in the Lilacs, PubMed, SciElo and Science Direct databases, using the keywords "gut microbiota" and "obesity". RESULTS AND DISCUSSION: We identified 613 original studies. After careful selection, 61 original articles were included in this review. The others indicated that there are differences in the microbial composition between obese and non-obese patients and the possible mechanisms involved. Alteration is caused in the energy homeostasis, in the use of dietary intake and storage of lipids due to the composition of the intestinal microbiota. Among the studies that evaluated the microbiota modulation, seven used probiotics; 24 used prebiotics, and five studies were performed using food. After dietary manipulation, the growth of bifidobacteria was obtained in 10 studies, in association with weight reduction, adipogenic effects of diet, intestinal permeability and inflammatory markers. CONCLUSION: Knowledge on the impact of the microbiota on metabolic pathways allows to conceive new factors associated with obesity and modulation by prebiotics and probiotics. In this sense, the main effect observed was the increase in bifidobacteria, usually accompanied by weight loss and enhancement of parameters related to obesity (AU)

Introducción: La microbiota intestinal tiene varias funciones beneficiosas relacionadas con la salud del hombre y estudios sugieren una posible relación con la presencia de enfermedades metabólicas como la obesidad. Objetivos: Se realizó una revisión sobre la relación entre la microbiotaintestinal y la obesidad, así como los posibles impactos del uso de pre y probióticos, a fin de conocer como ocurre esta compleja interacción. Métodos: Se realizó una búsqueda electrónica de la literatura en las bases de datos Lilacs, PubMed, Science Direct y Scielo utilizandose las palabras clave “microbiota intestinal” y “obesidad”. Resultados y discusión: Se identificaron 613 estudios. Después de aplicar los criterios de inclusión y exclusión, 61 artículos originales fueron incluidos. La composición de la microbiota intestinal promueve alteración en la homeostasis energética, en la utilización de la dieta ingerida y en el almacenamiento de los lípidos. De los estudios que evaluaron la modulación de la microbiota, siete utilizaron probióticos y 24 prebióticos, de estos cinco estudios con alimentos. El aumento de bifidobacterias tras la manipulación dietética se observó en 10 estudios, asociándose a la reducción de peso, a los efectos adipogénicos de la dieta, a la permeabilidad intestinal y a los marcadores inflamatorios. Conclusiones: La aclaración del impacto de la microbiota en las vías metabólicas permite encontrar nuevos factores asociados a la obesidad y la modulación por prey probióticos. En este sentido, el principal efecto observado fue un aumento de bifidobacterias, que usualmente está acompañado por la pérdida de peso y los parámetros relacionados con la obesidad (AU)

Calcium and caffeine interaction in increased calcium balance in ovariectomized rats / Interação cálcio e cafeína no aumento do balanço de cálcio em ratas ovariectomizadas

OBJECTIVE: This study investigated the effects of caffeine intake associated with inadequate or adequate calcium intake in laparotomized or ovariectomized rats by means of the calcium balance. Forty adults Wistar rats were ovariectomized or laparotomized. METHODS: The animals (n=40) were randomly placed in eight groups receiving the AIN-93 diet with 100% or 50% of the recommended calcium intake with or without added caffeine (6mg/kg/day). The animals were kept in individuals metabolic cages at a temperature of 24°±2ºC, light/dark cycles of 12/12 hours, and deionized water available ad libitum. On the 8th week of the experiment, food consumption was measured and 24-hour urine and 4-day feces were collected to determine calcium balance [Balance=Ca intake-(Urinary Ca+Fecal Ca)]. RESULTS: Animals with adequate calcium intake presented higher balances and rates of calcium absorption and retention (p<0.05) than those with inadequate calcium intake, regardless of caffeine intake (p<0.05). Caffeine intake did not affect urinary calcium excretion but increased balance (p<0.05) in the groups with adequate calcium intake. CONCLUSION: Adequate calcium intake attenuated the negative effects of estrogen deficiency and improved calcium balance even in the presence of caffeine.

OBJETIVO: Investigar a relação entre a ingestão de cafeína e a adequação de cálcio dietético em ratas ovariectomizadas ou inteiras, por meio do balanço de cálcio. Foram utilizadas 40 ratas Wistar adultas submetidas à cirurgia de ovariectomia ou laparotomia. MÉTODOS: Os animais foram alocados em grupos (n=5) e receberam dieta AIN-93M contendo 100 ou 50% da recomendação de cálcio com ou sem adição de cafeína (6mg/kg/dia). As fêmeas foram alojadas em gaiolas metabólicas individuais, à temperatura de 24±2ºC e ciclo de 12 horas claro/escuro e receberam água deionizada ad libitum. Na oitava semana de experimento, quantificou-se a ingestão da dieta e coletaram-se fezes de 4 dias e urina dos animais por 24 horas para determinação do balanço [Balanço=Ca Ingerido - (Ca Fecal+Ca Urinário)]. RESULTADOS: Por meio de interação entre fatores, foi observado que o consumo de 100% de cálcio elevou o balanço e os teores de cálcio absorvido e retido (p<0,05) quando comparados aos grupos 50%. As ratas com adequação no consumo de cálcio aumentaram o balanço (p<0,05), independentemente da suplementação de cafeína. A ingestão de cafeína não afetou a excreção urinária de cálcio e elevou (p<0,05) o balanço nas ratas com 100% de cálcio, mas não nas com 50%. CONCLUSÃO: A adequação no consumo de cálcio atenuou os efeitos deletérios da redução estrogênica e proporcionou maior balanço de cálcio mesmo com ingestão de cafeína.