Lifestyle Intervention in Reducing Cardiometabolic Risk Factors in Students with Dyslipidemia and Abdominal Obesity: A Randomized Study

Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak's test, and Friedman ANOVA on Ranks and Dunn's test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges' g and Cliff's δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students' quality of life.

Aplicação do Índice de Qualidade da Dieta Revisado antes e após orientação nutricional / Administration of the Revised Diet Quality Index before and after nutritional counseling

Objetivo Avaliar o efeito da orientação nutricional individual nas mudanças das práticas alimentares e estilo de vida dos pacientes. Métodos Foram aplicados recordatórios de 24 horas antes e depois da orientação nutricional, para posterior cálculo do Índice Qualidade da Dieta Revisado, referente a cada um dos recordatórios. Foram avaliados trinta pacientes encaminhados para orientação nutricional individual no Ambulatório de Nutrição do Adulto do Centro de Saúde Escola, unidade auxiliar da Faculdade de Medicina de Botucatu, da Universidade Estadual Paulista. Resultados Como resultados da análise comparativa Índice Qualidade da Dieta Revisado, calculados, foi verificado o aumento do consumo de frutas, verduras, legumes e leguminosas, assim como a diminuição do consumo de carnes vermelhas, doces, bebidas açucaradas e laticínios integrais, depois das orientações nutricionais. Para as primeiras entrevistas, a pontuação média conquistada pelos pacientes foi de 61,45 e para a segunda entrevista foi visto que a pontuação aumentou para 70,20. A adesão ao programa nutricional proposto não foi muito satisfatória: 57% dos pacientes necessitaram ser reagendados duas ou mais vezes até comparecerem a consulta de retorno. Conclusão Houve mudança positiva no padrão alimentar dos participantes após orientação nutricional. A adesão ao tratamento pode ser estimulada por meio da educação nutricional, fundamental para que mudanças alimentares e de estilo de vida sejam efetivamente realizadas.

Objective In face of the early diagnosis of chronic diseases and the recognition that diet affects their development, the objective of this study was to assess the effect of individual nutritional counseling on the participants' eating practices and lifestyle. Methods Twenty-four-hour recalls were administered before and after nutritional counseling with subsequent calculation of the Revised Diet Quality Index for each recall. The study assessed thirty patients referred to individual nutritional counseling at the Adult Nutrition Outpatient Clinic of the Health Center School, a unit of Botucatu's School of Medicine of Paulista State University. Results Comparison of the Revised Diet Quality Index scores showed that the intakes of fruits, vegetables, and legumes increased, and the intakes of red meats, sweets, sugary beverages, and whole dairy products decreased after nutritional counseling. The mean score for the first interviews was 61.45, and for the second interviews, 70.20. Adherence to the proposed nutritional program was not very satisfactory: 57% of the patients had to be rescheduled two or more times before they attended the return visit. Conclusion A positive change occurred in the dietary pattern of the participants after nutritional counseling. Adherence to treatment can be encouraged by nutrition education, essential for the execution of dietary and lifestyle changes.