Tobacco cessation in patients with multiple chronic conditions: nutritional strategies as an additional tool in treatment

Abstract Objective To evaluate the impacts of a nutritional education intervention for patients with multiple chronic conditions during smoking cessation. Methods The non-probabilistic sample comprised 18 adults and seniors of both sexes recruited from a smoking cessation treatment group. At the beginning of treatment, smoking history, degree of dependence, and stage of motivation were assessed. Degree of craving was evaluated weekly for the 1st month. Anthropometric and biochemical assessments were conducted at baseline, at 1 month, and at 3 months. Dietary intake was assessed with the "How is your diet?" questionnaire. The nutritional intervention was delivered in three sessions. The themes covered were energy balance and physical activity, healthy eating, and the importance of fruit and vegetables in the diet. Statistical analysis was conducted with the Shapiro Wilk test of normality, the paired t test, and the Wilcoxon or Mann-Whitney U tests (significance ≤ 0.05). Results Most people (55.6%) in the intervention group had a high degree of smoking dependence, while the frequency in the control group was 22.2%. Degree of craving decreased significantly after 1 month of treatment (p = 0.017). After 3 months, both groups had a positive variation in mean body weight, although below 3%. In both groups, the average percentage of weight gain was less than 3%, suggesting that delivery of the nutritional education sessions and the nutritionist's use of the protocol proposed by the Instituto Nacional de Câncer (INCA) helped to control weight gain. Blood glucose and homeostasis model assessment-insulin resistance (HOMA-IR) both increased significantly in the intervention group (p = 0.15 and p = 0.50, respectively). Conclusion Greater proximity and more frequent intervention by a nutritionist assists and encourages healthy eating practices during the smoking cessation process, which can benefit individuals' control of chronic diseases over the long term.

Nutrição em rede: um relato de experiência de lives produzidas por um Grupo de Educação Tutorial durante a pandemia de covid-19 / Network nutrition: an experience report of lives produced by a Tutorial Education Group during the covid-19 pandemic / Nutrición en red: un relato de experiencia de directos producidos por un Grupo de Educación Tutorial durante la pandemia del covid-19

Devido às complexidades do período de pandemia de covid-19, houve um aumento do acesso às redes sociais para a busca de informações científicas. Este trabalho visa apresentar as adaptações de uma atividade de ensino, através de relato de experiência, promovido pelo Grupo de Educação Tutorial (GET) do Curso de Nutrição da Universidade Federal de Juiz de Fora (UFJF). Foram ciclos de palestras com atualizações científicas e vivência prática, utilizando a rede social Instagram em formato de lives, sendo o conteúdo transmitido como entrevista, em dois blocos, totalizando seis lives com aproximadamente 55 minutos cada. O público interagiu com o palestrante, ao expressar opinião e encaminhar dúvidas através do recurso de comentários. Houve sucesso na participação dos alunos, fato confirmado pelo número de visualizações, uma vez que o total foi superior quando comparado às edições presenciais. A internet viabilizou encontros de pessoas, mesmo distantes, possibilitando o acesso a profissionais de outras cidades e transmitindo informações através da rede social

Due to the complexities of the covid-19 pandemic period, there has been an increase in access to social net-works to search for scientific information. This work aims to present the adaptations of a teaching activity, through an experience report, promoted by the Tutorial Education Group, of the Nutrition Course from the Federal University of Juiz de Fora. There were lecture cycles with scientific updates and practical experience, using the social network Instagram in the format of lives, with the content being transmitted as an interview, in two blocks, totaling six lives with approximately 55 minutes each. The audience interacted with the speaker, expressing their opinion and doubts through the comment section. There was success in student participation, which can be confirmed by the number of online views, since this was higher when compared to the face-to-face editions. The internet made it possible for people to meet, even if they were far away, allowing access to professionals from other cities and transmitting information through the social network

Debido a las complejidades del período de la pandemia de covid-19, se ha incrementado el acceso a las redes sociales para buscar información científica. Este trabajo tiene como objetivo presentar las adaptaciones de una actividad docente, a través de un relato de experiencia, promovida por el Grupo de Educación Tutorial (GET) del Curso de Nutrición de la Universidad Federal de Juiz de Fora. Se realizaron ciclos de conferencias con actualización científica y experiencia práctica, utilizando la red social Instagram en formato de directos, siendo el contenido transmitido como entrevista, en dos bloques que suman seis directos con aproximada-mente 55 minutos cada una. El público interactuó con el ponente, expresando su opinión y dudas a través de la función de comentarios. Hubo éxito en la participación de los estudiantes, lo que se puede confirmar con el número de visualizaciones en línea, ya que fue mayor en comparación con las ediciones presenciales. Internet hizo posible que las personas se encontraran, aunque estuvieran lejos, permitiendo el acceso a profesionales de otras ciudades y transmitiendo información a través de la red social

Dark chocolate (70% cocoa) reduces craving in smokers with severe cardiovascular comorbidities without interference in anthropometric measures / Chocolate amargo (70% cacau) reduz fissura em tabagistas com comorbidades cardiovasculares graves sem interferir nas medidas antropométricas

ABSTRACT Objective: Analyze craving in smokers with cardiovascular comorbidities submitted to a nutritional approach. Methods: Two groups were randomized and submitted to clinical intervention (n = 32): Group 1 (G1, n = 15): ingested 40 g of chocolate containing 70% cocoa/day and behavioral intervention for smoking cessation for one month; Group 2 (G2, n = 17): control group, only behavioral intervention. Questionnaire of Smoking Urges-Brief (QSU-Brief) - Brazil version measured total craving and its factors. Anthropometric measurements verified the nutritional interference of the procedure and the serum assessment verified the interference of inflammatory processes related to smoking. The study was registered on the Brazilian Registry of Clinical Trials (ReBEC): RBR-83jr3. Results: After one month, compared to the initial evaluation, the G1 reduced the craving evaluated by the QSU-Brief and its Factors 1 and 2. Total QSU-Brief: 44.27 ± 15.82 x 27.00 ± 18.03 (p = 0.008); Factor 1: 21.90 ± 7.70 x 12.90 ± 8.87 (p = 0.006); Factor 2: 11.90 ± 6.30 x 7.00 ± 6.63 (0.007). G2 showed a reduction in total QSU-Brief and Factor 1, but not in Factor 2. QSU-Brief total 28.17 ± 17.24 x 19.52 ± 9.50 (p = 0.049); Factor 1: 14.47 ± 8.74 x 9.23 ± 6.11 (p = 0.046). Serum levels of cortisol, leptin, serotonin, C-Reactive Protein (CRP) and insulin did not show differences (p > 0.05). No anthropometric differences were found. Conclusion: The results demonstrate that daily consumption of chocolate for one month (70%) reduced craving in smokers at the beginning of treatment. Chocolate potentiated the well-known effect of behavioral counseling on Factor 1 (pleasurable drug effects) and also interfered with factor 2 (unpleasant withdrawal effects).

RESUMO Objetivo: Analisar o craving em fumantes com comorbidades cardiovasculares submetidos a uma abordagem nutricional. Métodos: Intervenção clínica (n = 32) com dois grupos randomizados: Grupo 1 (G1, n = 15): recebendo 40 g de chocolate contendo 70% de cacau/dia e intervenção comportamental para cessação do tabagismo por um mês; Grupo 2 (G2, n = 17): grupo controle, recebendo apenas intervenção comportamental pelo mesmo período. O Questionnaire of Smoking Urges-Brief (QSU-Brief) - versão Brasil foi utilizado para avaliar o craving. As medidas antropométricas verificaram a interferência nutricional do procedimento e a avaliação sérica, a interferência de processos inflamatórios relacionados ao tabagismo. O estudo foi registrado no Registro Brasileiro de Ensaios Clínicos (ReBEC), RBR-83jr3. Resultados: Um mês depois, comparado à avaliação inicial, o G1 reduziu o craving total e seus fatores (1 e 2). QSU-Brief total: 44,27 ± 15,82 x 27,00 ± 18,03 (p = 0,008); Fator 1: 21,90 ± 7,70 x 12,90 ± 8,87 (p = 0,006); Fator 2: 11,90 ± 6,30 x 7,00 ± 6,63 (0,007). G2: redução no QSU-Brief total e Fator 1, mas não no Fator 2. QSU-Brief total 28,17 ± 17,24 x 19,52 ± 9,50 (p = 0,049); Fator 1: 14,47 ± 8,74 x 9,23 ± 6,11 (p = 0,046). Níveis séricos de cortisol, leptina, serotonina, proteína C-reativa (PCR) e insulina não apresentaram diferenças (p > 0,05). Não foram encontradas diferenças antropométricas significativas. Conclusão: Os resultados demonstram que o consumo diário de chocolate por um mês (70%) reduziu o craving em fumantes no início do tratamento. O chocolate potencializou o conhecido efeito do aconselhamento comportamental sobre o Fator 1 (efeitos prazerosos da droga) e também interferiu no fator 2 (efeitos desagradáveis da abstinência).