Mindful eating durante a gravidez: um estudo comparativo conforme a atenção pré-natal / Mindful eating during pregnancy: a comparative study according to prenatal care

Mudanças no estilo de vida global levaram a comportamentos alimentares disfuncionais durante a gravidez. Nesse sentido, a abordagem Mindful Eating é uma prática com potencial para influenciar positivamente os hábitos alimentares, com impacto benéfico na saúde das gestantes. Para avaliar os níveis de Mindful Eating de mulheres antes e durante a gravidez e associá-los ao tipo de assistência pré-natal (Sistema Único de Saúde ou Setor Privado), foi realizado um estudo transversal com 184 gestantes com idade ≥18 anos, acompanhadas por Sistema Único de Saúde (SUS) ou Setor Privado no município de Lavras-MG, Brasil. Foram coletados dados socioeconômicos e obstétricos e informações sobre Mindful Eating foram obtidas por meio do questionário autoaplicável de Mindful Eating. O Mindful Eating foi maior durante a gravidez do que durante o período pré-gestacional. As gestantes atendidas pelo SUS apresentaram menor nível de Mindful Eating em comparação às mulheres do setor privado. As atendidas pelo SUS obtiveram maiores valores durante o período gestacional na subescala Emocional. As gestantes que atenderam no setor privado obtiveram valores mais elevados durante o período gestacional nas subescalas Consciência, Distração e Desinibição. Durante a gravidez, as mulheres apresentaram níveis mais elevados de Mindful Eating, indicando uma melhoria no comportamento alimentar. A pontuação do Mindful Eating das mulheres atendidas no pré-natal pelo Setor Privado foi superior a das mulheres atendidas pelo SUS, necessitando de intervenção individualizada em cada setor para abranger os fatores socioeconômicos inerentes a cada grupo e sua influência na melhoria dos comportamentos alimentares.

Changes in the global lifestyle have led to dysfunctional eating behaviors during pregnancy. In this sense, the Mindful Eating approach is a practice with the potential to positively influence eating habits, with a beneficial impact on the health of pregnant women. To evaluate the levels of Mindful Eating of women before and during pregnancy and to associate them with the type of prenatal care (Unified Health System or Private Sector), a cross-sectional study was conducted with 184 pregnant women aged ≥18 years, accompanied by the Unified Health System (SUS) or the Private Sector in the municipality of Lavras-MG, Brazil. Socioeconomic and obstetric data were collected, and information on Mindful Eating was obtained through the self-administered Mindful Eating Questionnaire. Mindful Eating was higher during pregnancy than during the pre-gestational period. Pregnant women assisted by SUS showed lower Mindful Eating compared with women in the private sector. Those attended by SUS obtained higher values during the gestational period in the Emotional subscale. Pregnant women who attended in the private sector obtained higher values during the gestational period in the Awareness, Distraction and Disinhibition subscales. During pregnancy, women presented higher levels of Mindful Eating, indicating an improvement in eating behavior. The Mindful Eating score of women attended in prenatal care by the Private Sector was higher than that of women attended by SUS, requiring individualized intervention in each sector to cover the socioeconomic factors inherent to each group and their influence on the improvement of eating behaviors.

The Mini Nutritional Assessment-Short Form is more effective in predicting clinical outcomes among hospitalised patients with overweight than the Nutritional Risk Screening-2002.

Understanding of the association between nutritional risk and clinical outcomes in hospitalised patients with overweight is still at an early stage. Given the lack of specific tools for the patient with overweight, the objective of this study was to compare two of the main general screening instruments for assessing nutritional risk in predicting clinical outcomes in a population of hospitalised patients with overweight. A retrospective study was carried out in a medium-sized hospital in Brazil, with patients ≥20 years old admitted between July 2017 and December 2019. Patients who were overweight and had records of Nutritional Risk Screening-2002 (NRS-2002) and Mini-Nutritional Assessment-Short Form (MNA-SF) in their medical files were included in the study. Clinical outcomes data (longer length of stay, readmission during the study period and mortality before the end of study or during hospitalisation) were obtained. The Kappa coefficient assessed agreement between both tools, and their performance for predicting outcomes was analysed using characteristic receiver operating curves (ROC). Data were collected from 643 patients. The prevalence of nutritional risk was 17.7% and 36.1% according to the NRS-2002 and MNA-SF (k = 0.390; p < 0.001), respectively. According to both tools, all clinical outcomes were significantly more common among individuals at nutritional risk (p < 0.05). Only the MNA-SF showed a significant percentage of predictions for readmission (57.2%) and death during hospitalisation (65.7%). For mortality until the end of the study, the area under the ROC curve was similar for MNA-SF (60.5%) and NRS-2002 (60.7%; p = 0.057). The MNA-SF detected a greater proportion of nutritional risk among hospitalised patients with overweight and better predicted all clinical outcomes compared to the NRS-2002 and should be used to screen patients with overweight for nutritional risk.

Is the management of obesity in primary health care appropriate in Brazil?

This study aims to describe the adequacy of basic health units (UBS) in Brazil regarding structure and work process for obesity management and to evaluate user satisfaction with primary health care services. This cross-sectional study was conducted with data from the 2013-2014 National Program for Improving Primary Care Access and Quality (PMAQ) - an initiative to assess primary health care teams' performance. Data were collected between 2013 and 2014 through interviews with primary health care teams and users. All indicators of adequate care for obesity were defined within the article scope, based on data from the PMAQ. Of the 24,055 UBS analyzed, located in 4,845 different cities, only 7.6% had adequate structure for obesity management. Likewise, only 26.6% of the 114,615 users interviewed reported adequate access, and 27.8% of the UBS showed adequate service organization. Healthcare was considered as "good" or "very good" by 82.4% of users. These indicators varied according to geographic region, showing better results for the South and Southeast. Our results suggest that the country may still be at the initial stage of systematizing care with obesity, presenting significant disparities among regions.

Promoting fruit and vegetable consumption: Methodological protocol of a randomized controlled community trial.

This study aimed to develop community educational activities in Brazilian primary health care settings. A randomized controlled community trial was conducted to encourage fruit and vegetable consumption (FV-RCT) in a representative sample of consumers aged 20 years or older in a Brazilian city. The fruit and vegetable consumption was classified according to the transtheoretical model's stages of change, reflecting different degrees of readiness for change. The educational activities were based on the transtheoretical model and a problematizing-dialogic pedagogy, planned by an interdisciplinary team, using information collected in a qualitative pilot study. The actions were conducted over seven months, and baseline data were collected from 1483 participants. The educational strategies included workshops interspersed with motivational messages conveyed via postcard, interactive environment-based activities, and informative material. In the workshops, different techniques were used - conversation circles, image theatre, self-portraits, cooking and art as experience. The applied intervention based on the chosen theories implied in a refinement of the intervention, but, nevertheless, proved to be feasible for large population groups and to the scenario of health services. Thus, this interdisciplinary FV-RCT study represents an effort to advance methodological issues and provide theoretical subsidies for actions.

Coexistence of risk behaviors for being overweight among Brazilian adolescents.

This study aimed to evaluate the magnitude of and the factors associated with the coexistence of risk behaviors for being overweight among Brazilian adolescents. This is a cross-sectional study with a representative sample of adolescents (mostly aged 13-15years) enrolled from public and private schools of Brazil in 2012. The co-occurring sedentary behavior and inadequate food consumption (regular intake of sugary and fried foods, and irregular consumption of fruits and vegetables-FV) was estimated using a Venn diagram. Sociodemographic, familial, and behavioral factors associated with the number of risk behaviors for being overweight were identified using an ordinal logistic regression analysis. Sedentary behavior was observed in 62.0% of adolescents. Regular intake of sugary or fried food was observed in 55.3% and 23.5% of adolescents, respectively, with 51.9% having an inadequate intake of FV. At least one risk behavior was reported in >90.0% of adolescents; 6.1% reported all 4. Being female, having a higher maternal education level, attending private school, not having breakfast or meals with parents regularly, eat watching television, and not practicing weekly leisure time physical activity were associated with an increased chance of having multiple risk behaviors. This study observed a high prevalence of coexisting of risk behaviors, which was associated with sociodemographic, familial, and behavioral factors. These findings may contribute to a clearer understanding of the associations between different behaviors among adolescents, and may be used to improve public health surveillance and to develop strategies that address multiple behaviors, in order to prevent overweight among adolescents.

Occupational status and nutrition profile and health of public municipal employees / Estado ocupacional y perfil nutricional y salud de los empleados públicos municipales

Background: Unhealthy lifestyles occur more often in low-socioeconomic status (SES) groups. The assessment of isolated factors reduces the understanding of the problem instead of clarifying the dynamic interaction of these factors in influencing the health. Objective: To study the relationship between nutrition habits and health, and the coexistence of dietary risk factors, according to the occupational status of public municipal employees. Materials and Methods: An electronic epidemiological survey was conducted from September to December 2009. In total, 5,646 public municipal employees (temporary and permanent) of the municipality (14.7%) answered the questionnaire. Sociodemographic information, health, physical activity, nutritional profile, and working conditions related to eating were investigated. Occupational status was defined by the International Socio-Economic Index. The coexistence of dietary risk factors (low consumption of fruits and vegetables, high consumption of chicken skin and meat fat, and insufficient time to eat at work) were evaluated using Venn diagrams. Results: Arterial hypertension, diabetes mellitus and overweight were more frequently reported in the low occupational status, and positive self-reported health was directly related to the occupational status of participants. Conclusion: Differences in health conditions and in the dietary habits of individuals according to occupational status indicate its relevance in the development of public and institutional policies that aim to promote health and reduce inequalities and the need for greater focus on those with lower occupational status (AU)

Introducción: Estilos de vida poco saludables son más frecuentes en los grupos de bajo nivel socioeconómico. La investigación de factores aislados reduce la comprensión de los problemas en lugar de explicar la dinámica que los factores interactúan para influir en la salud. Objetivo: Estudiar la relación entre los hábitos nutricionales y el perfil de salud, y la coexistencia de factores de riesgo relacionados con la alimentación, según el estatus ocupacional de los empleados públicos municipales. Material y Método: Se realizó una encuesta epidemiológica electrónica de septiembre a diciembre de 2009. Un total de 5.646 empleados públicos municipales de la ciudad (14,7%) respondieron el cuestionario. Se investigaron información sociodemográfica, la salud, la actividad física, el perfil nutricional y las condiciones de trabajo relacionados con la alimentación. Para la definición del estatus ocupacional se utilizó el Índice Socioeconómico Internacional. Se evaluó la coexistencia de factores de riesgo dietéticos (bajo consumo de frutas y verduras, alto consumo de piel del pollo y grasa de carne, y la falta de tiempo para comer en el trabajo), de acuerdo con los diagramas de Venn (temporales y permanentes). Resultados: La hipertensión arterial, la diabetes mellitus y el sobrepeso fueron reportados con mayor frecuencia en el grupo de la categoría ocupacional más baja, y la autoevaluación positiva estuvo directamente relacionada con la situación ocupacional de los participantes. Conclusiones: Las diferencias en las condiciones de salud y alimentación de los individuos, de acuerdo con el estatus ocupacional, indican su relevancia en el desarrollo de políticas públicas e institucionales que buscan promover la salud y reducir las desigualdades. Es necesaria mayor atención a los grupos de categorías ocupacionales más bajas (AU)

Alimentação de estudantes: associação com fatores individuais, familiares, comportamentais e indicadores socioeconômicos / Food consumption of students: association with individual, family, behavioral and socioeconomic indicators

A alimentação na adolescência possui múltiplos determinantes individuais e contextuais, cujo monitoramento em sistemas de vigilância pode subsidiar políticas públicas mais efetivas. Deste modo, esta tese objetivou investigar a alimentação de estudantes e sua relação com fatores individuais, familiares, comportamentais e indicadores macroeconômicos. Para isto, apresenta três artigos: 1) “Consumption of sugar-rich food products among Brazilian students: National School Health Survey (PeNSE 2012)”; 2) “Coexistence of risk behaviors for being overweight among Brazilian adolescents”; e 3) “Marcadores do consumo alimentar saudável e não saudável e indicadores macroeconômicos: Análise de estudantes de 74 países”. Os dois primeiros artigos possuem delineamento transversal e utilizaram dados de amostra representativa de estudantes brasileiros, de escolas públicas e privadas, de áreas urbanas e rurais, avaliados na Pesquisa Nacional de Saúde do Escolar (PeNSE 2012). No Artigo 1, analisou-se o consumo de alimentos ricos em açúcar (guloseimas e refrigerantes) entre estudantes brasileiros e foram identificados os fatores associados a esse consumo. No segundo artigo, avaliou-se a magnitude e os aspectos relacionados à coexistência de comportamentos de risco para o excesso de peso (comportamento sedentário, consumo regular de alimentos ricos em açúcar e frituras, e irregular de frutas, verduras e legumes). O Artigo 3, de delineamento ecológico, foi realizado a partir de amostras representativas de estudantes brasileiros (Amostra 2 - PeNSE 2015) e de outros 73 países avaliados pela Global School-Based Student Health Survey (GSHS). O seu objetivo foi comparar as prevalências de consumo diário de marcadores de alimentação saudável (frutas, verduras e legumes) e não saudável (refrigerantes) entre estudantes destes 74 países, segundo indicadores macroeconômicos. O consumo regular de alimentos rico...

Adolescent food consumption has multiple individual and contextual determinants, whose monitoring in surveillance systems can support public policies that are more effective. Therefore, this thesis aimed to investigate the food consumption of students and its relation with individual, family, behavioral, and macroeconomic indicators. For this, it presents three articles: 1) "Consumption of sugar-rich food products among Brazilian students: National School Health Survey (PeNSE 2012)"; 2) "Coexistence of risk behaviors for being overweight among Brazilian adolescents"; and 3) "Markers of healthy and unhealthy food consumption and macroeconomic indicators: Analysis of students from 74 countries". The first two articles present a cross-sectional design and used from a representative sample of Brazilian students from public and private schools in urban and rural areas, evaluated in the National School Health Survey (PeNSE 2012). In article 1, the objective was to analyze the consumption of sugary foods (sweets and soft drinks) among Brazilian students and to identify the associated factors. The second article evaluated the magnitude and the aspects associated with the coexistence of risk behaviors for being overweight (sedentary behavior, regular consumption of sugary and fried foods, and irregular fruits and vegetables). Article 3 has an ecological design and was based on representative samples of Brazilian students (Sample 2 - PeNSE 2015) and from 73 other countries evaluated in the Global School-Based Student Health Survey (GSHS). The objective of this study was to compare the prevalence of daily consumption of healthy (fruits and vegetables) and unhealthy (soft drinks) food markers among students from these 74 countries, according to macroeconomic indicators. The regular consumption of sugary foods (sweets or soft drinks) was verified among 36.1% of Brazilian adolescents, and was higher among girls, 14-15 years old students, with higher maternal education...

Limitantes da evolução ponderal de mulheres com excesso de peso após intervenção nutricional / Limiting of unsatisfactory weight loss among overweight women after nutritional intervention

Insuficiente redução ponderal em intervenções conduzidas com indivíduos com excesso de peso remete à necessidade de constatar os aspectos preditores do insucesso, visando redirecionar ações, contribuindo para seu maior êxito. Assim, objetivou-se identificar os fatores preditores da evolução ponderal insatisfatória de mulheres com excesso de peso após acompanhamento nutricional na Atenção Primária à Saúde. Estudo retrospectivo realizado com mulheres com excesso de peso após 12 meses de acompanhamento nutricional individual mensal. Dados coletados por anamnese constando de dados sociodemográficos, morbidades referidas, hábitos e consumo alimentar, além de medidas antropométricas. Classificou-se a evolução ponderal como insatisfatória (<5% do peso inicial) e satisfatória (>=5%), sendo os grupos comparados a partir dos testes estatísticos t de Student, Mann Whitney, Qui-quadrado e Exato de Fisher (p<0,05). Das 70 participantes, 62,9% (n=44) evoluíram insatisfatoriamente, apresentando média de 52,6±11,9 anos e renda per capita mensal de 63,6% do salário mínimo vigente (18,6%; 198,3%), características semelhantes às das mulheres com evolução satisfatória. Usuárias com evolução insatisfatória apresentaram, no início do acompanhamento, maior prevalência de hipertensão arterial, dormiam menos horas por noite, assistiam televisão e/ou utilizavam computador por mais tempo e relataram menor sudorese durante a prática de atividade física. Os resultados apontam que o insucesso da redução ponderal pode estar relacionado a aspectos que extrapolam a adoção de uma alimentação adequada, perpassando por fatores como sono, sedentarismo e presença de comorbidades. Sugere-se assim, o desenvolvimento de intervenções diferenciadas e ampliadas quanto à abordagem terapêutica, que considerem a complexidade envolvida no manejo do excesso de peso, almejando o maior sucesso das ações.

Insufficient weight loss in interventions conducted with overweight individuals demonstrate the need to identify their predictors in order to redirect actions and promote greater success. Thus, we aimed to identify predictors of unsatisfactory weight loss among overweight women after nutritional monitoring in Primary Health Care. This was a retrospective study of overweight women after 12 months of monthly individual nutritional monitoring. Data were collected through anamnesis containing sociodemographic data, reported morbidities, habits and food consumption, as well as anthropometric measurements. The weight loss was classified as unsatisfactory (<5% of initial weight) and satisfactory (≥5%), and these groups were compared using the Student's t-test, Mann Whitney, Chi-square and Fisher's Exact statistical tests. (p < 0.05). 62.9% of the 70 participants (n=44) presented unsatisfactory weight loss. They were aged 52.6±11.9 years old who on average had a monthly per capita income of 63.6% of minimum salary (18.6%; 198.3%), ; characteristics similar to those women who progressed satisfactorily. Those with unsatisfactory weight loss presented a greater prevalence of hypertension, slept less hours per night, watched TV or used computer for longer periods of time, and reported less sweating during physical activity at the start of monitoring. The results show that the failure to lose weight may be related to aspects that go beyond the adoption of adequate food, including factors such as sleep, physical inactivity, and comorbidities. It is therefore suggested that the development of differentiated and expanded interventions regarding the therapeutic approach, consider the complexity involved in instituting more effective, healthy, and satisfying weight-loss programs

Consumption of sugar-rich food products among Brazilian students:National School Health Survey (PeNSE 2012) / Consumo de alimentos ricos em açúcar entre estudantes brasileiros:Pesquisa Nacional de Saúde do Escolar (PeNSE 2012) / Consumo de alimentos ricos en azúcar entre estudiantes brasileños:Encuesta Nacional de Salud Escolar (PeNSE 2012)

Abstract This study aimed to analyze the consumption of high-sugar foods by Brazilian schoolchildren and to identify associated factors, based on data from the National School Health Survey (PeNSE 2012). Consumption of these foods was classified as: do not consume sweets and soft drinks regularly; consume sweets or soft drinks regularly; and consume sweets and soft drinks regularly. Its association with sociodemographic information, eating habits, and family contexts were investigated via multiple ordinal regressions. Regular consumption of sweets and/or soft drinks was reported by 19.2% and 36.1% of adolescents, respectively, and higher prevalence was associated with female gender, age 14-15 years, higher maternal education, not living with the mother and father, not eating meals with the parents, eating while watching TV, and longer TV time. Nearly one-fifth of adolescents regularly consumed sweets and soft drinks, which was associated with socio-demographic and behavioral factors that should be targeted in order to improve their food consumption.

Resumo Objetivou-se analisar o consumo de alimentos ricos em açúcar entre estudantes brasileiros e identificar seus fatores associados. Utilizaram-se dados da Pesquisa Nacional de Saúde do Escolar (PeNSE 2012). O consumo desses alimentos foi classificado como: não consomem guloseimas/refrigerantes regularmente; consomem guloseimas ou refrigerantes regularmente; consomem guloseimas e refrigerantes regularmente. Fatores sociodemográficos, alimentares e familiares associados foram avaliados por regressão ordinal múltipla. O consumo regular de guloseimas e/ou refrigerantes foi relatado por 19,2% e 36,1% dos adolescentes, respectivamente, sendo mais prevalente entre estudantes do sexo feminino, com 14-15 anos de idade, com maior escolaridade materna, que não viviam com a mãe e o pai, que não realizam as refeições com os pais, que comiam assistindo TV e que passavam mais tempo diante da TV. Quase 1/5 dos adolescentes consumia guloseimas e refrigerantes regularmente, condição associada a fatores sociodemográficos e comportamentais, os quais devem ser priorizados visando a melhorar seu consumo alimentar.

Resumen Se tuvo como objetivo analizar el consumo de alimentos ricos en azúcar entre estudiantes brasileños e identificar sus factores asociados. Se utilizaron datos de la Encuesta Nacional de Salud Escolar (PeNSE 2012). El consumo de estos alimentos fue clasificado como: no consumen golosinas/refrescos regularmente; consumen golosinas o refrescos regularmente; consumen golosinas y refrescos regularmente. Factores sociodemográficos, alimentarios y familiares asociados fueron evaluados por regresión ordinal múltiple. El consumo regular de golosinas y/o refrescos fue relatado por 19,2% y 36,1% de los adolescentes, respectivamente, siendo más prevalente entre estudiantes del sexo femenino, con 14-15 años de edad, con mayor escolaridad materna, que no vivían con la madre y el padre, que no realizan las comidas con los padres, que comían viendo TV y que pasaban más tiempo viendo TV. Casi 1/5 de los adolescentes consumía golosinas y refrescos regularmente, condición asociada a factores sociodemográficos y de comportamiento, que deben ser observados como prioridad para mejorar el consumo alimenticio.

Consumption of sugar-rich food products among Brazilian students:National School Health Survey (PeNSE 2012).

This study aimed to analyze the consumption of high-sugar foods by Brazilian schoolchildren and to identify associated factors, based on data from the National School Health Survey (PeNSE 2012). Consumption of these foods was classified as: do not consume sweets and soft drinks regularly; consume sweets or soft drinks regularly; and consume sweets and soft drinks regularly. Its association with sociodemographic information, eating habits, and family contexts were investigated via multiple ordinal regressions. Regular consumption of sweets and/or soft drinks was reported by 19.2% and 36.1% of adolescents, respectively, and higher prevalence was associated with female gender, age 14-15 years, higher maternal education, not living with the mother and father, not eating meals with the parents, eating while watching TV, and longer TV time. Nearly one-fifth of adolescents regularly consumed sweets and soft drinks, which was associated with socio-demographic and behavioral factors that should be targeted in order to improve their food consumption.

Effectiveness of nutritional intervention in overweight women in Primary Health Care / Efetividade de intervenção nutricional em mulheres com excesso de peso na Atenção Primária à Saúde

Objective: To assess the effectiveness of nutritional intervention in overweight women undergoing Primary Health Care. Methods: An intervention study was conducted with overweight adult and elderly women aged 20 years or older (body mass index ≥25.0 kg/m² and ≥27.0 kg/m², respectively) who were subjected to 12 months of individual nutritional monitoring. The effectiveness of the intervention was assessed by dietary, health, and anthropometric indicators. Results: Most of the 71 individuals were adults with a low income and poor level of education. After the intervention, there was an increase in number of meals and in the frequency of breakfasting. Moreover, there were more fruits and vegetables consumed, in addition to a decrease in household availability of salt, sugar, oil, and fried foods consumption. An improvement in health and weight self-perception was observed, as well as a decrease in body mass and abdominal adiposity, in particular among those participating in several consultations (n >9). Conclusion: The proposed nutritional intervention was effective and viable for improving the care of overweight individuals and those suffering from destabilized comorbidities, and may be extended to other contexts. .

Objetivo: O presente estudo tem como objetivo avaliar a efetividade de intervenção nutricional em mulheres com excesso de peso acompanhadas na Atenção Primária à Saúde. Métodos: Trata-se de estudo de intervenção, com mulheres com excesso de peso (índice de massa corporal ≥25,0 kg/m² em adultas; e ≥27,0 kg/m² em idosas), ≥20 anos, em acompanhamento nutricional individual durante 12 meses. Avaliou-se a efetividade da intervenção por indicadores dietéticos, de saúde e antropométricos. Resultados: A maioria das 71 usuárias era adulta, com baixa renda e escolaridade. Após a intervenção, houve aumento do número de refeições, realização do desjejum e consumo de frutas e hortaliças, além da redução da disponibilidade domiciliar de sal, açúcar e óleo, e diminuição no consumo de frituras. Observou-se melhoria da autopercepção da saúde e do peso, bem como diminuição da massa corporal e adiposidade abdominal, sobretudo entre aquelas que participaram de mais encontros (n>9). Conclusão: A intervenção nutricional proposta foi efetiva e viável para o cuidado de indivíduos com excesso de peso e comorbidades desestabilizadas, podendo ser ampliada para outros contextos. .

Efetividade do aconselhamento nutricional em mulheres com excesso de peso atendidas na Atenção Primária à Saúde / Effectiveness of nutritional counseling for women with overweight in monitoring in Primary Health Care

Introducao: As altas taxas de doencas cronicas demandam por acoes alicercadas em mudancas nos modos de vida da populacao, sobretudo na Atencao Primaria a Saude (APS). Objetivo: Avaliar a efetividade do aconselhamento nutricional em mulheres com excesso de peso acompanhadas em Unidades Basicas de Saude (UBS). Metodos: Estudo de intervencao do tipo antes-e-depois, com mulheres com excesso de peso, . 20 anos, encaminhadas para acompanhamento nutricional em UBS dos Distritos Sanitarios Leste (UBS-L) e Barreiro (UBS-B) de Belo Horizonte-MG, durante 12 meses. Verificou-se a evolucao do estado nutricional pela aplicacao de anamnese no inicio e ao final do estudo, contendo dados sociodemograficos, economicos, de saude, habitos e consumo alimentar, e antropometria. A intervencao consistiu em aconselhamento nutricional individual, com intervalos de 30 a 50 dias. Foram realizados os testes t de Student pareado, Wilcoxon de postos sinalizados e McNemar e, regressao linear multipla para identificar variaveis da linha de base associadas aos desfechos: delta percentual do peso, da circunferencia da cintura (CC) e do Indice de conicidade (Indice C) (p<0,05). Resultados: Foram avaliadas 48 mulheres (24 em cada UBS), a maioria adulta (62,5%-UBS-L; 79,2%-UBS-B). Apos 12 meses, na UBS-L houve incremento do consumo semanal de frutas (p=0,013), e numero de refeicoes (p=0,039); reducao do consumo de liquidos nas refeicoes (p=0,031); calorias (p=0,010), carboidratos (p=0,004), lipidios (p=0,014), acidos graxos monoinsaturados - AGM (p=0,004); Indice massa corporal . IMC (p=0,017), CC (p=0,019) e Razao cintura-altura - RCA (p=0,012). Na UBS-B constatou-se aumento da percepcao corporal como magra/normal (p=0,008), ingestao diaria de verduras (p=0,001) e legumes (p=0,039), numero de refeicoes (p=0,002), consumo de selenio (p=0,053) e vitamina C (p=0,015); e diminuicao da ingestao de sal (p=0,012), oleo (p=0,001), calorias (p=0,021), lipidios (p=0,001), acidos...

The high prevalence of chronic diseases demand interventions that encourage healthier lifestyles, specially in Primary Health Care (PHC). Objective: To evaluate the effectiveness of nutritional counseling for women with overweight in monitoring at PHC Units. Methods: Before-and-after intervention study, with overweight women, ≥20 years, that were referred to nutritional monitoring at PHC Units (PHCU) in the East District (PHCU-E) and Barreiro District (PHCU-B) of Belo Horizonte-MG, during 12 months. Was verified the evolution of nutritional status by applying anamnesis at the beginning and the end of intervention, aimed to assess sociodemographic and economic characteristics, health profile, habits and dietary intake, and anthropometry. The intervention consisted of individual nutritional counseling (intervals of 30-50 days). Descriptive analysis was performed and used statistical tests paired Student’s t, Wilcoxon and McNemar. Multiple linear regression was used to examine which baseline variables were associated with the outcomes: delta percentage of weight, Waist circumference (WC) and Conicity index - C Index (p<0.05). Results: Were evaluated 48 women (24 at each PHCU), most adults (PHCU-E: 62.5%; PHCU-B: 79.2%). After the intervention, at the PHCU-E there was an increase in consume of fruits (p=0.013), increase of the number of meals (p=0.039), reducing of the habit of consuming liquids at meals (p = 0.031), reducing of the consumption of calories (p=0.010), carbohydrates (p=0.004), fat (p=0.014), monounsaturated fatty acids - MUFA (p=0.004), and reducing in the body mass index-BMI (p=0.017), WC (p=0.019) and the waist to height ratio - WHtR (p=0.012). At PHCU-B, there was increased body perception as slim/normal (p=0.008), increase in the daily intake of leafy vegetables (p=0.001) and other vegetables (p=0.039), increase in the number of meals (p=0.002), increase in the consumption of selenium (p=0.053) and vitamin C (p=0.015)...

[Nutritional factors associated with dyslipidemia in users of service in primary health care]. / Fatores nutricionais associados às dislipidemias em usuários de serviço de atenção primária à saúde.

BACKGROUND: Dyslipidemias are relevant to public health because are one of the major risk factors for Non-Communicable Diseases and Disorders, especially cardiovascular diseases. OBJECTIVE: Identify factors associated with dyslipidemias on users of Primary Health Care Center. METHODS: Users were assessed through the nutritional anamnesis (demographic data, consumption of foods and nutrients and morbidity) and anthropometry. Was performed descriptive analysis, t-Student, Chi-Square and Mann Whitney tests (p<0.05) and multivariate analysis employing the decision tree through CHAID algorithm. RESULTS: It was evaluated 105 users, 93.3% were female, mean 52.3 years (±13.6) and the prevalence of dyslipidemia was 29.8%. Dyslipidemic subjects had higher mean age (p=0.057), higher daily consumption of calories (p=0.013) and sugar (p=0.026), higher inadequate consumption of eggs (p=0.043) and lower percentage of adequacy monounsaturated fatty acids (MUFA) (p=0.007). In contrast, had higher proportion of adequacy of lipid (p=0.017), lower mean weight (p=0.044) and lower inadequate intake of fatty meat (p=0.005). Multivariate analysis showed that insufficient consumption of MUFA (p=0.005) and inadequate intake of lard (p=0.021) were the main variables which influenced the presence of dyslipidemia. CONCLUSIONS: The results show that important dietary changes for the prevention and control of dyslipidemia have not been implemented, demonstrating the importance of nutritional interventions aimed at to clarify new dietary strategies, such as reduce consumption of sugar and to maintain an adequate consumption of lipid fractions.