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2.
Nutr Hosp ; 28(1): 137-41, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23808441

RESUMO

BACKGROUND: Lifestyle intervention is fundamental for obesity treatment. The aim of this study was to evaluate the effects of a program focused on diet, exercise and psychological support on Lifestyle Modification in overweight and obese patients treated in Primary Health Care setting. METHODS: 60 patients with grade II overweight and non-morbid grade I-II obesity were included in this pilot clinical trial. Ages ranged from 18 to 50 years. They were provided with a program combining nutritional education, physical activity and psychological support. Subjects attended group sessions every 2 weeks. The main outcome measures at baseline and 6 months were body composition parameters (BMI, body fat percentage, waist circumference) and lifestyle intervention using the Questionnaire for the assessment of overweight and obesity related lifestyles at baseline and six months. This questionnaire yields an five dimensions: diet caloric intake (CC), healthy eating (AS), physical activity (EF), searching for psychological well-being eating (BP) and alcohol intake (CA). The higher score indicates better lifestyles for CC, AS, EF and worse for BP y CA. RESULTS: At the end of the intervention the program achieved improvements in Questionnaire related lifestyles subscales: CC (2,60 ± 0,5 vs. 3,49 ± 0,7, p<0,001), EF (2,19 ± 0,9 vs. 3,17 ± 1,0, p<0,001) and AS (3,04 ± 0,4 vs. 3,43 ± 0,4, p<0,05); CA (3,98 ± 0,7 vs. 4,25 ± 0,7, p<0,05) and BP (2,82 ± 1,0 vs. 3,34 ± 0,7, p<0,001) has got worse. CONCLUSION: The Program focused on balanced and moderate energy-restricted diets, increased physical activity and psychological support may improve the anthropometric parameters and the Lifestyle intervention in obese patients treated in a primary healthcare center.


Introducción y Objetivos: la modificación de conductas no saludables es fundamental para tratar la obesidad. El objetivo de este estudio fue evaluar los efectos de un programa basado en dieta, ejercicio y apoyo psicológico en la modificación conductual de pacientes con sobrepeso y obesidad tratados en Atención Primaria. Métodos: 60 pacientes con sobrepeso grado II y obesidad grado I-II fueron incluidos en este ensayo piloto. Edad entre 18-50 2013s. Los pacientes recibieron un programa que combinaba educación nutricional, actividad física y apoyo psicológico. Formato grupal, periodicidad quincenal. Los principales resultados medidos al inicio y 6 meses fueron parámetros antropométricos (índice de masa corporal, porcentaje de masa grasa, perímetro cintura) y de estilos de vida usando el Cuestionario para la valoración de hábitos de vida relacionados con el sobrepeso y la obesidad. Consta de 5 dimensiones: contenido calórico de la dieta (CC), alimentación saludable (AS), ejercicio físico (EF), comer por bienestar psicológico (BP) y consumo de alcohol (CA). La mayor puntuación indica mejores hábitos para CC, AS y EF y peores para BP y CA. Resultados: al final de la intervención mejoraron las escalas CC (2,60± 0,5 vs 3,49± 0,7, p<0,001), EF (2,19± 0,9 vs 3,17± 1,0, p<0,001) y AS (3,04± 0,4 vs 3,43± 0,4, p<0,05) del cuestionario; CA (3,98± 0,7 vs. 4,25± 0,7, p<0,05) y BP (2,82± 1,0 vs. 3,34± 0,7, p<0,001) empeoraron. Conclusión: el programa basado en moderada restricción de la dieta, aumento de actividad física y apoyo psicológico puede mejorar parámetros antropométricos y estilos de vida en pacientes obesos tratados en un centro de Atención Primaria.


Assuntos
Estilo de Vida , Obesidade/terapia , Sobrepeso/terapia , Atenção Primária à Saúde/métodos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/metabolismo , Composição Corporal , Dieta , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Inquéritos e Questionários , Adulto Jovem
3.
Nutr. hosp ; 28(1): 137-141, ene.-feb. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-123120

RESUMO

Introducción y Objetivos: la modificación de conductas no saludables es fundamental para tratar la obesidad. El objetivo de este estudio fue evaluar los efectos de un programa basado en dieta, ejercicio y apoyo psicológico en la modificación conductual de pacientes con sobrepeso y obesidad tratados en Atención Primaria. Métodos: 60 pacientes con sobrepeso grado II y obesidad grado I-II fueron incluidos en este ensayo piloto. Edad entre 18-50 años. Los pacientes recibieron un programa que combinaba educación nutricional, actividad física y apoyo psicológico. Formato grupal, periodicidad quincenal. Los principales resultados medidos al inicio y 6 meses fueron parámetros antropométricos (índice de masa corporal, porcentaje de masa grasa, perímetro cintura) y de estilos de vida usando el Cuestionario para la valoración de hábitos de vida relacionados con el sobrepeso y la obesidad. Consta de 5 dimensiones: contenido calórico de la dieta (CC), alimentación saludable (AS), ejercicio físico (EF), comer por bienestar psicológico (BP) y consumo de alcohol (CA). La mayor puntuación indica mejores hábitos para CC, AS y EF y peores para BP y CA. Resultados: al final de la intervención mejoraron las escalas CC (2,60± 0,5 vs 3,49± 0,7, p<0,001), EF (2,19± 0,9 vs 3,17± 1,0, p<0,001) y AS (3,04± 0,4 vs 3,43± 0,4, p<0,05) del cuestionario; CA (3,98± 0,7 vs. 4,25± 0,7, p<0,05) y BP (2,82± 1,0 vs. 3,34± 0,7, p<0,001) empeoraron. Conclusión: el programa basado en moderada restricción de la dieta, aumento de actividad física y apoyo psicológico puede mejorar parámetros antropométricos y estilos de vida en pacientes obesos tratados en un centro de Atención Primaria (AU)


Background: Lifestyle intervention is fundamental for obesity treatment. The aim of this study was to evaluate the effects of a program focused on diet, exercise and psychological support on Lifestyle Modification in overweight and obese patients treated in Primary Health Care setting. Methods: 60 patients with grade II overweight and non-morbid grade I-II obesity were included in this pilot clinical trial. Ages ranged from18 to 50 years. They were provided with a program combining nutritional education, physical activity and psychological support. Subjects attended group sessions every 2 weeks. The main outcome measures at baseline and 6 months were body composition parameters (BMI, body fat percentage, waist circumference) and lifestyle intervention using the Questionnaire for the assessment of overweight and obesity related lifestyles at baseline and six months. This questionnaire yields an five dimensions: diet caloric intake (CC), healthy eating (AS), physical activity (EF), searching for psychological well-being eating (BP) and alcohol intake (CA). The higher score indicates better lifestyles for CC, AS, EF and worse for BP y CA. Results: At the end of the intervention the program achieved improvements in Questionnaire related lifestyles subscales: CC (2,60± 0,5 vs. 3,49± 0,7, p<0,001), EF (2,19± 0,9 vs. 3,17± 1,0, p<0,001) and AS (3,04± 0,4 vs. 3,43± 0,4, p<0,05); CA (3,98± 0,7 vs. 4,25± 0,7, p<0,05) and BP (2,82± 1,0 vs. 3,34± 0,7, p<0,001) has got worse. Conclusion: The Program focused on balanced and moderate energy-restricted diets, increased physical activity and psychological support may improve the anthropometric parameters and the Lifestyle intervention in obese patients treated in a primary healthcare center (AU)


Assuntos
Humanos , Obesidade/terapia , Sobrepeso/terapia , Educação Alimentar e Nutricional , Programas Gente Saudável , Atenção Primária à Saúde/métodos , Estilo de Vida , Distribuição por Idade e Sexo
4.
Nutr Hosp ; 26(2): 323-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21666970

RESUMO

The modification of dietary patterns has led to a change in fatty acid consumption, with an increase in the consumption of ω-6 fatty acids and a marked reduction in the consumption of ω-3 fatty acids. This in turn has given rise to an imbalance in the ω-6/ω-3 ratio, which is now very different from the original 1:1 ratio of humans in the past. Given the involvement of ω-6 and ω-3 essential fatty acids in disease processes, the present article examines changes in dietary patterns that have led to the present reduction in the consumption of ω-3 essential fatty acids, and to study the importance of the ω-6/ω-3 balance in maintaining good health. In addition, an assessment is made of the established recommendations for preventing a poor intake of ω-3 essential fatty acids, and the possible options for compensating the lack of these fatty acids in the diet.


Assuntos
Dieta , Ácidos Graxos Ômega-3/fisiologia , Ácidos Graxos Ômega-6/fisiologia , Estado Nutricional , Animais , Ácidos Graxos/metabolismo , Ácidos Graxos/fisiologia , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-6/metabolismo , Comportamento Alimentar , Peixes , Humanos , Fenômenos Fisiológicos da Nutrição , Necessidades Nutricionais
5.
Nutr Hosp ; 26(1): 97-106, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-21519735

RESUMO

INTRODUCTION: Nutrition labelling (NL) provides information on the energy and nutrients in a food and it represents a valuable tool to help consumers make informed decisions about their diet and lifestyle. However, little is known about how consumers perceive the nutrition labelling information. OBJECTIVES: Evaluate the knowledge of NL of a population survey and examine aspects such as attention, reading, understanding and utility. MATERIAL AND METHODS: 200 volunteers were interviewed about NL on National Nutrition Day (NND) on May 28, 2010 at the La Paz University Hospital in Madrid. The questionnaire was self-administered and this contained 10 closed multiple choice questions. RESULTS: The surveyed group (66.7% women and 33.3% men) had a mean age of 42.0 ± 15 years and a BMI of 24.1 ± 3.8 kg/m². A percentage of 86.5% had completed secondary and higher education. The concept about NL was knocked by 77.1% of them. This percentage was significantly higher according to the level of their studies (primary 7.1%, secondary 32.1% and higher studies 60.9%; p < 0.0001) and also regarding the age range (42.3% vs. 25% of over that 50, p < 0.05). 73.8% always or almost always readied NL; 67.7% of those who declared that always readied were women and 71% had higher education. 53.8% of people over 50 years were not capable of reading labels due to the small letters. The most interesting information for the consumers was: calories (61%), fats (39%) and cholesterol (25.7%). Nutritional concepts questions had a low percentage of right answers, especially in volunteers with lower level of education and among older age groups. CONCLUSIONS: Results show that consumers have a low level of nutrition information that would enable a better choice to purchase food. Nutrition education is needed should be necessary to NL had a significant impact on the foods election. Therefore, this fact could contribute to the maintenance of health and disease prevention.


Assuntos
Rotulagem de Alimentos , Educação em Saúde , Adolescente , Adulto , Fatores Etários , Coleta de Dados , Feminino , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores Sexuais , Espanha , Inquéritos e Questionários , Adulto Jovem
6.
Nutr. hosp ; 26(1): 97-106, ene.-feb. 2011. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-94130

RESUMO

Introducción: El etiquetado nutricional es toda la información en relación con el valor energético y los nutrientes que componen al alimento y representa una valiosa herramienta para ayudar a los consumidores a tomar decisiones informadas acerca de su dieta y estilo de vida. Sin embargo, es poco conocido como percibe el consumidor esta información. Objetivos: Conocer el grado de información de la población encuestada sobre el etiquetado nutricional y evaluar aspectos como atención, lectura, comprensión y uso del mismo. Materiales y métodos: 200 voluntarios que asistieron el día 28 de mayo de 2010 (Día Nacional de la Nutrición DNN) al Hospital La Paz y completaron un cuestionario sobre etiquetado nutricional autoadministrado, consistente en 10 preguntas cerradas de opción múltiple. Resultados: El colectivo entrevistado (66,7% mujeres y 33,3% hombres) presentaba una edad media de 42,0 ± 15 años y un IMC de 24,1 ± 3,8 kg/m2. Un 86,5% tenía estudios medios y superiores. Un 77,1% conocía el concepto del etiquetado nutricional. El porcentaje fue significativamente mayor entre aquellos con estudios superiores (primarios 7,1%, medios 32,1% y superiores 60,9%; p < 0,0001) y en las edades comprendidas entre 30-49,9 años (42,3% vs 25% en mayores de 50 años, p < 0,05). Un 73,8% declaró que leía el EN siempre o casi siempre; entre aquellos que declararon que los leían siempre 67,7% fueron mujeres y 71% tenía estudios superiores. Un 53,8% de los mayores de 50 años declaró no poder leer el etiquetado debido al tamaño reducido de las letras. La información que despierta mayor interés sobre los consumidores son las calorías (61%), las grasas (39%) y el colesterol (25,7%). Las preguntas relacionadas con conocimientos nutricionales tuvieron un bajo porcentaje de respuestas correctas, sobre todo en el grupo con menor nivel de estudios y entre las personas mayores. Conclusiones: Los resultados obtenidos muestran que la población presenta un nivel bajo de información nutricional que permita hacer una mejor elección de los productos que se compran. La educación nutricional es necesaria para que el etiquetado nutricional tenga impacto en la elección de los alimentos, ya que permite informar y concienciar a la población sobre como la dieta puede contribuir al mantenimiento de la salud y la prevención de la enfermedad (AU)


Introduction: Nutrition labelling (NL) provides information on the energy and nutrients in a food and it represents a valuable tool to help consumers make informed decisions about their diet and lifestyle. However, little is known about how consumers perceive the nutrition labelling information. Objectives: Evaluate the knowledge of NL of a population survey and examine aspects such as attention, reading, understanding and utility. Material and methods: 200 volunteers were interviewed about NL on National Nutrition Day (NND) on May 28, 2010 at the La Paz University Hospital in Madrid. The questionnaire was self-administered and this contained 10 closed multiple choice questions. Results: The surveyed group (66.7% women and 33.3% men) had a mean age of 42.0 ± 15 years and a BMI of 24.1 ± 3.8 kg/m2. A percentage of 86.5% had completed secondary and higher education. The concept about NL was knocked by 77.1% of them. This percentage was significantly higher according to the level of their studies (primary 7.1%, secondary 32.1% and higher studies 60,9%; p < 0,0001) and also regarding the age range (42.3% vs. 25% of over that 50, p < 0.05). 73.8% always or almost always readied NL; 67.7% of those who declared that always readied were women and 71% had higher education. 53.8% of people over 50 years were not capable of reading labels due to the small letters. The most interesting information for the consumers was: calories (61%), fats (39%) and cholesterol (25.7%). Nutritional concepts questions had a low percentage of right answers, especially in volunteers with lower level of education and among older age groups. Conclusions: Results show that consumers have a low level of nutrition information that would enable a better choice to purchase food. Nutrition education is needed should be necessary to NL had a significant impact on the foods election. Therefore, this fact could contribute to the maintenance of health and disease prevention (AU)


Assuntos
Humanos , Rotulagem de Alimentos/estatística & dados numéricos , Análise de Alimentos/normas , Composição de Alimentos , Inquéritos Nutricionais , Conhecimentos, Atitudes e Prática em Saúde , Qualidade dos Alimentos
7.
Nutr Hosp ; 26(4): 884-9, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-22470038

RESUMO

BACKGROUND AND OBJECTIVES: The aim of this study was to describe the hormonal and inflammatory status of a group of overweight/obese women. PATIENTS AND METHODS: The sample studied was a crosssectional cohort of women > 18 years of age, BMI ≥ 25 < 40 kg/m², prior to starting a weight control program. Data collected were: demographic characteristics, blood pressure, anthropometric parameters, physical activity data, and biochemical, hormonal and inflammatory biomarkers. RESULTS: The study involved 104 women with a mean age of 48.4 ± 9 years and a BMI of 29.8 ± 3.5 kg/m². Some 48% of the women studied were in menopause. Some 8.9% had hyperinsulinemia. The mean ghrelin value was 38.8 ± 33.6 pg/ml; there was no correlation between ghrelin levels and anthropometric and biochemical variables. CRP, leptin, adiponectin, resistin, IL6, IL10, and PAI1 were 3.0 ± 2.7 mg/dl, 36.3 ± 19.5 ng/ml, 8.3 ± 4.5 mg/ml, 24.3 ± 23.2 ng/ml, 51.6 ± 93.6 pg/ml, 10.0 ± 34.2 pg/ml and 22.3 ± 30.6 ng/ml, respectively. Obese patients had significantly higher mean values of resistin and PAI 1 than those who were overweight. These levels correlated significantly with anthropometric and biochemical variables; however, the correlations were weak. Age, menopause or the regular practice of physical activity had no effect on mean values. CONCLUSIONS: The group of women studied had altered inflammatory biomarkers in relation to people of normal weight. The study shows the inflammatory status of overweight/ obese individuals, and the values obtained may help to establish standard ranges for these markers.


Assuntos
Biomarcadores/sangue , Hormônios/sangue , Inflamação/sangue , Obesidade/sangue , Sobrepeso/sangue , Adulto , Idoso , Antropometria , Composição Corporal/fisiologia , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Estudos Transversais , Feminino , Humanos , Resistência à Insulina/fisiologia , Pessoa de Meia-Idade , Estado Nutricional
8.
Nutr Hosp ; 24(5): 558-67, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19893866

RESUMO

INTRODUCTION: As eating disorders include both psychological and physiological components, appropriate management of these disorders requires input from a number of disciplines working together in a coordinated manner, following an integrated Programme. The Eating Disorders-Nutrition Education Programme has as its purpose achieving healthier habits and modifying eating behaviour. The Programme should take place as one part of Eating Disorders treatment. OBJECTIVES: To determine the efficacy of a Nutrition Education Programme about nutritional state and eating patterns in a group of patients diagnosed with Eating Disorders who follow the usual check-up protocol in the clinic for nutrition and mental health. MATERIAL AND METHODS: 89 patients were included, including 5% men. They received individual nutritional education with weekly/fortnightly appointments during a period of 4-6 months. Educational counseling was carried out by a dietician. The mean age of the sample was 24 +/- 8 years and the diagnoses were: Anorexia Nervosa Restrictive (ANR) 32.5% Anorexia Nervosa Purgative (ANP) 26.5%, Bulimia Nervosa (BN) 18%, Eating Disorder Not Otherwise Specified (EDNOS) 21% and Binge Eating Disorder (BED) 2%. The average evolution time since the diagnosis was 4.8 +/- 5 years. An anthropometric assessment, assessment of daily oral intake, 24-hour dietary recall, and Eating Attitudes Test (EAT26) questionnaires were completed at the first appointment and again at the end of the programme. RESULTS: The mean score of the EAT26 questionnaire was 32 +/- 15 initially, and after 4-6 months the score was 23.7 +/- 14 (p < 0.001). This change represents a significant improvement in the patients' symptoms after the Programme. Furthermore there were significant differences in the evaluation of the questionnaire by scales and by diagnosis. After 4-6 months, there was a meaningful reduction in episodes of vomiting per week (from 7.5 +/- 10 to 1 +/- 1.8 p < 0.001) in ANP and BN binge-purging (8 +/- 9.7 vs 2.2 +/- 3.2 p < 0,01). In addition, a favourable trend in the number of binges per week was observed for both diagnoses. The percentage of subjects that ate less than 4 meals per day decreased from 70% to 19% after the Education Programme (p < 0.001). Some 67% of the patients dedicated a specific time for eating and a 54% started to have complete meals. These results that show a very favourable tendency with respect to the normalization of eating patterns. There was improvement in the intake of dairy products, vegetables, fruits, cereals and oil (p < 0.05). At the beginning, 34% consumed at least 3 of the 6 food groups within the recommended range, but at the end 70% did (p < 0.001). After the nutritional education programme, an important increase in energy ingestion and carbonhydrate consumption took place (p < 0.001), as much with ANR as with ANP. With respect to micronutrients, the ingestion of vitamin B2 significantly increased, as well as folic acid and calcium (p < 0.001) in ANP, and magnesium and calcium (p < 0.001) in ANR. In ANR, we found a significant improvement in nutritional status (p < 0.001). Variables including weight, BMI, muscular circumference of the arm and tricipetal fold were at the limit of significance. Regarding ANP and EDNOS, the initial evaluation demonstrated that they were within normal limits, and they were maintained after nutritional education. In BN, progress towards normalization of BMI took place, increasing from 26.4 +/- 6.6 to 25.5 +/- 5.7 (-2.3 kg). CONCLUSIONS: The Nutritional Education Programme carried out by qualified professionals should be a part of Eating Disorders treatment, along with medical and psychological monitoring and as part of an interdisciplinary, multiprofessional team effort.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Educação de Pacientes como Assunto , Feminino , Humanos , Masculino , Estado Nutricional , Avaliação de Programas e Projetos de Saúde , Adulto Jovem
9.
Nutr. hosp ; 24(5): 558-567, sept.-oct. 2009. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-76616

RESUMO

Introducción: Los Trastornos de la Conducta Alimentaria incluyen componentes psíquicos y físicos, por lo que para un adecuado abordaje de los mismos se debe trabajar dentro de un Programa integral con la participación de diferentes disciplinas. La Educación Nutricional busca la modificación de la conducta alimentaria hacia patrones más saludables y debe formar parte del Programa de tratamiento de esta enfermedad. Objetivo: Determinar el efecto de un programa de Educación Nutricional sobre el estado nutricional y el patrón alimentario de un grupo de pacientes con Trastornos de la Conducta Alimentaria que siguen con el protocolo habitual de seguimiento en consulta de Nutrición y deSalud Mental. Metodología: Se incluyeron 89 pacientes, 5% hombres, que recibieron Educación Nutricional individual con visitas semanales/quincenales por 4-6 meses, llevadas a cabo por una Dietista. La edad media 24 ± 8 años. La distribución por diagnóstico fue: Anorexia Nerviosa Restrictiva (ANR) 32,5% y Anorexia Nerviosa Purgativa (ANP) 26,5%, Bulimia Nerviosa (BN) 18%, Trastorno Alimentario No Específico (TANE) 21% y Trastorno por Atracón (TA) 2%. La media del tiempo de evolución desde el diagnóstico fue de 4,8 ± 5 años. Los pacientes completaban el cuestionario EAT26 (Eating Attitudes Test-26), se realizaba evaluación antropométrica, registro de 24 h y frecuencia habitual de consumo de alimentos en la primera consulta y tras recibir el programa de educación nutricional. Resultados: El valor medio del cuestionario EAT26 fue inicialmente 32 ± 15, tras la intervención fue 23,7 ± 14 (p < 0,001), lo que evidencia cambios significativos en la sintomatología de los pacientes muy positivos. También hubo diferencias significativas en el análisis del cuestionario por escalas y en la evaluación por diagnósticos. Tras los 4-6 meses del programa, disminuyó significativamente el número de vómitos/semana tanto en ANP (7,2 ± 10 vs 1 ± 1,8 p < 0,001) como en BN (8 ± 9,7 vs 2,2 ± 3,2 p < 0,01). También se observó una tendencia favorable en la disminución en el número de atracones/semana para ambos diagnósticos. El porcentaje de pacientes que consumían menos de 4 comidas/día se redujo de un 70% a un 19% (p < 0,001). El 67% de los pacientes logró dedicar un tiempo definido como correcto a comer y un 54% pasó a consumir una comida completa, resultados que muestran una tendencia muy favorable respecto a la normalización del patrón alimentario. Aumentó significativamente el consumo de lácteos, verduras, cereales, aceite (p < 0,001), carnes (p < 0,05) y frutas (p < 0,01). Inicialmente un 34% consumía por lo menos 3 de los 6 grupos de alimentos dentro del rango recomendado, al final lo hizo el 70% (p < 0,001). Tras la educación nutricional se produjo un incremento significativo en la ingesta energética y en el consumo de hidratos de carbono (p < 0,001) tanto en ANR como en ANP. Respecto a los micronutrientes aumentó significativamente la ingesta de vitamina B2, ácido fólico y calcio (p < 0,001) en ANP y de magnesio y calcio (p < 0,001) en ANR. Se produjo una mejoría significativa en el estado nutricional en ANR (p < 0,001) en las variables peso, IMC y circunferencia muscular del brazo y el pliegue tricipital estuvo en el límite de la significación. Para ANP y TANE su valoración inicial demostraba que se encontraban dentro de rangos de normalidad, situación que se mantuvo tras la educación nutricional. En BN se produjo una evolución hacia la normalización del IMC, que pasó de 26,4 ± 6,6 a 25,5 ± 5,7 (-2,3 kg). Conclusión: Los programas de educación nutricional llevados a cabo por profesionales cualificados y expertos, deben formar parte del tratamiento de los TCA, junto al seguimiento médico y psicológico y dentro del marco de la interdisciplina y el trabajo en equipo (AU)


Introduction: As eating disorders include both psychological and physiological components, appropriate management of these disorders requires input from a number of disciplines working together in a coordinated manner, following an integrated Programme. The Eating Disorders-Nutrition Education Programme has as its purpose achieving healthier habits and modifying eating behaviour. The Programme should take place as one part of Eating Disorders treatment. Objectives: To determine the efficacy of a Nutrition Education Programme about nutritional state and eating patterns in a group of patients diagnosed with Eating Disorders who follow the usual check-up protocol in the clinic for nutrition and mental health. Material and methods: 89 patients were included, including 5% men. They received individual nutritional education with weekly/fortnightly appointments during a period of 4-6 months. Educational counseling was carried out by a dietician. The mean age of the sample was 24 ± 8 years and the diagnoses were: Anorexia Nervosa Restrictive (ANR) 32.5% Anorexia Nervosa Purgative (ANP) 26.5%, Bulimia Nervosa (BN) 18%, Eating Disorder Not Otherwise Specified (EDNOS) 21% and Binge Eating Disorder (BED) 2%. The average evolution time since the diagnosis was 4.8 ± 5 years. An anthropometric assessment, assessment of daily oral intake, 24-hour dietary recall, and Eating Attitudes Test (EAT26) questionnaires were completed at the first appointment and again at the end of the programme. Results: The mean score of the EAT26 questionnaire was 32 ± 15 initially, and after 4-6 months the score was 23.7 ± 14 (p < 0.001). This change represents a significant improvement in the patients' symptoms after the Programme. Furthermore there were significant differences in the evaluation of the questionnaire by scales and by diagnosis. After 4-6 months, there was a meaningful reduction in episodes of vomiting per week (from 7.5 ± 10 to 1 ± 1.8 p < 0.001) in ANP and BN binge-purging (8 ± 9.7 vs 2.2 ± 3.2 p < 0,01). In addition, a favourable trend in the number of binges per week was observed for both diagnoses. The percentage of subjects that ate less than 4 meals per day decreased from 70% to 19% after the Education Programme (p < 0.001). Some 67% of the patients dedicated a specific time for eating and a 54% started to have complete meals. These results that show a very favourable tendency with respect to the normalization of eating patterns. There was improvement in the intake of dairy products, vegetables, fruits, cereals and oil (p < 0.05). At the beginning, 34% consumed at least 3 of the 6 food groups within the recommended range, but at the end 70% did (p < 0.001). After the nutritional education programme, an important increase in energy ingestion and carbonhydrate consumption took place (p < 0.001), as much with ANR as with ANP. With respect to micronutrients, the ingestion of vitamin B2 significantly increased, as well as folic acid and calcium (p < 0.001) in ANP, and magnesium and calcium (p < 0.001) in ANR. In ANR, we found a significant improvement in nutritional status (p < 0.001). Variables including weight, BMI, muscular circumference of the arm and tricipetal fold were at the limit of significance. Regarding ANP and EDNOS, the initial evaluation demonstrated that they were within normal limits, and they were maintained after nutritional education. In BN, progress towards normalization of BMI took place, increasing from 26.4 ± 6.6 to 25.5 ± 5.7 (-2.3 kg). Conclusions: The Nutritional Education Programme carried out by qualified professionals should be a part of Eating Disorders treatment, along with medical and psychological monitoring and as part of an interdisciplinary, multiprofessional team effort (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Educação de Pacientes como Assunto , Avaliação de Programas e Projetos de Saúde , Estado Nutricional
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