Adherence to secondary prevention measures after acute coronary syndrome in patients associated exclusively with the public and private healthcare systems in Brazil.

Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.

Assessment of Malnutrition in Heart Failure and Its Relationship with Clinical Problems in Brazilian Health Services.

Malnutrition in heart failure (HF) is frequent and associated with a worse prognosis. Due to differences in investment and the profile of those assisted, the objective of this study was to evaluate the frequency of malnutrition in hospitalized patients with HF and its association with clinical outcomes in the public and private health systems. Methodology: A cross-sectional study, with 247 volunteers hospitalized with HF in three public hospitals and one private hospital in Aracaju, SE, Brazil. A subjective global nutritional assessment (SGA) and mini nutritional assessment (MNA) were performed. Results: Sample with 72.5% users of the public health system and 75.3% with malnutrition (public = 74.9%; private = 76.5%; p = 0.793). Regardless of the healthcare system, hospital stay (>14 days) was longer (p = 0.020) among those with malnutrition (48.4%) than well-nourished patients (29.5%). Malnutrition in the public system had higher mortality (7.5%; 5.8%; p < 0.001) and hospital transfer rate (21.1%; 0.0%; p < 0.001) than those in the private system. Death after discharge was observed only in the public system (p = 0.039). Conclusion: Malnutrition was frequent in both systems and was associated with longer hospital stays and, in the public hospital, in-hospital death and transfers.

Quality of Life among Patients with Acute Coronary Syndromes Receiving Care from Public and Private Health Care Systems in Brazil.

(1) Background: Quality of life (QOL) is used as a health indicator to assess the effectiveness and impact of therapies in certain groups of patients. This study aimed to analyze the QOL of patients with acute coronary syndrome (ACS) who received medical treatment by a public or private health care system. (2) Methods: This observational, prospective, longitudinal study was carried out in four referral hospitals providing cardiology services in Sergipe, Brazil. QoL was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey. The volunteers were divided into two groups (public or private health care group) according to the type of health care provided. Multiple linear regression models were used to evaluate QoL at 180 days after ACS. (3) Results: A total of 581 patients were eligible, including 44.1% and 55.9% for public and private health care, respectively. At 180 days after ACS, the public health care group had lower QoL scores for all domains (functional capacity, physical aspects, pain, general health status, vitality, social condition, emotional profile, and health) (p < 0.05) than the private group. The highest QoL level was associated with male sex (p < 0.05) and adherence to physical activity (p ≤ 0.003) for all assessed domains. (4) Conclusions: This shows that social factors and health status disparities influence QoL after ACS in Sergipe.

BALANCE Dietary Index in Patients with Heart Failure, and Its Adherence in Sergipe, Brazil.

BACKGROUND: "The effective treatment of Heart Failure (HF) involves care with food intake. Recently, the Ministry of Health created the Brazilian Cardioprotective Diet and its dietary index, BALANCE, which assesses adherence to the standard's recommendations". METHODS: This observational prospective study is part of the Congestive Heart Failure Registry (VICTIM-CHF) of Aracaju/SE. Observations and data collection took place from April 2018 to February 2021. Sociodemographic and clinical aspects and food consumption were evaluated. Food intake was determined using the food frequency questionnaire. Foods were categorized using the BALANCE dietary index into green, yellow, blue and red food groups. The BALANCE dietary index was obtained using median and interquartile ranges, scores of the Mann-Whitney U test, and associations between clinical variables and the index, through linear regression. RESULTS: Participants included 240 patients with HF (61.12 ± 1.06 years), who were assisted by the Unified Health System (67.5%). Individuals with a partner showed greater adherence to the green food group recommendations (0.09; 0.00-0.17). The lowest adherence to recommendations regarding the blue food group was observed in individuals with excess weight, who had a higher consumption of foods rich in animal protein (0.54; 0.38-0.78). As for the red food group (ultra-processed foods) the highest adherence was observed by patients with diabetes mellitus (0.41; 0.05-0.77). The greatest adherence to the yellow food group, and a higher score, was observed in patients with the smallest left ventricular systolic diameter (LVSD). CONCLUSIONS: Being married was directly associated with the consumption of foods in the green group, while being overweight and having diabetes were inversely associated with adherence to the blue and red food groups, respectively. Greater adherence to the yellow food group recommendations was inversely associated with less change in the DSFVE.

Food Patterns of Hospitalized Patients with Heart Failure and Their Relationship with Demographic, Economic and Clinical Factors in Sergipe, Brazil.

Background: The high rates of hospitalization and mortality caused by Heart Failure (HF) have attracted the attention of health sectors around the world. Dietary patterns that involve food combinations and preparations with synergistic or antagonistic effects of different dietary components can influence the worsening and negative outcomes of this disease. Objectives: To describe the dietary patterns of patients hospitalized for HF decompensation and associate them with demographic, economic, and clinical factors, and the type of care provided in Sergipe. Materials and Methods: Cross-sectional study that is part of the Congestive Heart Failure Registry (VICTIM-CHF)" of Aracaju/SE. Prospective data collection took place with all patients hospitalized between April 2018 and February 2021 in cardiology referral hospitals, 2 public and 1 private. The data collected were sociodemographic, clinical, lifestyle, anthropometric and food consumption variables. Daily dietary intake was estimated by applying a semiquantitative food frequency questionnaire. The extraction of dietary patterns, by exploratory factor analysis, was performed after grouping the foods according to the nutritional value and form of preparation into 34 groups. To assess the association between the factorial scores for adherence to the standards and the variables studied, the Mann-Whitney U test was applied. Linear regressions were also performed, considering the dietary pattern (one for each pattern) as a dependent variable. Results: The study included 240 patients hospitalized for HF decompensation, most of them elderly (mean age 61.12 ± 1.06 years), male (52.08%) and attended by the Unified Health System­SUS (67.5%). Three dietary patterns were identified, labeled "traditional" (typical foods of the Brazilian northeastern population added to ultra-processed foods), "Mediterranean" (foods recommended by the Mediterranean diet) and "dual" (healthy foods combined with fast and easy-to-prepare foods like snacks, bread, sweets and desserts). Adherence to the "traditional" pattern was greater among men (p < 0.031) and non-diabetics (p < 0.003). The "Mediterranean" was more consumed by the elderly (p < 0.001), with partners (p = 0.001) and a lower income (p < 0.001), assisted by the SUS (p < 0.001) and without hypertension (p = 0,04). The "dual" diet pattern had greater adherence by the elderly (p < 0.001), self-declared non-black (p = 0.012), with higher income (p < 0.001), assisted in the private sector (p < 0.001) and with less impaired functional capacity (p = 0.037). It was also observed that being female (p = 0.031) and being older reduced the average scores of performing the "traditional" pattern (p = 0.002). Regarding the type of service, being from the public service reduced the average scores for adhering to the "dual" pattern (p = 0.008). Conclusions: Three dietary patterns representative of the population were found, called traditional, Mediterranean and dual, which were associated with demographic, economic and clinical factors. Thus, these standards must be considered in the development of nutritional strategies and recommendations in order to increase adherence to diets that are more protective against cardiovascular diseases.

Bariatric Surgery: Late Outcomes in Patients Who Reduced Comorbidities at Early Follow-Up.

Backgroundand Objectives: In severe obesity, a relevant weight loss can promote the reduction of comorbidities, such as systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM2). Bariatric surgery (BS) has been an essential resource in the therapy of this disease with a short-term reduction of cardiometabolic risk (CR). This study aimed to evaluate the reduction of factors associated with the CR in patients undergoing BS at a 5-year follow-up. Materials and Methods: This is a longitudinal, retrospective study carried out with patients undergoing BS by the Brazilian Public Healthcare System (PHS). Anthropometric and clinical parameters related to the CR (DM2, dyslipidemia, and SAH), quantified by the Assessment of Obesity-Related Comorbidities (AORC) score, were evaluated at the following moments: admission and preoperative and postoperative returns (3 months, 6 months, 1 to 5 years). Results: The sample had a mean age of 44.69 ± 9.49 years and were predominantly in the age group 20-29 years (34.80%) and women (72.46%). At admission to the service, 42.3% had DM2, 50.7% dyslipidemia, and 78.9% SAH. Regarding BS, the gastric bypass technique was used in 92.86% of the sample, and the waiting time for the procedure was 28.3 ± 24.4 months. In the pre- and postoperative period of 3 months, there was a significant reduction in the frequency of DM2 (p < 0.003), dyslipidemia (p < 0.000), and SAH (p < 0.000). However, at postoperative follow-up from 6 months to 5 years, there was no significant reduction in the comorbidities studied. After five years, 35.7% had total remission of DM2 and 2.9% partial remission of DM2, 44.2% had control and remission of dyslipidemia, and 19.6% of SAH (AORC score ≤ 2 for the comorbidities). Conclusion: BS promoted a reduction of the CR in the first three months after BS in severely obese PHS users.

Contribution of minimally processed and ultra-processed foods to the cardiometabolic risk of Brazilian young adults: a cross-sectional study / Contribución de los alimentos mínimamente procesados y ultraprocesados al riesgo cardiometabólico de adultos jóvenes brasileños: un estudio transversal

INTRODUCTION: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). OBJECTIVE: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. METHODS: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. RESULTS: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). CONCLUSIONS: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations

INTRODUCCIÓN: la alta prevalencia de enfermedades cardiometabólicas y el avance de los alimentos ultraprocesados en la dieta sugieren una posible relación entre ellos. OBJETIVO: valorar la asociación entre el consumo de alimentos clasificado por el grado de procesamiento y el riesgo cardiometabólico en adultos jóvenes. MÉTODOS: estudio transversal con una muestra compuesta por 120 jóvenes brasileños de 18 a 25 años, que fueron categorizados según el riesgo cardiometabólico (presencia o ausencia). El consumo de alimentos se evaluó mediante un cuestionario semicuantitativo de frecuencias a partir del que se clasificó la ingesta de acuerdo con el grado de procesamiento. Estos resultados se dividieron en terciles de gramos de alimentos (procesados y mínimamente procesados, procesados y ultraprocessados). Las diferencias de consumo diario de alimentos entre los terciles se compararon por medio del test de Kruskal-Wallis. Se realizó una regresión logística para asociar el grado de procesamiento con los componentes del riesgo cardiometabólico. RESULTADOS: se observó una alta contribución energética de los alimentos ultraprocesados en la dieta de la muestra estudiada. La ingestión de grasas totales (p = 0,04) y alimentos ultraprocesados (p = 0,03) fue mayor entre el grupo con riesgo cardiometabólico. El consumo de alimentos ultraprocesados fue un factor de riesgo de obesidad abdominal (OR = 1,09; IC 95 %: 1,00-1,18), mientras que el consumo de los mínimamente procesados fue protector frente a las alteraciones del LDL-c, independientemente del sexo, la actividad física y la ingesta de alcohol (OR = 0,70; IC 95 % = 0,50-0,98). CONCLUSIÓN: los alimentos ultraprocesados contribuyeron a aumentar la ingesta de grasas y a la obesidad abdominal; en cambio, los alimentos no procesados y mínimamente procesados redujeron los niveles de LDL-c

Contribution of minimally processed and ultra-processed foods to the cardiometabolic risk of Brazilian young adults: a cross-sectional study.

INTRODUCTION: Introduction: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). Objective: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. Methods: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. Results: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). Conclusions: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations.

INTRODUCCIÓN: Introducción: la alta prevalencia de enfermedades cardiometabólicas y el avance de los alimentos ultraprocesados en la dieta sugieren una posible relación entre ellos. Objetivo: valorar la asociación entre el consumo de alimentos clasificado por el grado de procesamiento y el riesgo cardiometabólico en adultos jóvenes. Métodos: estudio transversal con una muestra compuesta por 120 jóvenes brasileños de 18 a 25 años, que fueron categorizados según el riesgo cardiometabólico (presencia o ausencia). El consumo de alimentos se evaluó mediante un cuestionario semicuantitativo de frecuencias a partir del que se clasificó la ingesta de acuerdo con el grado de procesamiento. Estos resultados se dividieron en terciles de gramos de alimentos (procesados y mínimamente procesados, procesados y ultraprocessados). Las diferencias de consumo diario de alimentos entre los terciles se compararon por medio del test de Kruskal-Wallis. Se realizó una regresión logística para asociar el grado de procesamiento con los componentes del riesgo cardiometabólico. Resultados: se observó una alta contribución energética de los alimentos ultraprocesados en la dieta de la muestra estudiada. La ingestión de grasas totales (p = 0,04) y alimentos ultraprocesados (p = 0,03) fue mayor entre el grupo con riesgo cardiometabólico. El consumo de alimentos ultraprocesados fue un factor de riesgo de obesidad abdominal (OR = 1,09; IC 95 %: 1,00-1,18), mientras que el consumo de los mínimamente procesados fue protector frente a las alteraciones del LDL-c, independientemente del sexo, la actividad física y la ingesta de alcohol (OR = 0,70; IC 95 % = 0,50-0,98). Conclusión: los alimentos ultraprocesados contribuyeron a aumentar la ingesta de grasas y a la obesidad abdominal; en cambio, los alimentos no procesados y mínimamente procesados redujeron los niveles de LDL-c.

Oxidized Low-Density Lipoprotein (Ox-LDL) and Triggering Receptor-Expressed Myeloid Cell (TREM-1) Levels Are Associated with Cardiometabolic Risk in Nonobese, Clinically Healthy, and Young Adults.

Oxidative and inflammatory substances play an important role in the genesis of processes related to cardiometabolic risk. High levels of oxidized low-density lipoprotein (Ox-LDL) and of triggering receptor-expressed myeloid cells (TREM-1) are associated with cardiovascular and inflammatory diseases. In this study, we evaluate the association of the plasma concentrations of Ox-LDL and serum levels of circulating TREM-1 (sTREM-1) with the components of cardiometabolic risk (CMR) and other associated risk parameters. Although the individuals in this study were young, nonobese, and did not have signs, symptoms, and diagnosis of diseases, they already presented components of CMR. Ox-LDL lipid fraction correlated positively with CMR-related markers: body mass index (BMI), waist circumference (WC), body fat percentage, total cholesterol, LDL-c, VLDL-c, triglycerides, atherogenic cholesterol, and atherogenic index. Among these parameters, atherogenic cholesterol had a greater predictive effect for Ox-LDL alterations. Individuals with higher serum concentrations of sTREM-1 presented higher values for BMI, WC, triglycerides, VLDL-c, and atherogenic cholesterol. WC showed an effect on the association between the sTREM-1's inflammatory response and the components of CMR. The association of oxidative and inflammatory markers with anthropometric parameters and atherogenic cholesterol in nonobese, clinically healthy, and young individuals suggests the importance of early evaluation of these markers in order to prevent future cardiac events.

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults / Capacidade Antioxidante Total do Plasma e Risco Cardiometabólico em Adultos Jovens, Não Obesos e Clinicamente Saudáveis

Abstract Background: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. Objective: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. Methods: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. Results: Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; β = 0.17; p = 0.001). Conclusions: The plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions.

Resumo Fundamentos: Os biomarcadores oxidativos exercem um importante papel na gênese dos processos relacionados ao risco cardiometabólico. Objetivo: Investigar a capacidade antioxidante total do plasma e sua associação com risco cardiometabólico em adultos jovens, não obesos e clinicamente saudáveis. Métodos: Estudantes universitários do estado de Sergipe, Brasil, com idade entre 18 e 25 anos, foram recrutados entre maio de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. Resultados: Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; β = 0,17; p = 0,001). Conclusões: A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

BACKGROUND:: The oxidative biomarkers play an important role in the genesis of cardiometabolic risk-related processes. OBJECTIVE:: To investigate the total antioxidant capacity of plasma and its association with cardiometabolic risk in non-obese and clinically healthy young adults. METHODS:: University students of the state of Sergipe, Brazil, aged between 18 and 25 years, were recruited for this study from May of 2013 and October of 2014. Anthropometric, clinical and biochemical parameters were measured and analyzed using protocols which were previously standardized and described in the literature. The measurement of plasma total antioxidant capacity was based on the ability that all the antioxidants present in the sample (plasma) have to inhibit the oxidation of the oxidizable substrate ABTS (2,2`- Azino-di-[3-ethylbenzthiazoline sulphonate]) to ABTS•+ by metmyoglobin. RESULTS:: Approximately 25% of the sample presented more than one component of cardiometabolic risk. Low HDL-cholesterol was the most prevalent component. Compared to absence of components, the subjects with at least one component presented greater body weight and waist circumference, higher levels of diastolic blood pressure and fasting glucose, greater total cholesterol/HDL-c ratio, and lower levels of HDL-c (p < 0.05). Fasting glycemia was the only parameter which was associated with total antioxidant capacity (R2 = 0.10; ß = 0.17; p = 0.001). CONCLUSIONS:: The plasma total antioxidant capacity was not able to predict the cardiometabolic risk components due possibly to the establishment of compensatory mechanisms that become activated in physiological conditions. FUNDAMENTOS:: Os biomarcadores oxidativos exercem um importante papel na gênese dos processos relacionados ao risco cardiometabólico. OBJETIVO:: Investigar a capacidade antioxidante total do plasma e sua associação com risco cardiometabólico em adultos jovens, não obesos e clinicamente saudáveis. MÉTODOS:: Estudantes universitários do estado de Sergipe, Brasil, com idade entre 18 e 25 anos, foram recrutados entre maio de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. RESULTADOS:: Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; ß = 0,17; p = 0,001). CONCLUSÕES:: A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Comparação entre o Índice de Massa Corporal e o percentual de gordura como indicadores do risco cardiometabólico / Body Mass Index as cardiometabolic risk indicator compared to body fat percentage

Objetivo ­ Avaliar a manifestação dos componentes do risco cardiometabólico (RCM) em adultos jovens saudáveis de acordo com o IMC e a gordura corporal. Métodos ­ Analisou-se as concentrações de glicemia de jejum, triglicérides, HDL-c, pressão arterial, circunferência da cintura, IMC, percentual de gordura corporal, além de informações sobre tabagismo e atividade física. Resultados ­ A população estudada foi composta por 163 jovens adultos com idade média de 21,5 ± 2,03 anos; sendo 74,2% mulheres. Os componentes do risco cardiometabólico mais frequentes na população estudada foram a redução da concentração de HDL-c (20,6%) e a obesidade abdominal (13,1%). O IMC apresentou melhor associação aos componentes do RCM, estando associado à obesidade abdominal (p<0,001), hiperglicemia (p=0,047), hipertrigliceridemia (p=0,001) e PAS (p<0,001). A gordura corporal associou-se a obesidade abdominal (p<0,001), hipertrigliceridemia (p=0,003) e PAS (p=0,028). Conclusão ­ Pode-se observar que apesar de clinicamente saudáveis e, predominantemente eutróficos, os adultos jovens já apresentavam alterações antropométricas, clínicas e/ou bioquímicas relativas aos componentes do RCM, e que o IMC foi o instrumento mais eficaz na detecção dos componentes do risco quando comparado a gordura corporal total.

Objective ­ To evaluate the expression of the components of cardiometabolic risk (CMR) in healthy young adults according to BMI and body fat. Methods ­ We analyzed the fasting glucose concentrations, triglycerides, HDL-c, blood pressure, waist circumference, BMI, body fat percentage, and information on smoking and physical activity. Results ­ The study population consisted of 163 young adults with an average age of 21.5 ± 2.03, from which 74.2% were women. Low HDL-c concentration (20.6%) and abdominal obesity (13.1%) were the most prevalent risk components in the studied population. BMI showed a better association with the components of CMR, being associated with abdominal obesity (p<0.001), hyperglycemia (p=0.047), hypertriglyceridemia (p=0.001) and systolic blood pressure (p<0.001). Body fat was associated to abdominal obesity (p<0.001), hypertriglyceridemia (p=0.003) and systolic blood pressure (p=0.028). Conclusion ­ Although the young adults are clinically healthy and predominantly normal weight, they already show anthropometric, clinical and/or biochemical alterations related to the components of CMR. In addition, BMI was the most effective measure in the detection of risk components when compared to total body fat

Intervenção nutricional educativa como ferramenta eficaz para mudança de hábitos alimentares e peso corporal entre praticantes de atividade física / Educational nutritional intervention as an effective tool for changing eating habits and body weight among those who practice physical activities

O presente estudo avaliou a eficácia de dois métodos de intervenção nutricional educativa entre mulheres praticantes de atividade física regular visando à adoção de práticas alimentares saudáveis. A população foi constituída de 52 mulheres de 19 a 59 anos, frequentadoras do Programa Academia da Cidade (Aracaju, SE). O estudo teve delineamento de comparação de dois grupos de intervenção e foi do tipo pré-teste/pós-teste. As ações educativas foram baseadas em dois protocolos, uma com ação menos intensiva (Grupo P1) e outra mais intensiva (Grupo P2), num período de dois meses. As variáveis analisadas foram as de conhecimento nutricional, medidas antropométricas e mudanças nos hábitos alimentares. As modificações identificadas foram melhora nos hábitos alimentares e redução do peso e Índice de Massa Corpórea para o Grupo P2. As modificações citadas referiram-se, principalmente, ao aumento do consumo de frutas, verduras e legumes, redução de gordura das preparações, redução do volume do alimento ingerido por refeição e aumento do fracionamento da dieta. Em relação aos conhecimentos em nutrição apenas 2 das 12 perguntas apresentaram aumento significativo da nota. A intervenção nutricional mais intensiva mostrou-se eficaz para mudanças de hábitos alimentares com repercussão na perda de peso corporal.

The scope of this study was to evaluate the effectiveness of two methods of educational nutritional intervention together with women who practice regular physical activities by fostering the adoption of healthy eating habits. The study population consisted of 52 women aged between 19 and 59 who frequented the Academia da Cidade Program in Aracaju in the State of Sergipe. The study was a randomized comparison of two intervention groups and was of the pre-test/post-test variety. The educational activities were based on two protocols - one less intensive (P1 Group) and one more intensive (P2 Group) - over a period of two months. The variables analyzed were nutritional knowledge, anthropometric measurements and changes in eating habits. The changes identified were improvement in eating habits and reduction in weight and Body Mass Index for the P2 group. The modifications identified referred mainly to increased consumption of fruit and vegetables, reduction of fat in cooking, reduction in the volume of food eaten per meal and increased meal frequency. In relation to nutritional knowledge, only 2 of the 12 questions showed significant changes. The most intensive method proved effective in changing dietary habits leading to weight loss.

[Educational nutritional intervention as an effective tool for changing eating habits and body weight among those who practice physical activities]. / Intervenção nutricional educativa como ferramenta eficaz para mudança de hábitos alimentares e peso corporal entre praticantes de atividade física.

The scope of this study was to evaluate the effectiveness of two methods of educational nutritional intervention together with women who practice regular physical activities by fostering the adoption of healthy eating habits. The study population consisted of 52 women aged between 19 and 59 who frequented the Academia da Cidade Program in Aracaju in the State of Sergipe. The study was a randomized comparison of two intervention groups and was of the pre-test/post-test variety. The educational activities were based on two protocols - one less intensive (P1 Group) and one more intensive (P2 Group) - over a period of two months. The variables analyzed were nutritional knowledge, anthropometric measurements and changes in eating habits. The changes identified were improvement in eating habits and reduction in weight and Body Mass Index for the P2 group. The modifications identified referred mainly to increased consumption of fruit and vegetables, reduction of fat in cooking, reduction in the volume of food eaten per meal and increased meal frequency. In relation to nutritional knowledge, only 2 of the 12 questions showed significant changes. The most intensive method proved effective in changing dietary habits leading to weight loss.

Índice de qualidade da dieta de mulheres usuárias de um programa de atividade física regular "Academia da Cidade", Aracajú, SE / Healthy eating index of women exercising in the "City Gym Program", Aracajú, Sergipe, Brazil

OBJETIVO: Avaliar a qualidade da dieta de mulheres praticantes de atividades físicas do Programa Academia da Cidade segundo idade e estado nutricional, Aracajú, Sergipe. MÉTODOS: Foram coletados dados sociodemográficos, antropométricos e dietéticos de 169 mulheres. O Índice de Qualidade da Dieta foi obtido a partir da média de aplicação de dois recordatórios de 24 horas. Os dados do Índice de Qualidade da Dieta total e de seus componentes foram analisados de acordo com o índice de massa corporal (obesos e não obesos) e a faixa etária (adultos jovens e adultos velhos). Foram realizadas análise estatística descritiva e Análise de Variância para a comparação das médias de pontuação do Índice de Qualidade da Dieta entre os grupos. RESULTADOS: Na população estudada, com idade média de 49,2 anos, 24,85% das mulheres foram consideradas obesas, e 43,20% com obesidade abdominal. A pontuação média do Índice de Qualidade da Dieta foi 66,64 pontos, com 90,60% da população apresentando dieta com necessidade de modificações. No componente hortaliças, as obesas apresentaram menor consumo do que as não obesas. Com relação à idade, aos componentes hortaliças, leite e derivados, à variedade da dieta e à pontuação final, obtiveram-se notas maiores entre adultos velhos. CONCLUSÃO: A população apresentou hábitos alimentares inadequados principalmente entre as mais novas e as com excesso de peso. Assim, frisa-se a importância de estratégias educacionais voltadas à nutrição na efetivação de uma vida saudável.

OBJECTIVE: The aim of the present study was to assess the diet quality of women exercising in the "City Gym Program" according to age and nutritional status, in Aracajú, Sergipe, Brazil. METHODS: Sociodemographic, anthropometric and dietary data of 169 women were collected. The Diet Quality Index was calculated by taking the average of two 24-hour recalls. Total Diet Quality Index data and its components were analyzed according to BMI (obese and non-obese) and age (young adults and older adults). Descriptive statistical analysis and analysis of variance were done for comparing the mean Diet Quality Index score of the groups. RESULTS: SThe average age of the sample of 169 women was 49.24 years, of which 24.85% were obese and 43.20% had abdominal obesity. The average Diet Quality Index score was 66.64 points, with 90.60% of the population requiring dietary changes. Obese women consumed fewer vegetables than non-obese. Meanwhile, older adults had better scores regarding vegetable intake, dairy product intake and diet variety, and a better final score. CONCLUSION: The population presented poor eating habits, especially young and overweight women. Therefore, educational nutrition strategies are very important and highly recommended for the promotion of healthier lifestyles.

Perfil de saúde, estado nutricional e nível de conhecimento em nutrição de usuárias do Programa Academia da Cidade - Aracaju, SE / Profile of health, nutritional status and knowledge of level in nutrition Academia da Cidade Program of users - Aracaju, SE

Condições sócio-econômicas desfavoráveis, hábitos alimentares inadequados e sedentarismo representam fatores de risco para o desenvolvimento da obesidade e das doenças crônicas não transmissíveis na população. Assim, o objetivo desse estudo foi avaliar o perfil de saúde, o estado nutricional e o nível de conhecimento nutricional de mulheres praticantes de atividade física do Programa Academia da Cidade, Aracaju, SE. Foram coletados dados sócio-econômicos, condições de saúde, nutrição e conhecimento nutricional. O questionário é composto por 12 questões divididas por assunto em 3 grupos de perguntas. As medidas antropométricas aferidas foram massa corporal, estatura, perímetro da cintura e quadril. Foram avaliadas 191 usuárias do programa com média de idade de 51,9 (±9,02) anos, estando 75,4% com excesso de peso de acordo com o índice de massa corporal e 57,7 % com alto risco de desenvolvimento para doenças crônicas não transmissíveis, segundo a relação cintura-quadril. Foi observado que mulheres com maior gordura central (RCQ?0,85cm) apresentaram maior prevalência de hipertensão e diabetes (p<0,05). Cerca de 64,8 % da população apresentou conhecimento nutricional moderado com nota média de 7,0. Indivíduos com maior renda apresentaram notas significativamente maiores no conhecimento nutricional total e no grupo 2 de perguntas (alimentos fonte de fibras e gorduras) . A população estudada apresentou alta prevalência de sobrepeso e obesidade, colocando em risco seu quadro de saúde. O moderado conhecimento em nutrição e a obtenção de notas inferiores entre aqueles com menor renda mostra a necessidade do desenvolvimento de ações de educação nutricional nesta população para promoção de hábitos alimentares saudáveis.

Inadequate socioeconomic conditions, dietary habits and physical inactivity are risk factors for developing obesity and chronic diseases in population. Therefore, the aim of this study was to evaluate the health profile, nutritional status and nutritional knowledge level of women who practice physical activity from the Academia da Cidade Program, Aracaju, SE. Were collected socio-economics data, health and nutrition profiles, besides the application of a questionnaire of nutritional knowledge evaluation. The questionnaire consists of 12 questions divided by subject into three groups of questions. The anthropometric data measured were body weight, height, waist and hip circumference. Were evaluated 191 users of the program with a mean age of 51,9 years, being 45.1% overweight according to body mass index and 57.7% with high risk, according to waist-to-hip ratio risk for development of chronic diseases. Women with greater central fat (WHR ? 0.85 cm) showed a higher prevalence of hypertension and diabetes (p <0.05). About 64.8% of the population presented moderate nutritional knowledge with an average score of 7,0. Individuals with higher incomes had significantly higher scores of total nutrition knowledge and in group 2 (food source of fiber and fat) of questions. The studied population had high prevalence of overweight and abdominal obesity. The moderate knowledge in nutrition and getting lower scores among those with lower income shows the necessity of developing nutritional education activities in this population to promote healthy eating habits.

Características socioeconômicas e estado nutricional de crianças e adolescentes de assentamentos rurais de Pacatuba, Sergipe / Socio-economical characteristics and nutritional status of children and adolescents in rural settlements in Pacatuba, Sergipe

Nutritional evaluation is an essential tool for the measurement of population health status. The aim of the present study was to point out the socio-economic, dietary and anthropometric profiles in school-age residents of rural settlements in Pacatuba (State of Sergipe, Brazil). Nutritional status was assessed through Body Mass Index (BMI)/age (weight evaluation) and height/age (growth evaluation) using z-score. Food intake was assessed by a 24-hour recall method and analyzed using Dietary Reference Intakes. The participants included 145 children and teenagers, whose legal guardians had informal jobs (79%) (agriculture and handicraft) and received less than a minimum wage per month (82%), also 35% of the participant's mothers had attended school for less than 3 years. According to BMI/age and height/age indexes, the studied population presented a weight and growth deficit (children, 7.1%, and teenagers, 14.8%; P>0.05). According to gender, the girls presented a higher prevalence of weight deficit (P>0.05). The energy intake of children and teenagers was considered inadequate (72.6% and 63.9%, respectively, of the daily value recommendation). The analysis of micronutrients showed a high probability of inadequate consumption of iron, zinc, vitamin A and calcium in both studied groups. These findings indicate that the socioeconomic and nutritional status are factors which determine the nutritional situation of this population, thus justifying the relevance of the scholar's nutrition surveillance.

La evaluación del estado nutricional es un parámetro clave para medir la salud de una población. Este estudio tuvo como objetivo caracterizar el perfil socio-económico, dietético y antropométrico de estudiantes de una región de asentamientos rurales en la ciudad de Pacatuba, SE, Brasil. Para la evaluación del estado nutricional se adoptaron los índices IMC/I(evaluación ponderal) y talla/edad (evaluación del crecimiento) y para la clasificación, el escore Z. La evaluación del consumo alimentar se llevó a cabo por medio de la aplicación del recordatorio de 24 horas que fue analizado según las Ingestiones Dietéticas de Referencia. Fueron evaluados 145 niños y adolescentes y cuyos responsables: 79% tenían trabajos informales (jardinería y artesanía), 82% recibía menos de un salario mínimo al mes y 35% de las madres tenía menos de tres años de escolaridad. Según el índice IMC/A y T/E, el 10,3% de la población estudiada presentaba déficit ponderal y de estatura, siendo el 7,1% en los niños y el 14,8% en los adolescentes (p> 0,05). Cuando analizamos en relación al género, las niñas presentaron mayor prevalencia de déficit ponderal (p <0,05). El consumo de energía fue insuficiente para los niños y adolescentes que mostraron respectivamente solo el 72,6% y 63,9% de las necesidades diarias suplidas. Cuando evaluamos los micronutrientes se percibe una alta probabilidad de inadecuación de consumo de hierro, zinc, vitamina A y calcio en los dos grupos estudiados. Los resultados indican que las condiciones socio-económicas y el perfil alimentar son factores determinantes de la situación nutricional de esta población, justificando así la importancia de vigilar el estado nutricional de los estudiantes.

A avaliação da situação nutricional é um parâmetro essencial para aferição das condições de saúde de uma população. O presente estudo tem como objetivo caracterizar o perfil socioeconômico, dietético e antropométrico de escolares de uma região de assentamento rural no município de Pacatuba-SE. Na avaliação do estado nutricional, foram adotados os índices IMC/I (avaliação ponderal) e Altura/idade (avaliação do crescimento), utilizando a classificação por escore Z. A avaliação do consumo alimentar foi realizada através da aplicação do recordatório de 24h e analisada segundo as Ingestões Dietéticas de Referência. Foram avaliadas 145 crianças e adolescentes em que 79% dos seus responsáveis tinham trabalhos informais (roça e artesanatos), 82%recebiam menos de um salário mínimo por mês e 35% das mães tinham menos de três anos de escolaridade. Segundo os índices IMC/I e A/I,10,3% da população estudada apresentou déficit ponderal e estatural, sendo 7,1% em crianças e 14,8% em adolescentes (p>0,05). Quando os dados foram analisados quanto ao gênero, as meninas apresentaram maior prevalência de déficit ponderal (p<0,05). O consumo de energia foi insuficiente para crianças e adolescentes, apresentando, respectivamente, 72,6% e 63,9% das necessidades diárias. Quando avaliados os micronutrientes houve uma alta probabilidade de inadequação de consumo para ferro, zinco, vitamina A e cálcio para os dois grupos analisados. Os resultados apresentados indicam que as condições socioeconômicas e o perfil alimentar sejam fatores determinantes da situação nutricional desta população, justificando assim a importância da vigilância do estado nutricional de escolares.