Permanent health education actions in pandemic times: priorities in state and national contingency plans. / Ações de educação permanente em saúde em tempos de pandemia: prioridades nos planos estaduais e nacional de contingência.

OBJECTIVE: to assess permanent health education actions regarding the national and state contingency plans to face the COVID-19 pandemic in Brazil. METHOD: documentary research, using 54 plans in the initial and final versions, published between January 2020 and May 2021. The content analysis included the identification and systematization of proposals aimed at training and reorganizing the work process, as well as physical and mental health care of health workers. RESULTS: the actions were focused on training workers with an emphasis on flu syndrome, infection risk control measures and knowledge about biosafety. Few plans addressed the teams' working hours and work process, promotion and assistance to the workers' mental health, mainly in the hospital environment. CONCLUSION: the superficiality regarding the approach to permanent education actions in contingency plans need to include actions in the strategic agenda of the Ministry of Health and State and Municipal Health Secretariats, with the qualification of workers to face this and other epidemics. They propose the adoption of health protection and promotion measures in daily health work management within the scope of the SUS.

OBJETIVO: analisar ações de educação permanente em saúde nos Planos Nacional e Estaduais de Contingência para enfrentamento à pandemia de COVID-19 no Brasil. METODOLOGIA: pesquisa documental, com utilização de 54 planos nas versões iniciais e finais, publicados entre janeiro de 2020 e maio de 2021. A análise do conteúdo contemplou identificação e sistematização das propostas voltadas para capacitação e reorganização do processo de trabalho e cuidados à saúde física e mental dos trabalhadores de saúde. RESULTADOS: as ações voltaram-se à capacitação dos trabalhadores com ênfase em síndrome gripal, medidas de controle de riscos de infeção e conhecimento sobre biossegurança. Poucos planos abordaram jornadas e processo de trabalho das equipes, promoção e assistência à saúde mental dos trabalhadores principalmente no âmbito hospitalar. CONCLUSÃO: superficialidade nas abordagens das ações de educação permanente nos planos de contingência, necessidade de inclusão de ações na agenda estratégica do Ministério da Saúde e das secretarias estaduais e municipais de saúde com qualificação dos trabalhadores para enfrentar esta e outras epidemias. Propõe adoção de medidas de proteção e promoção da saúde no cotidiano da gestão do trabalho em saúde no âmbito do SUS.

Ações de educação permanente em saúde em tempos de pandemia: prioridades nos planos estaduais e nacional de contingência / Permanent health education actions in pandemic times: priorities in state and national contingency plans

Resumo Objetivo: analisar ações de educação permanente em saúde nos Planos Nacional e Estaduais de Contingência para enfrentamento à pandemia de COVID-19 no Brasil. Metodologia: pesquisa documental, com utilização de 54 planos nas versões iniciais e finais, publicados entre janeiro de 2020 e maio de 2021. A análise do conteúdo contemplou identificação e sistematização das propostas voltadas para capacitação e reorganização do processo de trabalho e cuidados à saúde física e mental dos trabalhadores de saúde. Resultados: as ações voltaram-se à capacitação dos trabalhadores com ênfase em síndrome gripal, medidas de controle de riscos de infeção e conhecimento sobre biossegurança. Poucos planos abordaram jornadas e processo de trabalho das equipes, promoção e assistência à saúde mental dos trabalhadores principalmente no âmbito hospitalar. Conclusão: superficialidade nas abordagens das ações de educação permanente nos planos de contingência, necessidade de inclusão de ações na agenda estratégica do Ministério da Saúde e das secretarias estaduais e municipais de saúde com qualificação dos trabalhadores para enfrentar esta e outras epidemias. Propõe adoção de medidas de proteção e promoção da saúde no cotidiano da gestão do trabalho em saúde no âmbito do SUS.

Abstract Objective: to assess permanent health education actions regarding the national and state contingency plans to face the COVID-19 pandemic in Brazil. Method: documentary research, using 54 plans in the initial and final versions, published between January 2020 and May 2021. The content analysis included the identification and systematization of proposals aimed at training and reorganizing the work process, as well as physical and mental health care of health workers. Results: the actions were focused on training workers with an emphasis on flu syndrome, infection risk control measures and knowledge about biosafety. Few plans addressed the teams' working hours and work process, promotion and assistance to the workers' mental health, mainly in the hospital environment. Conclusion: the superficiality regarding the approach to permanent education actions in contingency plans need to include actions in the strategic agenda of the Ministry of Health and State and Municipal Health Secretariats, with the qualification of workers to face this and other epidemics. They propose the adoption of health protection and promotion measures in daily health work management within the scope of the SUS.

Quercetin prevents insulin dysfunction in hypertensive animals.

Angiotensin II induced increase in hypertension enhances oxidative stress and compromises insulin action and pancreatic function. Quercetin-rich foods are beneficial for hypertensive and diabetic animals owing to their antioxidant function. The aim of this study was to evaluate the antioxidant effects of quercetin in hypertensive rats on insulin action, signaling, and secretion. Wistar rats were randomly divided into three groups: sham, hypertensive rats (H), and hypertensive rats supplemented with quercetin (HQ). After three months of initial hypertension, quercetin was administered at 50 mg/kg/day for 30 days. Our results indicate that hypertension and serum lipid peroxidation levels were reduced by quercetin supplementation. We observed increased insulin sensitivity in adipose tissue, corroborating the insulin tolerance test, HOMA index, and improvements in lipid profile. Despite normal insulin secretion at 2.8 and 20 mM of glucose, animals treated with quercetin exhibited increased number of islets per section; increased protein expression of muscarinic receptor type 3, VEGF, and catalase in islets; and hepatic mRNA levels of Ide were normalized. In conclusion, supplementation with quercetin improved insulin action and prevented pancreatic and metabolic dysfunction.

Mercury Contamination: A Growing Threat to Riverine and Urban Communities in the Brazilian Amazon.

In recent decades, widespread and uncontrolled use of mercury (Hg) in artisanal small-scale gold mining has released thousands of tons of mercury-contaminated waste in the Amazon biome, endangering the largest tropical rainforest worldwide. In this study, we assessed and compared blood Hg levels in individuals living in urban and riverine areas in the lower Tapajós basin and examined the association between Hg exposure and specific biochemical parameters. In total, 462 adults from eight riverine communities and one urban area were assessed. Overall, 75.6% of the participants exhibited Hg concentrations exceeding the safe limit (10 µg/L). Hg exposure was higher in the riverine population (90%) than in urban areas (57.1%). Mean Hg levels were 21.8 ± 30.9 µg/L and 50.6 µg/L in urban and riverine residents, respectively. The mean Hg level was higher in those aged 41-60 years in both urban and riparian areas, with riparian residents exhibiting a mean double that of urban residents. The highest glucose and hepatic biomarker levels were detected in the urban area, whereas the highest levels of renal biomarker occurred in the riverine population. Our results indicate that Hg contamination remains a persistent challenge for the urban population of Santarém, a major city in the Brazilian Amazon.

[Role of dairy and alternative plant products in a healthy and sustainable diet]. / Rol de los lácteos y de las alternativas vegetales en una alimentación saludable y sostenible.

INTRODUCTION: Dairy products and plant alternatives are two food groups that are part of the Spanish population's diet. Both have a very different nutritional composition - unlike plant products, the high nutritional density of dairy products makes it easier to meet nutrient requirements at different stages of life. Although the environmental impact of dairy production is greater than that of plant-based products, it falls below that of other food groups such as red meat, including pork and beef. Dairy and plant alternatives meet critical points of the sustainable diet definition, and several food guides from countries around the world are including them within healthy and sustainable eating patterns. For this reason, it is necessary to clarify that both products can be part of a healthy and sustainable diet, although they belong to different food groups, which are not interchangeable and should not be used alternatively.

INTRODUCCIÓN: Los productos lácteos y las alternativas vegetales son dos grupos de alimentos que forman parte de la dieta de la población española. Estos alimentos tienen una composición nutricional muy diferente: a diferencia de los productos vegetales, la elevada densidad nutricional de los productos lácteos hace que sea más fácil cubrir los requerimientos de nutrientes en las diferentes etapas de la vida. Por otro lado, a pesar de que el impacto sobre el medioambiente de la producción de los lácteos es mayor que el de los productos de origen vegetal, queda por debajo del de otros grupos de alimentos como la carne roja, el cerdo o el vacuno. Por ese motivo, ambos grupos de alimentos cumplen con varios puntos críticos de la definición de alimentos sostenibles y cada vez son más las guías alimentarias de países de todo el mundo que los incluyen dentro de los patrones de alimentación saludable y sostenible. Por este motivo, es necesario clarificar que ambos productos pueden formar parte de una alimentación correcta, saludable y sostenible, aunque pertenecen a grupos de alimentos distintos, que no son intercambiables y no deben utilizarse de manera alternativa.

Rol de los lácteos y de las alternativas vegetales en una alimentación saludable y sostenible / Role of dairy and alternative plant products in a healthy and sustainable diet

Los productos lácteos y las alternativas vegetales son dos grupos de alimentos que forman parte de la dieta de la población española. Estos alimentos tienen una composición nutricional muy diferente: a diferencia de los productos vegetales, la elevada densidad nutricional de los productos lácteos hace que sea más fácil cubrir los requerimientos de nutrientes en las diferentes etapas de la vida. Por otro lado, a pesar de que el impacto sobre el medioambiente de la producción de los lácteos es mayor que el de los productos de origen vegetal, queda por debajo del de otros grupos de alimentos como la carne roja, el cerdo o el vacuno. Por ese motivo, ambos grupos de alimentos cumplen con varios puntos críticos de la definición de alimentos sostenibles y cada vez son más las guías alimentarias de países de todo el mundo que los incluyen dentro de los patrones de alimentación saludable y sostenible. Por este motivo, es necesario clarificar que ambos productos pueden formar parte de una alimentación correcta, saludable y sostenible, aunque pertenecen a grupos de alimentos distintos, que no son intercambiables y no deben utilizarse de manera alternativa. (AU)

Dairy products and plant alternatives are two food groups that are part of the Spanish population's diet. Both have a very different nutritional composition - unlike plant products, the high nutritional density of dairy products makes it easier to meet nutrient requirements at different stages of life. Although the environmental impact of dairy production is greater than that of plant-based products, it falls below that of other food groups such as red meat, including pork and beef. Dairy and plant alternatives meet critical points of the sustainable diet definition, and several food guides from countries around the world are including them within healthy and sustainable eating patterns. For this reason, it is necessary to clarify that both products can be part of a healthy and sustainable diet, although they belong to different food groups, which are not interchangeable and should not be used alternatively. (AU)

Motivating Self-Efficacy in Diverse Biomedical Science Post-baccalaureate and Graduate Students Through Scientific Conference Implementation.

Tactics to increase the number of underrepresented (UR) students in biomedical research PhD training programs have not yet translated to UR faculty numbers that reflect the diversity of the United States. Continued interventions are required to build skills beyond those that result in placement into a PhD program. We hypothesize that successful interventions must build skills that give UR students foundations for confident self-efficacy in leadership. We seek interventions that allow UR students to envision themselves as successful faculty. We posit that development of such skills is difficult in the classroom or laboratory alone. Therefore, novel interventions are required. As part of the NIH-funded Post-baccalaureate Research Education Program (PREP) and Initiative for Maximizing Student Development (IMSD) at the Mayo Clinic Graduate School of Biomedical Sciences, we designed and implemented a unique intervention to support development of student leadership skills: a biannual student-organized and student-led national research conference titled "Scientific Innovation Through Diverse Perspectives" (SITDP). This initiative is based on the concept that students who actively live out realistic roles as scientific leaders will be encouraged to persist to scientific leadership as faculty. Here we describe the motivation for, design of, and outcomes from, the first three pilot conferences of this series. We further discuss approaches needed to rigorously evaluate the effectiveness of such interventions in the future.

Effect of chocolate and mate tea on the lipid profile of individuals with HIV/AIDS on antiretroviral therapy: A clinical trial.

OBJECTIVE: HIV/AIDS is generally associated with dyslipidemia and oxidative imbalance, which are caused by the infection itself and by antiretroviral therapy (ART). The flavonoids, found in cocoa and yerba mate, have antioxidant and hypolipidemic properties. The aim of this study was to evaluate the effects of the consumption of dark chocolate and mate tea on the lipid profiles of individuals with HIV/AIDS who are undergoing ART. METHODS: A randomized, double-blind, placebo-controlled crossover clinical trial was conducted with 92 patients receiving ART for ≥6 mo and with viral suppression. The participants were randomized to receive either 65 g of chocolate (with 2148 mg polyphenols) or placebo chocolate (without polyphenols) or 3 g of mate tea (with 107 mg total phenols and 84.24 mg chlorogenic acid) or placebo mate (without polyphenols) for 15 d each, separated by a washout period of 15 d. The lipid profile, including determination of electronegative low-density lipoprotein, was determined after each intervention. The data were analyzed by analysis of variance using the pkcross procedure of the Stata 11.0 software. RESULTS: Analysis of variance revealed a significant overall difference in mean high-density lipoprotein cholesterol (HDL-C) between all supplements (P = 0.047). Using the paired t test, the effect was attributed to the consumption of dark chocolate (P = 0.046). The other parameters investigated were not improved. CONCLUSIONS: The consumption of dark chocolate for 15 d improved HDL-C concentrations of individuals with HIV/AIDS undergoing ART, possibly due to the presence of fatty acids (stearic acid), polyphenols, and theobromine. This fact is important for the cardiovascular protection of these individuals.

The impact of dark chocolate intake on arterial elasticity in individuals with HIV/AIDS undergoing ART: a randomized, double-blind, crossover trial.

An increase in the frequency of cardiovascular diseases has been observed in the HIV/AIDS population. Studies involving healthy subjects or subjects with other diseases have shown benefits of chocolate supplementation on endothelial function and vasodilation. We evaluate the impact of chocolate consumption on arterial elasticity in people living with human immunodeficiency virus - PLHIV. A double-blind, crossover trial including 110 PLHIV (19 to 59 years) on antiretroviral therapy - ART for at least 6 months and with a viral load of <500 copies per mL was conducted. All subjects were randomly assigned to 15-d dietary supplements containing dark chocolate or placebo with a 15-d washout period. Each participant received one of the two sequences: A (dark chocolate, placebo chocolate); B (placebo chocolate, dark chocolate). Arterial elasticity was measured using the HDI/PulseWave™ CR-2000 CardioVascular Profiling System®. Body composition, lipid profile, C-reactive protein, and thiobarbituric acid reactive substances were also assessed. Analysis of variance (ANOVA) for repeated measures using the Stata 11.0® program was used for cross-over analysis. Most subjects were men (59.0%) and Caucasian (46.1%) and the mean age was 44.6 ± 7.1 years. The mean time since diagnosis of HIV infection was 13.7 ± 5.3 years and the mean duration of ART was 12.9 ± 4.2 years. Chocolate consumption resulted in significant alterations in the large artery elasticity index - LAEI (p = 0.049) and the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.045). This is the first study to evaluate the effect of chocolate on arterial elasticity in PLHIV. The results showed that dark chocolate consumption for 15 days improved the elastic properties of the LAEI in PLHIV. These findings, added to the noninvasive method used, may expand the knowledge of CVDs in this population.

Effect of Chocolate and Yerba Mate Phenolic Compounds on Inflammatory and Oxidative Biomarkers in HIV/AIDS Individuals.

Flavonoids in cocoa and yerba mate have a beneficial role on inflammation and oxidative disorders. Their effect on HIV individuals has not been studied yet, despite the high cardiovascular risk of this population. This study investigated the role of cocoa and yerba mate consumption on oxidative and inflammatory biomarkers in HIV+ individuals. A cross-over, placebo-controlled, double-blind, randomized clinical trial was conducted in 92 individuals on antiretroviral therapy for at least six months and at viral suppression. Participants were randomized to receive either 65 g of chocolate or chocolate-placebo or 3 g of yerba mate or mate-placebo for 15 days each, alternating by a washout period of 15 days. At baseline, and at the end of each intervention regimen, data regarding anthropometry, inflammatory, oxidative and immunological parameters were collected. High-sensitivity C-reactive protein, fibrinogen, lipid profile, white blood cell profile and thiobarbituric acid reactive substances were assessed. There was a difference between mean concentrations of HDL-c (ANOVA; p ≤ 0.05) among the different regimens: dark chocolate, chocolate-placebo, yerba mate and mate-placebo. When a paired Student t-test was used for comparisons between mean HDL-c at baseline and after each regimen, the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.008).

Influence of hormonal variation on periodontal tissues during premenstrual and preovulatory periods

The aim of this work was to evaluate the hormonal influence on periodontal tissues in two moments: premenstrual and preovulatory, in women whose are in the reproductive phase between 18 and 45 years. The sample is composed by 30 women, who were analyzed following the inclusion criteria as: not pregnant women, who are not using contraceptive or other means of hormonal replacement, who were not in the menopause and who did not present systemic diseases. The periodontal exams were accomplished in two periods: premenstrual and preovulatory, when it was verified blee din gon probing (BOP) and probing depth (PD) indexes. The premenstrual period obtained greater bleeding on probing index when compared with preovulatory period, showing a statistically significant difference. However, in spite of the probing depth measurements have been greater in the premenstrual period (1.684±0.4728) than in the preovulatoryone (1.679 ± 0.4749); the differences were not statistically significant. Basin gon the resultsand according to the methodology used, it was possible conclude that the hormonal variation influences on periodontal tissues.

Lipid profile of HIV-infected patients in relation to antiretroviral therapy: a review.

This study reviewed the lipid profile of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in relation to use of antiretroviral therapy (ART), and its different classes of drugs. A total of 190 articles published in peer-reviewed journals were retrieved from PubMed and LILACS databases; 88 of them met the selection criteria and were included in the review. Patients with HIV/AIDS without ART presented an increase of triglycerides and decreases of total cholesterol, low density lipoprotein (LDL-c), and high density lipoprotein (HDL-c) levels. Distinct ART regimens appear to promote different alterations in lipid metabolism. Protease inhibitors, particularly indinavir and lopinavir, were commonly associated with hypercholesterolemia, high LDL-c, low HDL-c, and hypertriglyceridemia. The protease inhibitor atazanavir is apparently associated with a more advantageous lipid profile. Some nucleoside reverse-transcriptase inhibitors (didanosine, stavudine, and zidovudine) induced lipoatrophy and hypertriglyceridemia, whereas abacavir increased the risk of cardiovascular diseases even in the absence of apparent lipid disorders, and tenofovir resulted in lower levels of cholesterol and triglycerides. Although non-nucleoside reverse-transcriptase inhibitors predisposed to hypertriglyceridemia and hypercholesterolemia, nevirapine was particularly associated with high HDL-c levels, a protective factor against cardiovascular diseases. Therefore, the infection itself, different classes of drugs, and some drugs from the same class of ART appear to exert distinct alterations in lipid metabolism.

Lipid profile of HIV-infected patients in relation to antiretroviral therapy: a review / Perfil lipídico de pacientes infectados pelo HIV em relação à terapia antirretroviral: uma revisão

This study reviewed the lipid profile of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in relation to use of antiretroviral therapy (ART), and its different classes of drugs. A total of 190 articles published in peer-reviewed journals were retrieved from PubMed and LILACS databases; 88 of them met the selection criteria and were included in the review. Patients with HIV/AIDS without ART presented an increase of triglycerides and decreases of total cholesterol, low density lipoprotein (LDL-c), and high density lipoprotein (HDL-c) levels. Distinct ART regimens appear to promote different alterations in lipid metabolism. Protease inhibitors, particularly indinavir and lopinavir, were commonly associated with hypercholesterolemia, high LDL-c, low HDL-c, and hypertriglyceridemia. The protease inhibitor atazanavir is apparently associated with a more advantageous lipid profile. Some nucleoside reverse-transcriptase inhibitors (didanosine, stavudine, and zidovudine) induced lipoatrophy and hypertriglyceridemia, whereas abacavir increased the risk of cardiovascular diseases even in the absence of apparent lipid disorders, and tenofovir resulted in lower levels of cholesterol and triglycerides. Although non-nucleoside reverse-transcriptase inhibitors predisposed to hypertriglyceridemia and hypercholesterolemia, nevirapine was particularly associated with high HDL-c levels, a protective factor against cardiovascular diseases. Therefore, the infection itself, different classes of drugs, and some drugs from the same class of ART appear to exert distinct alterations in lipid metabolism.

Este estudo faz uma revisão sobre o perfil lipídico de pacientes com vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida (HIV/AIDS) em relação ao uso da terapia antirretroviral (TARV), e suas diferentes classes de fármacos. Um total de 190 artigos publicados em revistas indexadas foram selecionados das bases de dados PubMed e LILACS; 88 deles preencheram os critérios de seleção e foram incluídos nesta revisão. Pacientes com HIV/AIDS sem uso de TARV apresentaram aumento de triglicérides e diminuição dos níveis de colesterol total, lipoproteína de baixa densidade (LDL-c) e lipoproteína de alta densidade (HDL-c). Distintos regimes de TARV promoveram diferentes alterações no metabolismo lipídico. Inibidores de protease, particularmente indinavir e lopinavir, foram comumente associados com hipercolesterolemia, aumento de LDL-c, diminuição de HDL-c e hipertrigliceridemia. O inibidor de protease atazanavir aparentemente está associado a menores alterações do perfil lipídico. Alguns inibidores da transcripitase reversa análogos de nucleosídeos (didanosina, estavudina e zidovudina), induziram lipoatrofia e hipertrigliceridemia, enquanto o abacavir aumentou o risco cardiovascular mesmo na ausência de aparentes distúrbios lipídicos, e o tenofovir resultou em menores níveis de colesterol e triglicérides. Embora os inibidores da transcriptase reversa não análogos de nucleosídeos possam predispor a hipertrigliceridemia e hipercolesterolemia, a nevirapina, particularmente, foi associada a maiores níveis de HDL-c, um fator de proteção contra doenças cardiovasculares. Portanto, a própria infecção, diferentes classes de fármacos e alguns fármacos da mesma classe de TARV podem exercer distintas alterações no metabolismo lipídico.

Efeito da ingestão de chocolate e erva mate no perfil lipídico e oxidativo de indivíduos com HIV/AIDS em uso de terapia antirretroviral / Effect of chocolate and yerba mate consumption on lipid and oxidative profile of individuals with HIV/AIDS on antiretroviral therapy

Introdução: Atualmente observa-se aumento das complicações cardiovasculares, como alterações no perfil lipídico e oxidativo, em indivíduos com HIV/AIDS, devido à própria infecção, bem como aos diferentes componentes da terapia antirretroviral (TARV). Vários estudos, em outras populações, mostram que os flavonóides presentes no cacau (Theobroma cacao) e erva mate (Ilex paraguariensis) podem melhorar a função cardiovascular devido às suas propriedades antioxidantes e hipolipemiantes. Objetivo: Avaliar o efeito da ingestão de chocolate e erva mate no perfil lipídico e oxidativo de indivíduos com HIV/AIDS em TARV. Metodologia: Ensaio clínico do tipo cross-over, aleatorizado, cego e controlado com placebo envolvendo 89 voluntários, de 28-59 anos de idade, em tratamento regular com TARV por, no mínimo, seis meses e com carga viral <500 cópias/mL. Os voluntários consumiram 65g de chocolate em barra (chocolate preto contendo 36g de cacau e placebo) e 3g de chá (erva mate solúvel e placebo) por 15 dias cada, seguido por 15 dias de washout entre cada período de suplementação. Foram avaliadas as seguintes características: perfil demográfico e socio-econômico, variáveis antropométricas, imunológicas, prática de atividade física, perfil lipídico (colesterol total, LDL-c, HDL-c, não HDL-c, triacilgliceróis e índices de Castelli I e II), e oxidação lipídica (LDL eletronegativa e substâncias reativas ao ácido tiobarbitúrico-TBARS). As análises estatísticas do cross-over foram realizadas através de análises de variância (ANOVA) utilizando o procedimento pkcross no software Stata versão 11.0. Também se realizou teste t de Student pareado entre os parâmetros no baseline e após consumo dos suplementos de interesse (chocolate preto e erva mate). Considerou-se significante p<0,05.Resultados: Os pacientes eram na maioria do sexo masculino (62,9 por cento), com média de idade de 44,6 (±7,1) anos. Observou-se média de 13,2 (±4,8) anos de diagnóstico de HIV/AIDS, com 10,6 (±5,1) anos de uso de TARV. Não houve diferença significativa comparando as médias das variáveis do perfil lipídico e oxidativo entre as diferentes suplementações (chocolate preto, erva mate e placebos) por ANOVA. Entretanto, na comparação entre as variáveis no baseline e após consumo de chocolate preto, pelo teste t de Student pareado, observou-se aumento de colesterol total (p=0,005), HDL-c (p=0,019) e LDL-c (p=0,002).