Weight loss-what's the most effective diet type?: a scoping review / Pérdida de peso-¿cuál es el tipo de dieta más eficaz?: una revisión sistemática exploratoria

OBJECTIVE: To evaluate which type of diet is most effective for weight loss. METHODS: Relevant studies for this type of review were identified from March to May 2018 by several sources, in the electronic databases PubMed, CINAHL, Scielo, SCOPUS, Web of Science, BVS Portal, EMBASE and Cochrane Library. For gray literature, Open Green and Base search and hand search repositories, which is a free search for materials that address the subject were searched. RESULTS: The selected publications totaled 537, of which 104 were from the electronic databases and 433 records identified through other databases. After the removal of duplicates, 113 titles and abstracts and 37 complete texts were selected, after reading the articles in full, 14 articles were selected for inclusion in this review. Out of the 14 articles analyzed, relevant results were presented for a diet rich in fruits and vegetables; oleaginous, especially nuts; a Mediterranean diet was noted in three studies; dietary guidelines based on guides was mentioned in two studies and a high-protein diet was cited four times. CONCLUSION: The most effective diet for weight loss was the high fiber diet, although it contributes with small percentage value.

OBJETIVO: evaluar qué tipo de dieta es la más efectiva para perder peso. MÉTODOS: los estudios relevantes para este tipo de revisión fueron identificados de marzo a mayo de 2018 por varias fuentes, en las bases de datos electrónicas PubMed, CINAHL, Scielo, SCOPUS, Web of Science, BVS Portal, EMBASE y Cochrane Library en la literatura gris Open Creen y Base de búsqueda y repositorios de búsqueda manual, que es una búsqueda gratuita de materiales que tratan el tema. RESULTADOS: Las publicaciones seleccionadas totalizaron 537, de las cuales 104 eran de las bases de datos electrónicas y 433 registros identificados a través de otras bases de datos. Después de la eliminación de los artículos duplicados, se seleccionaron 113 títulos y resúmenes y 37 textos completos; después de leer los artículos completos, se seleccionaron 14 artículos para su inclusión en esta revisión. De los 14 artículos analizados se presentaron resultados relevantes para una dieta rica en frutas y verduras; oleaginoso, especialmente los frutos secos; Dieta mediterránea en tres estudios; Pautas dietéticas basadas en guías dietéticas, presentes en dos estudios y dieta hiperproteica, citadas cuatro veces. CONCLUSIÓN: la dieta más efectiva para perder peso es la dieta alta en fibra, aunque contribuye con un pequeño valor porcentual.

Dietary patterns and metabolic phenotypes in Brazilian adults: a population-based cross-sectional study.

OBJECTIVE: Dietary patterns have been pointed out as useful diet quality indicators, but evidence about their relationship to metabolic phenotypes is still scarce. Thus, the present study aimed to verify the relationship between dietary patterns and metabolic phenotypes in Brazilian adults. DESIGN: Cross-sectional study. A food consumption frequency questionnaire assessed food consumption profiles. Metabolic phenotypes were defined based on the criteria of the National Health and Nutrition Examination Survey: overweight or normal weight and metabolically healthy (MHOW and MHNW) or unhealthy (MUOW and MUNW). Dietary patterns were established through exploratory factor analysis and principal component analysis. The associations were tested using multinomial logistic regression. SETTING: Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Individuals (n 896) aged 20-59 years of both sexes, selected using probabilistic sampling. RESULTS: Three dietary patterns were identified: Unhealthy pattern (alcoholic beverages, oils and fats, condiments, soda and juice, sugars and sweets, snacks, and meat and derivatives), Traditional pattern (culinary preparations, beans, milk and dairy products, and coffee and tea) and Healthy pattern (vegetables and fruits, whole grains, chicken and fish, and skimmed milk). Unhealthy pattern was positively associated with the MHOW and MUOW phenotypes in the fourth quartile (OR = 1·84; 95 % CI 1·06, 3·22) and in the third (OR = 1·94; 95 % CI 1·11, 3·39) and fourth (OR = 2·56; 95 % CI 1·41, 4·64) quartiles of consumption, respectively. Healthy pattern was also associated with these phenotypes. CONCLUSIONS: Both the pattern comprising energy-dense foods and the healthier pattern were associated with overweight phenotypes among Brazilian adults.

Revisitando a puboplastia pós-bariátrica / Revisiting Postbariatric Monsplasty

INTRODUÇÃO: O tratamento da região pubiana é parte integrante do reajuste corporal inferior nos pacientes pós-bariátricos, tendo em vista a fisiopatologia e o caráter generalizado das deformidades de contorno após grandes emagrecimentos. O objetivo é apresentar nossa experiência no tratamento de pacientes pós-bariátricos, exclusivamente pela marcação baixa da abdominoplastia com vetores adequados de mobilização tecidual, sem a necessidade de cicatrizes verticais ou oblíquas na região do púbis. MÉTODOS: Foram avaliados retrospectivamente prontuários médicos e registros fotográficos de pacientes submetidos a diferentes abordagens abdominais, com aplicação dos princípios descritos acima no tratamento associado da região pubiana. Incisão cutânea anterior baixa, descolamento cranial angulado em direção ao plano aponeurótico (bisel preservando gordura profunda superior), e manutenção um excedente gorduroso nos bordos superiores para a facilitar a fixação dos retalhos através do Sistema Fascial Superficial. Uma avaliação subjetiva da qualidade dos resultados foi caracterizada por observador único. RESULTADOS: Numa casuística de 126 pacientes consecutivos, a tática empregada possibilitou restabelecer a melhor posição, tônus e formato do púbis em 100% dos casos, cujos resultados foram subjetivamente classificados como bom (40%) ou ótimo (60%). As intercorrências mais frequentemente encontradas na evolução pós-operatória foram pequenas deiscências da sutura (23,8%) e seromas (19%), com boa evolução pelos curativos e punções seriadas. CONCLUSÃO: A tática cirúrgica apresentada, com posicionamento baixo da incisão anterior e aproximação dos retalhos por fixação no sistema fascial superficial e pele, possibilita o tratamento adequado da região pubiana durante as abdominoplastias pós-bariátricas, sem a necessidade de ressecções e cicatrizes adicionais.

INTRODUCTION: The treatment of the pubic region is an integral part of lower body readjustment in post-bariatric patients, considering the pathophysiology and generalized characteristics of contour deformities after a considerable weight loss. The objective is to present our experience in the treatment of post-bariatric patients, exclusively by low marking of abdominoplasty with appropriate tissue mobilization vectors, without the necessity to leave vertical or oblique scars in the pubic region. METHODS: The medical and photographic records of patients subjected to different abdominal approaches were retrospectively evaluated, applying the principles described above in the combined treatment of the pubic region. A low anterior skin incision was created, and angled cranial detachment towards the aponeurotic plane (with the bevel preserving the deep upper fat) and maintenance of excess fat on the upper edges to facilitate the fixation of the flaps through the superficial fascial system were performed. The outcomes' quality was subjectively evaluated by a single observer. RESULTS: In the case series of 126 consecutive patients, the strategy used restored the best position, tone, and shape of the pubis in 100% of the cases; the results were subjectively classified as good (40%) or very good (60%). The complications more frequently found in the post-operative period were small suture dehiscence (23.8%) and seroma formation (19%), with good evolution provided by dressings and serial punctures. CONCLUSION: The surgical strategy presented involving low positioning of the anterior incision and flap alignment in the superficial fascial system and skin by fixation allows the proper treatment of the pubic region during post-bariatric abdominoplasty procedures, without the need for additional resections and scars.