Eating behavior and nutritional status in patients who underwent coronary angioplasty

Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty). It was realized comparison of averages by analysis of variance or Student's test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04), higher consumption of calories (p = 0.04), meat/eggs (p = 0.01) and sweets (p = 0.03) in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13), although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.

Dyslipidemia: evidence of efficacy of the pharmacological and non-pharmacological treatment in the elderly

The clinical decision to control risk factors for cardiovascular disease (CVD) in the elderly takes the followings into consideration: (1) the elderly life expectancy; (2) the elderly biological age and functional capacity; (3) the role of cardiovascular disease in the elderly group; (4) the prevalence of risk factors in the elderly; and (5) The effectiveness of treatment of risk factors in the elderly. A large number of studies showed the efficacy of secondary and primary prevention of dyslipidemia in the elderly. However, the only trial that included patients over 80 years was the Heart Protection Study (HPS). Statins are considered the first line therapy for lowering low-density lipoprotein cholesterol (LDL-C). Because lifestyle changes are very difficult to achieve, doctors in general tend to prescribe many drugs to control cardiovascular risk factors. However, healthy food consumption remains a cornerstone in primary and secondary cardiovascular prevention and should be implemented by everyone.

Urinary acidifier in diet with high excess base for adult cats

Maintaining the pH of urine in the ideal range (6.2 - 6.4) is of great importance for health promotion in the lower urinary tract of cats. In the economic and standard feed sector this is a major concern, given that the animal urine tends to be alkaline after food consumption of those commercial segments, which predispose to the formation of struvite urolith. Therefore, this study aimed to study the effects of increasing levels of urinary acidifiers (0.0%, 0.3%, 0.6% and 0.9%, on a dry matter base) in feed with high excess base over the acid-basic balance in the organism, apparent digestibility coefficients of nutrients, urinary pH, hydro-electrolyte balance in cats, as well as the adequacy of equations proposed in the literature to estimate the urinary pH. Twenty-four adult cats, males and females were distributed in a completely randomized design, consisting of six animals per treatment. The dry matter content of urine presented a quadratic behavior (p<0,05; y = 9.5863 + 3.2299x + 0.7871x2 R2 = 99,91%), HCO3-, total CO2 and excess blood base during the period in which the animals were fed were high when including 0.9% acidifier compared to 0.6% (p<0.05). In contrast, the use of the additive did not change the urinary pH, blood electrolyte concentration, nutrient digestibility, fecal score, food and water intake (p>0.05). The equations proposed in the literature, which use excess of base in feed to estimate urinary pH, overestimated the pH values found in this study.

Densidade energética da dieta e fatores associados: como está a população de São Paulo?

OBJETIVO: Avaliar a densidade energética da dieta de adultos do município de São Paulo e fatores associados. SUJEITOS E MÉTODOS: Participantes do estudo ISA-Capital, com amostragem probabilística (n = 710 adultos). O consumo alimentar foi avaliado pelo R24h. As correlações foram investigadas pelo coeficiente de correlação de Pearson. As associações com dados demográficos, socioeconômicos e de estilo de vida foram investigadas por modelos de regressão multivariados. RESULTADOS: A densidade energética média foi 1,98 kcal/g (IC95% [1,94; 2,01]) e correlacionou-se positivamente com a ingestão de energia, gordura, carboidrato, colesterol, gordura saturada, sacarose, gordura trans e açúcar adicionado e negativamente com fibras. Apenas idade e hábito de fumar apresentaram associação com a densidade energética. CONCLUSÕES: Os valores elevados da densidade energética da dieta e a relação demonstrada com outros constituintes nutricionais denotam má qualidade da dieta nessa população, o que pode estar contribuindo para crescentes taxas de excesso de peso. Arq Bras Endocrinol Metab. 2012;56(9):638-45

Mudanças no consumo alimentar e atividade física de escolares de Florianópolis, SC, 2002 - 2007

OBJETIVO: Avaliar a mudança em cinco anos do consumo alimentar e nível de atividade física em escolares. MÉTODOS: Estudo com amostra representativa (n = 4.168) de escolares de sete a dez anos de idade de Florianópolis, SC. Medidas do consumo alimentar e atividade física foram realizadas em dois estudos de base escolar em 2002 (n = 2.936; 51% meninos; idade média = 8,5 anos) e 2007 (n = 1.232; 50,7% meninos; idade média = 8,6 anos), utilizando questionários ilustrados. O teste do qui-quadrado foi utilizado para avaliar a mudança no consumo de oito alimentos/grupos de alimentos, no atendimento às recomendações do Guia Alimentar para a População Brasileira e no nível de atividade física (avaliado segundo os terços de distribuição do escore e o tipo de deslocamento para a escola). As análises foram realizadas segundo a rede de ensino. RESULTADOS: Houve redução da proporção de crianças que relatou o consumo de frutas, verduras e legumes, feijão, carnes, guloseimas, pizza, batata frita e refrigerantes. Maior proporção de escolares da rede privada atendeu às recomendações de restrição de consumo de refrigerantes, pizzas e batata frita, e de maior consumo de frutas, verduras e legumes, em ambos os estudos. Por outro lado, maior proporção de escolares da rede pública atendeu às recomendações para o consumo de carnes em 2007. Os valores medianos do escore de atividade física diminuíram em 2007. Em ambos os anos escolares da rede privada foram mais ativos. A proporção de escolares que se deslocou ativamente para a escola reduziu de 49% para 41% (p < 0,01). CONCLUSÕES: Houve redução no consumo de alimentos marcadores de dieta saudável (feijão, carnes/peixes, frutas, legumes e verduras) e de alimentos de alta densidade energética e baixo valor nutricional (refrigerantes, guloseimas e pizza/batatas fritas). Também houve decréscimo da proporção de escolares que relataram deslocamento ativo para a escola.

Estado nutricional e consumo de energia e nutrientes de pré-escolares que frequentam creches no município de Manaus, Amazonas: existem diferenças entre creches públicas e privadas?

OBJETIVO: Verificar o estado nutricional e o consumo alimentar de crianças assistidas em creches públicas e privadas no município de Manaus, Amazonas. MÉTODOS: Foram avaliadas crianças entre 24 e 72 meses de duas creches públicas (n=217) e duas creches privadas (n=91) de Manaus. O estado nutricional foi classificado pelos índices peso para idade, peso para estatura, estatura para idade e índice de massa corporal (IMC) para idade, em valores de escores Z. O consumo alimentar na creche foi avaliado pelo método da pesagem direta individual dos alimentos e, no domicílio, pelo registro alimentar de um dia aplicado aos responsáveis. Estimou-se a frequência de crianças com ingestão de nutrientes acima ou abaixo dos pontos de corte de Estimated Average Intake (EAR) ou Adequate Intake (AI). RESULTADOS: Verificou-se maior frequência de crianças com excesso de peso nas creches privadas segundo os índices peso para estatura e IMC para idade. As crianças das instituições públicas, quando comparadas àquelas das privadas, consumiram mais gorduras poli-insaturadas, trans, ácido graxo ômega-6, vitamina C e sódio, e menos zinco. Em ambos os tipos de creches observaram-se consumo elevado de energia e proporção elevada de crianças com consumo de vitaminas A e C, zinco e sódio acima do limite superior tolerável de ingestão. A proporção de crianças com inadequação de consumo de cálcio foi maior nas creches públicas do que nas privadas (27,6 versus 7,9%; p<0,001). CONCLUSÕES: O consumo de energia e de sódio foi elevado em ambos os tipos de creche e o consumo de cálcio, insuficiente, principalmente nas creches públicas. Recomenda-se melhor monitoramento da dieta infantil para prevenção de doenças futuras.

Substituição de refeições por lanches em adolescentes

OBJETIVO: Verificar a prevalência da substituição do almoço e do jantar por lanches em adolescentes e a associação com estado nutricional e sexo, assim como avaliar os alimentos que substituem as refeições. MÉTODOS: Estudo transversal com 106 adolescentes do ensino médio de uma escola técnica localizada no município de São Paulo, que responderam a um questionário sobre atitudes alimentares a partir do qual foi avaliada a frequência de substituição do almoço e do jantar por lanche e os alimentos substitutos. Foram aferidos o peso e a altura para o cálculo do índice de massa corpórea por idade, e a classificação do estado nutricional de acordo com o critério da Organização Mundial da Saúde. Foi realizada análise descritiva com nível de significância de 5%. RESULTADOS: Um terço dos adolescentes substituiu o almoço e metade deles substituiu o jantar por lanches. Verificou-se que mais meninas costumavam substituir refeições. Observou-se maior prevalência de substituição do almoço (40%) e do jantar (70%) por lanche entre adolescentes obesos. Sanduíches, salgados, pizzas e hambúrgueres foram os principais substitutos das refeições. CONCLUSÕES: Verificou-se prevalência elevada de substituição de refeições principais, principalmente do jantar, por lanches. Os substitutos do almoço e do jantar apresentavam, em sua maioria, alta densidade energética e baixo valor nutritivo.

Estado nutricional e consumo alimentar de pacientes com psoríase dos tipos sistêmica e artropática sistêmica associada

OBJECTIVE: To identify the nutritional status and food intake of individuals with systemic psoriasis and psoriatic arthritis associated. METHODS: This is an exploratory and cross-sectional study with 34 men aged between 19 and 60 years seen at a Psoriasis Center. Participants were divided into systemic psoriasis group and arthritic-systemic psoriasis associated group. For nutritional assessment we used anthropometry, bioelectrical impedance analysis and whole-body plethysmography. Clinical and nutritional information were assessed using the clinical and nutritional history-taking, and the 24-hour dietary recall. For statistics the general linear model test (p < 0.05) was used. RESULTS: According to the body mass index 29.4% patients (n = 10) were eutrophic, 41.2% (n = 14) overweight and 29% (n = 10) obese. Almost all individuals (60%; n = 21) had body fat percentage above normal levels (> 25%) and a high risk for metabolic complications according to the waist circumference and the obesity index, however, there were no statistically significant differences between groups. The mean food intake, total fat, calories and protein were above recommended levels, being 58.8% for lipids (319.17 ± 241.02 mg of cholesterol and 17.42 ± 11.4 g saturated fatty acids); 29.4% for calories and 67.6% for proteins. Thus, regardless of the psoriasis type, an excessive consumption of calories, lipids, fatty acids, cholesterol and a higher incidence of overweight were found. CONCLUSION: The sample showed an abnormal nutritional condition, an increased risk for chronic diseases related to obesity, worsening of the psoriatic lesions, and poor quality of life.

Zearalenone, an estrogenic mycotoxin, is an immunotoxic compound

The aim of this study was to assess the toxic effects of zearalenone (ZEA) on the immune function. Ovariectomised rats were treated daily by gavage with 3.0 mg/kg of ZEA for 28 days. Body weight gain, food consumption, haemotological parameters, lymphoid organs, and their cellularities were evaluated. Moreover, acquired immune responses and macrophage activity were also assessed. ZEA promoted reduction in body weight gain, which is not fully explained by diminished food consumption. Despite no effect on haematological parameters, ZEA caused thymic atrophy with histological and thymocyte phenotype changes and decrease in the B cell percentage in the spleen. With respect to acquired and innate immune responses, no statistically significant differences in delayed-type hypersensitivity were noticed; however, in the ZEA-treated rats, antibody production and peroxide release by macrophages were impaired. The observed results could be related to ZEA activity on ERs; thus, ZEA is an immunotoxic compound similar to estrogen and some endocrine disruptors.

Consumer attitudes, knowledge, and behavior related to salt consumption in sentinel countries of the Americas

Objective. To describe individual attitudes, knowledge, and behavior regarding salt intake, its dietary sources, and current food-labeling practices related to salt and sodium in five sentinel countries of the Americas. Methods. A convenience sample of 1 992 adults (>= 18 years old) from Argentina, Canada, Chile, Costa Rica, and Ecuador (approximately 400 from each country) was obtained between September 2010 and February 2011. Data collection was conducted in shopping malls or major commercial areas using a questionnaire containing 33 questions. Descriptive estimates are presented for the total sample and stratified by country and sociodemographic characteristics of the studied population. Results. Almost 90% of participants associated excess intake of salt with the occurrence of adverse health conditions, more than 60% indicated they were trying to reduce their current intake of salt, and more than 30% believed reducing dietary salt to be of high importance. Only 26% of participants claimed to know the existence of a recommended maximum value of salt or sodium intake and 47% of them stated they knew the content of salt in food items. More than 80% of participants said that they would like food labeling to indicate high, medium, and low levels of salt or sodium and would like to see a clear warning label on packages of foods high in salt. Conclusions. Additional effort is required to increase consumers' knowledge about the existence of a maximum limit for intake and to improve their capacity to accurately monitor and reduce their personal salt consumption.

Describing the Situational Contexts of Sweetened Product Consumption in a Middle Eastern Canadian Community: Application of a Mixed Method Design

Little is known about the situational contexts in which individuals consume processed sources of dietary sugars. This study aimed to describe the situational contexts associated with the consumption of sweetened food and drink products in a Catholic Middle Eastern Canadian community. A two-stage exploratory sequential mixed-method design was employed with a rationale of triangulation. In stage 1 (n = 62), items and themes describing the situational contexts of sweetened food and drink product consumption were identified from semi-structured interviews and were used to develop the content for the Situational Context Instrument for Sweetened Product Consumption (SCISPC). Face validity, readability and cultural relevance of the instrument were assessed. In stage 2 (n = 192), a cross-sectional study was conducted and exploratory factor analysis was used to examine the structure of themes that emerged from the qualitative analysis as a means of furthering construct validation. The SCISPC reliability and predictive validity on the daily consumption of sweetened products were also assessed. In stage 1, six themes and 40-items describing the situational contexts of sweetened product consumption emerged from the qualitative analysis and were used to construct the first draft of the SCISPC. In stage 2, factor analysis enabled the clarification and/or expansion of the instrument's initial thematic structure. The revised SCISPC has seven factors and 31 items describing the situational contexts of sweetened product consumption. Initial validation of the instrument indicated it has excellent internal consistency and adequate test-retest reliability. Two factors of the SCISPC had predictive validity for the daily consumption of total sugar from sweetened products (Snacking and Energy demands) while the other factors (Socialization, Indulgence, Constraints, Visual Stimuli and Emotional needs) were rather associated to occasional consumption of these products.

Food and Nutrition Security - meanings and appropriations from the civil society segment of the National Council for Food and Nutrition Security

The huge transformations that occurred in the last two decades had impacts on the standards of food production and consumption, and determined a wider discussion in Brazil about the theme of food and nutrition security. It has also expanded the scope of it, which now considers nourishing aspects regarding the entire population and not only its most vulnerable segments. This research identified different meanings present in the speech about food and nutrition security, terms incorporated by movements and civil society organizations that were represented at the National Council for Food and Nutrition Security (administration 2004-2007). Thematic appropriation could be observed in the following directions: a) privileging the interaction between thematic fields from both production and consumption spheres; b) strengthening the idea of nutrition as a human right; c) including an ethical goal to the country's development; d) development of an intra and intersectorial perspective; e) identifying the need of dialogic and freeing educational processes.

Rapid sample preparation procedure for As speciation in food samples by LC-ICP-MS

This paper describes a rapid method for arsenic (As) speciation by LC-ICP-MS in several types of food samples. Prior to analysis, samples were milled and the As species extracted from biological tissues by sonication in only 2 min with a solution containing MeOH (10%, v/v) plus HNO3 (2%, v/v). As species were separated by LC using an anion exchange column. Method detection limits for AsB, As3+,DMA, MMA and As5+ were 1.3, 0.9, 0.6, 0.7 and 0.8 ng g(-1), respectively. Method accuracy and precision were traceable to Certified Reference Materials SRM1577 bovine liver from the National Institute of Standards and Technology, CE278 mussel tissue from the Institute of Reference Materials and Measurements and DOLT-3 dogfish liver tissue and DORM-3 fish protein from the National Research Council of Canada. Finally, the method was applied to speciate As in food samples (egg, fish muscle, beef and chicken) purchased in Brazilian markets.

Added sugars: consumption and associated factors among adults and the elderly. São Paulo, Brazil

OBJECTIVE: To investigate added sugar intake, main dietary sources and factors associated with excessive intake of added sugar. METHODS: A population-based household survey was carried out in São Paulo, the largest city in Brazil. Cluster sampling was performed and the study sample comprised 689 adults and 622 elderly individuals. Dietary intake was estimated based on a 24-hour food recall. Usual nutrient intake was estimated by correcting for the within-person variance of intake using the Iowa State University (ISU) method. Linear regression analysis was conducted to identify factors associated with added sugar intake. RESULTS: Average of energy intake (EI) from added sugars was 9.1% (95% CI: 8.9%; 9.4%) among adults and 8.4% (95% CI: 8.2%; 8.7%) among the elderly (p < 0.05). Average added sugar intake (% EI) was higher among women than among men (p < 0.05). Soft drink was the main source of added sugar among adults, while table sugar was the main source of added sugar among the elderly. Added sugar intake increased with age among adults. Moreover, higher socioeconomic level was associated with added sugar intake in the same group. CONCLUSIONS: Added sugar intake is higher among younger adults of higher socioeconomic level. Soft drink and table sugar accounted for more than 50% of the sugar consumed.